The effects of cerebrospinal fluid (CSF) diversion on post-operative CSF leak following extended endoscopic anterior skull base surgery.
There is a paucity of high quality evidence regarding the routine placement of lumbar drain (LD) in reducing post-operative (op) cerebrospinal fluid (CSF) leak after extended endoscopic trans-sphenoidal resection of anterior skull base lesions. In this study, we sought to compare the incidence of post-op CSF leak between patients with upfront LD insertion and those without it. This was a prospective randomized controlled trial conducted over a period of 5 years with patients undergoing extended endoscopic trans-sphenoidal surgery randomly assigned to either LD insertion at the time of surgery, or no LD placement. Thirty-eight patients with anterior skull base tumors were accrued from three tertiary hospitals of Melbourne. Post-op leak was confirmed by β2-transferrin-positive rhinorrhea, and/or worsening pneumocephalus on brain imaging. Skull base defect size and pedicled nasoseptal flap viability were assessed on post-op CT and MRI, respectively. There was no significant difference in post-op CSF leak incidence between the two subgroups (12.50% in LD arm vs. 9.10% in no LD arm). Patients with LD insertion however, demonstrated substantially raised complication rates, longer hospital lengths of stay and lower subjective quality of life measures at 12 months compared with those without LD. In conclusion, routine placement of LD at the time of surgery for extended anterior skull base trans-nasal approach did not reduce the risk of post-op CSF leak. Discretion is warranted when using LD as an adjunct due to its associated morbidities, prolonged hospital stay and adverse effect on patients' subjective outcome measures.


Complement regulation during pregnancy.
Complement has an important role in innate immunity and inflammation. Complement also has the capacity to attack self tissues. Cells are protected from the deleterious effects of complement. The Crry protein belongs to a family of molecules that regulates complement activation, protecting tissues from complement-mediated damage. To investigate the role of these molecules in vivo, Crry-/- mice were generated. Crry-/- mice did not survive pregnancy owing to abnormal complement deposition in the placenta through the alternative pathway. Tissue damage related to C5 (production of C5a and C5b-9) was not required. Removal of inflammatory cells did not affect the phenotype. This suggests new noninflammatory mechanisms of pregnancy failure that are dependent solely on C3. The major abnormality was a failure of blood vessel formation in the placenta, revealing an unsuspected C3 effect in the vascular development of this organ.


The World Health Organization's QualityRights initiative: rights and recovery-oriented services should be at the centre not the margins of psychiatry.
The World Health Organization's QualityRights initiative represents an exciting shift towards creating mental health services that respect human rights and promote recovery. The initiative is the subject of a recent BJPsych editorial. In this article I challenge previously articulated criticism of QualityRights and suggest that psychiatry has much to gain from promoting rights-based practice.


Low-dose estradiol alters brain activity.
Although several studies have examined the effects of estrogen replacement therapy (ERT) on neural activity associated with tasks of learning and memory, no study has examined such effects on a sustained attention task. This study examined the effect of low-dose estrogen replacement therapy on hemodynamic activity elicited by a visual three-stimulus oddball task recorded using event-related functional magnetic resonance imaging (fMRI). Participants included 16 women between the ages of 73 and 84 who were part of a randomized controlled double-blind study to evaluate the effect of an ultralow dose micronized estradiol on bone. No significant differences in behavioral performance were found with ERT. However, there was evidence that ERT group participants had both reductions and increases in the amplitude of hemodynamic response in a variety of subcortical and cortical brain regions. These included regions involved in perception and attention such as the occipital and parietal lobes, motor cortex, anterior cingulate and prefrontal cortex. These findings suggest that estrogen may facilitate the efficiency of brain function during the performance of sustained attention tasks in post-menopausal elderly women.


Economic evaluation protocol of a short, all-oral bedaquiline-containing regimen for the treatment of rifampicin-resistant tuberculosis from the STREAM trial.
A December 2019 WHO rapid communication recommended the use of 9-month all-oral regimens for treating multidrug-resistant tuberculosis (MDR-TB). Besides the clinical benefits, they are thought to be less costly than the injectable-containing regimens, for both the patient and the health system. STREAM is the first randomised controlled trial with an economical evaluation to compare all-oral and injectable-containing 9-11-month MDR-TB treatment regimens. Health system costs of delivering a 9-month injectable-containing regimen and a 9-month all-oral bedaquiline-containing regimen will be collected in Ethiopia, India, Moldova and Uganda, using 'bottom-up' and 'top-down' costing approaches. Patient costs will be collected using questionnaires that have been developed based on the STOP-TB questionnaire. The primary objective of the study is to estimate the cost utility of the two regimens, from a health system perspective. Secondary objectives include estimating the cost utility from a societal perspective as well as evaluating the cost-effectiveness of the regimens, using both health system and societal perspectives. The effect measure for the cost-utility analysis will be the quality-adjusted life years (QALY), while the effect measure for the cost-effectiveness analysis will be the efficacy outcome from the clinical trial. The study has been evaluated and approved by the Ethics Advisory Group of the International Union Against Tuberculosis and Lung Disease and also approved by ethics committees in all participating countries. All participants have provided written informed consent. The results of the economic evaluation will be published in a peer-reviewed journal. ISRCTN18148631.


COVID-19 lockdown and reduction of traffic accidents in Tarragona province, Spain.
This paper analyses the impact that the lockdown decreed by the Spanish Government to combat the spread of COVID-19 has had on traffic accidents in Tarragona province (Spain). During the studied period of the lockdown (March 16 - April 26 2020) the number of accidents per day fell by 74,3% in coparison with those in February 14-20 (reference week) and 76% in respect to the equivalent period in 2018-2019. This reduction of accidents has been higher than the decrease of mobility during the same reference period (62.9%). This suggests a multiplicative positive effect of traffic reduction on roads safety. Our findings provide new evidences of the disruptive effect of the COVID-19 pandemic on transportation and of how it could be used as a catalyst to promote more sustainable and secure transport systems.


Alcohol and drug use disorders, HIV status and drug resistance in a sample of Russian TB patients.
Alcohol use, tuberculosis (TB) drug resistance and human immunodeficiency virus (HIV) risk behavior are of increasing concern in Russian TB patients. A prevalence study of alcohol use and HIV risk behavior was conducted in a sample of 200 adult men and women admitted to TB hospitals in St Petersburg and Ivanovo, Russia. Of the subjects, 72% were men. The mean age was 41. Active TB was diagnosed using a combination of chest X-ray, sputum smears and sputum cultures. Sixty-two per cent met DSM-IV criteria for current alcohol abuse or dependence. Drug use was uncommon, with only two patients reporting recent intravenous heroin use. There was one case of HIV infection. The mean total risk assessment battery score was 3.4. Depression was present in 60% of the sample, with 17% severely depressed. Alcohol abuse/dependence was associated with an eight-fold increase in drug resistance (OR 8.58; 95% CI 2.09-35.32). Patients with relapsing or chronic TB were more likely to meet the criteria for alcohol abuse/dependence (OR 2.56; 95% CI 1.0-6.54). Alcohol use disorders are common in patients being treated for active TB, and are associated with significant morbidity. Additional surveys are needed to examine the relationship between alcohol use disorders and anti-tuberculosis drug resistance.


Successful Total Knee Arthroplasty for Hoffa and Proximal Tibial Fractures: Report of Three Complex Cases After Failed Osteosynthesis Procedures.
BACKGROUND Distal femoral and proximal tibial fractures often lead to nonunion and post-traumatic osteoarthritis, and total knee arthroplasty (TKA) has emerged as an effective alternative for older patients. This report includes 3 cases of successful TKA treatment. The cases involve a 42-year-old man and a 62-year-old man with Hoffa coronal fractures of the distal femur, and a 50-year-old man with a proximal tibial fracture. These patients underwent multiple osteosynthesis procedures before receiving TKA. CASE REPORT Case 1: A 42-year-old man with a displaced Hoffa's fracture had persistent knee pain. Nonunion post-initial fixation led to reoperation with iliac bone grafting and plate fixation. TKA using a Posterior Stabilized (PS)-type implant resulted in improved motion and function after 3 years. Case 2: A 62-year-old man suffered lateral condyle and ligament injuries from a displaced Hoffa's fracture. Despite plate fixation, dislocation occurred, requiring conversion. TKA with long-stem hinge-type implant, using augmentation block, led to enhanced stability and outcomes at 2 years. Case 3: A 50-year-old man's tibial nonunion, treated with plate fixation, resulted in infection and bone fusion. TKA using a constrained PS-type implant insert addressed the lateral tibial adhesions via iliotibial band (ITB) release and treated severe tibial plateau damage. Positive results were seen at 1 year. CONCLUSIONS The challenges of pseudarthrosis, like bone defects and compromised tissue, highlight the need for precise implant selection based on evaluations of bone quality, defects, knee stability, and hyperextension, rather than resorting to overly-constrained implants.


Changes in specific binding sites of girisopam after chemical and surgical lesions in the striato-nigral system.
Neurotoxin (AMPA)-induced lesions in the caudate nucleus as well as unilateral surgical transection of the striato-nigral pathway strongly depleted the binding of a homophthalazine (formerly called 2,3-benzodiazepines) girisopam (GYKI-51189, EGIS 5810) selectively in the substantia nigra of the rat, ipsilateral to the lesions. In contrast to this, AMPA injections into the substantia nigra failed to effect on girisopam binding to either components of the nigro-striatal system. Data indicate that this homophthalazine may bind to a descending component of the striatum (striato-nigral projecting neurons), or its binding capacity to substantia nigra neurons depends on the integrity of striatal afferent pathways to the substantia nigra.


Helicopter Rescue Missions for Emergency Medical Aid at Sea: A New Assignment for the French Military Medical Service?
Historically in charge of the search and rescue of aircraft in distress alongside military aeronautical crews, the doctors and nurses of the French Military Medical Service (FMMS) also participate in helicopter rescue missions for emergency medical aid at sea off the French metropolitan coast. This public service mission is placed at the heart of force medicine because it can be transposed to external theaters of operations (OPEX). Recent changes in the regulation of medical aid at sea, in particular the creation in 2013 of maritime emergency mobile resuscitation services, initially weakened the role of the teams of the FMMS. However, their 2018 and 2019 activity report reflects the persistence of strong involvement. The "FMMS 2020" model, especially through its "openness" aspect, allows the FMMS the optimal conditions to maintain its position as a key player in this field, particularly through the development of institutional partnerships with the public health service. Associated with their mastery of the air-maritime environment, strengthening the skills in emergency medicine of the military medical teams in charge of this mission appears to be 1 of the main measures ensuring the achievement of this objective and a high quality of care for patients.


Influenza A (H1N1) pneumonia in an immunossupressed patient after heart transplantation.
The role of the immune response during Influenza H1N1 virus infection is not yet fully established, but it is believed that it decisively participates in the severity of the disease as well as in the development of acute respiratory distress syndrome. The role of immunomodulating therapies in the control of viral infections is not a consensus either, and data from the literature defining the indications for their use are lacking. The present report is, to our knowledge, the first on a heart transplant patient who developed H1N1 virus infection and had a favorable outcome, thus generating discussion on the real role of immunosuppressive therapy as a risk factor for the severe form of the disease.


Prescribing omissions in elderly patients admitted to a stroke unit: descriptive study using START criteria.
Underuse of medication considered beneficial is particularly common in elderly patients. A new Screening Tool to Alert Doctors to the Right Treatment (START) has been published to identify potential prescribing omissions. To quantify and characterize potential prescribing omissions of cardiovascular risk management therapy using START criteria. This study was conducted in the Stroke Unit of the university teaching hospital of Cova da Beira Hospital Centre, Covilhã, located in the Eastern Central Region of Portugal. During 6 months, the medical files of all elderly patients (age ≥ 65 years) admitted with acute cardiovascular disease were reviewed and the START criteria applied to the information of medication, at admission and at the time of discharge from the hospital Stroke Unit. Potential prescribing omissions of cardiovascular and endocrine pharmacological therapy were identified and the difference in the potential prescribing omissions between admission and discharge from hospital Stroke Unit was also evaluated. At the time of admission to the Stroke Unit, 101 potential prescribing omissions were found in 68.1 % (n = 91) of elderly (average 1.11 omissions per patient), of which 84.2 % (n = 85) were corrected at the time of discharge. In 14 patients, 16 omissions found at admission were not corrected during hospitalization, and in 5 patients 5 new omissions were detected. Prescribing omissions of beneficial drugs are highly prevalent in acutely ill admitted to a Stroke Unit. START criteria represent a simple, evidence-based and easy-to-use tool to screen underuse of cardiovascular risk management therapy in elderly patients.


Identifying technology innovations for marginalized smallholders-A conceptual approach.
This paper adds a contribution in the existing literature in terms of theoretical and conceptual background for the identification of idle potentials of marginal rural areas and people by means of technological and institutional innovations. The approach follows ex-ante assessment for identifying suitable technology and institutional innovations for marginalized smallholders in marginal areas-divided into three main parts (mapping, surveying and evaluating) and several steps. Finally, it contributes to the inclusion of marginalized smallholders by an improved way of understanding the interactions between technology needs, farming systems, ecological resources and poverty characteristics in the different segments of the poor, and to link these insights with productivity enhancing technologies.


Nomenclature and relationships of some Brazilian leguminous potyviruses related to bean common mosaic and/or passionfruit woodiness viruses.
The main Brazilian literature of the last 10 years on potyviruses of leguminous plants related to bean common mosaic virus (BCMV) and/or to passionfruit woodiness virus (PWV) is discussed and summarized. The viruses dealt with are canavalia acronecrosis, mosaico de canavalia, cassia yellow spot, cowpea green vein-banding, cowpea rugose mosaic and cowpea severe mottle. The viruses have similar biological properties, such as a host range restricted mainly to the Leguminosae, aphid transmission, seed transmission in leguminous plants, and various degrees of serological relationships with BCMV and PWV.


Childhood overweight and obesity: age stratification contributes to the differences in metabolic characteristics.
The aim of this study was to identify the differential metabolic characteristics of children with overweight and obesity and understand their potential mechanism in different age stratifications. Four hundred seventy-three children were recruited and divided into two age stratifications: >4 years (older children) and ≤4 years (younger children), and overweight and obesity were defined according to their BMI percentile. A one dimensional proton nuclear magnetic resonance (1 H-NMR)-based metabolomics strategy combined with pattern recognition methods was used to identify the metabolic characteristics of childhood overweight and obesity. Four and sixteen potential biomarkers related to overweight and two and twenty potential biomarkers related to obesity were identified from younger and older children, respectively. Fluctuations in phenylalanine, tyrosine, glutamine, leucine, histidine, and ascorbate co-occurred in children with obesity at two age stratifications. The disturbances in biosynthesis and metabolism of amino acids, lipid metabolism, and galactose metabolism disturbance were mainly involved in children with overweight and obesity. The metabolic disturbances show a significant progression from overweight to obesity in children, and different metabolic characteristics were demonstrated in age stratifications. The changes in the levels of phenylalanine, tyrosine, glutamine, leucine, histidine, and ascorbate were tracked with the persistence of childhood obesity. These findings will promote the mechanistic understanding of childhood overweight and obesity.


Low-dose alcohol ameliorated homocysteine-induced anxiety-related behavior via attenuating oxidative stress in mice.
Recent studies showed that homocysteine (Hcy) levels were obviously elevated in patients with anxiety, furthermore, oxidative stress and inflammation were closely linked with Hcy-related damage. Despite alcohol exposure has differential effects on different forms of anxiety, the role of alcohol on anxiety-related behavior induced by high Hcy levels is still not entirely clear. The present study investigated the protective potential of low-dose alcohol against homocysteine-induced anxiety-related behavior and explored the possible underlying mechanisms. Mice were administered intragastrically with methionine (2.0 g/kg/day) or alcohol (0.6 g/kg/day). After 21 days of administration, the anxiety-related behavior was evaluated through open field (OF) and elevated plus maze (EPM) tests, and the variations of oxidative stress and inflammation levels were measured. The results of OF and EPM tests showed that the anxiety-related behavior in mice was prevented by alcohol treatment. Alcohol lowered the elevated serum Hcy levels and alleviated the damage of hippocampal tissues in hyperhomocysteinemia (HHcy) mice. Meanwhile, the superoxide dismutase (SOD) activity of the hippocampal tissues enhanced, and the malondialdehyde (MDA) concentration of the hippocampal tissues and the serum interleukin-1β (IL-1β) level decreased. In addition, after administering alcohol, the increase of superoxide dismutase 1 (SOD1), heme oxygenase 1 (HO-1) protein expression and the decrease of IL-1β protein expression were also detected in HHcy mice hippocampal tissues. Taken together, low-dose alcohol significantly ameliorated the Hcy-induced anxiety-related behavior in mice, which might be related to SOD1 and HO-1 upregulation and IL-1β downregulation.


Action observation activates neurons of the monkey ventrolateral prefrontal cortex.
Prefrontal cortex is crucial for exploiting contextual information for the planning and guidance of behavioral responses. Among contextual cues, those provided by others' behavior are particularly important, in primates, for selecting appropriate reactions and suppressing the inappropriate ones. These latter functions deeply rely on the ability to understand others' actions. However, it is largely unknown whether prefrontal neurons are activated by action observation. To address this issue, we recorded the activity of ventrolateral prefrontal (VLPF) neurons of macaque monkeys during the observation of videos depicting biological movements performed by a monkey or a human agent, and object motion. Our results show that a population of VLPF neurons respond to the observation of biological movements, in particular those representing goal directed actions. Many of these neurons also show a preference for the agent performing the action. The neural response is present also when part of the observed movement is obscured, suggesting that these VLPF neurons code a high order representation of the observed action rather than a simple visual description of it.


Ventral segment-preserving right hepatectomy in patients with hepatocellular carcinoma.
Transection along the anterior fissure was proposed as a mechanism by which to open the third door of the liver. In this study, we investigated surgical outcomes of a ventral segment-preserving right hepatectomy (VSPRH) compared with those of conventional right hepatectomy in patients with hepatocellular carcinoma (HCC). Between January 2007 and December 2010, 595 primary HCC patients underwent liver resection at the authors' institution. Among them, the 123 HCC patients who underwent a right hepatectomy were retrospectively analyzed. The patients were classified into two groups according to the type of resection: those who underwent a VSPRH (Group A; 27 cases) and those who underwent a conventional right hepatectomy (Group B; 96 cases). In Group A, expected remnant liver volume after a right hepatectomy was calculated to be 32.1 ± 7.2% of functional total liver volume (FTLV); remnant liver volume increased up to 54.7 ± 7.2% of FTLV after a VSPRH. Clinicopathologic characteristics and intraoperative data did not differ between the two groups. The liver-related complication rate was higher in Group B (P = 0.02). Overall survival and disease-free survival rates were similar (3-year disease-free survival (Group A: 67.8%; Group B: 71.7%; P = 0.65); 3-year overall survival (Group A: 91.7%; Group B: 87.4%; P = 0.26). In regard to long-term synthetic function, the 1-year postoperative serum albumin level was higher in Group A. A VSPRH yielded fewer liver-related complications and similar long-term oncologic outcomes, compared with conventional right hepatectomy in cirrhotic patients with a small left lobe volume. Therefore, VSPRH can be considered to be an alternative procedure for a right hepatectomy.


Comparison of ethinylestradiol pharmacokinetics in three hormonal contraceptive formulations: the vaginal ring, the transdermal patch and an oral contraceptive.
This open-label, randomized study compared the pharmacokinetics of ethinylestradiol (EE) from the contraceptive vaginal ring NuvaRing (15 microg EE/day), the transdermal patch (20 microg EE/day) and a combined oral contraceptive (COC) containing 30 microg EE. After 2-8 weeks of synchronization by COC treatment, subjects were randomized to 21 days of treatment with NuvaRing, patch or COC. Analysis of area under the EE concentration-versus-time curve (AUC) during 21 days of treatment showed that exposure to EE in the NuvaRing group was 3.4 times lower than in the patch group (p < .05) and 2.1 times lower than in the pill group (p < .05). Serum EE levels of subjects showed much lower variation with NuvaRing than with the patch or the COC. Thus, exposure to EE was significantly lower with NuvaRing than with the patch and pill methods, demonstrating that NuvaRing is a low-estrogen-dose contraceptive method that also results in low estrogen exposure.


Long working hours in the healthcare system of the Belo Horizonte municipality, Brazil: a population-based cross-sectional survey.
Health personnel are key players in developing and improving healthcare systems, caring for individuals and their communities, and helping improve quality of life. However, these professionals are often exposed to long working hours because of the pressing need for their services at potentially any time of day. The long working hours they endure are a major risk factor for both acute and chronic health problems. The present study aimed to analyze occurrences of long working hours and their association with individual characteristics and employment factors among workers in the municipal healthcare system in Belo Horizonte, Brazil. In this cross-sectional study, a ramdomly selected proportional sample of 1549 participants was analyzed from among the total of 13 602 workers in the Belo Horizonte municipal healthcare system in 2009. "Long" working hours were defined as >44 h/week. A self-administered questionnaire was used for accumulating data. Associations with outcomes were estimated using logistic regression, in univariate and multivariate models. The rate of occurrence of long working hours was 31.4% (95% CI 29.1-33.7). Lower educational level (high school, technical, or uncompleted undergraduate [OR 0.60, 95% CI 0.47-0.78 p < 0.001], or elementary [OR 0.33, 95% CI 0.19-0.55 p < 0.001]) was associated with a lower likelihood of self-reporting long working hours in relation to the group with the highest educational level (completed undergraduate or postgraduate). Male sex (OR 1.62, 95% CI 1.26-2.09 p < 0.001), having children (PR 1.54, 95% CI 1.20-1.97 p = 0.001), and being in the healthcare provider group (OR 1.82, 95% CI 1.40-2.35 p < 0.001) were factors associated with greater likelihood of long working hours. It was observed that number of long weekly working hours was related to individual characteristics and employment factors.


RNAi-mediated silencing of ARV1 in Setaria digitata impairs in-vitro microfilariae release, embryogenesis and adult parasite viability.
Setaria digitata is a nematode that resides in the peritoneal cavity of ruminants causing cerebrospinal nematodiasis disease affecting livestock and inflicting significant economic forfeitures in Asia. Further, this nematode can infect humans, causing abscesses, allergic reactions, enlarged lymph nodes, eye lesions and inflammation of the lungs. The 'ARE2 required for viability1' (ARV1) encodes for putative lipid transporter localized in the endoplasmic reticulum (ER) and Golgi complex membrane in humans and yeast. In the present study, the functional role of S. digitata ARV1 (SD-ARV1) was investigated using RNA interference (RNAi) reverse genetic tool. The targeted silencing SD-ARV1 transcripts by siRNA mediated RNAi resulted in a dramatic reduction of SD-ARV1 gene and protein expressions in S. digitata, which in turn modulated the parasitic motility, its production of eggs and microfilaria viability. Further, the same silencing caused severe phenotypic deformities such as distortion of eggs and embryonic development arrest in the intrauterine stages of adult female S. digitata. These results suggest that SD-ARV1 plays a pivotal role in worm embryogenesis, adult parasite motility and microfilariae viability. Finally, the ubiquitous presence of ARV1 in human filarial nematodes, its crucial functional roles in nematode biology and its remarkable diversity in primary protein structure compared to homologues in their hosts warrants further investigations to ascertain its candidacy in anthelmintic drug development.


Zinc sulphate attenuates chloride secretion in human colonic mucosae in vitro.
Zinc's usefulness in the treatment of diarrhoea is well established as an addition to oral rehydration. Mechanisms of action of zinc have been explored in intestinal epithelia from rodents and in cell lines. The aim was to examine how zinc alters ion transport and signal transduction in human colon in vitro. Voltage clamped colonic sheets obtained at the time of surgical resection were used to quantify ion transport responses to established secretagogues. Nystatin permeabilisation was used to study basolaterally-sited ion channels. Direct actions of zinc were determined using preparations of colonic crypts isolated from human mucosal sheets. Electrophysiological measurements revealed zinc to be an inhibitor of electrogenic ion transport stimulated by forskolin, PGE(2), histamine and carbachol in isolated human colonic epithelium. Basolateral addition of zinc sulphate had no direct effect on the epithelium. To further outline the mechanism of action, levels of secondary intracellular messengers (3', 5'-cyclic adenosine monophosphate; cAMP) were determined in isolated colonic crypts, and were found to be reduced by zinc sulphate. Finally, indirect evidence from nystatin-permeabilised mucosae further suggested that zinc inhibits basolateral K(+) channels, which are critical for transepithelial Cl(-) secretion linked to water flux. Anti-secretory, and therefore anti-diarrhoeal, actions of exogenous zinc are due, at least in part, to direct basolateral epithelial K(+) channel inhibition.


Involvement of Onuf's nucleus in amyotrophic lateral sclerosis.
The Onufrowicz (Onuf's) nuclei from eight amyotrophic lateral sclerosis (ALS) cases and nine neurological control cases were studied histologically and morphometrically. To clarify the factors relating to the involvement of the Onuf's nucleus in ALS, we correlated the relationships among the age at death, clinical duration, morphometric findings for Onuf's neurons, and neuronal numbers in the posteroposterolateral (PPL) nuclei in the ALS cases with those in neurological controls. Intracytoplasmic inclusions such as Bunina bodies, ubiquitin-reactive inclusions, and conglomerate inclusion were found in the Onuf's neurons in ALS, but not in the controls. The total number of Onuf's neurons in the ALS cases was not decreased, but that of normal-appearing neurons was decreased while that of atrophic neurons was increased. Significantly decreased perikaryal, nuclear and nucleolar areas and decreased perikaryal (P)/nuclear and P/nucleolar area ratios of Onuf's neurons were found in ALS, not only in the atrophic neurons but also in the normal-appearing neurons, compared with the controls. The shrinkage in Onuf's neurons of ALS was different from that seen in the ageing process or in the axonal reactions of controls with atonic bladder. In ALS, the morphometric findings for the Onuf's neurons showed no correlation with age at death, clinical duration, or number of PPL neurons. Our results indicate that in ALS Onuf's nucleus is principally vulnerable to the ALS process, although the degree of degeneration differs from that seen in other motor neurons. The involvement of Onuf's nucleus might be slowed due to factors specific to this nucleus, including the biochemical and autonomic properties of the nucleus; nevertheless, it is histologically classified as part of the somatic cell column.


Clinical application of a new compression anastomotic device for colorectal surgery.
Fifty-six patients underwent large bowel anastomosis by the compression anastomotic device developed by the authors from May 1986 through December 1988. Operations performed were 40 left hemicolectomies or anterior resections of the sigmoid and rectum, 7 left colon resections, 7 right hemicolectomies, and 2 total colectomies. Twenty-one anastomoses were done on the extraperitoneal rectum, in 7 cases less than 4 cm from the anal verge and in 9 cases between 4.5 and 8 cm. Five intraoperative diverting colostomies were done (9%). The rings of the device were evacuated postoperatively after a mean of 11 days with little or no discomfort. Operative mortality was 1.8% (one patient died of myocardial infarction). Anastomotic complications were one (1.8%) clinical and one (1.8%) subclinical leak. Mean postoperative hospital stay was 14 days. This initial clinical experience shows that the anastomotic device is reliable.


Adults who use e-cigarettes have difficulty understanding nicotine concentrations presented as mg/ml and percent nicotine.
Nicotine in e-cigarettes typically is labeled as mg/ml or percent nicotine, but these metrics may be difficult to understand. We examined whether adults who use e-cigarettes accurately can compare nicotine concentrations presented as mg/ml and percent and/or can identify the strength of concentrations presented using these metrics. 310 adults completed an online survey in 2020. Participants viewed nicotine concentration pairs (e.g., 24 mg/ml vs 3%) and indicated which concentration was stronger or if they were equal. Participants also categorized nicotine concentrations presented as mg/ml (0-60 mg/ml) and percent (0-6%) into strength categories (no nicotine, very low, low, medium, high, very high). "Correct" answers for the strength of each concentration (e.g., 30 mg/ml is "high" nicotine) were based on the subjective opinion of e-cigarette researchers. When making direct comparisons, adults correctly identified that one concentration was stronger or that both were equivalent about half of the time (8.30 [5.08] of 19). Adults answered correctly more often when the stronger concentration was presented in mg/ml (4.75 [2.74] of 8) than percent (2.54 [2.60] of 8), p < .001). Adults "correctly" identified the strengths of 8.90 (3.22) of 18 nicotine concentrations, with more "correct" responses for mg/ml (5.27 [2.15]) than percent (3.63 [1.71], p < .001). Adults classified concentrations presented as percent as weaker than equivalent concentrations presented as mg/ml. Adults had difficulty understanding nicotine concentrations labeled using the most common metrics, especially percent nicotine. A singular, easy-to-understand labeling system may increase public knowledge about the nicotine concentration/strength of vaping products.


[False aneurysm of the deep femoral artery due to pertrochanteric fracture of the hip with displaced fragment of the lesser trochanter].
We report the case of an 82-year-old man with a pertrochanteric fracture of the hip and an avulsion of the lesser trochanter. During the third postoperative week after unproblematic correction with a gamma nail, a swelling of the proximal thigh occurred. Angiographs showed a false aneurysm of the deep femoral artery which was treated by suture.


Establishing score equivalence of the GDS-30 scale and International Classification of Functioning, Disability and Health range, using Rasch analysis.
Depression is a common problem among older adults. The Geriatric Depression Scale (GDS- 30) is a recommended tool for assessing the emotional state of the elderly. To-date, there are no data in literature on the description of GDS-30, according to the International Classification of Functioning, Disability and Health (ICF). The aim of the study is to transform the data obtained using the GDS-30 scale into the common scale of the ICF by applying the Rasch measurement theory. The study was conducted based on the results of 775 measurements made on people aged 65 and over. The Rasch model with the unconstrained Rasch parameter was used for the study. The GDS-30 scale was transformed into the ICF scale, where 0 points on the ICF scale were assigned to 0 points on the GDS-30 scale, 1 on the ICF scale - 1-4 points on the GDS-30 scale, 2 on the ICF scale - 5-7 on the GDS-30, 3 on the ICF scale, and 8-19 points on the GDS-30, whereas 4 on the ICF scale, 20-30 points on the GDS-30. Taken together, the results showed that the GDS-30 scale can be reliably transferred to the universal ICF scale for the b152 Emotional functions code. The ability to transfer the results into the universal language of the ICF category provides a coding system for more efficient information management in health systems, allows for data aggregation, and offers the possibility to compare them. It is also invaluable for clinical practice and research, including creating meta-analyses.


Otolaryngology consultations for COVID-19 patients: A retrospective cohort study of indications, interventions, and considerations.
To identify differences in inpatient otolaryngology consultations and interventions for patients based on COVID-19. Records were reviewed for all patients for whom otolaryngology was consulted at a high-volume tertiary care hospital from April 30, 2020 to October 1, 2020. Demographic information, length of stay, COVID-19 status, indication for consultation, and otolaryngology interventions were recorded. Statistical analysis was performed using R software. Bleeding composed a significantly higher proportion of otolaryngology consults in COVID-19 positive patients (28% vs. 8.4%, p<0.0001). Management of bleeding was the most common procedure performed in positive patients (n=37, 35%), and they had a higher median number of interventions performed when compared to bleeding patients who tested negative (1, IQR 1-2 vs. 1, IQR 0-1, p=0.04). COVID-19 positive patients with bleeding were more likely to expire than those with other indications for otolaryngology consultation (50% vs. 7%, p<0.001). Bleeding and associated interventions comprised the predominant discrepancy between COVID-19 positive and negative patients in our cohort. We encourage routine use of simple and cost-effective methods to decrease risk of bleeding.


Stress and disease: the missing link. A vasospastic theory. II. The nature of degenerative arterial disease.
An analysis of the evidence indicates that the initiation and progress of atherosclerosis might well be explained by repeated bouts of arterial constriction in relation to life stresses, through increased blood flow velocity and turbulence at points of constriction, and consequent endothelial damage, plasma insudation into the wall, and intimal smooth muscle cell - connective tissue proliferation.


Quantifying hysteresis of atrazine desorption from a sandy loam soil.
Batch experiments were carried out to investigate the effects of initial atrazine concentrations and consecutive desorption steps on the desorption characteristics of atrazine from a sandy loam soil. As initial atrazine concentration increased, the average percentage of atrazine desorption on the sandy loam soil ranged gradually from 23.1% to 38.5% after five consecutive desorption steps. The values of the Freundlich capacity parameter, k(des), derived from the initial concentration and time-dependent desorption isotherm were consistently higher than those associated with sorption. The opposite trend was observed only for the values of nonlinear parameter, n(des), from the initial concentration-dependent desorption isotherms. Atrazine hydrolysis to hydroxyatrazine and bound residue formation were mainly responsible for the observed hysteresis in its sorption and desorption isotherms. For the initial concentration-dependent desorption isotherms, as initial atrazine concentration increased, the values of hysteretic coefficients omega and lamda decreased, and eta values increased. However, the relationships between initial atrazine concentration and hysteretic coefficients were not pronounced for omega, eta, or lamda. For the time-dependent desorption isotherms, lamda and eta values increased as the atrazine desorption step proceeded. The correlation between hysteretic coefficient and desorption step was highly significant for lamda (P < 0.0001), but not for eta.


Serious leg injuries in motorcycle despatch riders. An unacceptable occupational hazard?
In the 3 years up to the end of 1988, 18 of the 46 patients admitted with lower limb fractures following a motorcycle accident were despatch riders. Ten of the despatch riders were injured in the final year of the study. The nature of the injuries sustained, the reasons for their apparent frequent incidence and possible preventive measures are discussed.


PI3K as Mediator of Apoptosis and Contractile Dysfunction in TGFβ1-Stimulated Cardiomyocytes.
TGFβ1 is a growth factor that plays a major role in the remodeling process of the heart by inducing cardiomyocyte dysfunction and apoptosis, as well as fibrosis thereby restricting heart function. TGFβ1 mediates its effect via the TGFβ receptor I (ALK5) and the activation of SMAD transcription factors, but TGFβ1 is also known as activator of phosphoinositide-3-kinase (PI3K) via the non-SMAD signaling pathway. The aim of this study was to investigate whether PI3K is also involved in TGFβ1-induced cardiomyocytes apoptosis and contractile dysfunction. Incubation of isolated ventricular cardiomyocytes with TGFβ1 resulted in impaired contractile function. Pre-incubation of cells with the PI3K inhibitor Ly294002 or the ALK5 inhibitor SB431542 attenuated the decreased cell shortening in TGFβ1-stimulated cells. Additionally, TGFβ-induced apoptosis was significantly reduced by the PI3K inhibitor Ly294002. Administration of a PI3Kγ-specific inhibitor AS605240 abolished the TGFβ effect on apoptosis and cell shortening. This was also confirmed in cardiomyocytes from PI3Kγ KO mice. Induction of SMAD binding activity and the TGFβ target gene collagen 1 could be blocked by the PI3K inhibitor Ly294002, but not by the specific PI3Kγ inhibitor AS605240. TGFβ1-induced SMAD activation, cardiomyocyte apoptosis, and impaired cell shortening are mediated via both, the ALK5 receptor and PI3K, in adult cardiomyocytes. PI3Kγ specifically contributes to apoptosis induction and impairment of contractile function independent of SMAD signaling.


Changes in CNS myelin proteins and glycoproteins after in situ autolysis.
The effects of postmortem autolysis in situ on myelin proteins and glycoproteins were studied in 25- and 125-day-old mouse brain and in adult bovine brainstem. In bovine myelin a loss of the major myelin glycoprotein was the only difference observed when the tissue was left at 19 degrees C for 24 hours compared to immediately frozen material. In the autolysed mouse brain, the myelin major glycoprotein was the most affected component with a 55% decrease. Both myelin basic protein components were degraded with a 35% loss. The other myelin proteins did not change under the conditions used for this study. There was also no change in the specific activity of 2',3'-cyclic nucleotide 3'-phosphohydrolase, a myelin-associated enzyme. Using the double labelling technique with [3H]fucose and [3 5S] sulfate as precursors injected intracranially, a shift of the major myelin glycoprotein labelled with radioactive sulfate towards a smaller apparent molecular size was observed as a result of the autolysis whereas the electrophoretic mobility of the fucose labelled major peak was unaffected.


Lasagna's law: A dish best served early.
It has been over 40 years since Lasagna's Law was first introduced and its main postulates are still permeating the clinical trial arena. This article attempts to identify the most pressing roadblocks in patient recruitment, categorizes them based on the stakeholders involved and provides suggestions on how to identify and mitigate the risks involved.


Hormonal Effects on Urticaria and Angioedema Conditions.
Women appear to be more frequently affected with urticaria and angioedema. Sex hormones are believed to have an important mechanistic role in regulating pathways involved in these conditions. This effect is likely nonspecific for chronic spontaneous urticaria (CSU) or many forms of angioedema (AE), because many other chronic diseases such as asthma are also affected by sex hormones. The role of sex hormones has been better elucidated for hereditary AE, because they have been shown to have multiple effects including upregulation of FXII, an important activator of the kallikrein pathway. However, their role in the underlying pathogenesis for CSU is less clear. Autoimmunity is clearly linked to CSU, which is more common in women. This suggests that sex hormones could act as adjuvants in activating or upregulating autoimmune pathways. The purpose of this review is to discuss in detail the role of sex hormones in CSU and AE and how a better understanding of the impact hormones has on these conditions might lead to new treatment advancements with better clinical outcomes.


K-ras and p53 mutations are an independent unfavourable prognostic indicator in patients with non-small-cell lung cancer.
We examined 159 consecutive cases of non-small-cell lung cancer (NSCLC) for a mutation at codon 12 of the K-ras gene and for a mutation of the p53 gene occurring in exons 5-8. Eleven (6.9%) had mutations of the K-ras (ras+) and 57 (35.8%) had mutations of the p53 (p53+). There were 95 cases (59.7%) with ras- p53-, seven cases (4.4%) with ras+/p53-, 53 cases (33.3%) with ras-/p53+ and four cases (2.5%) with ras+/p53+. The ras+ group had a worse prognosis than the ras group in all cases and in 107 early-stage cases (stage I-II, P<0.05). The p53+ group had a worse prognosis in 107 early-stage cases (P<0.01), but there was no statistically significant difference when 52 advanced-stage cases (stage III-IV) or all patients were considered. Both ras and p53 mutations were unfavourable prognostic factors in 94 cases with adenocarcinoma, but there was no statistical significance in 57 cases with squamous cell carcinoma. According to Cox's model, the pathological stage, ras mutation and p53 mutation were found to be independent prognostic factors. Our results suggest that ras and p53 mutations were independent unfavourable prognostic markers especially in the early stage of NSCLC or in adenocarcinoma.


A comparative study of modulatory interaction between cytokines and apoptotic proteins among Scleroderma patients with and without pulmonary involvement.
Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are the most eminent forms of pulmonary involvement in Scleroderma. In this study we investigate the interaction between cytokines and apoptotic proteins in treatment naive Scleroderma (SSc) patients with and without pulmonary involvement. Newly diagnosed treatment naïve Scleroderma (SSc) patients (n = 100) and healthy controls (n = 100) were enrolled. Patients were classified as ILD-SSc, PAH-SSc and non-pulmonary SSc (np-SSc). Study variables like mRSS score, autoantibody profile, serum cytokines, serum TGF-β (1,2,3) and apoptotic proteins were assessed for these patients. Scleroderma patients showed elevated levels of serum cytokines, but significantly lower IL-22 and TGF- β1 when compared to healthy controls (p < 0.05). Apoptotic proteins were significantly elevated among Scleroderma patients, but the patient groups also showed significant lower caspase 1/3/9 levels when compared to healthy controls (p < 0.05). ILD-SSc patients reported higher mRSS score (p = 0.0436) when compared with PAH-SSc and np-SSc. In ILD-SSc patients, finger tightening (p = 0.0481) and calcinosis/lesions (p = 0.0481) were significant clinical presentations whereas, digital ulcers were significantly prominent in np-SSc patients (p = 0.0132). Elevated TGF-β3 levels (p = 0.02) in SSC-ILD and reduced IL-4 levels (p = 0.02) in SSC-PAH were significant cytokines as compared to np-SSc. Significant correlations were obtained among serum cytokines and apoptotic proteins in Scleroderma patients with and without pulmonary involvement. (p < 0.05) CONCLUSION: Our study highlights the correlation between mRSS score, cytokines and apoptotic proteins in SSc patients with pulmonary involvement. A longitudinal follow up in these patients with assessment of these immunological parameters may be helpful in monitoring the disease.


Fusion of Preoperative and Postoperative Imaging May Predict the Diagnostic Yield of Stereotactic Needle Brain Biopsies.
Stereotactic needle brain biopsy is a commonly used neurosurgical procedure. However, up to 15% of biopsies result in undiagnostic pathology reports. Repeat biopsy or continued management without a diagnosis are often considered after undiagnostic biopsies. There have been no reports about the role of postoperative imaging in predicting the diagnostic yield of stereotactic biopsies. We retrospectively assessed all stereotactic biopsies performed over an 11-year period. We performed fusion of immediate postoperative computed tomography (CT) with preoperative MRI, to document whether the air bubble in the postoperative CT was located within the targeted lesion. We then evaluated the association of this fusion-based accuracy assessment with the diagnostic yield of the biopsy. Fewer than 5% of biopsies did not have an air bubble on postoperative CT. A total of 226 biopsies were performed for 219 patients. In our sample, 213 of 226 biopsies were accurate (94.2% accuracy rate), and 203 of 226 biopsies gave a definitive diagnosis (89.8% diagnostic rate). In those cases where the fusion was accurate, the diagnostic rate was 93.9%. When the fusion was inaccurate, the diagnostic rate was only 23.1% (odds ratio 51.5, 95% confidence interval 12.6-210.44, P < 0.001). Of all patient, imaging, surgical, and admission parameters, the only parameter that correlated with diagnostic outcome of the biopsy was the fusion construct accuracy. Fusion of immediate postoperative CT with preoperative imaging is predictive of the diagnostic rate. In cases where the pathology report following a biopsy is not diagnostic, this fusion may be useful in making decisions regarding repeat biopsy or considering other diagnostic options.


Influence of test tasks with different cognitive demands on salivary cortisol concentrations in school students.
This study aimed to investigate the effects of test tasks with different cognitive demands on salivary cortisol concentrations in school students. The salivary cortisol levels of 93 students (56 males and 37 females, mean age 17.86 yrs.) were measured before and after 2 brief tests and 2 control situations, respectively. One of the tests comprised reproductive, the other transfer and problem-solving tasks. In the control groups, students were instructed to either write whatever they want, or to wait. Statistical analysis (ANOVA) indicated a significant main effect of the experimental treatment on the cortisol response. The cortisol increase was significantly higher following the reproduction tasks as compared to both control conditions. Although not significant the cortisol increase during reproduction tasks was over twice as much in males compared to females. In contrast the increase during transfer and problem solving tasks does not differ significantly from the control conditions under which the cortisol concentration remains nearly the same and decreases respectively. These findings indicate an influence of the task demand on the cortisol concentration. Furthermore, it can be assumed that reproduction tasks in particular have the potential to be a major stressor during school examinations.


[Sleep disorders in children with attention-deficit hyperactivity disorder--results of a polysomnographic study].
We report results of a polysomnographic study carried out with children aged 6 to 12 years with either ADHD or a sleep disorder. The study focussed on whether the sleep structure and architecture of n = 36 ADHD children with and without sleep disorders differed from that of either n=15 children with sleep disorders or n=87 children without sleep disorders. Moreover, we assessed whether there was an increased risk for co-morbid sleep-related breathing disorders among ADHD children. All children underwent polysomnography in a paediatric clinic. Principal variables of the sleep structure and architecture as well as cardiorespirographic measures were analysed. Our findings demonstrate that sleep problems in children with ADHD seem to be unspecific concurrent symptoms since the sleep structure of sleep-disordered ADHD children and children with sleep disorders was similar. Only minor differences were found between non-sleep-disturbed ADHD children and healthy children without sleep problems. We conclude that sleep problems in ADHD are independent co-morbid symptoms without any pathogenetic relationship to vigilance functions in ADHD. The cardiorespirographic analyses showed that a subgroup of ADHD children with sleep problems may be at increased risk for co-morbid sleep-related breathing disorder. This finding is potentially important for differential diagnostic considerations in ADHD.


Preservation of the anus in the therapy of distal rectal cancers.
Using the gold standard of APR as a measure of cancer control, sphincter-sparing procedures appear to provide similar rates of local control and survival. Specifically, for T1, T2, and T3 lesions, local excision alone, local excision plus adjuvant therapy, and low anterior resection with coloanal anastomoses, respectively, have proven to be acceptable forms of therapy. However, questions remain as to the significance of certain prognostic factors, such as lymphatic invasion with regard to the treatment plan for patients with low rectal cancers. Lastly, quantitative studies addressing the issue of the function of the spared anal sphincters after surgery with or without adjuvant therapy, and how this relates to the patient's quality of life, need to be performed.


A new patient focused index for measuring quality of life in persons with severe and persistent mental illness.
The quality of life in persons with severe and persistent mental illness is often poor. Most treatment programmes have the goal of increasing quality of life. Unfortunately, existing methods to assess quality of life are cumbersome and oriented towards research rather than clinical settings. This study describes preliminary steps in the development, testing and application of a new patient focused index for measuring quality of life in persons with severe mental illness. The Quality of Life Index for Mental Health (QLI-MH) differs from existing instruments in that it is based on an easy to use, self-administered questionnaire that assesses nine separate domains that together encompass quality of life. Each domain can be individually weighted depending on its relative importance to the patient. Different parts of the instrument solicit information from the patient, the primary clinician, and, when available, the family. The instrument and its scoring system address limitations of previous approaches to quality of life measurement.


Lineage and non-lineage related expression of an anti-teratocarcinoma monoclonal antibody reactivity in the post-implantation embryo and adult mouse.
Distribution of monoclonal antibody 2C5 reactivity is studied in post-implantation embryonic material and the adult mouse. Reactivity of 2C5 monoclonal antibody, raised against PC13 embryonal carcinoma, is reduced on in vitro differentiation of teratocarcinoma stem cells. 2C5 antibody reacts with embryonic and extraembryonic endoderm in the post-implantation egg cylinder. Rathke's pouch at the tenth day and primordial germ cells at the thirteenth day of gestation express 2C5 antigen. In the adult, detectable 2C5 antigen expression is limited to the thymus, pituitary body and female reproductive tract. The apparent non-lineage related expression of 2C5 monoclonal antibody and the reactivities of other monoclonal antibodies are discussed.


Does cognitive decline/dementia increase Delirium risk after stroke?
Delirium is a common contributor to mortality and hospital costs in stroke patients. Different observational studies have showed inconsistent results regarding the association between cognitive decline/dementia and delirium after acute stroke. Therefore, we performed this meta-analysis with the aim of determining whether cognitive decline/dementia is related to the risk of delirium after acute stroke. We systematically searched PubMed, Embase, Google Scholar, and Web of Science for relevant studies from inception to September 2020. We calculated the pooled odds ratio (OR) with 95% confidence interval (CI) by using fixed or random effects models based on heterogeneity measured by the I2 index. The association between cognitive decline/dementia and post-stroke delirium was examined in 13 studies with 3183 participants. After pooled analysis, we found that cognitive decline/dementia was significantly associated with susceptibility to delirium in post-stroke patients (OR = 3.70, 95%CI: 2.90-4.71, P < 0.001). Subgroup analysis suggested that cognitive decline/dementia was associated with an increased risk of delirium in Caucasians (OR = 3.73, 95%CI: 2.73-5.11, P < 0.001), non-Caucasians (OR = 3.65, 95%CI: 2.50-5.33, P < 0.001), samples with <200 subjects (OR = 3.70, 95%CI: 2.17-6.31, P < 0.001), samples with ≥200 subjects (OR = 3.70, 95%CI: 2.82-4.85, P < 0.001), studies published in 1990-2009 (OR = 3.17, 95%CI: 1.48-6.77, P = 0.003), and studies published in 2010-2020 (OR = 3.76, 95%CI: 2.92-4.86, P < 0.001). We identified an association between cognitive decline/dementia and the risk of developing delirium. Cognitive decline/dementia may be a promising predictor for delirium in post-stroke patients.


Below background levels of blood lead impact cytokine levels in male and female mice.
A number of studies have documented that Pb exerts immunotoxic effects on T lymphocytes. In studies designed to explore this general response over a broad dose range, female Swiss mice were administered six different diets containing Pb acetate 1 day after mating. During lactation, the mothers received the same feed given during pregnancy, and the same diets were administered to the offspring for 9 months after weaning. At the end of exposure, blood Pb level in the offspring was determined, and possible changes in two type 1 cytokines (IL-2, INF-gamma) and one type 2 cytokine (IL-4) in the serum were measured. At higher dietary Pb levels (40 and 400 ppm), a significant increase in IL-4 production was associated with a profound decrease in INF-gamma and IL-2 production. At the lowest Pb diet level (0.02 ppm), which resulted in a blood lead level of (0.8 microg/dL), which is below background (2-3 microg/dL) values in humans, increases in INF-gamma and IL-2 production along with a significant decrease in IL-4 production were observed. The findings provide evidence of a reversal of lead-induced cytokine skewing depending on the blood lead concentration. As blood lead concentration increases, there is a notable skewing toward Th2, while the pattern is reversed favoring Th1 development at lower blood lead values. The present findings are also notable since they indicate the potential for dietary Pb to have significant biological effects below normal background concentrations.


Wavefront analysis to diagnose blunt trauma-induced Weigert ligament dialysis: Isolated peripheral posterior lenticonus.
A 15-year-old male patient presented with vision loss after blunt trauma to the right eye and with clinical evidence of posterior lenticonus. The posttraumatic lenticonus was eccentric (superotemporal). Irregular astigmatism with high myopia on dilated retinoscopy within the lenticonus, localized posterior convexity of peripheral capsule on ultrasound biomicroscopy, and increased higher-order aberrations (HOAs) on wavefront aberrometry compared with fellow-eye findings confirmed the diagnosis. To our knowledge, acquired peripheral posterior lenticonus representing dialysis of Weigert ligament after acute blunt trauma is a new finding. This case provides an insight into the pattern of higher HOAs associated with any type of lenticonus.


Solution structure of human proinsulin C-peptide.
The C-peptide of proinsulin is important for the biosynthesis of insulin, but has been considered for a long time to be biologically inert. Recent studies in diabetic patients have stimulated a new debate about its possible regulatory role, suggesting that it is a hormonally active peptide. We describe structural studies of the C-peptide using 2D NMR spectroscopy. In aqueous solution, the NOE patterns and chemical shifts indicate that the ensemble is a nonrandom structure and contains substructures with defined local conformations. These are more clearly visible in 50% H2O/50% 2,2,2-trifluoroethanol. The N-terminal region (residues 2-5) forms a type I beta-turn, whereas the C-terminal region (residues 27-31) presents the most well-defined structure of the whole molecule including a type III'beta-turn. The C-terminal pentapeptide (EGSLQ) has been suggested to be responsible for chiral interactions with an as yet uncharacterized, probably a G-protein-coupled, receptor. The three central regions of the molecule (residues 9-12, 15-18 and 22-25) show tendencies to form beta-bends. We propose that the structure described here for the C-terminal pentapeptide is consistent with the previously postulated CA knuckle, believed to represent the active site of the C-peptide of human proinsulin.


Multi-components of T2 relaxation in ex vivo cartilage and tendon.
The multi-components of T2 relaxation in cartilage and tendon were investigated by microscopic MRI (microMRI) at 13 and 26 microm transverse resolutions. Two imaging protocols were used to quantify T2 relaxation in the specimens, a 5-point sampling and a 60-point sampling. Both multi-exponential and non-negative-least-square (NNLS) fitting methods were used to analyze the microMRI signal. When the imaging voxel size was 6.76 x 10(-4)mm3 and within the limit of practical signal-to-noise ratio (SNR) in microscopic imaging experiments, we found that (1) canine tendon has multiple T2 components; (2) bovine nasal cartilage has a single T2 component; and (3) canine articular cartilage has a single T2 component. The T2 profiles from both 5-point and 60-point methods were found to be consistent in articular cartilage. In addition, the depletion of the glycosaminoglycan component in cartilage by the trypsin digestion method was found to result in a 9.81-20.52% increase in T2 relaxation in articular cartilage, depending upon the angle at which the tissue specimen was oriented in the magnetic field.


Amyloid-β: Structure, Function, and Pathophysiological Significance in Neurodegenerative Diseases.
The rate of dementia continues to increase worldwide; however, there currently exist no therapeutic strategies for this condition [...].


Impact of anatomical liver resection on patient survival in KRAS-wild-type colorectal liver metastasis: A multicenter retrospective study.
Liver resection is a standard therapy for colorectal liver metastasis. However, the impact of anatomical resection and nonanatomical resection on the survival in patients with Kirsten rat sarcoma-wild-type and Kirsten rat sarcoma-mutated colorectal liver metastasis remain unclear. We investigated whether anatomical resection versus nonanatomical resection improves survival in colorectal liver metastasis stratified by Kirsten rat sarcoma mutational status. Among 639 consecutive patients with colorectal liver metastasis who underwent primary liver resection between January 2008 and December 2017, 349 patients were excluded due to their unknown Kirsten rat sarcoma mutational status, or due to receiving anatomical resection with concomitant non-anatomical resection, radiofrequency, or R2 resection. Accordingly, 290 patients with colorectal liver metastasis were retrospectively assessed. The relationships between resection types and survival were investigated in Kirsten rat sarcoma-wild-type and -mutated groups. Anatomical resection was performed in 77/186 (41%) and 44/104 (42%) patients with Kirsten rat sarcoma-wild-type and Kirsten rat sarcoma-mutated genetic statuses, respectively. For both, the clinical-pathologic factors were comparable, except a larger maximum tumor size and surgical margin were observed in anatomical resection cases. Anatomical resection patients had significantly longer recurrence-free survival and overall survival than nonanatomical resection cases in the Kirsten rat sarcoma-wild-type group (recurrence-free survival, P < .001; overall survival, P = .005). No significant recurrence-free survival or overall survival differences were observed between Kirsten rat sarcoma-mutated anatomical resection and non-anatomical resection (recurrence-free survival, P = .132; overall survival, P = .563). Although, intrahepatic recurrence in Kirsten rat sarcoma-wild-type and -mutated colorectal liver metastasis was comparable (P = .973), extrahepatic recurrence was increased in Kirsten rat sarcoma-mutated versus -wild-type colorectal liver metastasis (P < .001). In contrast to Kirsten rat sarcoma-mutated colorectal liver metastasis with higher extrahepatic recurrence after liver resection, local liver control via anatomical resection improved the postoperative survival in patients with Kirsten rat sarcoma-wild-type colorectal liver metastasis.


Lipoprotein-elastin interactions in human aorta fibrous plaque lesions.
The nature of lipoprotein and elastin associated with hyaluronate in human atherosclerotic plaque tissue was studied by digesting the tissues with elastase. The elastase-solubilized lipoprotein-hyaluronate complexes, isolated by Bio-Gel A-50m column chromatography, contained 7.8 mg calcium/100 mg protein. The Sephadex G-200 chromatography of delipidated complexes yielded high (fraction I) and low (fraction II) molecular weight protein fractions. Dialysis of the complexes against 0.01% EDTA resulted in removal of fraction II. Fraction I reacted immunologically against antihuman LDL, and its amino acid composition resembled that of human apoB. Fraction II contained 5 peptide fragment and had high levels of nonpolar amino acids that are characteristic of elastin. However, these peptides also contained high levels of polar amino acids, thus resembling the plaque elastin. These findings suggest that certain regions of plaque elastin may have affinity for apoB containing lipoproteins and calcium.


Development and evaluation of a novel sterilizer with rotary vibrators.
A novel steam-air sterilizer with rotary vibrators was developed with the aim of promoting heat transfer and the effective sterilization of foods. To evaluate the effects of the sterilizer, experiments to examine heat transfer and sterilization tests were carried out. In the experiments to examine heat transfer, heat penetration factors of sterilizer with vibration, j and fh values, were 1.70 and 1.50, respectively, while those of sterilizer without vibration were 1.83 and 2.32, respectively. In the sterilization with vibration, no surviving cells were detected after 3 min, whereas 7 min were required for sterilization without vibration. The rate of the amino carbonyl reaction was repressed by heat treatment with vibration.


3'-end fluorochromized and haptenized oligonucleotides as in situ hybridization probes for multiple, simultaneous RNA detection.
We have used fluorescein-, digoxigenin- and biotin-(di)deoxyXTPs and terminal deoxynucleotidyl transferase for small scale labeling of synthetic oligonucleotide probes and here we show the applicability of such probes for the in situ detection of multiple RNA sequences. The enzymatic 3'-end-labeling methods proved to be good alternatives for the chemical fluorochrome and hapten labeling of 5'-end alkylamino-derivatized oligonucleotides. By combining 3'-end fluorescein-, biotin-, and digoxigenin-labeled oligonucleotides, double and triple hybridizations are feasible. For example, we demonstrated simultaneously mRNAs coding for caudodorsal cell hormone, a molluscan insulin-related peptide, and 28 S ribosomal RNA in cryostat sections of the cerebral ganglia of the pond snail Lymnaea stagnalis.


Breath-holding and tidal breathing nasal NO to screen children for Primary Ciliary Dyskinesia.
Nasal nitric oxide (nNO) measurement is recommended to screen for Primary Ciliary Dyskinesia (PCD) in subjects with suggestive history and symptoms. Clinical use of alternative methods (i.e., breath-hold [BH], tidal breathing [TB]) in children unable to perform the gold standard slow Exhalation against a Resistance (ER) method has not been sufficiently evaluated. We extracted retrospectively (2013-2019) 454 files (374 subjects) containing nNO results. Median [IQR] age at inclusion was 7.0 [4.7-11.0] years, 105 (28.1%) children were younger than 5 years. ER or BH methods were more frequently mastered by children older than 5 years compared to younger children (69.4% and 52.7% vs. 21% and 5.6%, respectively; p < .0001), the latter succeeding only in TB measurement in 77.4% of cases. In 130 files with both ER and BH measurements (nNO-ER and nNO-BH), nNO-BH was 102 [96.2; 108.3]% that of nNO-ER. In 175 files including nNO-ER and nNO-TB measurements, nNO-TB was 64.4 [IQR: 53.7; 80.4]% that of nNO-ER with an excellent correlation between nNO values (r = .94 [95% CI 0.91; 0.95]; p < .0001) and discordance in the interpretation of nNO results in 16 (10.2%) cases. Final PCD diagnosis was similar in patients included before or after 5 years of age (confirmed 16 (15.2%) and 48 (17.8%); excluded 81 (77.1%) and 192 (71.4%), respectively; p = .32). In conclusion, reliable nNO-BH and nNO-ER results are interchangeable. Children tested with ER or with TB method have similar final PCD diagnosis. Alternative methods to measure nNO might be studied further for use in clinical practice.


[Potential risk to patient safety by discontinuation of production of classical T-drains? : Nationwide survey in Germany and statement of the surgical working group for liver, gall bladder and pancreatic diseases (CALGP) of the German Society for General and Visceral Surgery (DGAV)].
The revision of the medical device regulation (MDR) legislation by the European Union and supplementations by the member states has been implemented for good reasons but causes dramatic side effects. It is no longer allowed to produce some rarely used medical devices by various manufacturers that have been successfully used for decades. Before production, a new application to the MDR would be necessary, which is not a realistic business case for companies producing rarely used devices. This problem currently relates to the Kehr T‑drain made from soft rubber or latex that has been in use since the late nineteenth century. A surgically placed T‑drain, although rarely necessary nowadays, is still in use worldwide for special indications in an attempt to avoid severe complications. These special indications include complex hepato-pancreato-biliary (HPB) procedures and perforations of the upper gastrointestinal (GI) tract where T‑drains may be used to secure the hepatojejunostomy or to create a stable fistula. The HPB working group (CALGP) of the German Society of General and Visceral Surgery (DGAV) provides a statement from a surgical perspective on this matter after a survey of all its members. Politics should be very careful not to generalize when implementing useful new regulations at a European and national level. Established and comprehensible treatment concepts should not be restricted and exemption permits should be quickly granted in these cases because the discontinuation of these niche products may lead to potential patient safety issues and even fatalities.


Gaps in Care and Support for Patients With Advanced Breast Cancer: A Report From the Advanced Breast Cancer Global Alliance.
Although new therapeutic options continue to improve disease-related outcomes in advanced breast cancer (ABC), enhanced focus is needed to improve quality of life for patients currently living with ABC. In November 2019, a multidisciplinary workshop to explore patient perceptions of their information and support needs was held at the ABC Global Alliance Annual Meeting in Lisbon, Portugal. Ninety-two attendees from 27 countries participated in the workshop. Several key unmet needs were identified and discussed in the workshop, including the following: (1) Significant patient knowledge gaps exist related to the diagnosis and management of ABC, and the availability of patient-focused information to support these gaps in knowledge remains limited. (2) The development of meaningful relationships between patients and health care professionals, and the role of patients in decision making, is often overlooked for patients with ABC. (3) Multidisciplinary care approaches are crucial for patients with ABC; however, these often lack effective coordination. (4) Access to clinical trials for ABC also remains limited. (5) Caregivers, friends, and family members do not receive sufficient guidance to support patients with ABC and manage their own well-being. The variety of unmet needs explored in the workshop demonstrates that patients with ABC still face considerable challenges related to quality of care and support, which will not be resolved until tangible action is taken. Issues highlighted in the workshop should be prioritized by working groups to shape the development of community-based solutions. There is a need for the global community to act proactively to maximize awareness of these ongoing unmet needs and existing resources, while socializing and building new initiatives and resources that will help to close these gaps for patients.


Induced and spontaneous abortion and breast cancer risk: results from the E3N cohort study.
Recent reviews reach conflicting conclusions on breast cancer risk after spontaneous or induced abortion. E3N is a large-scale cohort study collecting detailed information on environmental and reproductive factors. We investigated the relation between breast cancer and a history of induced and/or spontaneous abortion, using the data from the 100,000 women aged 40-65 at entrance in 1990. Among them, over 2,600 new invasive breast cancers had been diagnosed by June 2000. Multivariate analysis, adjusted for known potential confounders, showed no association between a history of induced abortion and breast cancer risk either in the whole population (relative risk [RR] = 0.91, 95% confidence interval [CI] 0.82-0.99) or in subgroups defined by parity or by menopausal status. Overall, the association between spontaneous abortion and breast cancer was not significant (RR = 1.05, 95% CI 0.95-1.15). However, there is a suggestion of increased risk with increased number of miscarriages (RR = 1.20, 95% CI 0.92-1.56 after 3 or more). Moreover, an interaction with menopausal status was observed. In premenopause, the risk decreased with increasing number of spontaneous abortions, whereas it increased in postmenopause. Among nulliparous and parous women, the relative risk estimates were respectively equal to 1.16 (95% CI 1.04-1.30, p trend < 0.0008) and 1.14 (95% CI 1.01-1.28, p trend = 0.005). Premenopausal breast cancer, on the other hand, appeared to be less frequent in women who had had repeated miscarriages. We conclude that there is no relationship between breast cancer and induced abortion but that an association with spontaneous abortion is possible and may depend on menopausal status.


De novo synthesis and salvage pathway coordinately regulate polyamine homeostasis and determine T cell proliferation and function.
Robust and effective T cell-mediated immune responses require proper allocation of metabolic resources through metabolic pathways to sustain the energetically costly immune response. As an essential class of polycationic metabolites ubiquitously present in all living organisms, the polyamine pool is tightly regulated by biosynthesis and salvage pathway. We demonstrated that arginine is a major carbon donor and glutamine is a minor carbon donor for polyamine biosynthesis in T cells. Accordingly, the dependence of T cells can be partially relieved by replenishing the polyamine pool. In response to the blockage of biosynthesis, T cells can rapidly restore the polyamine pool through a compensatory increase in extracellular polyamine uptake, indicating a layer of metabolic plasticity. Simultaneously blocking synthesis and uptake depletes the intracellular polyamine pool, inhibits T cell proliferation, and suppresses T cell inflammation, indicating the potential therapeutic value of targeting the polyamine pool for managing inflammatory and autoimmune diseases.


A nurse-led service to provide palliative care in the community.
Jersey Hospice Care, established in 1982, provides a care and support service for the community. The service includes provision of palliative care, focusing on pain assessment and control. Mainly a home-care service, it is supported by a day hospice, lymphoedema service, the provision of complementary therapies, a six-bed in-patient unit and a bereavement service.


Was it Ewing's? A Diagnostic and Therapeutic Dilemma.
We present an atypical case of histopathology suggesting hemangioendothelioma and immunohistochemistry-proven Ewing's sarcoma in a 39-year-old lady who presented with multiple stony hard swellings involving the occipital region of the scalp, right cervical lymph node, right scapular region, left infraclavicular region of the chest, right anterior abdominal wall swelling, and inner aspect of right thigh. She underwent left-sided below-knee amputation for parosteal osteosarcoma in the left distal tibia 3 years back. Palliative radiotherapy with dose of 30 Gy in 10 fractions over 2 weeks was administered to the right neck and right upper back following which she attained moderate pain relief but no reduction in swellings as was expected had it been a case of hemangioendothelioma or Ewing's sarcoma..


An exploration of technology acceptance among nursing faculty teaching online for the first time at the onset of the COVID-19 pandemic.
The COVID-19 pandemic has brought to the forefront the importance for schools of nursing to use creative and innovative tools that are of high quality and accessible to learners. Faculty who may have been resistant to teaching online prior to the pandemic, no longer had the option to teach face-to-face and were mandated to teach online despite any apprehensions they may have had. The purpose of this study was to learn more about faculty attitudes and acceptance of teaching online by applying the Technology Acceptance Model to nursing faculty teaching online for the first time during the COVID-19 pandemic. This descriptive-correlational study used an online survey tool to explore factors related to technology acceptance among nursing faculty teaching online for the first time during the COVID-19 pandemic. A sample of 87 full-time and part-time nursing faculty completed an adapted version of the Faculty Acceptance Survey. Findings from this study revealed an overall enjoyment of teaching online, confidence in online teaching skills and comfort with technology. However, findings also indicated struggles with workload balance, inferior interactions with students and the need for additional support. Findings from this study demonstrate that nursing faculty are generally accepting of technology and positive outcomes are possible if identified concerns are addressed and positive feelings are fostered and supported.


Time course of inflammatory response after renal artery stenting in patients with atherosclerotic renal stenosis.
Inflammatory response has been demonstrated in patients with coronary artery disease after percutaneous coronary intervention (PCI). Such response following renal artery stenting has not yet been established, however, in patients with atherosclerotic renal artery stenosis. A total of 44 patients were enrolled in this study. Of them, 22 patients with atherosclerotic renal artery stenosis received renal angioplasty with stent (group A, mean age 51+/-8 years), and 22 patients with age- and gender-matched underwent renal angiography for diagnostic purpose as a control group (group B, age 50+/-8 years). The peripheral blood samples were taken immediately before the procedure, 1, 6 and 24 h after the procedure in both groups. The concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured using ELISA. The result showed that there was no difference in clinical characteristics and baseline levels of CRP and IL-6 between the groups. The IL-6 increased in the first hour (before: 5.8+/-3 pg/ml; 1 h: 8.6+/-5 pg/ml, p<0.01), lasted at 6 h (12.2+/-8 pg/ml), returned to baseline at 24 h (5.4+/-3 pg/ml) in group A. The CRP did not changed at the first hour after stenting, but mean CRP increased from 0.30+/-0.09 to 0.37+/-0.15 mg/dl at 6 h (p<0.05), and peaked at 24 h (0.43+/-0.18 mg/dl, p<0.001 compared with baseline and control) after stenting in group A, while no such changes were observed in group B (p>0.05 at different time points compared with baseline and group B, respectively). The data indicated that renal artery stenting could trigger inflammatory response by evidence of increased plasma levels of CRP and IL-6. IL-6, however, was an early initiator of inflammatory cytokine, and CRP was a later marker of systemic inflammatory response to renal artery stenting.


Macular dystrophies associated with Stargardt-like phenotypes.
Stargardt-like phenotype has been described as associated with pathogenic variants besides the ABCA4 gene. This study aimed to describe four cases with retinal appearance of Stargardt disease phenotypes and unexpected molecular findings. This report reviewed medical records of four patients with macular dystrophy and clinical features of Stargardt disease. Ophthalmic examination, fundus imaging, and next-generation sequencing were performed to evaluate pathogenic variants related to the phenotypes. Patients presented macular atrophy and pigmentary changes suggesting Stargardt disease. The phenotypes of the two patients were associated with autosomal dominant inheritance pattern genes (RIMS1 and CRX) and in the other two patients were associated with recessive dominant inheritance pattern genes (CRB1 and RDH12) with variants predicted to be pathogenic. Macular dystrophies may have phenotypic similarities to Stargardt-like phenotype associated with other genes besides the classic ones.


Exploring the Sustainability of Age-Friendly Initiatives in a Canadian Province.
Based on the World Health Organization Age-Friendly Cities and Communities (AFCC) framework, the government of Manitoba, Canada, launched a province-wide age-friendly initiative in 2008. The objective of this study was to explore the sustainability of the AFCC initiative more than a decade later. The study was guided by conceptualizations of sustainability as multidimensional and dynamic, composed of 4 aspects (continued capacity, institutionalization, continued benefits, and development/adaptation), and an ecologic perspective that highlights the importance of contextual influences, and their change over time, on AFCC activities. The study involved a qualitative, multiple case study design. Semistructured interviews were conducted in 2020 with a key informant from each of 52 AFCC. Interview data were analyzed deductively, guided by the sustainability framework and an ecologic perspective. Census data were used to describe the demographic characteristics of AFCC. We identified 6 groups of AFCC initiatives that varied in degree from the most to the least sustainable: active, in hiatus, reorganized, stalled, discontinued, and never got off the ground. Both local community factors (e.g., lack of capacity) and broader contextual factors, such as demographic changes and provincial legislations, influenced initiatives' sustainability. AFCC initiatives can range in their degree of sustainability and can wax or wane over time. Ongoing external support for AFCC (e.g., from provincial or state government) to promote the vision of age-friendliness and to address lack of capacity (e.g., to assist with community assessments) could help with the long-term sustainability of initiatives.


Psychosocial Assessment Rather Than Severity of Liver Failure Dominates Selection for Liver Transplantation in Patients With Alcohol-Related Liver Disease.
The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a validated interview tool to assess psychosocial well-being in candidates for solid organ transplants, with higher scores indicating greater vulnerability. We hypothesized that patients with alcohol-related liver disease (ALD) undergoing liver transplantation (LT) evaluation would have higher SIPAT scores than candidates with non-ALD, but that only patients with ALD who have low scores would be selected. We analyzed retrospectively consecutive adults undergoing LT evaluation from June 2018 to December 2019. Comparisons between patients with ALD and patients with non-ALD were made using the nonparametric Wilcoxon rank sum test plus a multivariate analysis to determine independent predictors for approval. In the study cohort of 358 patients, there were 199 (56%) patients with ALD with a mean age of 55 years, and 133 (67%) were men. There were 159 (44%) patients with non-ALD with a mean age of 57 years, and 95 (60%) were men. Mean Model for End-Stage Liver Disease-sodium scores were similar for selected versus not selected patients with ALD (25 versus 25.6) and selected versus not selected patients with non-ALD (18.3 versus 17.4), although the ALD group had substantially higher Model for End-Stage Liver Disease scores. Patients with ALD had higher mean SIPAT composite and individual domain scores compared with their non-ALD counterparts. SIPAT scores were not affected by age or sex. Proportionately more candidates with non-ALD were selected compared to candidates with ALD (68% versus 42%; P < 0.001; odds ratio for approval of non-ALD versus ALD, 2.9; 95% confidence interval, 1.8-4.7; P < 0.001). Composite SIPAT scores were lower in the selected versus nonselected in both ALD and non-ALD groups, although the SIPAT scores were significantly higher in selected patients with ALD (median, 39) than selected patients with non-ALD (median, 23; P = 0.001). Psychosocial assessment has a greater influence than acuity of liver failure on the selection of patients with ALD for LT listing, whereas psychosocial assessment has a minor influence on the selection of non-ALD candidates.


Successful wound healing of refractory digital ulcer in patient with systemic sclerosis by Waon therapy.
The treatment of digital ulcer (DU) in systemic sclerosis (SSc) has not been established. A 77-year-old female with a refractory DU in SSc on the right foot was transferred to our hospital. Wound healing had not been achieved despite several endovascular treatments (EVT) and minor amputations. We started Waon therapy 5 days per week as an adjunct therapy. She was placed in a far-infrared-ray dry sauna maintained at 45 °C for 15 min, and was subsequently kept to rest with soothing warmth using a blanket for additional 30 min outside the room. Gradually, the wound had become smaller and the skin perfusion pressure (SPP) had increased. The increase of the blood flow to the wound could be observed in the angiogram on day 109. An additional EVT on day 109 also accelerated wound healing. Finally, wound healing was completely achieved without additional amputations on day 173. In this presented case, Waon therapy contributed to increase of the blood flow to the wound, evidenced by SPP value. Waon therapy may serve as an effective adjunct therapy of DU in SSc. <Learning objective: Digital ulcer (DU) frequently occurs in patients with systemic sclerosis (SSc). However, the treatment of them has not been established. We experienced a case of complete wound healing of DU in SSc following Waon therapy. Waon therapy has a potential to increase the microcirculation, as evidenced by increased SPP and angiogram. Waon therapy can be considered one option of adjunct therapy for the patient with refractory DU in SSc.>.


Explaining the difference between men's and women's football.
Women's football is gaining supporters and practitioners worldwide, raising questions about what the differences are with men's football. While the two sports are often compared based on the players' physical attributes, we analyze the spatio-temporal events during matches in the last World Cups to compare male and female teams based on their technical performance. We train an artificial intelligence model to recognize if a team is male or female based on variables that describe a match's playing intensity, accuracy, and performance quality. Our model accurately distinguishes between men's and women's football, revealing crucial technical differences, which we investigate through the extraction of explanations from the classifier's decisions. The differences between men's and women's football are rooted in play accuracy, the recovery time of ball possession, and the players' performance quality. Our methodology may help journalists and fans understand what makes women's football a distinct sport and coaches design tactics tailored to female teams.


Visible-Light-Driven Redox Neutral Direct C-H Amination of Glycine Derivatives and Peptides with N-Acyloxyphthalimides.
A room temperature, visible-light-promoted and redox neutral direct C-H amination of glycine and peptides has been firstly accomplished by using N-acyloxyphthalimide or -succinimide as nitrogen-radical precursor. The present strategy provides ways to introduce functionalities such as N-acyloxyphthalimide or -succinimide specifically to terminal glycine segment of peptides. Herein, mild conditions and high functional-group tolerance allow the preparation of non-natural α-amino acids and modification of corresponding peptides in this way.


Functional study of mucus secretion of the eustachian tube in Guinea pigs.
Our aim was to verify neural regulation of submucous gland mucus secretions in the Eustachian tubes of guinea pigs. Prospective animal study. Eustachian tubes harvested from 12 guinea pigs were used for this study. For real-time resolution of pure glandular secretion, we used a modified method of single-gland optical measurement. Secretory monitoring was undertaken after each preparation with phenylephrine, isoproterenol, forskolin, and substance P. To confirm the viability of each tissue, we examined glandular secretion after treatment with carbachol. Secretory effects of each agonist were evaluated by comparing with basal secretion using a Student's t test (p < 0.01). The Ca-elevating agonists carbachol and substance P showed greater effects on submucous gland secretions of the Eustachian tube than the cyclic adenosine monophosphate (cAMP)-elevating agonists forskolin and isoproterenol. However, phenylephrine, although it belongs to the Ca-elevating agonist group, did not show any significant secretory effect. The optical measurement method used in this study had the merit of real-time resolution of submucous glandular secretion. Submucous glandular secretion in the Eustachian tube was regulated by both Ca- and cAMP-elevating agonists, and Ca-elevating agonists seemed to be more potent than cAMP-elevating agonists except phenylephrine. Our results suggest that not only the autonomic nerve system but also the neuropeptides such as substance P are closely related to glandular secretion in the Eustachian tube, and beta-adrenergic receptors seem to be more related to submucous glandular secretion of the Eustachian tube in guinea pig than alpha-adrenergic receptors.


IL-17 induces reactive astrocytes and up-regulation of vascular endothelial growth factor (VEGF) through JAK/STAT signaling.
Spinal cord injury is a grave neurological disability resulting in neuron degeneration and permanent paralysis. The inflammation triggered by the injury would promote the spinal cord lesion in turn. Activated astrocytes during inflammatory response could promote glial scar formation and contribute to the progression of the spinal cord injury. Interleukin 17 (IL-17) was upregulated in inflammatory responses to contusion or compression of the spinal cord. in this study, IL-17 could induce reactive astrocytes which was indicated by a well-known hallmark glial fibrillary acidic protein (GFAP) in vitro and in vivo. Moreover, we demonstrated that the upregulation of VEGF was induced by IL-17 human astrocytoma cells. In our further investigation, IL-17 induced the expression of VEGF in spinal cord injury by activating JAK/STAT signaling pathway both in vitro and in vivo. In addition, we also found that IL-17 significantly changed tissue preservation and residual urine volumes and blood-spinal cord-barrier integrity in vivo. This newly found IL-17-JAK/STAT-VEGF axis improves our understanding of the molecular mechanism of spinal cord injury during inflammatory response and provides another potential target of spinal cord injury.


Localization of the gene for human erythrocyte glycophorin C to chromosome 2, q14-q21.
A complementary cDNA clone (900 bp) representing the 3' untranslated region and almost the entire coding sequence of the human erythrocyte membrane glycophorin C has been used to determine the chromosomal location of the blood group Gerbich locus by in situ hybridization. The results indicate that this locus is assigned to the region q14-q21 of chromosome 2.


RF pulse design using the inverse scattering transform.
The inverse scattering transform (IST) is a mathematical transformation that can be used to derive RF pulses from functions called continuous spectra describing the final state of the spin system. This paper reviews three seemingly unrelated numerical algorithms that have appeared in the literature, and shows that they are all derivable from the IST. When the continuous spectra are rational, the finite rank kernel method is used to convert the IST to a matrix equation that is easily solved. Another algorithm, equivalent to the so-called "layer stripping" algorithm used in seismology, is derived by assuming that the spectra are Fourier series. Finally, the Shinnar-Le Roux (SLR) algorithm is derived by assuming that the spectra are ratios of Fourier series. With proper interconversion between the rational, series, and ratio of series forms of the continuous spectra, these algorithms generate RF pulses with identical or nearly identical shapes and performance properties, and can be regarded as equivalent.


Retraction: Serological Predictors for the Recurrence of Atrial Fibrillation After Electrical Cardioversion.
This corrects the article on p.185 in vol.40, PMID: 20421959.


Child Marriage Acceptability Index (CMAI) as an essential indicator: an investigation in South and Central Sulawesi, Indonesia.
Child marriage remains an important social issue in Indonesia. Child marriages were reported from 14.67% in 2008 to 10.82% in 2019. However, 22 out of 34 provinces in Indonesia still had high child marriage rates above the national average in 2019. This study aims to assess child marriage acceptability in the two locations in Indonesia by gender inequality, financial security, education rates, legal frameworks, dowry, and sexual and gender-based violence (SGBV). This study used a quantitative approach with a cross-sectional study design. A total of 1000 respondents consisting of 500 households in Bone District, South Sulawesi and 500 households in Palu, Sigi, and Donggala District in Central Sulawesi participated in the study. Data analyses were conducted based on the Child Marriage Acceptability Index (CMAI) using the bivariate correlation, ANOVA (analysis of variance), and logistic regression. This study found several significant factors that contributed to child marriage acceptance in Central and South Sulawesi: household financial security (p = 0.016), dowry (p < 0.001) and legal frameworks (p = 0.017) based on ANOVA analysis. After conducting a bivariate correlation, dowry (p < 0.001) and sexual and gender-based violence (p < 0.001) remain significant factors. Dowry (p < 0.001), with expected B = 0.122, and sexual and gender-based violence (p < 0.001, with expected B = 0.064) remains significant after the linear regression analysis. Dowry practice and sexual and gender-based violence were the most significant factors contributing to child marriage acceptance in Central and South Sulawesi. There is a need to conduct interventions to prevent child marriage, including providing sexual and reproductive health education.


Developmental language disorders: cognitive processes, semantics, pragmatics, phonology, and syntax.
Five areas of research concerned with language acquisition--cognitive processes, semantics, pragmatics, phonology, and syntax--are reviewed in terms of their contribution to understanding language disorders. Two views of cognitive processes are discussed. One of these, emphasizing cognitive mechanisms such as short-term memory, is seen as providing possible explanations for some types of language deficits. The other, a concern with conceptual knowledge, is subjected to a critical analysis questioning how complete an explanation it is able to offer for some aspects of language acquisition. Problems of definition are also discussed when semantic aspects of language are considered. Problems in the pragmatic component of language are seen as providing an explanation for particular aspects of language disorder in some autistic children. The importance of focusing on phonology as a central grammatical process is discussed and linked to dyslexia and to spelling disorders. Finally, it is argued that the acquisition of syntactic structure is not yet understood. Impairments such as a hierarchical planning order deficit may affect syntactic ability and lead to disordered language, as found in some types of developmentally aphasic children. It is concluded that it is important to study all five areas of the title, and their interrelationships, if various language disorders are to be adequately understood.


Enhancement of oxygen transfer by pressure pulsation in aqueous glycerol fermentation.
Aeration plays an important role in the production of glycerol by fermentation with yeast. Effective aeration depends on a number of factors, such as amount of air, fineness of air dispersion, rate of agitation, and time of gas-liquid contact. This investigation dealt with the effect of periodic variation in gas pressure on oxygen transfer measured by sulfite oxidation and glycerol fermentation in stirred tanks. The oxygen transfer rate measured with the sulfite oxidation method was improved by 20-30% under the condition of pressure pulsation (PP) at 30 degrees C. The yield and productivity of glycerol were increased by about 26 and 6.8%, respectively, in 48 h by employing a glucose concentration of 250 g/L with PP at 30 degrees C.