High-Intensity Focused Ultrasound Ablation for Postoperative Recurrent Desmoid Tumors: Preliminary Results.
This study was aimed at evaluating the feasibility, safety and therapeutic effects of high-intensity focused ultrasound ablation (HIFUA) in the treatment of post-operative recurrent desmoid tumors. From September 2017 to May 2020, 42 consecutive patients with pathologically proven desmoid tumors treated with HIFUA for the first time were enrolled. These were divided into two groups: post-operative recurrent group (30 cases) and non-surgery group (12 cases). The basic characteristics, treatment parameters, ablation efficacy, tolerance and adverse events were recorded and compared between groups. The minimum distance between the tumor and skin surface in the post-operative recurrent group was significantly smaller than that in the non-surgery group (6.9 mm vs. 10.8 mm, p = 0.011), but there was no significant difference in the other basic characteristics (p > 0.05). The average acoustic power and intensity of treatment in the post-operative recurrent group were significantly lower than those in the non-surgery group (p = 0.006 and 0.036, respectively), but there was no significant difference in the remaining parameters or in ablation efficacy between groups (p > 0.05). HIFUA was successfully performed, and a large volume of coagulation necrosis was obtained from all patients without serious or life-threatening adverse events. Furthermore, there was no significant difference in the incidence of moderate adverse events and average length of stay between groups (p > 0.05). The average power and intensity of HIFUA treatment were adversely affected by surgical scar and tumor infiltration along the surgical path. However, HIFUA can still be used as an effective minimally invasive therapy for the local control of post-operative recurrent desmoid tumors.


Dual-signal readout paper-based wearable biosensor with a 3D origami structure for multiplexed analyte detection in sweat.
In this research, we design and implement a small, convenient, and noninvasive paper-based microfluidic sweat sensor that can simultaneously detect multiple key biomarkers in human sweat. The origami structure of the chip includes colorimetric and electrochemical sensing regions. Different colorimetric sensing regions are modified with specific chromogenic reagents to selectively identify glucose, lactate, uric acid, and magnesium ions in sweat, as well as the pH value. The regions of electrochemical sensing detect cortisol in sweat by molecular imprinting. The entire chip is composed of hydrophilically and hydrophobically treated filter paper, and 3D microfluidic channels are constructed by using folding paper. The thread-based channels formed after the hydrophilic and hydrophobic modifications are used to control the rate of sweat flow, which in turn can be used to control the sequence of reactions in the differently developing colored regions to ensure that signals of the best color can be captured simultaneously by the colorimetric sensing regions. Finally, the results of on-body experiments verify the reliability of the proposed sweat sensor and its potential for the noninvasive identification of a variety of sweat biomarkers.


MRI-guided percutaneous sclerotherapy of venous malformations: initial clinical experience using a 3T MRI system.
Venous malformations (VMs) are low-flow vascular anomalies that are commonly treated with image-guided percutaneous sclerotherapy. Although many VMs can be safely accessed and treated using ultrasonography and fluoroscopy, some lesions may be better treated with magnetic resonance imaging (MRI)-guided sclerotherapy. The aim of this study is to evaluate the feasibility, efficiency, and outcomes of MRI-guided sclerotherapy of VMs using a 3T MRI system. Six patients with VMs in the neck (n = 2), chest (n = 1), and extremities (n = 3) underwent sclerotherapy with 3T MRI guidance. Feasibility was assessed by calculating the technical success rate and procedural efficiency. Efficiency was evaluated by using planning, targeting, intervention, and total procedure times. Outcomes were assessed by measuring VM volumes before and after sclerotherapy, patient-reported pain scores, and occurrence of complications. Technical success was achieved in all 6 procedures. There was a non-significant 30% decrease in mean VM volume after the procedure (P = .350). The procedure resulted in a decrease in mean pain score (on an 11-point scale) of 2.6 points (P = .003). After the procedure, 4 patients reported complete pain resolution, 1 reported partial pain resolution, and 1 reported no change in pain. Procedural efficiency was consistent with similar sclerotherapy procedures performed at our institution. There were no major or minor complications. 3T MRI guidance is feasible for percutaneous sclerotherapy of VMs, with promising initial technical success rates, procedural efficiency, and therapeutic outcomes without complications.


Secretion of alpha and beta subunits of TSH by the anterior pituitary.
We have attempted to determine whether blood concentrations of the alpha chains of TSH arise by direct pituitary secretion of alpha chain or by degradation of the intact hormone after secretion. Highly purified human TSH was administered by infusion to euthyroid volunteers; blood TSH concentrations were raised to 36 muu/ml. After TSH infusion, circulating blood alpha chain concentrations did not change. The same volunteers received an infusion of TRH which stimulated pituitary secretion of TSH, raising blood concentrations to 15 muu/ml in one series of subjects and to 23 muu/ml in a second series. After TRH, blood concentrations of alpha chain increased from undetectable to over 400 pg/ml. We conclude that alpha subunits of TSH are directly secreted by the pituitary gland and are not formed by degradation of intact TSH in the peripheral circulation.


Poly[[tri-μ-aqua-do-deca-aqua-tris-(μ3-1-hy-droxy-ethyl-idene-1,1-di-phospho-nato)tricalcium(II)tripalladium(II)] penta-hydrate].
The asymmetric unit of the title compound, {[CaPd{CH3OHC(PO3)2}(H2O)5]·5/3H2O} n , consists of one half of the complex [Pd{CH3OHC(PO3)2}](2-) anion (point group symmetry m..), one Ca(2+) cation [site symmetry (.2.)] that is surrounded by three water mol-ecules (one of which is on the same rotation axis) and by three disordered lattice water mol-ecules. The anions form a trinuclear metallocycle around a crystallographic threefold rotation axis. The cations are related by a twofold rotation axis to form a [Ca2(H2O)10](2+) dimer. The slightly distorted square-planar coordination environment of the Pd(II) atoms in the complex anions is formed by O atoms of the bidentate chelating phospho-nate groups of the 1-hy-droxy-ethyl-idene-1,1-di-phospho-nate ligands. In the crystal, cations are bound to anions through -Ca-O-P-O- bonds, as well as through O-H⋯O hydrogen bonds, resulting in a three-dimensional polymer. The structure is completed by five disordered solvent mol-ecules localized in cavities within the framework.


Decontamination of actual radioactive wastewater containing 137Cs using bentonite as a natural adsorbent: equilibrium, kinetics, and thermodynamic studies.
Batch adsorption treatment using Iraqi bentonite as a natural adsorbent was adopted in this study to decontaminate actual 137Cs radioactive wastewater from the Al-Tuwaitha Nuclear Research Center, located south of Baghdad. The bentonite characterization was applied before and after treatment, using chemical compositions analyses, X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), Brunauer-Emmett-Teller (BET) surface area analysis and Fourier-transform infrared spectroscopy (FT-IR). The batch adsorption mode was applied with the initial radioactivity concentration (1440.5 Bq/L), solid/liquid ratio (1 g/L), pH (6-8), contact time (1.5 h), and temperature (298°K). The adsorption experiments showed a decontamination removal efficiency of about 95.66% of 137Cs. A Freundlich adsorption isotherm model was approved for the adsorption of 137Cs, with a coefficient of determination R2 = 0.998. A pseudo-second-order model fitted well with the adsorption of 137Cs, with R2 = 0.983. The positive value of ΔH° in the thermodynamic results indicated that the adsorption process was endothermic physisorption (ΔH° = 15.01 kJ mol-1), spontaneous and favorable (ΔG° = -7.66 kJ mol-1 K-1), with a very low degree of disorder (ΔS° = 0.076 kJ mol-1 K-1).


Practical and reliable enzyme test for the detection of mucopolysaccharidosis IVA (Morquio Syndrome type A) in dried blood samples.
Mucopolysaccharidosis IVA (MPS IVA), or Morquio Syndrome type A, is an autosomal recessive disease caused by deficiency of the lysosomal enzyme N-acetylgalactosamine-6-sulfatase (GALNS), resulting in excessive lysosomal storage of keratan sulfate in many tissues and organs. This accumulation causes a severe skeletal dysplasia with short stature, and affects the eye, heart and other organs, with many signs and symptoms. Morquio A syndrome is estimated to occur in 1 in 200,000 to 300,000 live births. Clinical trials with enzyme replacement therapy for this disease are in progress, and it is probable that the treatment, when available, would be more effective if started early. We describe an innovative fluorometric method for the assay of GALNS in dried blood spots (DBS). We used dried blood spots (DBS) as the enzyme source and compared it with leukocytes samples, having studied 25 MPS IVA patients and 54 healthy controls. We optimized the assay conditions, including incubation time and stability of DBS samples. To eppendorf type tubes containing a 3-mm diameter blood spot we added elution liquid and substrate solution. After 2 different incubations at 37°C, the amount of hydrolyzed product was compared with a calibrator to allow the quantification of the enzyme activity. Results in DBS were compared to the ones obtained in leukocytes using the standard technique. The fluorescent methodology was validated in our laboratory and the assay was found sensitive and specific, allowing reliable detection of MPS IVA patients. The use of DBS simplifies the collection and transport steps, and is especially useful for testing patients from more remote areas of large countries, and when samples need to cross country borders. This assay could be easily incorporated into the protocol of reference laboratories and play a role in the screening for MPS IVA, contributing to earlier detection of affected patients.


Diel infection of a cyanobacterium by a contractile bacteriophage.
Light was found to strongly influence the infection of a freshwater cyanobacterium (Synechococcus elongatus PCC 7942) by a contractile DNA phage named AS-1. Phage progeny production was correlated with the amount of light in the laboratory and occurred in a diel pattern under natural light. At least one effect of light on AS-1 infection is at the level of adsorption.


Polymorphisms in the CYP2A6 and ABCC4 genes are associated with a protective effect on chronic myeloid leukemia in the Brazilian Amazon population.
Susceptibility to Chronic Myeloid Leukemia (CML) may be modulated by genetic variables. However, the majority of previous investigations have focused on genetically homogeneous populations, resulting in a lack of evidence on how genetic factors may influence the development of CML in miscegenated populations. We analyzed 30 polymorphisms in genes related to DNA repair, folate metabolism, transmembrane transport, xenobiotic metabolism, and pyrimidine synthesis in relation to their potential role in the susceptibility of the individual to CML. This case-control study included 126 healthy individuals and 143 patients diagnosed with CML from the admixed population of the Brazilian Amazon. The samples were genotyped by real-time PCR and the genetic ancestry analysis was based on a panel of 61 ancestry informative markers. The results indicated a protective effect against the development of CML in carriers of the C allele of the rs28399433 (CYP2A6) gene and the CC genotype of the rs3742106 (ABCC4) gene. Our findings suggest that the rs3742106 (ABCC4) and rs28399433 (CYP2A6) polymorphisms may modulate susceptibility to CML in a population of the Brazilian Amazon region.


[Prevalence and network-characteristics of risky sexual behaviors among clients receiving methadone maintenance treatment at clinics in Taizhou prefecture of Zhejiang province].
To investigate the risky sexual behaviors, associated factors and characteristics of sexual network among clients receiving methadone maintenance treatment (MMT) at the clinics in Taizhou prefecture of Zhejiang province. A cross-sectional survey was conducted. Data was collected through questionnaire and from the national unified MMT system. Urine was collected to test heroin, methamphetamine, 3, 4-methylenedioxymethamphetamine (MDMA) and ketamine. Blood was collected to test infections on HIV, hepatitis C virus (HCV) and syphilis. Totally, 362 clients were recruited. Most of the clients were male (88.7%), 31-40 year-olds (54.5%), married (61.6%) and having received junior high school education (56.6%). 85.1% of them received urine test with 82(26.6%)positive for heroin, 21 (6.8%) positive for methamphetamine, 19(6.2%) positive for MDMA and none for ketamine. 77.1% of them received blood test, and prevalence rates for HIV, HCV and syphilis were 1.1% , 36.7% and 3.6% . 19.5% of the clients who had sex in the past 6 months. Factors as having multiple sexual partners and positive for club drugs were under higher risk. Sexual networking seemed to be loose, linear and acyclic among this population but overlapping with the drug-using network. Effective and targeted interventions should be taken among the MMT clients since continuing drug use and HIV/STD related sexual behavior were found common in them, suggesting there was a risk of HIV/STD transmission in this population.


Detection of mosaic 15q11.1-q11.2 deletion encompassing NBEAP1 and POTEB in a fetus with diffuse lymphangiomatosis.
We present cytogenetic and molecular cytogenetic diagnoses of mosaic deletion of chromosome 15q11.1-q11.2 in a fetus with diffuse lymphangiomatosis. A 33-year-old woman underwent amniocentesis at 22 weeks of gestation because of fetal diffuse lymphangiomatosis involving left-side chest, abdominal cavity, thigh and vulva, and intrauterine growth restriction. Amniocentesis revealed a karyotype of 46,XX,del(15) (q11.1q11.2)[9]/46,XX[26]. The mother had a karyotype of 46,XX. The father had a karyotype of 46,XY. The parents elected to terminate the pregnancy. A 610-g female fetus was delivered at 23 weeks of gestation with large cystic lymphangioma over the left abdomen, thigh, and vulva. The umbilical cord had a karyotype of 46,XX,del(15)(q11.1q11.2)[24]/ 46,XX[16]. The placental tissue had a karyotype of 46,XX,del(15)(q11.1q11.2)[23]/ 46,XX[17]. Array comparative genomic hybridization analysis of the umbilical cord and placenta revealed a 2.42-Mb deletion of 15q11.1-q11.2 encompassing the genes of NBEAP1 and POTEB. Deletion of 15q11.1-q11.2 encompassing NBEAP1 and POTEB may be associated with diffuse lymphangiomatosis.


c-MYC and reactive oxygen species play roles in tetrandrine-induced leukemia differentiation.
Tetrandrine is a broadly used bisbenzylisoquinoline alkaloid component of traditional Chinese medicine that has antitumor effects in some cancer types. In this study, we investigated the effects of tetrandrine on leukemia in vitro and in vivo. The results showed that tetrandrine effectively induced differentiation and autophagy in leukemia cells. In addition, tetrandrine treatment activated the accumulation of reactive oxygen species (ROS) and inhibited c-MYC protein expression. Further, we found that treatment with the ROS scavengers N-acetyl-L-cysteine (NAC) and Tiron as well as overexpression of c-MYC reduced tetrandrine-induced autophagy and differentiation. Moreover, a small molecular c-MYC inhibitor, 10058-F4, enhanced the tetrandrine-induced differentiation of leukemia cells. These results suggest that ROS generation and c-MYC suppression play important roles in tetrandrine-induced autophagy and differentiation, and the results from in vivo experiments were consistent with those from in vitro studies. Therefore, our data suggest that tetrandrine may be a promising agent for the treatment of leukemia.


A novel risk score to predict survival in advanced heart failure due to cardiac amyloidosis.
Cardiac amyloidosis, caused by deposition of immunoglobulin light chains (AL) or transthyretin (ATTR), carries a poor prognosis. Established risk scores for amyloidosis may not predict outcomes in those patients who develop advanced heart failure and who are potential candidates for heart transplantation. Here, we aimed to identify predictive parameters for patients with severe heart failure due to amyloidosis. Out of > 1000 patients with cardiac amyloidosis (AL or ATTR) admitted to our centre between September 1998 and January 2016, a cohort of 120 patients with a complete cardiac assessment at diagnosis, including right heart catheterization, echocardiography and biomarkers, was analysed retrospectively in this study. Primary endpoint was all-cause mortality. We performed univariate and multivariate Cox regression analysis, generated risk scores to predict outcomes in AL and ATTR amyloidosis and compared those to established risk models for amyloidosis. In the Cox multivariate model, high-sensitivity troponin T (hsTnT; hazard ratio (HR) 1.003; confidence interval (CI) 1.001-1.005; p = 0.009) and mean pulmonary artery pressure (HR 1.061; CI 1.024-1.100; p = 0.001) were found to significantly and independently predict outcomes for AL amyloidosis, whereas QRS duration (HR 1.021; CI 1.004-1.039; p = 0.013), hsTnT (HR 1.021; CI 1.006-1.036; p = 0.006) and N-terminal pro-brain natriuretic peptide (HR 1.0003; CI 1.0001-1.0004; p = 0.002) were the best predictors for ATTR amyloidosis. A simple risk score ("HeiRisk") including these parameters for AL and ATTR allowed a more precise risk stratification in our patient population compared to established risk models. Risk stratification for cardiac amyloidosis with the newly developed "HeiRisk" score may be superior to other staging systems for patients with advanced heart failure due to amyloid cardiomyopathy.


TNF-alpha and its inhibitors in cancer.
Tumor necrosis factor (TNF)-alpha is implicated in the same time in apoptosis and in cell proliferation. TNF-alpha not only acts as pro-inflammatory cytokine conducing to wide spectrum of human diseases including inflammatory diseases, but can also induce tumor development. The molecular mechanisms of TNF-alpha functions have been intensively investigated. In this review we covered TNF-alpha, the molecule, its signaling pathway, and its therapeutic functions. We provide a particular insight in its paradoxical role in tumor promotion and in its use as anti-tumor agent. This review considers also the recent findings regarding TNF-alpha inhibitors, their pharmacokinetics, and their pharmacodynamics. Six TNF-alpha inhibitors have been considered here: Infliximab, Adalimumab, Golimumab, CDP870, CDP571, Etanercept, and Thalidomide. We discussed the clinical relevance of their functions in treatment of several diseases such as advanced inflammatory rheumatic and bowel disease, with a focus in cancer treatment. Targeting TNF-alpha by these drugs has many side effects like malignancies development, and the long-term sequels are not very well explored. Their efficacy and their safety were discussed, underscoring the necessity of close patients monitoring and of their caution use.


Saccadic latency is prolonged in Spinocerebellar Ataxia type 2 and correlates with the frontal-executive dysfunctions.
Data on saccadic latency in patients with Spinocerebellar Ataxia 2 (SCA2) are sparse and contradictory. In order to determine whether saccadic latency is definitely prolonged, identify its possible determinants and evaluate it as disease biomarker we assessed the saccadic latency by electronystagmography in 110 SCA2 patients and their paired controls. Mean saccadic latencies were significantly longer in patients when compared to controls for all tested target displacements. Forty-six percent of SCA2 patients had saccadic latencies above the normal range. Reciprobit plots of saccadic latency demonstrated a skewed distribution in the direction of longer latencies for the patients compared to controls. As saccadic latency increased, the velocity and amplitude of saccades significantly decreased in SCA2 subjects but not in controls. Saccadic latency was not influenced by any demographical, clinical or molecular SCA2 variables, but it showed a significant correlation with the performance of the Stroop test, the verbal fluency test and the Wisconsin Card Sorting Test in SCA2 patients. This paper demonstrated that saccadic latency is prolonged in SCA2 patients and it significantly correlates with the performance of frontal-executive functions, thus this parameter could be a useful biomarker to evaluate the efficiency of future therapeutical options on these dysfunctions.


Involvement of the retinohypothalamic tract in the photic-like effects of the serotonin agonist quipazine in the rat.
Light is the major synchronizer of the mammalian circadian pacemaker located in the suprachiasmatic nucleus. Photic information is perceived by the retina and conveyed to the suprachiasmatic nucleus either directly by the retinohypothalamic tract or indirectly by the intergeniculate leaflet and the geniculohypothalamic tract. In addition, serotonin has been shown to affect the suprachiasmatic nucleus by both direct and indirect serotonin projections from the raphe nuclei. Indeed, systemic as well as local administrations of the serotonin agonist quipazine in the region of the suprachiasmatic nucleus mimic the effects of light on the circadian system of rats, i.e. they induce phase-advances of the locomotor activity rhythm as well as c-FOS expression in the suprachiasmatic nucleus during late subjective night. The aim of this study was to localize the site(s) of action mediating those effects. Phase shifts of the locomotor activity rhythm as well as c-FOS expression in the suprachiasmatic nucleus after s.c. injection of quipazine (10 mg/kg) were assessed in Lewis rats, which had received either radio-frequency lesions of the intergeniculate leaflet or infusions of the serotonin neurotoxin 5,7-dihydroxytryptamine into the suprachiasmatic nucleus (25 microg) or bilateral enucleation. Lesions of intergeniculate leaflet and serotonin afferents to the suprachiasmatic nucleus did not reduce the photic-like effects of quipazine, whereas bilateral enucleation and the subsequent degeneration of the retinohypothalamic tract abolished both the phase-shifting and the FOS-inducing effects of quipazine. The results indicate that photic-like effects of quipazine are mediated via the retinohypothalamic tract.


A New Clinical Instrument for Estimating the Ambulatory Status after Irradiation for Malignant Spinal Cord Compression.
Estimating post-treatment ambulatory status can improve treatment personalization of patients irradiated for malignant spinal cord compression (MSCC). A new clinical score was developed from data of 283 patients treated with radiotherapy alone in prospective trials. Radiotherapy regimen, age, gender, tumor type, interval from tumor diagnosis to MSCC, number of affected vertebrae, other bone metastases, visceral metastases, time developing motor deficits, ambulatory status, performance score, sensory deficits, and sphincter dysfunction were evaluated. For factors with prognostic relevance in the multivariable logistic regression model after backward stepwise variable selection, scoring points were calculated (post-radiotherapy ambulatory rate in % divided by 10) and added for each patient. Four factors (primary tumor type, sensory deficits, sphincter dysfunction, ambulatory status) were used for the instrument that includes three prognostic groups (17-21, 22-31, and 32-37 points). Post-radiotherapy ambulatory rates were 10%, 65%, and 97%, respectively, and 2-year local control rates were 100%, 75%, and 88%, respectively. Positive predictive values to predict ambulatory and non-ambulatory status were 97% and 90% using the new score, and 98% and 79% using the previous instrument. The new score appeared more precise in predicting non-ambulatory status. Since patients with 32-37 points had high post-radiotherapy ambulatory and local control rates, they may not require surgery.


Bioactive compounds from Prosthechea karwinskii decrease obesity, insulin resistance, pro-inflammatory status, and cardiovascular risk in Wistar rats with metabolic syndrome.
The orchid Prosthechea karwinskii is a species endemic to Mexico, which is used in traditional medicine to lower glucose levels in patients with diabetes, and to treat inflammation-related problems. Recent studies have shown that this orchids can reduce glucose, cholesterol, and triglyceride levels in Wistar rats, which were previously induced to have metabolic syndrome (MS). To evaluate the effect of P. karwinskii leaves extract on the components of metabolic syndrome: obesity, insulin resistance, pro-inflammatory status, and cardiovascular risk in a Wistar rat model, and to identify the bioactive compounds in the extract. UPLC-ESI-qTOF-MS/MS was used to identify the compounds present in the extract. MS was induced in Wistar rats through administration of a 40% sucrose diet for 20 weeks. The rats were divided into five groups that received different treatments for 4 weeks: one group without any treatment, one group receiving metformin (200 mg/kg p.o.), and three groups receiving different doses of P. karwinskii leaves extract (100, 200, and 300 mg/kg p.o.). The animals' body weights were recorded weekly, and at the end of the experiment, they were sacrificed after fasting for 18 h to determine the levels of glucose, insulin, insulin resistance index, total cholesterol, triglycerides, and adiponectin in the serum, as well as levels of TNF-α and HS-CRP in the serum and liver homogenates. The abdominal and pericardial fat weights were also recorded. The main bioactive compounds of the extract were quinic acid, neochlorogenic acid, chlorogenic acid, rutin, kaempferol-3-o-β-rutinoside, and embelin, known to exhibit MS-related bioactivity. Oral administration of P. karwinskii leaves extract at a dose of 300 mg/kg decreased weight gain, abdominal and pericardial fat deposits, and insulin resistance. At the end of the treatment, levels of triglycerides, TNF-α, HS-CRP, and adiponectin returned to levels similar to normal. P. karwinskii extract (300 mg/kg) had an anti-obesity effect, decreased insulin resistance, pro-inflammatory status, and cardiovascular risk in rats with induced MS by increasing adiponectin levels and decreasing TNF-α and HS-CRP levels. The compounds identified in the extract could be responsible for these effects, acting alone or in synergy, as several compounds in the extract are known to have MS-related bioactivity. The foliar extract of P. karwinskii has potential as an effective alternative to a cocktail of drugs used to treat problems associated with MS.


Tissue engineering and cartilage regeneration for auricular reconstruction.
This paper will provide (a) a review on current status of auricular reconstruction (b) particularly focusing on the current data about pinna reconstruction using stem cells in combination with tissue engineering. The paper is divided into two sections. The first section presents a brief overview of the current status of auricular reconstruction. In the second section, the authors review the aspects and the current status of stem cells and tissue engineering researches related to cartilage regeneration. Total auricular reconstruction represents one of the greatest challenges for the ENT and Facial Plastic surgeon. The matter of auricular cartilage reconstruction is complex, and progresses in material designs as well as in stem cells field are essential. Even if this bio-technology field is promising, the progresses still are not adequate as patient expectations remain high.


Adipogenic differentiation of human induced pluripotent stem cells: comparison with that of human embryonic stem cells.
Induced pluripotent stem (iPS) cells were recently established from human fibroblasts. In the present study we investigated the adipogenic differentiation properties of four human iPS cell lines and compared them with those of two human embryonic stem (ES) cell lines. After 12 days of embryoid body formation and an additional 10 days of differentiation on Poly-l-ornithine and fibronectin- coated dishes with adipogenic differentiation medium, human iPS cells exhibited lipid accumulation and transcription of adipogenesis-related molecules such as C/EBPalpha, PPARgamma2, leptin and aP2. These results demonstrate that human iPS cells have an adipogenic potential comparable to human ES cells.


Are eco-innovation and export diversification mutually exclusive to control carbon emissions in G-7 countries?
Most of the member countries of COP21 have been struggling to devise relevant policies in order to control carbon dioxide (CO2) emissions since the Paris agreement in 2015. In our view, without analyzing the role of two extremely important variables i.e., ecological innovation and export diversification, in the whole chain of carbon emissions, expecting significant results from such policies would be far fetched. This study, therefore, is aimed to explore the effect of export diversification (ED) and ecological innovation (EI) on carbon emissions for G-7 countries from 1990 to 2017, along with renewable energy consumption (REC) as an important control variable. The results show that export diversification (ED) increases carbon emissions; however, ecological innovation (EI) helps reduce carbon emissions, and similarly, renewable energy consumption (REC) also controls carbon emissions. More important, however, is the realization that the negative impact of export diversification on the CO2 emissions gets weakened as the degree of environmental innovation increases. Based on our findings, the promotion of renewable energy, along with the adoption of environmentally friendly technology, is strongly recommended for G-7 countries. Our results also highlight that Government policies regarding export diversification (ED), ecological innovation (EI), and renewable energy consumption (REC) approximately take more than a year to be able to deliver the results effectively.


Effects of three pesticides on MSX-induced ammonia photoproduction by the cyanobacterium Nostoc linckia.
Three pesticides (2,4-D, basalin, aldrin) inhibited L-methionine-DL-sulfoximine (MSX)-induced photoproduction of ammonia by the nitrogen-fixing cyanobacterium Nostoc linckia. Combinations of pesticides and MSX were inhibitory except at low concentrations (100 and 500 micrograms/ml) of 2,4-D which stimulated NH+4 production. Similar results were obtained when pesticides were added 6 hr after the addition of MSX, but the inhibition was weaker. When MSX was added to the culture 6 hr after the addition of pesticides, the pesticides stimulated NH+4 photoproduction. Similar results were obtained on nitrogenase activity of the organism.


Effect of Pinkwater BioSolve on expression of proinflammatory cytokines and histological changes in Gallus domesticus embryo.
Pinkwater Biosolve (BioSolve®) is one bioremediating chemical which has been widely used for cleanup of crude oil spill in Nigeria. It is a water-based formulation of nonionic surfactants and other specialty chemicals. The level of toxicity resulting from environmental exposure to this chemical has not been well understood. The level of expression of proinflammatory cytokines and histological changes in Gallus domesticus embryo were investigated. The embryo were pretreated with different doses of BioSolve, soil water from remediated soil sample, 10% soluble crude oil portion and a combination of the BioSolve with the soluble crude portion all constituted in normal saline solution. Reverse transcriptase PCR technique was used to assess the expression of hepatic proinflammatory cytokines. Histological examination was also carried out on liver fragments. The results showed that the pretreatment caused lesion on hepatocytes of all tested chick embryos except in the group administered with normal saline solution when compared with the normal control. The chick embryo exposed to 0.5 mg/kg BioSolve, 5% decanted soil water (v/v) obtained from crude oil remediated (using BioSolve) soil, and 10% (v/v) decanted crude oil remediated (using BioSolve) soil water all showed significant expression (at p < 0.05) of IFNγ, TGFβ1, IL-1β, IL-2 and TNF. The group treated with 10% soluble portion of crude oil showed significant changes in their expression pattern when compared with the control; TNF was up regulated, while IL-1β, IFNγ and TGFβ1 were down regulated. Only TNF was upregulated at p < 0.05 indicating the chances of soluble portion of crude oil causing cancer. IFNγ, TGFβ1, IL-1β and IL-2 were all down regulated significantly at p < 0.05 due to exposure to a combination of 10% soluble crude and 0.036 mg/kg BioSolve. The combination of 10% soluble crude and 0.36 mg/kg BioSolve caused lethal effect to the developing chick embryo.


How health systems can adapt to a population ageing with HIV and comorbid disease.
As people age with HIV, their needs increase beyond solely managing HIV care. Ageing people with HIV, defined as people with HIV who are 50 years or older, face increased risk of both age-regulated comorbidities and ageing-related issues. Globally, health-care systems have struggled to meet these changing needs of ageing people with HIV. We argue that health systems need to rethink care strategies to meet the growing needs of this population and propose models of care that meet these needs using the WHO health system building blocks. We focus on care provision for ageing people with HIV in the three different funding mechanisms: President's Emergency Plan for AIDS Relief and Global Fund funded nations, the USA, and single-payer government health-care systems. Although our categorisation is necessarily incomplete, our efforts provide a valuable contribution to the debate on health systems strengthening as the need for integrated, people-centred, health services increase.


Performance Evaluation of Serial SARS-CoV-2 Rapid Antigen Testing During a Nursing Home Outbreak.
To address high COVID-19 burden in U.S. nursing homes, rapid SARS-CoV-2 antigen tests have been widely distributed in those facilities. However, performance data are lacking, especially in asymptomatic people. To evaluate the performance of SARS-CoV-2 antigen testing when used for facility-wide testing during a nursing home outbreak. A prospective evaluation involving 3 facility-wide rounds of testing where paired respiratory specimens were collected to evaluate the performance of the BinaxNOW antigen test compared with virus culture and real-time reverse transcription polymerase chain reaction (RT-PCR). Early and late infection were defined using changes in RT-PCR cycle threshold values and prior test results. A nursing home with an ongoing SARS-CoV-2 outbreak. 532 paired specimens collected from 234 available residents and staff. Percentage of positive agreement (PPA) and percentage of negative agreement (PNA) for BinaxNOW compared with RT-PCR and virus culture. BinaxNOW PPA with virus culture, used for detection of replication-competent virus, was 95%. However, the overall PPA of antigen testing with RT-PCR was 69%, and PNA was 98%. When only the first positive test result was analyzed for each participant, PPA of antigen testing with RT-PCR was 82% among 45 symptomatic people and 52% among 343 asymptomatic people. Compared with RT-PCR and virus culture, the BinaxNOW test performed well in early infection (86% and 95%, respectively) and poorly in late infection (51% and no recovered virus, respectively). Accurate symptom ascertainment was challenging in nursing home residents; test performance may not be representative of testing done by nonlaboratory staff. Despite lower positive agreement compared with RT-PCR, antigen test positivity had higher agreement with shedding of replication-competent virus. These results suggest that antigen testing could be a useful tool to rapidly identify contagious people at risk for transmitting SARS-CoV-2 during nascent outbreaks and help reduce COVID-19 burden in nursing homes. None.


Pre-Hospital Diagnosis in Mobile Stroke Unit.
Mobile stroke unit (MSU) has been shown to rapidly provide pre-hospital thrombolysis in acute ischemic stroke (AIS). MSU encounters neurological disorders other than AIS that require emergent treatment. We obtained pre-hospital diagnosis and treatment data from the prospectively collected dataset on 221 consecutive MSU encounters. Based on initial clinical evaluation and neuroimaging obtained on MSU, the diagnosis of AIS (definite, probable, and possible AIS, transient ischemic attack), intracranial hemorrhage, and likely stroke mimics was made. From July 2014 to April 2015, 221 patients were treated on MSU. 78 (35%) patients had initial clinical diagnosis of definite/probable AIS or TIA, 69 (31%) were diagnosed as possible AIS or TIA, 15 (7%) had intracranial hemorrhage while 59 patients (27%) were diagnosed as likely stroke mimics. Stroke mimics encountered included 13 (6%) metabolic encephalopathy, 11 (5%) seizures, 9 (4%) migraines, 3 (1%) substance abuse, 2 (1%) CNS tumor, 3 (1%) infectious etiology and 3 (1%) hypoglycemia. Fifty-four (24%) patients received non-thrombolytic treatments on MSU CONCLUSION: About one third of MSU encounters were not AIS initially, including intracranial hemorrhage and stroke mimics. MSU can be utilized to provide pre-hospital treatments in emergent neurological conditions other than AIS.


Morphofunctional changes in incubated Mauthner neurons in goldfish treated with peptides from scorpion venom.
Electron microscopy with negative contrast showed that direct interaction of one of the peptide fractions of scorpion venom with monomeric chromatographically pure actin led to polymerization of actin, transforming it from the globular form to the fibrillar form. The effects of prolonged orthodromic stimulation on the evoked electrical activity and ultrastructure of Mauthner neurons (MN) were studied in incubated slices of goldfish medulla oblongata in the presence of this actin-polymerizing venom fraction. Peptides in this fraction were found to stabilize the amplitude of the electrical response of MN to exhaustion and to protect the ultrastructure of afferent chemical synapses and the neurons themselves from damage induced by stimulation. Enhancements in morphofunctional resistance were accompanied by stabilization of actin-containing specialized synaptic structures--desmosome-like contacts. The data obtained here provide evidence that peptides of this fraction of scorpion venom have direct actions on the actin component of the MN cytoskeleton and demonstrate potential for its use as a pharmacological tool able to penetrate living cells with value for studying the role of actin in the mechanisms of adaptation and memory.


A Case of Lung Involvement in Peripheral T Cell Lymphoma.
Lung involvement is rare in peripheral T cell lymphoma, and there is a lack of sufficient clinical study. The authors describe a rare case of lung involvement in a 40-year-old male patient with peripheral T cell lymphoma. Hematological investigation, bone marrow aspirate, and lung biopsy were performed. The patient received 4 courses of CHOP regimen chemotherapy. He achieved partial response (PR) at the 2nd course, but showed disease progressive (PD) at the 4th course. Then he received 2 courses of GDP regimen chemotherapy. Unfortunately, the patient died of tumor overload with hyper-lactacidemia 6 months after the onset of the disease. Lung biopsy is important to confirm a diagnosis of primary pulmonary lymphoma. Lung involvement in peripheral T cell lymphoma as a prognostic factor needs further studies.


GH and IGF-I levels and tumor shrinkage in response to first generation somatostatin receptor ligands in acromegaly: a comparative study between two reference centers for pituitary diseases in Brazil.
To compare biochemical and tumor response rates between two reference centers for pituitary diseases in Brazil after primary and adjuvant therapy with somatostatin receptor ligands (SRL) in acromegaly. Patients were classified as non-responders (NR), partial responders (PR), and full responders (FR) to 12-month SRL therapy according to: [criteria A] normal IGF-I and random GH (rGH) < 1 ng/mL (FR); ≥ 50% decrease of IGF-I and/or rGH (PR); < 50% decrease of IGF-I and rGH (NR); [criteria B] normal IGF-I (FR); ≥ 50% decrease of IGF-I (PR); < 50% decrease of IGF-I (NR). Tumor shrinkage <20% defined poor responders (tPR) and ≥ 20% good responders (tGR). We studied 219 acromegaly patients (59% women, age 43.1 ± 13.9 years; 73 from Center I and 146 from Center II). After SRL therapy, the proportion of FR, PR, and NR by criteria A and B was 30.2 vs 49.1%, 52.8 vs 21.2% and 17 vs 29.7%, respectively (p < 0.001). Considering criteria A or B separately, there was no difference in the proportion of FR, PR and NR between two centers. However, when comparing criteria A and B, the Center I showed a difference of 30.9% in classification of FR in relation to 13.2% observed in Center II (p = 0.006). tGR were 51.4% of patients, with no differences between the centers. IGF-I alone significantly increased positive response rates to SRLs, whereas the inclusion of rGH levels into therapeutic decision might lead to a significant increment on the costs of acromegaly management.


Deep Spinal Infection after Outpatient Epidural Injections for Pain: A Retrospective Sample Cohort Study Using a Claims Database in South Korea.
Deep spinal infection is a devastating complication after epidural injection. This study aimed to investigate the incidence of deep spinal infection primarily after outpatient single-shot epidural injection for pain. Secondarily, this study assessed the national trends of the procedure and risk factors for said infection. Using South Korea's National Health Insurance Service sample cohort database, the 10-yr national trend of single-shot epidural injections for pain and the incidence rate of deep spinal infection after the procedure with its risk factors were determined. New-onset deep spinal infections were defined as those occurring within 90 days of the most recent outpatient single-shot epidural injection for pain, needing hospitalization for at least 1 night, and receiving at least a 4-week course of antibiotics. The number of outpatient single-shot epidural injections per 1,000 persons in pain practice doubled from 40.8 in 2006 to 84.4 in 2015 in South Korea. Among the 501,509 injections performed between 2007 and 2015, 52 cases of deep spinal infections were detected within 90 days postprocedurally (0.01% per injection). In multivariable analysis, age of 65 yr or more (odds ratio, 2.91; 95% CI, 1.62 to 5.5; P = 0.001), living in a rural area (odds ratio, 2.85; 95% CI, 1.57 to 5.0; P < 0.001), complicated diabetes (odds ratio, 3.18; 95% CI, 1.30 to 6.7; P = 0.005), multiple epidural injections (three times or more) within the previous 90 days (odds ratio, 2.34; 95% CI, 1.22 to 4.2; P = 0.007), and recent use of immunosuppressants (odds ratio, 2.90; 95% CI, 1.00 to 6.7; P = 0.025) were significant risk factors of the infection postprocedurally. The incidence of deep spinal infection after outpatient single-shot epidural injections for pain is very rare within 90 days of the procedure (0.01%). The data identify high-risk patients and procedure characteristics that may inform healthcare provider decision-making.


Acute exercise and cognition: A review with testable questions for future research into cognitive enhancement with blood flow restriction.
Blood flow restriction, in combination with low load/intensity exercise, has consistently been shown to increase both muscle size and strength. In contrast, the effects of blood flow restricted exercise on cognition have not been well studied. Therefore, the purpose of this paper is 1) to review the currently available literature investigating the impact of blood flow restricted exercise on cognition and 2) to provide some hypotheses for how blood flow restriction might provide an additive stimulus for augmenting specific cognitive domains above exercise alone. Given the lack of research in this area, the effects of blood flow restricted exercise on cognition are still unclear. We hypothesize that blood flow restricted exercise could potentially enhance several cognitive domains (such as attention, executive functioning, and memory) through increases in lactate production, catecholamine concentration, and PGC-1α expression. We review work that suggests that blood flow restriction is not only a beneficial strategy to improve musculoskeletal function but could also be a favorable method for enhancing multiple domains of cognition. Nonetheless, it must be emphasized this is a hypothesis that currently has only minimal experimental support, and further investigations in the future are necessary to test the hypothesis.


Galvanic current activates the NLRP3 inflammasome to promote Type I collagen production in tendon.
The NLRP3 inflammasome coordinates inflammation in response to different pathogen- and damage-associated molecular patterns, being implicated in different infectious, chronic inflammatory, metabolic and degenerative diseases. In chronic tendinopathic lesions, different non-resolving mechanisms produce a degenerative condition that impairs tissue healing and which therefore complicates their clinical management. Percutaneous needle electrolysis consists of the application of a galvanic current and is an emerging treatment for tendinopathies. In the present study, we found that galvanic current activates the NLRP3 inflammasome and induces an inflammatory response that promotes a collagen-mediated regeneration of the tendon in mice. This study establishes the molecular mechanism of percutaneous electrolysis that can be used to treat chronic lesions and describes the beneficial effects of an induced inflammasome-related response.


Addressing Pediatric Mental Health Using Telehealth During Coronavirus Disease-2019 and Beyond: A Narrative Review.
The pediatrician serves as a frontline provider addressing patients' medical and mental health needs, yet coronavirus disease-2019 (COVID-19) is reshaping the way physicians deliver care. Pediatricians are increasingly faced with the challenge of delivering care, including mental health care, remotely. Given the rapidly evolving literature, we performed a narrative review of the use of telehealth for mental health care for pediatric populations during the COVID-19 pandemic. Areas of focus included 1) pediatric primary care settings, 2) special pediatric populations (eg, eating disorders, autism), 3) access and engagement in telehealth care, and 4) training opportunities available for mental health providers. Themes that emerged across studies included the importance of meeting patients' needs (eg, access to technological resources) to optimize success in using telehealth tools and challenges around provider access to support tools for use during telehealth. Thus, we provided a summary of evidence-based tools (including COVID-19 specific resources) for improving the remote delivery of mental health care by pediatricians. We also reviewed future directions including trials currently underway to enhance understanding of future telehealth applications for pediatric mental health care.


Extended N(6) substitution of rigid C2-arylethynyl nucleosides for exploring the role of extracellular loops in ligand recognition at the A3 adenosine receptor.
2-Arylethynyl-(N)-methanocarba adenosine 5'-methyluronamides containing rigid N(6)-(trans-2-phenylcyclopropyl) and 2-phenylethynyl groups were synthesized as agonists for probing structural features of the A3 adenosine receptor (AR). Radioligand binding confirmed A3AR selectivity and N(6)-1S,2R stereoselectivity for one diastereomeric pair. The environment of receptor-bound, conformationally constrained N(6) groups was explored by docking to an A3AR homology model, indicating specific hydrophobic interactions with the second extracellular loop able to modulate the affinity profile. 2-Pyridylethynyl derivative 18 was administered orally in mice to reduce chronic neuropathic pain in the chronic constriction injury model.


High-frequency (20 MHz) high-intensity focused ultrasound system for dermal intervention: A 12-week local tolerance study in minipigs.
High-intensity focused ultrasound (HIFU) operating at 20 MHz is new and applicable to skin. Details of use and instrumentation are not documented. A GLP compliant 12-week study of Göttingen minipigs (n = 3) was undertaken. Effects of HIFU treatment at different focal depths, energy levels and field size (single shot vs 5 × 5 multiple shots) were studied. Clinical scoring and histology of treated sites were made. High-intensity focused ultrasound showed instant and initial effects with wheal and flare responses followed by delayed inflammatory reactions associated with outer skin necrosis, depending on energy dose. HIFU treatment was tunable in the range 0.3-1.5 J, ablative at higher energy level. Transducers with deeper focal points gave more profound effects, while epidermal effects were comparable. Multiple doses of 5 × 5 shots produced stronger reactions than single dose indicating that nearby applied shots were synergistic. Recovery from single doses was faster than in multidose areas. Clinical scarring at the end point was not seen despite occasional fibrous change of dermis. Findings illustrated intended therapeutic use; no special safety issues of concern were raised. The new 20 MHz HIFU was reproducible, tunable and produced targeted effects in the outer skin, for example instant wheal and flare followed by inflammation and possibly necrosis depending on energy setting. Reactions recovered during the study with only minor findings at study end. No special safety concerns were raised. The method can be controlled and modulated, and it is ready for clinical testing of dermatological disease indications including conditions presently treated with lasers.


An unusual combination of simultaneous fracture of the tuberosity of the trapezium and the hook of the hamate.
A case of simultaneous fracture of the tuberosity of the trapezium associated with fracture of the hook of the hamate is described. The mechanism of injury is thought to be traction force through the transverse carpal ligament caused by flattening of the transverse carpal arch.


Analysis of patients unable to return to play following arthroscopic Bankart repair.
The purpose of this study was to analyze patients that did not return to play (RTP) following arthroscopic Bankart repair (ABR) compared to those who did RTP, and analyze factors associated with not returning to play. A retrospective review of patients who underwent ABR, and subsequently did not RTP after a minimum of 24-month follow-up was performed. Additionally, these were pair matched in a 3:1 ratio for age, gender, sport and level of pre-operative play with a control group who RTP. Patients were evaluated for their psychological readiness to return to sport using the SIRSI score. Multivariate regression models were used to evaluate factors affecting RTP. The study included a total of 52 patients who were unable to RTP and 156 who returned to play. Ten patients (19.2 %) who did not RTP passed the SIRSI benchmark of 56 with a mean overall score of 39.8 ± 24.6, in those who returned 73.0 % passed the SIRSI benchmark of 56 with a mean overall score of 68.9 ± 22.0 (p < 0.0001 for both). The most common primary reasons for not returning were 27 felt physically unable to return, whilst 21 felt it was a natural end to their career or their lifestyle had changed. Multi-logistic regression revealed that 4 of the 12 components of the SIRSI score (p < 0.05 for all) and SSV (p = 0.0049), were the factors that were associated with RTP. Following ABR, those that do not return to play exhibit poor psychological readiness to return to play, with multi-linear regression revealing the SIRSI questions associated with fear of re-injury were associated with a lower rate of RTP. Additionally, functional limitations were found to be associated with a lower rate of RTP. Level III; Retrospective Comparative Cohort Study.


Role of hepatectomy in gastric cancer with multiple liver-limited metastases.
Several studies have demonstrated the benefit of hepatectomy for treating gastric cancer (GC) with liver-limited metastases (LLM). The survival benefit of hepatectomy compared with that of systemic chemotherapy is unknown, particularly in patients with multiple LLM. This study investigated the survival benefit of hepatectomy compared with that of systemic chemotherapy administered to patients with GC with multiple LLM. We retrospectively reviewed the data of consecutive patients with GC with two or three LLM who underwent hepatectomy or received systemic chemotherapy as initial treatment at the Shizuoka Cancer Center between December 2004 and December 2015. Nine of 24 patients who met the inclusion criteria underwent hepatectomy, and 15 received chemotherapy. In the hepatectomy group, all patients achieved R0 resection and none died during hospitalization. Three patients received adjuvant chemotherapy. Disease recurred in eight patients (88.9%). In the chemotherapy group, three patients underwent hepatectomy following initial chemotherapy and did not experience recurrence or death during follow-up. Median follow-up was 47.9 months and median overall survival (OS) was 38.1 and 24.8 months in the chemotherapy and hepatectomy groups, respectively. Multivariate analysis of OS, including initial treatment, revealed that unilobar liver metastasis was the only independent favorable prognostic factor. Although hepatectomy for patients with GC with multiple LLM is not recommended as the initial therapy, it prolonged the survival of patients with tumors controlled using systemic chemotherapy.


Design of on-target FAAH inhibitors.
In this issue of Chemistry & Biology, Alexander and Cravatt propose a model for the binding of carbamate inhibitors to fatty acid amide hydrolase (FAAH), the enzyme that breaks down signaling lipids. Using competitive activity-based protein profiling and click chemistry, they designed potent and selective FAAH inhibitors and characterized their off-target reactions.


Primary stabbing headache in children and adolescents.
To examine the characteristics of primary stabbing headache (PSH) in typically developing children and adolescents. In this prospective non-interventional hospital-based study, we examined 42 eligible individuals (24 females, 18 males; 26 white; mean age 12y 1mo, range 6y-16y 1mo) with spontaneous transient stabs. A headache focused history and/or a headache diary was obtained from each patient. All patients had normal neurological examination. Diagnosis of primary headache was based on the International Classification of Headache Disorders, Third Edition (ICHD-3) beta version. Duration of stabs ranged from a few seconds to up to 10 minutes. Stabs were located in a variety of sites on the cranium but mostly in the extra-trigeminal regions (n=28). Intensity of stabs varied from moderate (n=4) to severe (n=38). The frequency of the stabs ranged from daily to monthly. There were up to 50 stabs per headache attack. Stabs among our patients occurred independently from those caused by other primary headache types. Accompanying symptoms during stabs were reported by eight patients. Family history of primary headaches was identified (n=17). Familial transmission of PSH was recognized among two patients. All patients had normal brain magnetic resonance imaging. The presentation and nature of PSH in children and adolescents varies widely. PSH in children may be a different entity to that in adults, and there is a need for further research to support changes in the ICHD-3 criteria for PSH in children and adolescents. Presentation of childhood primary stabbing headache (PSH) varies widely. Duration of PSH could last from a few seconds up to 10 minutes.


Near-infrared quantum dots for deep tissue imaging.
Developments in nanotechnology have paved the way for the early detection, treatment, and prevention of several tumors which affect mankind. In the past few years, near-infrared (NIR) fluorescence imaging techniques have emerged that enable the in vivo imaging of physiological, metabolic, and molecular function. The NIR window, also known as the diagnostic window (700-900 nm), can be explored for sensitive detection techniques. Nanoparticles, particularly semiconductor quantum dots (QDs), can be utilized for the purpose of optical imaging. These semiconductor QDs possess novel electronic, optical, magnetic, and structural properties which are quite different from those of bulk materials. NIR QDs with these unique properties can be utilized as contrast agents for optical imaging, particularly for deep tissue imaging. Deep tissue imaging provides more information about the pathological status of the disease, which makes the treatment more effective and efficient. In this review we highlight the importance of NIR QDs as probes for optical imaging. We describe the different types of NIR QDs, their synthesis, and their application for deep tissue imaging along with recently developed self-illuminating NIR QDs.


Personality, staff attitudes and their association with absenteeism and presenteeism in Australian public sector hospital-based nurses: A cross-sectional study.
To examine how personality and attitudes to sick leave influence nurses self-reported rates of absenteeism and presenteeism. Despite the significant economic cost and negative impact of absenteeism and presenteeism in health care, there has been limited research looking at personality (using the five-factor model) and absenteeism and presenteeism in nurses. A cross-sectional online survey of 320 nurses. Low emotional stability was significantly associated with higher presenteeism. Shift work predicted more absenteeism, whereas those who believed that a culture of entitlement to sick leave existed in the health service were less likely to be absent from work. Increased work-related stress was also a significant predictor of presenteeism. The results of this study highlight the role of personality, stress and attitudes in nurses' decision to be absent or present at work when they are sick. Nurses are the largest workforce in health care settings. Reducing absenteeism and presenteeism in nursing through a greater understanding of the influencing factors will limit the economic impacts of this behaviour and improve patient safety.


Susceptibility of individuals with lung dysfunction to systemic inflammation associated with ambient fine particle exposure: A panel study in Beijing.
The underlying mechanism on the susceptibility of chronic obstructive pulmonary disease (COPD) patients to air pollution has yet to be clarified. Based on the COPD in Beijing (COPDB) study, we examined whether lung dysfunction contributed to pollutant-associated systemic inflammation in COPD patients. Proinflammatory biomarkers including interleukin-8 (IL-8) and tumor necrosis factor α (TNFα) were measured in serum samples collected from 53 COPD and 82 healthy participants. Concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), carbonaceous components in PM2.5, and PM size distribution were continuously monitored. Linear mixed effects models were used to examine the associations of biomarker differences with particle exposure, between COPD and healthy participants, and across subgroups with different levels of lung dysfunction. COPD patients showed higher differences in IL-8 and TNFα levels associated with exposure to measured pollutants, comparing to healthy controls. In advanced analysis, particle-associated differences in IL-8 and TNFα levels were higher in participants with poorer lung ventilation and diffusion capacity, and higher ratio of residual volume. For example, an interquartile range increase in average PM2.5 concentration 2 weeks before visits was associated with a 15.7% difference in IL-8 level in participants with the lowest ratio of measured value to predicted value of forced expiratory volume in 1 s (FEV1%pred) (65.2%), and the association decreased monotonically with increasing FEV1%pred. Associations between differences in TNFα level and average ultrafine particle concentration 1 week before visits increased gradually with increasing ratio of measured value to predicted value of residual volume/total lung capacity. COPD patients, especially those with poorer lung function, are more susceptible to systemic inflammation associated with fine particle exposure.


Hall Effect in Bulk-Doped Organic Single Crystals.
The standard technique to separately and simultaneously determine the carrier concentration per unit volume (N, cm-3 ) and the mobility (μ) of doped inorganic single crystals is to measure the Hall effect. However, this technique has not been reported for bulk-doped organic single crystals. Here, the Hall effect in bulk-doped single-crystal organic semiconductors is measured. A key feature of this work is the ultraslow co-deposition technique, which reaches as low as 10-9 nm s-1 and enables us to dope homoepitaxial organic single crystals with acceptors at extremely low concentrations of 1 ppm. Both the hole concentration per unit volume (N, cm-3 ) and the Hall mobility (μH ) of bulk-doped rubrene single crystals, which have a band-like nature, are systematically observed. It is found that these rubrene single crystals have (i) a high ionization rate and (ii) scattering effects because of lattice disturbances, which are peculiar to this organic single crystal.


Reconstructed bladder innervation below the level of spinal cord injury: the knee-tendon to bladder artificial reflex arc.
To study the effectiveness of knee-tendon to bladder artificial reflex arc in dogs. In 6 beagles, the proximal end of the right L5 anterior motor root and the distal end of the right S2 anterior root were anastomosed to build a knee-tendon to bladder reflex, whereas the right L5 posterior sensory root was kept intact. Action potential (AP) curves and electromyograms (EMGs) of the detrusor muscle, the intravesical pressure, horseradish peroxidase (HRP)-labeled neurons, and the passing rates of myelinic nerve fibers were calculated to evaluate its feasibility. AP curves and EMG detected in all 6 dogs were similar to those of the control. Six and 18 months after surgery, the means for bladder contraction induced by percussion of the right knee-tendon were 38 +/- 27% and 62 +/- 5% that of the normal control, respectively. The mean duration times induced by percussion of the right knee-tendon at 6 and 18 months after surgery were 51 +/- 37% and 84 +/- 12% that of the normal control, respectively. HRP retrograde tracing and neurohistologic observation indicated the feasibility of the artificial reflex arc. Our data showed the effectiveness of bladder innervation below the level of spinal cord injury producing urination by knee-tendon to bladder reflex contractions, and therefore, might provide a new clinical approach for restoring bladder function in individuals with paraplegia.


Glucagon-like peptide-2 promotes gallbladder refilling via a TGR5-independent, GLP-2R-dependent pathway.
Glucagon-like peptides (GLPs) are secreted from enteroendocrine cells in response to nutrients and bile acids and control metabolism via actions on structurally-related yet distinct G protein coupled receptors. GLP-1 regulates gut motility, appetite, islet function, and glucose homeostasis, whereas GLP-2 enhances intestinal nutrient absorption. GLP-1R agonists are used to treat diabetes and obesity, and a GLP-2R agonist is approved to treat short bowel syndrome. Unexpectedly, reports of gallbladder disease have been associated with the use of both GLP-1R and GLP-2R agonists and after bariatric surgery, although the mechanisms remain unknown. We investigated whether GLP-1 or GLP-2 acutely controls gallbladder (GB) volume and whether GLP-2 regulates GB muscle activity in mice. The expression of Tgr5, Glp2r, and Glp1r was assessed in mouse GB, and the effects of GLP-2 on hepatic bile acid (BA) flow, intestinal and liver BA uptake, and GB gene expression were determined. GLP-2 regulation of GB volume was assessed in wildtype, Glp2r-/- and Tgr5-/- mice. The effect of GLP-2 on GB smooth muscle (GBSM) calcium transients was characterized ex vivo. Acute administration of the GLP-1R agonist exendin-4 lowered glucose but had no effect on GB volume in mice. In contrast, GLP-2 rapidly enhanced GB filling in a dose-dependent manner, actions maintained in the presence of cholecystokinin, and mediated through the canonical GLP-2R. GLP-2 also rapidly induced immediate early gene expression in GB, consistent with detection of the endogenous Glp2r in GB RNA. The ability of GLP-2 to increase GB volume was not abrogated by systemic administration of hexamethonium, propranolol, a vasoactive peptide receptor antagonist or N-Nitroarginine methyl ester, and was maintained in Tgr5-/- mice. In contrast, lithocholic acid, a Tgr5 agonist, increased GB filling in Glp2r-/- but not in Tgr5-/- mice. GLP-2 had no effect on ileal uptake or hepatic clearance of taurocholic acid or on hepatic bile flow, yet reduced the frequency of spontaneous calcium transients in murine GBSM ex vivo, in a tetrodotoxin-sensitive manner. Our data extend endocrine concepts of regulation of GB filling beyond FXR-FGF15/19 and the direct effects of BA via Tgr5, to encompass a novel BA-Tgr5-L cell GLP-2 axis providing nutrient-mediated feedback from BA to terminate meal-related GB contraction. These findings have implications for conditions characterized by elevated circulating levels of GLP-2 such as after bariatric surgery and the development and use of agents that promote Tgr5 activation, L cell secretion, or GLP-2R agonism for the treatment of metabolic disease.


Predicting personal protective equipment use, trauma symptoms, and physical symptoms in the USA during the early weeks of the COVID-19 lockdown (April 9-18, 2020).
The COVID-19 pandemic created a complex psychological environment for Americans. In this study, 450 MTurk workers completed measures of sociodemographic characteristics, perceived risk for COVID-19, general perceived vulnerability to disease, intolerance of uncertainty, and psychological flexibility. These variables were used to predict COVID-19 preventive health behaviors (PPE use), psychological distress, and physical symptoms. The surveys were completed between April 9, 2020 and April 18, 2020 which is a period that corresponded to the first 2-3 weeks of lockdown for most participants. A demographically diverse sample of participants was recruited. A substantial number of participants reported a reduction employment status and 69% were in self-isolation. Participants reported a high degree of perceived vulnerability to COVID-19. PPE mask wearing was variable: 16% "not at all," 20% "some of the time," 42% "a good part of the time," and 26 "most of the time." Using clinical cutoff on the post-trauma scale, 70% of the sample would be considered to have symptoms consistent with PTSD. Physical symptom reporting was also high. Intolerance of uncertainty and psychological inflexibility were significant predictors of psychological distress and physical symptoms. Psychological flexibility moderated the relationship between intolerance of uncertainty and psychological distress/physical symptoms. The relationship between intolerance of uncertainty and psychological distress/physical symptoms was stronger among participants with lower levels of psychological flexibility. These findings indicate psychological flexibility can reduce distress associated with COVID-19. Additionally, these results support the workability of the Unified Flexibility and Mindfulness Model as a framework for studying health behavior.


[Kinetic, radiographic, and histologic demonstration of the curing of congenital osteopetrosis in rats].
In the "op" rat congenital osteopetrosis is a lethal condition. The management of this disease can be achieved by a single injection of a marrow cell suspension from a normal donor or by temporary parabiosis with a normal Rat, the latter procedure being less efficient than the former according to kinetic, roentgenographical and histological examinations.


Impact of water-sediment regulation on the concentration and transport of dissolved heavy metals in the middle and lower reaches of the Yellow River.
Anthropogenic activities in river basins, especially large-scale water conservancy projects, have notably impacted the physical, chemical and ecological environments of estuaries and coastal areas. In this paper, the effects of water and sediment regulation (WSR) on the concentration and transport of heavy metals in the Yellow River were studied based on a continuous daily heavy metal survey in both the middle reaches (Xiaolangdi station) and lower reaches (Lijin station) of the Yellow River during the WSR period in 2019. The results indicated that the variation in the water oxidation-reduction environment of the Xiaolangdi reservoir during the WSR process exerted an important impact on the concentrations of dissolved Cu, Cd, Pb, Cr and As at the Xiaolangdi station but exerted almost no influence on the concentration of dissolved Ni. At Lijin station, the dissolved heavy metal content first increased and then decreased in the first stage, which mainly depended on the release of heavy metals from resuspended sediments. In the second stage, the heavy metal content gradually decreased due to adsorption onto fine particles discharged from the reservoir. The dissolved heavy metal flux during the water-sediment regulation scheme (WSRS) period accounted for 16.9-33.4% of the annual total dissolved heavy metal flux. WSRS changed transport of water and sediment. The dissolved heavy metal concentrations at the Xiaolangdi station were mainly controlled by the discharge of water and sediments from the Xiaolangdi reservoir, while the dissolved heavy metal concentration at the Lijin station was largely affected by the sediments resuspended from downstream riverbeds and the water and sediment scheduling mode of the Xiaolangdi reservoir. Dissolved heavy metal transportation was highly influenced by the WSR process within a short time. Human intervention, especially WSRS operation, apparently alters the natural states of both the mainstream and estuarine environments of the Yellow River.


Anesthetic management of a patient with methamphetamine-associated pulmonary arterial hypertension undergoing laparoscopic cholecystectomy.
Methamphetamine abuse is a serious public health concern and causes various life-threatening disorders including pulmonary arterial hypertension (PAH). Herein, we present the first case report describing the anesthetic management of a patient with methamphetamine-associated PAH (M-A PAH) undergoing laparoscopic cholecystectomy. A 34-year-old female with M-A PAH suffered from deterioration of right ventricular (RV) heart failure due to recurrent cholecystitis and was scheduled for laparoscopic cholecystectomy. Preoperative assessment of PA pressure showed 82/32 (mean, 50) mmHg, and transthoracic echocardiology revealed a slight reduction of RV function. General anesthesia was induced and maintained by thiopental, remifentanil, sevoflurane, and rocuronium. PA pressure gradually increased after peritoneal insufflation; therefore, we administered dobutamine and nitroglycerin to decrease pulmonary vascular resistance (PVR). The patient emerged from anesthesia smoothly. Avoiding increased PVR by appropriate anesthesia and medical hemodynamic support is an important consideration for patients with M-A PAH.


Structural characterization of the BH3-like motif of hepatitis B virus X protein.
Hepatitis B virus X protein (HBx) is a multifunctional protein, which is considered to be an essential molecule for viral replication and the development of liver diseases. Recently, it has been demonstrated that HBx can directly interact with Bcl-2 and Bcl-xL through a sequence (termed the BH3-like motif) that is related to the BH3 motif of pro-apoptotic BH3-only proteins. Here, we present the first structural characterization of the HBx BH3-like motif by circular dichroism and NMR spectroscopies. Our results demonstrated that the HBx BH3-like motif has the ability to form an α-helix, and the potential helical region involves residues L108-L134. This is a common characteristic among the BH3 peptides of pro-apoptotic BH3-only proteins, implying that HBx may interact with Bcl-2 and Bcl-xL, by forming an α-helix, similar to the interaction mode of other BH3 peptides with Bcl-2 and Bcl-xL.


Opportunities and Limitations for Reproductive Science in Species Conservation.
Reproductive science in the context of conservation biology is often understood solely in terms of breeding threatened species. Although technologies developed primarily for agriculture or biomedicine have a potentially important role in species conservation, their effectiveness is limited if we regard the main objective of animal conservation as helping to support populations rather than to breed a small number of individuals. The global threats facing wild species include the consequences of climate change, population growth, urbanization, atmospheric and water pollution, and the release of chemicals into the environment, to cite but a few. Reproductive sciences provide important and often unexpected windows into many of these consequences, and our aim here is both to demonstrate the breadth of reproductive science and the importance of basic knowledge and to suggest where some of the insights might be useful in mitigating the problems.


User interfaces for older adults to support social interaction through digital technology: a systematic review update.
This systematic review aims to update the results related to user interfaces and digital technologies that support the social interactions of older adults. Multiple innovative technological forms in existing research were evaluated to obtain evidence that digital technologies improve older adults' quality of life and social well-being. A search for relevant studies published in the last five years was conducted using the databases of Google Scholar, IEEE Xplore, PubMed, Scopus, Springer Link and Web of Science. Of the 4959 records identified, a total of 29 studies met the inclusion criteria. The findings were reviewed in three areas: social interaction of older adults supported by user interface, the digital technologies used in the user interface, and the effects of user interfaces on the social interactions of older adults. Future research should develop digital technologies and service models to enhance the quality of life of older adults. Long-term solutions to promote social interaction in older adults require more user interface support. Community connection-based user interfaces can support existing social relationships and develop new social circles for older adults.


Native vessel angioplasty as treatment strategy for left internal mammary artery to pulmonary vasculature fistula producing coronary steal phenomenon.
Formation of fistulous connection between internal mammary graft and pulmonary vasculature after coronary artery bypass graft (CABG) is a rare event, which can result in recurrence of symptoms ranging from stable angina to myocardial infarction related to coronary steal. We hereby report a case of a 56-year-old man who was detected to have such a fistulous communication leading to coronary steal as the cause of effort angina 3 years after CABG. Coronary angioplasty and stenting of left anterior descending artery resulted in resolution of symptoms. Native vessel percutaneous coronary intervention as a treatment strategy for internal mammary artery to pulmonary artery fistula has not been reported previously.


Life-Threatening Enterovirus 71 Encephalitis in Unrelated Children with Autosomal Dominant TLR3 Deficiency.
Enterovirus A71 (EV71) causes a broad spectrum of childhood diseases, ranging from asymptomatic infection or self-limited hand-foot-and-mouth disease (HFMD) to life-threatening encephalitis. The molecular mechanisms underlying these different clinical presentations remain unknown. We hypothesized that EV71 encephalitis in children might reflect an intrinsic host single-gene defect of antiviral immunity. We searched for mutations in the toll-like receptor 3 (TLR3) gene. Such mutations have already been identified in children with herpes simplex virus encephalitis (HSE). We sequenced TLR3 and assessed the impact of the mutations identified. We tested dermal fibroblasts from a patient with EV71 encephalitis and a TLR3 mutation and other patients with known genetic defects of TLR3 or related genes, assessing the response of these cells to TLR3 agonist poly(I:C) stimulation and EV71 infection. Three children with EV71 encephalitis were heterozygous for rare mutations-TLR3 W769X, E211K, and R867Q-all of which were shown to affect TLR3 function. Furthermore, fibroblasts from the patient heterozygous for the W769X mutation displayed an impaired, but not abolished, response to poly(I:C). We found that TLR3-deficient and TLR3-heterozygous W769X fibroblasts were highly susceptible to EV71 infection. Autosomal dominant TLR3 deficiency may underlie severe EV71 infection with encephalitis. Human TLR3 immunity is essential to protect the central nervous system against HSV-1 and EV71. Children with severe EV71 infections, such as encephalitis in particular, should be tested for inborn errors of TLR3 immunity.


Erythrocyte membrane elasticity during in vivo ageing.
Changes in the ability of senescent erythrocytes to pass through the microcirculation may cause them to be trapped in the spleen and removed from the blood. To help understand this process we have measured erythrocyte membrane elasticity, to see whether it changes during in vivo ageing. Human and rabbit red cells were fractionated by isopycnic sedimentation to obtain samples of aged and young cells. These were subjected to micropipette analysis in order to determine their membrane shear elastic modulus. We found that the membrane rigidity did not significantly alter as red cells aged. Previously we have also demonstrated that the changed size and shape of aged cells is unlikely to explain their removal from the circulation (Nash, G.B. and Wyard, S.J. (1981) Biorheology, in the press). Thus we conclude that the lifespan of erythrocytes is not determined by factors related to membrane flexibility or cell shape but may depend on changes in their viscous properties (as suggested by Williams, A.R. and Morris, D.R. (1980), Scand. J. Haematol. 24, 57--62).


Precursor-mediated in situ growth of hierarchical N-doped graphene nanofibers confining nickel single atoms for CO2 electroreduction.
Despite the various strategies for achieving metal-nitrogen-carbon (M-N-C) single-atom catalysts (SACs) with different microenvironments for electrochemical carbon dioxide reduction reaction (CO2RR), the synthesis-structure-performance correlation remains elusive due to the lack of well-controlled synthetic approaches. Here, we employed Ni nanoparticles as starting materials for the direct synthesis of nickel (Ni) SACs in one spot through harvesting the interaction between metallic Ni and N atoms in the precursor during the chemical vapor deposition growth of hierarchical N-doped graphene fibers. By combining with first-principle calculations, we found that the Ni-N configuration is closely correlated to the N contents in the precursor, in which the acetonitrile with a high N/C ratio favors the formation of Ni-N3, while the pyridine with a low N/C ratio is more likely to promote the evolution of Ni-N2. Moreover, we revealed that the presence of N favors the formation of H-terminated edge of sp2 carbon and consequently leads to the formation of graphene fibers consisting of vertically stacked graphene flakes, instead of the traditional growth of carbon nanotubes on Ni nanoparticles. With a high capability in balancing the *COOH formation and *CO desorption, the as-prepared hierarchical N-doped graphene nanofibers with Ni-N3 sites exhibit a superior CO2RR performance compared to that with Ni-N2 and Ni-N4 ones.


A Novel Low-Shrinkage Resin for 3D Printing.
To evaluate the shrinkage, accuracy, and mechanical properties of a newly developed photo-polymerizable resin material for 3D printing dental applications and compare it with three commercially available resins. An experimental novel proprietary resin material for 3D printing was formulated. This new resin, Die and Model Tan (SprintRay), Formlabs Grey (FormLabs), and LCD Grey (Roxel 3D) were evaluated and tested for volumetric shrinkage, accuracy, and flexural and tensile properties. Volumetric shrinkage was measured using the AcuVol video imaging method. The accuracy of the 3D printed objects through the DLP (digital light processing) printing system was determined by the 3D deviation between the scanned model and the original computer-aided-design (CAD) digital model. Parallelepiped specimens (2 × 2 × 25 mm, n = 5) were printed for flexural strength, flexural modulus, and modulus of resilience and measured in accordance with ISO-4049. Dumbbell-shaped specimens (Type V, n = 5) were printed to investigate the tensile strength and tested according to ASTM-D638. Data were analyzed using one-way ANOVA and post-hoc Tukey tests (p ≤ 0.05). The experimental resin exhibited significantly lower volumetric shrinkage and significantly higher accuracy than the other commercially available resins (p < 0.001). The experimental resin showed flexural strength, flexural modulus, and tensile strength similar to Die and Model Tan resin (SprintRay) (p > 0.05), and these parameters were significantly higher than those of Formlabs Grey resin (Formlabs) and lower than those of LCD Grey resin (Roxel3D)(p <0.001). The newly formulated 3D printing resin demonstrated lower volumetric shrinkage, high accuracy, and adequate mechanical properties compared to the commercially available resin materials. The new 3D printed objects exhibited higher accuracy, good stability over time, and adequate mechanical properties; hence, it is a good candidate for modeling applications for restoration, orthodontics and implants.


Glial mechanisms underlying major depressive disorder: Potential therapeutic opportunities.
Major depressive disorder is a severe and the most prevalent form of neuropsychiatric disorder that affects millions of individuals worldwide. The current treatment focuses on brain monoamine hypothesis and conventional antidepressants that inhibit the reuptake of monoamine neurotransmitters to elevate synaptic monoamine concentrations to interact with postsynaptic receptors. However, many people with major depressive disorder fail to respond to conventional therapies experiencing relapse and significant functional impairment. It is increasingly recognized that glia-associated inflammatory mechanisms contribute to the pathophysiology of major depressive disorder. Furthermore, microglial nicotinic cholinergic mechanisms were recently proposed to play a critical role in major depressive disorder-linked inflammatory processes. In this review, we will provide recent advances on glial dysfunctions, the role of inflammatory cytokines, transcription factors, and brain derived neurotrophic factor underlying the pathophysiology of major depressive disorder. We will also evaluate and discuss the anti-inflammatory effects of nicotinic acetylcholine receptor positive allosteric modulators and glial nicotinic receptor-mediated mechanisms that might be responsive to potential pharmacologic interventions. Overall, these important, but underappreciated, roles of brain glial targets and mechanisms might offer new therapeutic opportunities for major depressive disorder.


Novel device for application of continuous mechanical tensile strain to mammalian cells.
During orthodontic tooth movement, the periodontal ligament (PDL) is exposed to continuous mechanical strain. However, many researchers have applied cyclic tensile strain, not continuous tensile strain, to PDL cells in vitro because there has been no adequate device to apply continuous tensile strain to cultured cells. In this study, we contrived a novel device designed to apply continuous tensile strain to cells in culture. The continuous tensile strain was applied to human immortalized periodontal ligament cell line (HPL cells) and the cytoskeletal structures of HPL cells were examined by immunohistochemistry. The expression of both inflammatory and osteogenic markers was also examined by real-time reverse transcription polymerase chain reaction. The osteogenic protein, Osteopontin (OPN), was also detected by western blot analysis. The actin filaments of HPL cells showed uniform arrangement under continuous tensile strain. The continuous tensile strain increased the expression of inflammatory genes such as IL-1β, IL-6, COX-2 and TNF-α, and osteogenic genes such as RUNX2 and OPN in HPL cells. It also elevated the expression of OPN protein in HPL cells. These results suggest that our new simple device is useful for exploring the responses to continuous tensile strain applied to the cells.


Simultaneous open and endoluminal repair of ruptured abdominal and thoracic aortic aneurysms: report of a case.
A 66-year-old woman was transferred to our hospital for emergency treatment of a ruptured abdominal aortic aneurysm (AAA) and impending rupture of a descending thoracic aortic aneurysm (TAA) caused by a Stanford type-B dissection. She had severe coronary artery disease and a highly calcified aorta, and had been taking long-term steroids for rheumatoid arthritis. Endovascular repair of the TAA failed because the femoral artery was too small, so we performed simultaneous repair of the TAA and the AAA. A temporary axillofemoral bypass was constructed and the AAA was replaced with a bifurcated prosthetic graft. A thoracic stent graft was delivered successfully through a chimney graft of the abdominal graft. About 4 months later, the TAA extended proximally, causing hemoptysis, which was stopped by placing a new stent graft proximal to the previous one. This case report shows that a combination of open and endovascular repair is useful for treating a TAA with an AAA, especially in a small or frail patient.


Perforating veins: an anatomical approach to arteriovenous fistula performance in the forearm.
Arteriovenous fistulae (AVFs) play a key role for people who rely on chronic haemodialysis. Stenosis in the venous outflow of the AVF will cause an alternative route of the subcutaneous blood flow via the deeper venous pathways by means of side branches and the perforating veins (PVs). The purpose for the present study was to define the number and anatomical localisation of the perforating veins in the forearm. Twenty forearms were dissected to study the venous anatomy. The localisation, size and connections of the perforators were recorded and stored digitally. In total, 189 PVs were defined (mean, 9.5 per arm; range, 6-19), with 60 (32%) PVs connected to the cephalic vein, 97 (51%) connections to the basilic vein and 32 (17%) PVs to the median vein of the forearm. Most PVs originate from the basilic vein and connect with the ulnar venae comitans. The cephalic vein connects equally to the radial venae comitans, interossea veins and the muscles. The cephalic vein has the fewest PVs and almost a third of them connect to the muscles. This is probably important for the maturation of the AVF, the superficial flow volume and the accessibility for puncture.


Beyond TAM and UTAUT: Future directions for HIT implementation research.
The Technology Acceptance Model (TAM) and Unified Theory of Acceptance and Use of Technology (UTAUT) have been used widely in studies of health information technology (HIT) implementation. However, TAM and UTAUT have also been criticized for being overly simplistic (TAM) and for taking a narrow perspective, which focuses only on individual adopters' beliefs, perceptions and usage intention. Furthermore, with thousands of studies using these theories, their contribution to knowledge has reached a plateau. In this commentary, we discuss some of the criticism of TAM and UTAUT, and argue that biomedical informatics research would benefit from shifting attention from these theories to multi-dimensional approaches that can better capture the complexity of issues surrounding implementation and use of HIT. We propose a number of future undertakings which, in our opinion, are more likely to move the field forward.


The effect of spinal manipulation on the efficacy of a rehabilitation protocol for patients with chronic neck pain: a pilot study.
This pilot study sought to (1) determine whether a 4-week period of chiropractic care improved the ability of chronic neck pain patients to respond to an 8-week period of exercise rehabilitation and (2) determine effect sizes to use in sample size calculations for future studies. Twenty male and female participants (age, 43 +/- 12 years; body mass index, 27 +/- 4.5 [mean +/- SD]) with chronic nonspecific neck pain were randomized into either a chiropractic care combined with exercise or an exercise only group. Group 1 received 4 weeks of chiropractic care, and group 2 waited 4 weeks before both groups participated in an 8-week exercise intervention. The following outcome measures were assessed in week 1 (baseline), week 4, and at week 12: Neck Disability Index (NDI); Visual Analogue Scale (VAS), both now and worst; neck flexion-relaxation response; and feed-forward activation (FFA) times. A repeated-measures analysis of variance was used to evaluate the changes in the NDI and VAS over time. Effect sizes were calculated for changes in neuromuscular parameters. There were significant decreases in the NDI score (P < .001) and VAS in (P < .005) in both groups with no significant differences between the groups. Effect sizes (ESs) were as follows: NDI (.293); VAS now (.175); VAS worst (.392); flexion-relaxation (.636); FFA times: sternocleidomastoid (.1321), anterior scalene (.195). This lead to sample size estimates as follows: flexion-relaxation response, 64 subjects per group; NDI, 145 subjects per group; VAS, 166 subjects per group. Chiropractic care combined with exercise and exercise alone are both effective at reducing functional disability and pain in chronic nonspecific neck pain patients. Future studies will need at least 64 subjects per group to determine if there are differences between the groups and if these differences are attributable to changes in neuromuscular measures.


Ultrasonic identification and examination of fetal heart structures.
Ultrasonic studies were performed on normal fetuses ranging from 36 to 40 weeks gestational age in an attempt to visualize anatomical details of the fetal heart. We were able to visualize cardiac structures hitherto thought to be unidentifiable. Two-dimensional B-scan exposures of sections showed transverse and longitudinal sections of the fetal heart, including the cardiac septa and inlet and outlet sites of the large vessels. To attempt to elucidate the dynamics of the fetal heart, the motility patterns of the cardiac structures were examined by time-motion mode scanning and the patterns obtained were compared to those observed in the postnatal heart. The reliability of the theories advanced and the further prospects are discussed.


[Fiftieth anniversary of the description of the chemical structure of antibodies].
The identification of the antitoxic property of serum in 1890 by Emil von Behring and the introduction of the term "Antikörper" by Paul Ehrlich in 1891 referring to one of the most relevant mechanisms of defense of the adaptive immune system, i.e., the humoral immune response mediators, mark the beginning of modern immunology. The "Y" structure was described 50 years ago by Gerald M. Edelman and Rodney R. Porter. Thus, on the fiftieth anniversary of the description of the chemical structure of antibodies, we consider it appropriate to celebrate this fact by sketching a brief outline and review of these epoch-making achievements.


[Evaluation of biogeochemical factors influence on the prevalence of urolithiasis in the regions of Tajikistan].
The investigation has been undertaken to study a relationship between some biogeochemical and environmental factors and nephrolithiasis morbidity in the regions of Tajikistan. The paper presents the data of a comprehensive study comprising the biochemical, chromatographic, and mass-spectrometric studies of 1180 patients aged 14 to 76 years, treated at the Dushanbe Urology Medical Center. The performed examination has established a relationship of the higher urolithiasis mortality rates in the poor environmental regions of the Republic of Tajikistan to the high pollution by organic and inorganic substances, the high natural mineralization and hardness of water, the high levels of chlorides, sulfates, and other components of salt composition, which in turn affects the course of a pathological process.


Breeds and muscle types modulate performance of near-infrared reflectance spectroscopy to predict the fatty acid composition of bovine meat.
This study aims to assess near-infrared reflectance spectroscopy feasibility for predicting beef fatty acid (FA) composition. Experimental scheme included four breeds (Angus, Blond d'Aquitaine, Charolais, Limousin) and three muscles, Longissimus thoracis (LT), Rectus abdominis (RA), Semitendinosus (ST). The results showed that 1) increasing FA content variability with several breeds increased calibration model reliability (R(2)CV>0.86) for the major individual and groups of FA unless polyunsaturated FAs, 2) Longissimus thoracis FAs were better predicted than RA FAs while no ST FAs were correctly predicted (R(2)CV<0.71). This difference could be explained by FA content, FA variability or specific muscle physico-chemical characteristics.


Effects of patient size on radiation dose reduction and image quality in low-kVp CT pulmonary angiography performed with reduced IV contrast dose.
The purpose of the study is to evaluate image quality and radiation exposure as a function of patient size for CT pulmonary angiography (CTPA) performed at reduced tube voltage and reduced intravenous (IV) contrast dose. We reviewed consecutive CTPAs performed between 9/1/2010 and 10/31/2010 on a 128-slice Siemens AS+ scanner using automated tube current modulation with quality reference mAs 200 and IV contrast concentration 370 mg I/ml followed by a saline flush: 99 scans at 120 kVp using 75 ml of contrast at 5 ml/s and 53 scans on patients lighter than 175 lbs at 100 kVp using 50 ml of contrast at 4 ml/s. We measured patient size (mean water-equivalent diameter) using a topogram analysis tool, signal (mean CT density) and noise (standard deviation) in the main pulmonary artery (MPA) on axial images, and calculated local CTDI(vol) from the kVp and mAs. Linear regression models were created for dependent variables ln(CTDI(vol)), signal, noise, and signal to noise ratio (SNR) as a function of independent variables size, age, gender, and kVp. After controlling for other variables, scanning at 100 kVp yielded CTDI(vol) reduction of 33 % (p < 0.0001), signal increase of 96 HU (p < 0.0001), and increased image noise (p < 0.0001), but without significant difference in SNR (p = 0.99). Relative to 120 kVp, 100-kVp CTPA allows simultaneous reduction of radiation exposure by 33 % and IV contrast dose by 33 % while maintaining image quality. Scanning at 100 kVp is recommended in all patients for whom the required mAs does not exceed maximum X-ray tube output.


[Functional study of metal and radiation in the mechanism of toxic action of plutonium injected in its elemental form].
A ponderal variations study of rats contaminated either with the same metal mass of two isotopes 238Pu and 239Pu or with an equal activity level entitles us to conclude that plutonium toxicity for below 50 muCi/kg levels arises from particles alpha. For higher levels, about 120 muCi/kg, the quantity effect of metal has an influence on localisation and repartition of toxicity. Beneficial effect of oxygenotherapy for 120 muCi/kg appears only after a delay of several days, the time required for toxic manifestation, confirming in acute intoxication, the function of ionising radiation emitted by the metal.


Outcomes of acute lymphoblastic leukaemia in adolescent and young adult Korean patients.
This study used Korean national data to investigate the relationship between treatment patterns and outcomes in Korean adolescent and young-adult (AYA) acute lymphoblastic leukaemia (ALL) patients. Chemotherapy incorporating L-asparaginase was considered paediatric-inspired (PI), as opposed to adult protocols. In total, 65·3% of patients received PI therapy. Five-year overall survival (OS) of PI-treated patients outperformed adult protocols (63·1% vs. 40·4%; P < 0·0001); this trend was maintained within various age subgroups. Younger age, L-asparaginase therapy, and radiotherapy corresponded with superior OS by multivariable analysis. OS tends to improve with PI protocols that include L-asparaginase in AYA ALL, suggesting that therapy protocol is critical in the treatment performance of this group.