Benefits of tai ji quan practice on neuromuscular functions in older adults: A Systematic Review and meta-analysis.
Tai Ji Quan (TJQ) practice has been recommended for reducing falls in older adults, but a gap exists in our understanding of the neuromuscular mechanisms underlying TJQ practice benefits. This study aims to quantify and validate neuromuscular mechanisms underlying TJQ practice benefits in older adults. This review and analysis followed the PRISMA framework. All meta-analyses were performed in R. For healthy older adults, TJQ practice was found to decrease muscle onset latency. Higher leg muscle activations were found during TJQ gait in comparison to normal gait. A significant interaction between TJQ practice time and age of the cohort was observed in muscle onset latency. For adults with pre-existing health conditions, TJQ practice has similar neuromuscular benefits as conventional rehabilitation methods. Neuromuscular function improvements associated with TJQ practice provide a mechanism for reducing falls in older adults with and without pre-existing health conditions.


IFN-α boosts epitope cross-presentation by dendritic cells via modulation of proteasome activity.
We have investigated the molecular mechanisms underlying the peculiar cross-presentation efficiency of human dendritic cells (DCs) differentiated from monocytes in the presence of Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) and Interferon (IFN)-α (IFN-DCs). To this end, we evaluated the capability of IFN-DCs to present and cross-present epitopes derived from Epstein-Barr Virus (EBV) or human melanoma-associated antigens after exposure to cell lysates or apoptotic cells. In an autologous setting, IFN-DCs loaded with Lymphoblastoid Cell Lines (LCL) lysates or apoptotic LCL were highly efficient in expanding, respectively, EBV-specific class II- or class I-restricted memory T cell responses. Of note, IFN-DCs loaded with apoptotic LCL were more potent than fully mature DCs in triggering the cytotoxicity of CD8(+) T lymphocytes recognizing a subdominant HLA-A*0201-restricted epitope derived from EBV latent membrane protein 2 (LMP2). In addition, IFN-DCs loaded with apoptotic human melanoma cells were highly efficient in cross-presenting the MART-1(27-35) epitope to a specific CD8(+) cytotoxic T cell clone, and this functional activity was proteasome-dependent. These IFN-DC properties were associated with an enhanced expression of all the immunoproteasome subunits as well as of TAP-1, TAP-2 and tapasin, and, interestingly, to a higher proteasome proteolytic activity as compared to immature or mature DCs. Altogether, these results highlight new mechanisms by which IFN-α influences antigen processing and cross-presentation ability of monocyte-derived DCs, with potentially important implications for the development of DC-based therapeutic vaccines.


[The epidemiological analysis of Salmonella typhimurium infections in cattle--results of lysotyping and biochemotyping in the region of East Thuringia from 1974 to 1991].
597 strains of Salmonella typhimurium found in samples from cattle in Eastern Thuringia from 1974 to 1991 were investigated to their phage types and biochemotypes. 21 different combined types were found out among which the phage types n.c. 1/72/n. c.(204), 2 b/23 (92) and 1 a/9 (49) dominated at certain times. With the help of two examples it is shown that cases of Salmonellosis with Salmonella typhimurium within one farm occurring one after another can be different infections that are independent from each other. The complex typings are capable to clear up epidemiological connections and therewith support the control of infections and the protection of people's health consequently.


Bidirectional nucleolar dysfunction in C9orf72 frontotemporal lobar degeneration.
An intronic GGGGCC expansion in C9orf72 is the most common known cause of both frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). The repeat expansion leads to the generation of sense and antisense repeat RNA aggregates and dipeptide repeat (DPR) proteins, generated by repeat-associated non-ATG translation. The arginine-rich DPR proteins poly(glycine-arginine or GR) and poly(proline-arginine or PR) are potently neurotoxic and can localise to the nucleolus when expressed in cells, resulting in enlarged nucleoli with disrupted functionality. Furthermore, GGGGCC repeat RNA can bind nucleolar proteins in vitro. However, the relevance of nucleolar stress is unclear, as the arginine-rich DPR proteins do not localise to the nucleolus in C9orf72-associated FTLD/ALS (C9FTLD/ALS) patient brain. We measured nucleolar size in C9FTLD frontal cortex neurons using a three-dimensional, volumetric approach. Intriguingly, we found that C9FTLD brain exhibited bidirectional nucleolar stress. C9FTLD neuronal nucleoli were significantly smaller than control neuronal nucleoli. However, within C9FTLD brains, neurons containing poly(GR) inclusions had significantly larger nucleolar volumes than neurons without poly(GR) inclusions. In addition, expression of poly(GR) in adult Drosophila neurons led to significantly enlarged nucleoli. A small but significant increase in nucleolar volume was also observed in C9FTLD frontal cortex neurons containing GGGGCC repeat-containing RNA foci. These data show that nucleolar abnormalities are a consistent feature of C9FTLD brain, but that diverse pathomechanisms are at play, involving both DPR protein and repeat RNA toxicity.


Inflammatory-miR-301a circuitry drives mTOR and Stat3-dependent PSC activation in chronic pancreatitis and PanIN.
Activated pancreatic stellate cells (PSCs) are the main cells involved in chronic pancreatitis and pancreatic intraepithelial neoplasia lesion (PanIN). Fine-tuning the precise molecular targets in PSC activation might help the development of PSC-specific therapeutic strategies to tackle progression of pancreatic cancer-related fibrosis. miR-301a is a pro-inflammatory microRNA known to be activated by multiple inflammatory factors in the tumor stroma. Here, we show that miR-301a is highly expressed in activated PSCs in mice, sustained tissue fibrosis in caerulein-induced chronic pancreatitis, and accelerated PanIN formation. Genetic ablation of miR-301a reduced pancreatic fibrosis in mouse models with chronic pancreatitis and PanIN. Cell proliferation and activation of PSCs was inhibited by downregulation of miR-301a via two of its targets, Tsc1 and Gadd45g. Moreover, aberrant PSC expression of miR-301a and Gadd45g restricted the interplay between PSCs and pancreatic cancer cells in tumorigenesis. Our findings suggest that miR-301a activates two major cell proliferation pathways, Tsc1/mTOR and Gadd45g/Stat3, in vivo, to facilitate development of inflammatory-induced PanIN and maintenance of PSC activation and desmoplasia in pancreatic cancer.


Quality and Quantity: Evaluating Tumor Biology Alongside Novel Imaging on Diagnosis of Metastatic Hormone-sensitive Prostate Cancer.
Tumor biology may play an important role as an effective predictive biomarker that is complementary to functional imaging for metastatic hormone-sensitive prostate cancer.


Ladies from hell, Aberdeen free gardeners, and the Russian influenza: an anthropometric analysis of WWI-era Scottish soldiers and civilians.
We analyze data on the height of Scottish men, both civilians and members of the military forces serving in World War I measured in the 1910s, in order to provide another window into the biological well-being of late nineteenth-century birth cohorts. The evidence indicates that rural residents still had a distinct height advantage over their urban counterparts and that military men displayed a slower growth profile than did civilians, but mean heights for the two groups of adults were similar. Mean stature for both groups is well above those found by Floud for British troops born in the 1880s and greater than that of Scottish convicts from the 1830s. Men who were in utero between 1889 and 1893 were slightly stunted, "marked for life" by an encounter with the Russian influenza which struck the region repeatedly.


[Detection of adverse events using trigger tools in 2hospital units in Spain].
Adverse events (AE) related to health care are frequent due to the nature of this activity, and for this reason, it is necessary to develop methods to detect them and prevent their recurrence. One of these methods uses what are called trigger tools, which are markers that allow AE to be identified retrospectively for subsequent analysis. To evaluate the usefulness of a trigger tools system to detect AE related to patient safety in Internal Medicine and General Surgery units of a tertiary referral hospital. As secondary objectives, measurements were made of the rate of AE, its prevalence in admissions, as well as a description of the different types of AE, and to evaluate the time spent using this tool. A retrospective descriptive study of patients admitted to the units of Internal Medicine and General Surgery and discharged during 2016. Inclusion criteria were hospital stay over 24h and the presence of a complete clinical record of the studied acute episode. Patients admitted to short-stay units were excluded. A verification questionnaire was designed to registry key study variables and associated AE. The study included 118 patients from Internal Medicine and 115 from General Surgery. The presence of at least one trigger was detected in 86 (72.9%) Internal Medicine and 56 (48.7%) General Surgery patients. Of these, 13 (15.1%) were associated with the presence of an AE in Internal Medicine and 34 (60.7%) in General Surgery. The trigger tool system failed to detect 7 AE, 4 of them in Internal Medicine. The median of triggers identified in each patient was 1.5 (IQR p25-p75: 1-2.5) in Internal Medicine and 2 (IQR p25-p75: 1-4) in General Surgery. In total, 262 positive triggers were detected, of which 157 corresponded to Internal Medicine, most of them related to early emergency re-admission after discharge. Most of the identified AEs required re-hospitalisation or extending the length of stay. Trigger tools systems are useful for the detection and characterisation of AE, which helps to analyse and implement improvement measures.


Effect of dexamethasone on the frequency of postdural puncture headache after spinal anesthesia for cesarean section: a double-blind randomized clinical trial.
In this study, we evaluated the effect of dexamethasone used as a prophylaxis for nausea and vomiting on the incidence of postdural puncture headache (PDPH) in pregnant women receiving spinal anesthesia for cesarean section. In a prospective, randomized, double-blind, placebo-controlled study, 372 women under spinal anesthesia received 8 mg of dexamethasone or placebo intravenously just after the umbilical cord was clamped. The rate of PDPH and correlated risk factors were evaluated. The prevalence of nausea and vomiting in the dexamethasone and placebo groups was 54.4 and 51.7%, respectively. There was no statistically meaningful difference between the results (P value = 0.673). The overall incidence rate of PDPH was 10.8%, with 28 cases from the dexamethasone group compared with 11 subjects from the placebo group (P value = 0.006). This effect was most prominent on the first day (P value = 0.046) and disappeared on the second day after spinal anesthesia (P value = 0.678). Prophylactic treatment with 8 mg of dexamethasone not only increases the severity and incidence of PDPH, but is also ineffective in decreasing the prevalence of intra-operative nausea and vomiting during cesarean section. The treatment is a significant risk factor for the development of PDPH.


Carfilzomib-induced Thrombotic Microangiopathy: A Case Based Review.
Carfilzomib is an irreversible proteasome inhibitor currently approved for the treatment of relapsed multiple myeloma. It has been implicated as a cause of thrombotic microangiopathy (TMA) in several case reports. The incidence, risk factors, and treatment of carfilzomib-related TMA remain unclear. Here we describe the clinical presentation and outcome of a 58-year-old man with biopsy-proven TMA that occurred following treatment with carfilzomib-based therapy. We also reviewed the published literature with regard to the incidence, risk factors, treatment options, and outcome of carfilzomib-related TMA.


Supercurrent enhancement in Bloch domain walls.
Conventional spin-singlet Cooper pairs convert into spin-triplet pairs in ferromagnetic Josephson junctions in which the superconductor/ferromagnet interfaces (S/F) are magnetically inhomogeneous. Although much of the theoretical work describing this triplet proximity effect has considered ideal junctions with magnetic domain walls (DW) at the interfaces, in practice it is not easily possible to isolate a DW and propagate a supercurrent through it. The rare-earth magnet Gd can form a field-tuneable in-plane Bloch DW if grown between non-co-linearly aligned ferromagnets. Here we report supercurrents through magnetic Ni-Gd-Ni nanopillars: by field annealing at room temperature, we are able to modify the low temperature DW-state in Gd and this result has a striking effect on the junction supercurrent at 4.2 K. We argue that this result can only be explained in terms of the interconversion of triplet and singlet pairs, the efficiency of which depends on the magnetic helicity of the structure.


Prevalence of thyroid nodules and carcinomas in patients operated on for renal hyperparathyroidism: experience with 339 consecutive patients and review of the literature.
The association between renal hyperparathyroidism (HPT) and differentiated thyroid carcinoma is discussed. To determine the prevalence and potential risk factors, we performed a retrospective analysis of our patients (1998-2004) and compared the data with the data from other surgical and autopsy studies. At our hospital, a total of 347 parathyroidectomies in 339 patients with renal HPT were performed. Most patients underwent preoperative ultrasound investigation of the thyroid gland and, if indicate, thyroid scintigraphy. Intraoperatively, both thyroid lobes were mobilized and palpated. Detected thyroid nodules were adequately resected and investigated histologically. A systematic analysis of the international literature was performed using the PubMed/MEDLINE system to identify publications on the prevalence of papillary thyroid carcinoma (PTC) in patients with renal HPT and in the overall population. Altogether, 133 patients (39.2%) underwent simultaneous thyroid surgery. The initial operation was hemithyroidectomy in 55 (16.2%), Dunhill operation in 36 (10.6%), unilateral subtotal resection in 17 (5.0%), bilateral subtotal resection in 5 (1.5%), and enucleation of a thyroid nodule in 18 (5.3%). A PTC was found in 8 of 339 patients (2.4%) and a follicular thyroid carcinoma in 1. Among 311 patients with primary cervical operation, 6 (1.9%) had a papillary thyroid carcinoma. All papillary tumors were classified as pT1 with a diameter of 1 to 12 mm; three were bifocal, and only one patient had positive lymph nodes. None of the analyzed factors showed a significant correlation with the occurrence of thyroid carcinoma. Depending on the screening method, the prevalence of occult PTC in European autopsy studies ranged from 5% to 9% and was markedly higher in almost all studies than in the present one. The prevalence of PTC in the present study makes an etiologic association between renal HPT and PTC unlikely. The clinical significance of these tumors remains unclear because all incidental tumors were small. However, if easily and safely feasible, relevant thyroid nodules should be removed during parathyroid surgery.


Trusted strangers: social affordances for social cohesion.
How could the paradigm shift towards enactive embodied cognitive science have implications for society and politics? Translating insights form enactive embodied cognitive science into ways of dealing with real-life issues is an important challenge. This paper focuses of the urgent societal issue of social cohesion, which is crucial in our increasingly segregated and polarized Western societies. We use Rietveld's (2016) philosophical Skilled Intentionality Framework and work by the multidisciplinary studio RAAAF to extend Lambros Malafouris' Material Engagement Theory (2013) to the social domain. How could a landscape of social affordances generate change in the behavioral patterns of people from different socio-cultural backgrounds? RAAAF is currently imagining and planning an ambitious intervention in the public domain that could really change existing socio-cultural practices and aims to contribute to social cohesion. An animation film it made introduces a landscape of social affordances. We will present and discuss this Trusted Strangers animation film, which is a thinking model for new public domain all over the world. Tha animation film visualizes how a well-designed landscape of social affordances could invite all sorts of interactions between people from different socio-cultural backgrounds.


The supraduodenal artery.
The present work deals with a study of the supraduodenal a. in 30 specimens. It was present in 28 cases: when absent it was substituted by the right gastric a. Its origin is discussed, the most frequent being the gastroduodenal a., with 2 cases in the pericholedochal plexus. Distribution to the distal two thirds of the upper portion of the duodenum was constant, extending to the supra- and retroduodenal portions of the common duct. Its anastomosis with the gastric right a. and the posterior superior pancreaticoduodenal a. was established in half the cases, being more frequent with the former.


Decreased Quality of Life Is Significantly Associated With Body Composition in Patients With Nonalcoholic Fatty Liver Disease.
We studied impaired quality of life (QOL) and its determinants among individuals with nonalcoholic fatty liver disease (NAFLD). We collected data from 341 patients with NAFLD who completed the short form 36 (SF-36) questionnaire. Body composition and liver fibrosis were assessed in patients with NAFLD using bioelectrical impedance and transient elastography, respectively. Advanced fibrosis was defined as liver stiffness measurements (LSMs) of 12.1 kPa or greater. SF-36 scores of patients with NAFLD were compared with SF36 scores of individuals with chronic medical illnesses and the general population obtained from the published literature. Among patients with NAFLD, percent body fat was negatively associated with scores from all 8 SF-36 scales, whereas lean body mass was positively associated with scores from 5 of 8 SF-36 scales. On multivariable analysis, SF-36 PF scores were negatively associated with type 2 diabetes, body mass index, and LSM and positively associated with lean body mass and level of alanine aminotransferase. Patients with NAFLD, and even those without advanced fibrosis, had significantly lower mean QOL scores than the control group or the general population. Individuals with NAFLD, even those without advanced fibrosis, have lower QOL than controls. Body composition associates with QOL in patients with NAFLD; both of the modifiable factors independently associated with QOL are related to body composition. Further studies are needed to investigate if interventions to improve body composition can increase QOL for patients with NAFLD.


Correction: Hypoxia-inducible factor 1 upregulation of both VEGF and ANGPTL4 is required to promote the angiogenic phenotype in uveal melanoma.
[This corrects the article DOI: 10.18632/oncotarget.6868.].


Under the influence of our older brother and sister: The association between sibling gender configuration and STEM degrees.
This study examines the association between sibling gender configuration and second-born siblings' choice of so-called STEM educational fields (i.e., science, technology, engineering, and mathematics) in Swedish two-child families. Using population data from administrative registers in Sweden, the findings show that younger siblings, net of parental characteristics, are more likely to choose a STEM field if their older sibling has attended or is already attending a STEM program. Moreover, a gender difference is clear concerning the choice of a STEM field among younger siblings: Girls are more likely to choose a STEM field if they have an older sister who has attended a STEM program, than if they have an older brother in a similar program. However, the corresponding results are not found for boys. Given that STEM fields are markedly male-dominated at tertiary level, this indicates an importance of a same-sex role model for young girls contemplating gender-atypical educational choices.


Plaque-bearing mice with reduced levels of oligomeric amyloid-beta assemblies have intact memory function.
The amyloid-beta (Abeta) protein exists in the aging mammalian brain in diverse assembly states, including amyloid plaques and soluble Abeta oligomers. Both forms of Abeta have been shown to impair neuronal function, but their precise roles in Alzheimer's disease (AD) -associated memory loss remain unclear. Both types of Abeta are usually present at the same time in the brain, which has made it difficult to evaluate the effects of plaques and oligomers individually on memory function. Recently, a particular oligomeric Abeta assembly, Abeta 56, was found to impair memory function in the absence of amyloid plaques. Until now it has not been possible to determine the effects of plaques, in the absence of Abeta oligomers, on memory function. We have identified Tg2576 mice with plaques but markedly reduced levels of Abeta oligomers, which enabled us to study the effects of plaques alone on memory function. We found that animals with amyloid plaques have normal memory function throughout an episode of reduced Abeta oligomers, which occurs during a period of accelerated amyloid plaque formation. These observations support the importance of Abeta oligomers in memory loss and indicate that, at least initially, amyloid plaques do not impair memory.


Intervention with the screening tool of older persons potentially inappropriate prescriptions/screening tool to alert doctors to right treatment criteria in elderly residents of a chronic geriatric facility: a randomized clinical trial.
To assess the effect of a Screening Tool of Older Persons potentially inappropriate Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) medication intervention on clinical and economic outcomes. Parallel-group randomized trial. Chronic care geriatric facility. Residents aged 65 and older prescribed with at least one medication (N = 359) were randomized to receive usual pharmaceutical care or undergo medication intervention. Screening medications with STOPP/START criteria followed up with recommendations to the chief physician. The outcome measures assessed at the initiation of the intervention and 1 year later were number of hospitalizations and falls, Functional Independence Measure (FIM), quality of life (measured using the Medical Outcomes Study 12-item Short-Form Health Survey), and costs of medications. The average number of drugs prescribed was significantly lower in the intervention than in the control group after 1 year (P < .001). The average drug costs in the intervention group decreased by 103 shekels (US$29) per participant per month (P < .001). The average number of falls in the intervention group dropped significantly (P = .006). Rates of hospitalization, FIM scores, and quality of life measurements were similar for both groups. Implementation of STOPP/START criteria reduced the number of medications, falls, and costs in a geriatric facility. Their incorporation in those and similar settings is recommended.


Transfusion rates and disease spectrum in neonates treated with blood transfusion in China.
This study aimed to investigate blood transfusion rates and spectrum of diseases in hospitalized neonates treated with blood transfusion in China to provide supporting data for future studies on neonatal blood transfusion.Data on hospitalized neonates were obtained from more than 100 experts from the Department of Neonatology of 55 hospitals in China between January 1, 2012 and December 31, 2016, using a standardized survey. A statistical analysis was conducted to evaluate the data collected, including the blood transfusion rates, blood component transfused, spectrum of diseases, and spectrum of major diseases.Between 2012 and 2016, 541,128 neonates were hospitalized in the 55 hospitals surveyed. There were 70,433 neonates who received blood transfusion, with an average transfusion rate of 13.02%. The rates of red blood cell transfusion, platelet transfusion, and plasma transfusion were 9.44%, 0.66%, and 4.77%, respectively. The neonatal blood transfusion rate was 17.99% in Northeast China, 9.74% in Northwest China, and between 10.60% and 16.22% in other regions. The neonatal blood transfusion rate was 12.3% in general hospitals and 13.8% in women and children's hospitals. The top 10 diseases identified in hospitalized neonates treated by blood transfusion were, in rank order, as follows:prematurity,pneumonia, hyperbilirubinemia, bacterial sepsis, respiratory distress syndrome, anemia, hemolytic disease, asphyxia, hemorrhage, and necrotizing enterocolitis.The neonatal blood transfusion rate in China is 13.03%.The rank order in the disease spectrum of the hospitalized neonates and that in hospitalized neonates treated with blood transfusion are different.


Prospective multicenter evaluation of moving cell metallic stents in endoscopic multiple stent deployment for hepatic hilar obstruction.
Bilateral stent deployment for malignant biliary obstruction (MHBO) can be achieved using side-by-side (SBS) or stent-in-stent (SIS) procedures. Compared with SBS techniques, the procedural steps of SIS are technically complex due to the necessity of introducing the delivery system into a contralateral biliary tract through the mesh of the SEMS. To overcome this issue, a novel uncovered SEMS, the HILZO Moving Cell Stent (MCS) has been released. The present study examined the technical feasibility of treating MHBO using bilateral deployment of this novel stent without dilating the mesh of the first stent to achieve insertion of the second stent within a single session, using a prospective, multicenter setting. The primary outcome in the present study was the technical success rate. Technical success was defined as deployment of bilateral MCSs into two or more biliary tracts using SIS without a dilation device in a single-session. A total of 27 patients with complications of MHBO were enrolled in this study. Bilateral SIS using two MCS was successfully performed in 23 patients without using dilation devices among 27 patients (initial technical success rate; 85.2%). Median time to recurrent biliary obstruction (TRBO) was 271 days. Stent dysfunction was observed in 12 patients (44.4%), and re-intervention was successfully performed in all patients without one patient who instead received best supportive care. The SIS technique using MCS without dilation of the mesh may be technically feasible and safe. In addition, this may be useful for re-intervention. Further comparative randomized trials are needed.


Effect of flexion angle on the pressure-volume of the human knee.
The objective of this study was to determine pressure-volume relationships in the human knee. Eight normal knees in eight patients undergoing elective arthroscopic surgery were studied to develop pressure-volume curves at 0 degrees, 15 degrees, 30 degrees, 60 degrees, and 80 degrees of flexion, and measure capsular volume at 0 degrees, 15 degrees, 30 degrees, 45 degrees, 60 degrees, and 80 degrees of flexion. The results showed that capsular volume decreases with flexion, whereas capsular stiffness increases. This suggests that during arthroscopy, flexion with obstructed outflow may cause significant intraarticular pressure and potential rupture of synovial membranes. Our results support the concept of flow rates with low distension pressures for maximum safety.


Biodegradable phase change materials with high latent heat: Preparation and application on Lentinus edodes storage.
In order to develop biodegradable phase change materials (PCMs) with high latent heat for cold chain logistics, superabsorbent resin (SAR) was prepared based on starch graft copolymerization. FTIR and DSC demonstrated that acrylic acid was successfully grafted onto starches and optimum latent heat of PCM was 330.4 J/g with 10% (w/w) starch. The water retention of PCM with 10% (w/w) starch was 0.49 after heating at 50 °C for 200 h, which was 4.9 folds higher than that of non-starch PCM. Biodegradation rate of PCM was 60.12% within 75-day burial, which was 6 folds higher than that of non-starch PCM. Moreover, significant reduction in browning index, odor, decay, relative conductivity and malondialdehyde (MDA) content was observed in Lentinus edodes treated by biodegradable PCM. These results indicated that the application of biodegradable PCM could extend the shelf life of fresh L. edodes stored at 25 °C.


Increased risk of adverse pregnancy outcome among Somali immigrants in Washington state.
The purpose of this study was to compare maternal and neonatal morbidity among Somali immigrants, US-born blacks and whites in Washington state. Washington state birth certificate data was linked to hospital discharge records comparing singleton deliveries among Somali immigrants with US-born blacks and whites between 1993 and 2001, in a 1:3 ratio. Outcomes were compared using unconditional multiple logistic regression models calculating odds ratios (ORs), and 95% confidence intervals (95% CIs). Five hundred seventy-nine pregnancies from Somali women were compared with 2384 and 2435 pregnancies from black and white women, respectively. Nulliparous Somali women were more likely to have a cesarean delivery than black or white control women, OR 1.6 (95% CI, 1.1-2.3) and 2.0 (95% CI, 1.4-2.8), respectively. Among all women who had cesarean deliveries, Somali women more commonly had cesarean deliveries associated with fetal distress and failed induction of labor. They were 9 times more likely than both control groups to deliver after 42 weeks gestation, and 4 times more likely than black women and 8 times more likely than white women to have oligohydramnios. Somali women were more likely to have gestational diabetes and significant perineal lacerations, and less likely to smoke. Newborns of Somali women were at increased risk for prolonged hospitalization, lower 5-minute Apgar scores, assisted ventilation, and meconium aspiration. Pregnancy outcomes should be evaluated within ethnically and culturally unique groups; Somali immigrants are a high-risk subpopulation.


Using a new video rating tool to crowd-source analysis of behavioural reaction to stimuli.
Quantifying the intensity of animals' reaction to stimuli is notoriously difficult as classic unidimensional measures of responses such as latency or duration of looking can fail to capture the overall strength of behavioural responses. More holistic rating can be useful but have the inherent risks of subjective bias and lack of repeatability. Here, we explored whether crowdsourcing could be used to efficiently and reliably overcome these potential flaws. A total of 396 participants watched online videos of dogs reacting to auditory stimuli and provided 23,248 ratings of the strength of the dogs' responses from zero (default) to 100 using an online survey form. We found that raters achieved very high inter-rater reliability across multiple datasets (although their responses were affected by their sex, age, and attitude towards animals) and that as few as 10 raters could be used to achieve a reliable result. A linear mixed model applied to PCA components of behaviours discovered that the dogs' facial expressions and head orientation influenced the strength of behaviour ratings the most. Further linear mixed models showed that that strength of behaviour ratings was moderately correlated to the duration of dogs' reactions but not to dogs' reaction latency (from the stimulus onset). This suggests that observers' ratings captured consistent dimensions of animals' responses that are not fully represented by more classic unidimensional metrics. Finally, we report that overall participants strongly enjoyed the experience. Thus, we suggest that using crowdsourcing can offer a useful, repeatable tool to assess behavioural intensity in experimental or observational studies where unidimensional coding may miss nuance, or where coding multiple dimensions may be too time-consuming.


Deep ensemble learning for accurate retinal vessel segmentation.
Significant progress has been made in deep learning-based retinal vessel segmentation in recent years. However, the current methods suffer from low performance and the robust of the models is not that good. Our work introduces an novel framework for retinal vessel segmentation based on deep ensemble learning. The results of benchmarking comparisons indicate that our model outperforms the existing ones on multiple datasets, demonstrating that our models are more effective, superior, and robust for the retinal vessel segmentation. It evinces the capability of our model to capture the discriminative feature representations through introducing the ensemble strategy to integrate different base deep learning models like pyramid vision Transformer and FCN-Transformer. We expect our proposed method can benefit and accelerate the development of accurate retinal vessel segmentation in this field.


Enhancing HMM-based biomedical named entity recognition by studying special phenomena.
The purpose of this research is to enhance an HMM-based named entity recognizer in the biomedical domain. First, we analyze the characteristics of biomedical named entities. Then, we propose a rich set of features, including orthographic, morphological, part-of-speech, and semantic trigger features. All these features are integrated via a Hidden Markov Model with back-off modeling. Furthermore, we propose a method for biomedical abbreviation recognition and two methods for cascaded named entity recognition. Evaluation on the GENIA V3.02 and V1.1 shows that our system achieves 66.5 and 62.5 F-measure, respectively, and outperforms the previous best published system by 8.1 F-measure on the same experimental setting. The major contribution of this paper lies in its rich feature set specially designed for biomedical domain and the effective methods for abbreviation and cascaded named entity recognition. To our best knowledge, our system is the first one that copes with the cascaded phenomena.


Spectrin interactions with globin chains in the presence of phosphate metabolites and hydrogen peroxide: implications for thalassaemia.
We have shown the differential interactions of the erythroid skeletal protein spectrin with the globin subunits of adult haemoglobin (HbA); these indicate a preference for alpha-globin over that for beta-globin and intact HbA in an adenosine 5'-triphosphate (ATP)-dependent manner. The presence of Mg/ATP led to an appreciable decrease in the binding affinity of the alpha-globin chain to spectrin and the overall yield of globin-spectrin cross-linked complexes formed in the presence of hydrogen peroxide. Similar effects were also seen in the presence of 2-,3-diphosphoglycerate (2,3 DPG), the other important phosphate metabolite of erythrocytes. The binding affinity and yield of cross-linked high molecular weight complexes (HMWCs) formed under oxidative conditions were significantly higher in alpha-globin compared with intact haemoglobin, HbA and the beta-globin chain. The results of this study indicate a possible correlation of the preferential spectrin binding of the alpha-globin chain over that of the beta-globin in the haemoglobin disorder beta-thalassaemia.


Integrons, β-lactamase and qnr genes in multidrug resistant clinical isolates of Proteus mirabilis and P. vulgaris.
Thirty-three isolates of Proteus mirabilis and two P. vulgaris were examined for their antimicrobial resistance, the presence of integrons with regard to gene cassette content, and genetic determinants of β-lactam and low-level quinolone resistance. Integrons were detected in 23 (69.7%) P. mirabilis isolates; six (18.2%) of them had class 1 integrons, 11 (33.3%) possessed class 2 integrons and six (18.2%) carried integrons of both classes. One P. vulgaris strain possessed class 1 and class 2 integrons. The presence of integrons was associated with increased frequency of resistance to gentamicin, ciprofloxacin, sulfamethoxazole and co-trimoxazole. Moreover, integron presence was associated with increased resistance range in terms of both the number of antimicrobials and the number of classes of antimicrobials to which a strain was resistant. Class 1 integrons contained aadA1, aadB-aadA1, dfrA1-aadA1, bla(PSE-1) -aadA1 and aacA4-orfA-orfB-aadA1 gene cassette arrays, whereas all class 2 integrons had a dfrA1-sat2-aada1 array. β-lactamase genes not associated with integrons comprised bla(TEM-2) , bla(DHA-1) and bla(CMY-15) . Plasmid-mediated fluoroquinolone resistance was determined by qnrD and qnrS1 genes. This is the first report of P. vulgaris strains harbouring qnrD genes in Europe.


Mother and son cases of Bickerstaff's brainstem encephalitis and fisher syndrome with serum anti-GQ1b IgG antibodies: a case report.
Bickerstaff's brainstem encephalitis (BBE) and Fisher syndrome (FS) are immune-mediated diseases associated with anti-ganglioside antibodies, specifically the anti-GQ1b IgG antibody. These two diseases potentially lie on a continuous spectrum with Guillain-Barré Syndrome (GBS). There are some reports of family cases of GBS and fewer of FS. However, there are no reports of family cases of BBE and FS. We report a familial case of an 18-year-old son who had BBE and his 52-year-old mother diagnosed with FS within 10 days. The son showed impaired consciousness 1 week after presenting with upper respiratory symptoms and was brought to our hospital by his mother. He showed decreased tendon reflexes, limb ataxia, albuminocytologic dissociation in his spinal fluid, and positive serum anti-GQ1b antibodies. Haemophilus influenzae was cultured from his sputum. He was diagnosed with BBE and treated with intravenous immunoglobulin (IVIg) therapy, which led to an improvement in symptoms. The mother presented with upper respiratory symptoms 3 days after her son was hospitalized. Seven days later, she was admitted to the hospital with diplopia due to limited abduction of the left eye. She showed mild ataxia and decreased tendon reflexes. Her blood was positive for anti-GQ1b antibodies. She was diagnosed with FS and treated with IVIg, which also led to symptomatic improvement. There are no previous reports of familial cases of BBE and FS; therefore, this valuable case may contribute to the elucidation of the relationship between genetic predisposition and the pathogenesis of BBE and FS.


Huntington disease: pathogenesis and treatment.
Huntington disease (HD) is an autosomal dominant inherited neurodegenerative disease characterized by progressive motor, behavioral, and cognitive decline, culminating in death. It is caused by an expanded CAG repeat in the huntingtin gene. Even years before symptoms become overt, mutation carriers show subtle but progressive striatal and cerebral white matter atrophy by volumetric MRI. Although there is currently no direct treatment of HD, management options are available for several symptoms. A better understanding of HD pathogenesis, and more sophisticated clinical trials using newer biomarkers, may lead to meaningful treatments. This article reviews the current knowledge of HD pathogenesis and treatment.


Adaptation towards climate change impacts among highland farmers in Malaysia.
This study aims to gain more understanding on highland farmers' adaptation towards the impacts of climate change in Malaysia. Via a multi-stage cluster sampling, this quantitative study has surveyed a total of 400 highland farmers as respondents. The results indicated that the highest climate change-resilient farmers were from Kundasang, specifically among the females, Dusun ethnic group, and those who work side jobs to cover household expenses. Furthermore, recorded factors such as age and years of experience yielded significant negative relationship with adaptation whereas income yielded significant positive relationship with adaptation. The paper concludes with recommendations related to occupational diversification, consistent information disseminations, access to financial assistance, and the need to empower extension officers and local leaders in the hope that a comprehensive approach can help implement any community climate change-adaptation plan.


The effect of iron oxide nanoparticles on Lactobacillus acidophilus growth at pH 4.
Probiotics, in particular, lactic acid bacteria (LAB) are widely used as starter cultures in food and pharmaceutical industries. Presence of LAB supports the production and preservation of a diverse range of food products, provides a positive effect on the human gastrointestinal tract, and prevents the progression of many diseases. However, the main limiting factor in the application of LAB is that they hardly survive in acidic conditions, including the human digestive system. This factor inhibits LAB to maintain their functionality and deliver their health benefits to the host. For this purpose, magnetic immobilisation of LAB with iron oxide nanoparticles (IONs) was conducted to evaluate the effect of IONs on bacterial growth and their viability at low pH. Gram-positive Lactobacillus acidophilus, a well-known species of LAB, was selected for this study. The IONs were successfully synthesised with the average size of 7 nm and used for decoration of L. acidophilus cells at low pH. Based on the results, a 1.8-fold increase in bacterial viability was observed by decorating cells with 360 µg/mL IONs.


Advances in the characterization and monitoring of natural organic matter using spectroscopic approaches.
Natural organic matter (NOM) is ubiquitous in environment and plays a fundamental role in the geochemical cycling of elements. It is involved in a wide range of environmental processes and can significantly affect the environmental fates of exogenous contaminants. Understanding the properties and environmental behaviors of NOM is critical to advance water treatment technologies and environmental remediation strategies. NOM is composed of characteristic light-absorbing/emitting functional groups, which are the "identification card" of NOM and susceptive to ambient physiochemical changes. These groups and their variations can be captured through optical sensing. Therefore, spectroscopic techniques are elegant tools to track the sources, features, and environmental behaviors of NOM. In this work, the most recent advances in molecular spectroscopic techniques, including UV-Vis, fluorescence, infrared, and Raman spectroscopy, for the characterization, measurement, and monitoring of NOM are reviewed, and the state-of-the-art innovations are highlighted. Furthermore, the limitations of current spectroscopic approaches for the exploration of NOM-related environmental processesand how these weaknesses/drawbacks can be addressed are explored. Finally, suggestions and directions are proposed to advance the development of spectroscopic methods in analyzing and elucidating the properties and behaviors of NOM in natural and engineered environments.


SOX2 hypomorphism disrupts development of the prechordal floor and optic cup.
Haploinsufficiency for the HMG-box transcription factor SOX2 results in abnormalities of the human ventral forebrain and its derivative structures. These defects include anophthalmia (absence of eye), microphthalmia (small eye) and hypothalamic hamartoma (HH), an overgrowth of the ventral hypothalamus. To determine how Sox2 deficiency affects the morphogenesis of the ventral diencephalon and eye, we generated a Sox2 allelic series (Sox2(IR), Sox2(LP), and Sox2(EGFP)), allowing for the generation of mice that express germline hypomorphic levels (<40%) of SOX2 protein and that faithfully recapitulate SOX2 haploinsufficient human phenotypes. We find that Sox2 hypomorphism significantly disrupts the development of the posterior hypothalamus, resulting in an ectopic protuberance of the prechordal floor, an upregulation of Shh signaling, and abnormal hypothalamic patterning. In the anterior diencephalon, both the optic stalks and optic cups (OC) of Sox2 hypomorphic (Sox2(HYP)) embryos are malformed. Furthermore, Sox2(HYP) eyes exhibit a loss of neural potential and coloboma, a common phenotype in SOX2 haploinsufficient humans that has not been described in a mouse model of SOX2 deficiency. These results establish for the first time that germline Sox2 hypomorphism disrupts the morphogenesis and patterning of the hypothalamus, optic stalk, and the early OC, establishing a model of the development of the abnormalities that are observed in SOX2 haploinsufficient humans.


A family of fuchs endothelial corneal dystrophy and anterior polar cataract with an analysis of whole exome sequencing.
Our aim was to introduce a family affected by this rare phenotype, and perform the whole exome sequencing (WES) to explore the potential candidate genes causing the disorders. A five-generation family including five patients affected by FECD with APC, and nine patients suffered from only FECD was recruited from the First Affiliated Hospital of Harbin Medical University. All participants received ophthalmic examinations. Eight family members were selected to perform WES with a bioinformatics analysis and genome-wide linkage analysis. The candidate genes were identified by polymerase chain reaction (PCR) and Sanger sequencing. Patients in this family had FECD as the common feature. The proband (a 65-year-old female) was affected by FECD and APC in both eyes, with epithelial bullae in the left eye. Slit-lamp, specular, and confocal microscope and OCT images showed guttae more serious in the central cornea than the peripheral area, confirming the diagnosis of FECD. In this family, most corneal guttae was bilateral with an almost equal degree of progression in the Descemet membrane, APC was found around the age of 10, perhaps even earlier. According to the analysis of bioinformatics analysis, two candidate genes were found and confirmed by PCR and Sanger sequencing, but could not achieve genotype-phenotype co-segregation in the family. We introduced a family of FECD with APC, with no known causative gene found by WES, inferring that there may be a novel gene-locus in the non-coding regions of genome, which needs further study by WGS. The contribution of this study was to exclude the possibility of the rare phenotype pathogenic site in exome and narrow the scope of pathogenic genes.


Synthesis of Heptamethine Cyanines from Furfural Derivatives.
Despite the widespread theranostic utilization of cyanine dyes (Cy7), their synthetic method is still limited with pyridine or cyclohexanone derivatives as starting materials. Herein, we report the synthesis of Cy7 from furfural derivatives. First, a one-pot reaction strategy is developed to solve the unstable problem of the Stenhouse salts. Second, a stepwise condensation strategy is exploited to regioselectively synthesize asymmetrical Cy7. The methodology possesses advantages, such as easy handling, high yield, wide substrate scopes, and good functional group tolerance.


Informed Consent for Online Research-Is Anybody Reading?: Assessing Comprehension and Individual Differences in Readings of Digital Consent Forms.
Informed consent is an important part of the research process; however, some participants either do not read or skim the consent form. When participants do not read or comprehend informed consent, then they may not understand the potential benefits, risks, or details of the study before participating. This study used previous research to develop experimentally manipulated online consent forms utilizing various presentations of the consent form and interactive elements. Participants (n = 576) were randomly exposed to one of six form variations. Results found that the highly interactive condition was significantly better for comprehension than any of the other conditions. The highly interactive condition also performed better for readability, though not significantly. Further research should explore the effects of interactive elements to combat habituation and to engage participants with the parts of the consent form unique to the study.


[Synthesis of RNA and protein during oogenesis and early embryogenesis of Acheta domestica].
During maturation of the cricket oocyte principally r-RNA and little t-RNA are formed. Furthermore it is possible to label an RNA-fraction that can be referred to as m-RNA according to its velocity of sedimentation in a sucrose density gradient.Data are discussed showing that the r-RNA formed during oogenesis is probably stable at least up to the stage of yolk cleavage.The incorporation of labelled aminoacids into dechorionated eggs starts during very early cleavage stages, whereas an incorporation of labelled uridine is scarcely detectable. This indicates that although protein synthesis proceeds, practically no measurable RNA synthesis exists. From these data it is concluded that in the cricket egg - just as in amphibian and sea urchin eggs - the first protein synthesis proceeds mainly on preexisting m-RNA.


A novel β-glucosidase from a hot-spring metagenome shows elevated thermal stability and tolerance to glucose and ethanol.
β-glucosidase causes hydrolysis of β-1,4-glycosidic bond in glycosides and oligosaccharides. It is an industrially important enzyme owing to its potential in biomass processing applications. In this study, computational screening of an extreme temperature aquatic habitat metagenomic resource was done, leading to the identification of a novel gene, bglM, encoding a β-glucosidase. The comparative protein sequence and homology structure analyses designated it as a GH1 family β-glucosidase. The bglM gene was expressed in a heterologous host, Escherichia coli. The purified protein, BglM, was biochemically characterized for β-glucosidase activity. BglM exhibited noteworthy hydrolytic potential towards cellobiose and lactose. BglM, showed substantial catalytic activity in the pH range of 5.0-7.0 and at the temperature 40 °C-70 °C. The enzyme was found quite stable at 50 °C with a loss of hardly 20% after 40 h of heat exposure. Furthermore, any drastically negative effect was not observed on the enzyme's activity in the presence of metal ions, non-ionic surfactants, metal chelating, and denaturing agents. A significantly high glucose tolerance, retaining 80% relative activity at 1 M, and 40% at 5 M glucose, and ethanol tolerance, exhibiting 80% relative activity in 10% ethanol, enrolled BglM as a promising enzyme for cellulose saccharification. Furthermore, its ability to catalyze the hydrolysis of daidzin and polydatin ascertained it as an admirably suited biocatalyst for enhancement of nutritional values in soya and wine industries.


Therapeutic strategies for autism: targeting three levels of the central dogma of molecular biology.
The past decade has yielded much success in the identification of risk genes for Autism Spectrum Disorder (ASD), with many studies implicating loss-of-function (LoF) mutations within these genes. Despite this, no significant clinical advances have been made so far in the development of therapeutics for ASD. Given the role of LoF mutations in ASD etiology, many of the therapeutics in development are designed to rescue the haploinsufficient effect of genes at the transcriptional, translational, and protein levels. This review will discuss the various therapeutic techniques being developed from each level of the central dogma with examples including: CRISPR activation (CRISPRa) and gene replacement at the DNA level, antisense oligonucleotides (ASOs) at the mRNA level, and small-molecule drugs at the protein level, followed by a review of current delivery methods for these therapeutics. Since central nervous system (CNS) penetrance is of utmost importance for ASD therapeutics, it is especially necessary to evaluate delivery methods that have higher efficiency in crossing the blood-brain barrier (BBB).


Ultrasound-guided alcoholization of celiac plexus for pain control in oncology.
Treatment of inoperable pancreatic cancer pain is of paramount importance. The ineffectiveness of pharmacological agents has led many investigators to recommend chemical neurolysis of the celiac ganglions for pain control. This procedure may be performed under either fluoroscopic or computed tomography (CT) guidance, or it may accompany laparotomy. The authors describe a modified sonographically (ultrasound-US)-guided technique for alcoholization of the celiac ganglions. Twelve patients underwent the neurolytic procedure. Nine of 12 suffered from pancreatic cancer. The remaining three were affected by inoperable hepatic, gastric, or colon cancer, respectively, with multiple hepatic metastases. US-guided alcohol neurolysis was performed by an anterior approach. In the last four patients, PIA (percutaneous injection alcohol) needles, modified by the authors, replaced the spinal needles employed in the first eight patients to inject the alcohol. Pain and pain relief were rated according to a Simple Descriptive Scale (SDS), and treatment success was gauged by declining opiate doses and need for pharmacological therapy. Results after treatment performed using different needles were compared. Procedure-related mortality was zero. Complications of the neurolytic procedure included left pleural effusion in one patient and mild diarrhea in two other patients. Positive, negative, and indeterminant results were noted in nine (75%, p < 0.001), two, and one patient(s), respectively. The neurolytic technique, although far from being considered a routine procedure, appears to provide patients with safe and effective pain relief for pain unresponsive to conventional medical treatment.


[Polyuria].
Polyuria is an important clinical sign that may pass unnoticed to the relatives and to the physician. In this paper, the definition of polyuria and the pathophysiological bases that condition its presence are reviewed. Likewise, the causes of polyuria in pediatric ages are discussed; this allows the clinician to approach the diagnosis in a systematized and organized manner. Finally, the outstanding clinical and laboratory findings of the entities that usually go with polyuria are reviewed; some of them are: neurogenic diabetes insipidus, primary polydipsia, osmotic diuresis, and nephrogenic diabetes insipidus.


Performance of sequential anaerobic/aerobic digestion applied to municipal sewage sludge.
A promising alternative to conventional single phase processing, the use of sequential anaerobic-aerobic digestion, was extensively investigated on municipal sewage sludge from a full scale wastewater treatment plant. The objective of the work was to evaluate sequential digestion performance by testing the characteristics of the digested sludge in terms of volatile solids (VS), Chemical Oxygen Demand (COD) and nitrogen reduction, biogas production, dewaterability and the content of proteins and polysaccharides. VS removal efficiencies of 32% in the anaerobic phase and 17% in the aerobic one were obtained, and similar COD removal efficiencies (29% anaerobic and 21% aerobic) were also observed. The aerobic stage was also efficient in nitrogen removal providing a decrease of the nitrogen content in the supernatant attributable to nitrification and simultaneous denitrification. Moreover, in the aerobic phase an additional marked removal of proteins and polysaccharides produced in the anaerobic phase was achieved. The sludge dewaterability was evaluated by determining the Optimal Polymer Dose (OPD) and the Capillary Suction Time (CST) and a significant positive effect due to the aerobic stage was observed. Biogas production was close to the upper limit of the range of values reported in the literature in spite of the low anaerobic sludge retention time of 15 days. From a preliminary analysis it was found that the energy demand of the aerobic phase was significantly lower than the recovered energy in the anaerobic phase and the associated additional cost was negligible in comparison to the saving derived from the reduced amount of sludge to be disposed.


Cognitive Changes with Omega-3 Polyunsaturated Fatty Acids in Non-Demented Older Adults with Low Omega-3 Index.
To investigate the changes in specific domains of cognitive function in older adults reporting subjective memory complaints with a low omega-3 index receiving omega 3 polyunsaturated fatty acid (n-3 PUFA) supplementation or placebo. This is a secondary exploratory analysis of the Multidomain Alzheimer Preventive Trial (MAPT) using subjects randomized to the n-3 PUFA supplementation or placebo group. French community dwellers aged 70 or over reporting subjective memory complaints, but free from clinical dementia. A subgroup of MAPT subjects in the lowest quartile of omega-3 index distribution with baseline values ≤ 4.83 % (n = 183). The n-3 PUFA supplementation group consumed a daily dose of DHA (800 mg) and EPA (a maximum amount of 225 mg) for 3 years. The placebo group received identical capsules comprising liquid paraffin oil. Linear mixed-model repeated-measures analyses were used including baseline, 6, 12, 24 and 36-month follow-up data to assess between-group differences in the change in eight cognitive tests over 36 months. There was less decline on the Controlled Oral Word Association Test (COWAT) in the n-3 PUFA supplementation group compared to placebo (p = 0.009; between group mean difference over 36 months, 2.3; 95% CI, 0.6,4.0). No significant differences for any of the other cognitive tests were found, including other tests of executive functioning, although, numerically all results were in favour of the n-3 PUFA supplementation. We found some evidence that n-3 PUFAs might be beneficial for the maintenance of executive functioning in older adults at risk of dementia with low omega-3 index, but this exploratory finding requires further confirmation. A larger specifically designed randomised controlled trial could be merited.


Pain-Induced Beta Activity in the Subthalamic Nucleus of Parkinson's Disease.
The subthalamic nucleus (STN) is a common target for deep brain stimulation (DBS) in Parkinson's disease (PD) and is believed to serve a role in sensorimotor integration. In addition to therapeutic neuromodulation, DBS facilitates the recording of local-field potentials (LFPs) in order to further understand the neurophysiological basis of disease. The capacity to wirelessly transmit these signals in real time has overcome the obstacle of externalization of electrodes during LFP recordings. Using the G102RS device (PINS Medical, China), we investigated the LFP changes in response to mechanical pain stimulation to further elucidate the representation of pain sensation in the basal ganglia. LFPs from 2 patients who had undergone bilateral STN-DBS were wirelessly recorded during no stimulation, low-frequency stimulation (60 and 90 Hz), and high-frequency stimulation (130 and 150 Hz) while introducing painful and nonpainful stimuli. Power spectral analysis was conducted to compare the changes in β frequency (13-30 Hz) during each stimulus. During painful stimuli, STN power spectra (n = 4) revealed a significant increase in β activity compared to non-painful and no-stimulus epochs. Both low- and high-frequency stimulation produced a significant decrease in pain-related β activity. These 2 cases have demonstrated the potential for acute noxious stimuli to exacerbate pathologic β oscillatory activity in the STN. Our findings represent novel evidence of the neurophysiologic representation of pain in the STN of PD patients.


Anatomic distribution of myocardial ischemia as a determinant of exercise-induced ST-segment depression.
Cardiac single-photon emission computed tomographic correlates of ST depression were examined in 129 subjects who had inducible ST depression of > or =0.1 mV and reversible perfusion defects. Patients were separated on the basis of single-photon emission computed tomographic defect distribution into a group with anatomically contiguous ischemia (anterior or posterior/inferior defects, n = 68) and a group with anatomically opposed ischemia (anterior and posterior/inferior defects, n = 61). ST depression in the contiguous ischemia group correlated with defect size (r = 0.40, p = 0.001) and severity (r = 0.38, p = 0.002); multivariate regression demonstrated each to be independent determinants of ST-depression magnitude (r = 0.51, p <0.001). In the opposed ischemia group, ST depression did not significantly correlate with defect extent or severity. After adjusting for differences in perfusion indexes, ST depression was paradoxically greater in the contiguous than in the opposed group (2.82 +/- 1.15 vs 2.44 +/- 1.15 mm, p <0.001). In conclusion, these findings demonstrate that the anatomic distribution of ischemia can alter the relation between ST depression and functional indexes of ischemia and may confound the accuracy of assessments of coronary artery disease based on ST-depression magnitude alone.


Factors Associated with Cardiovascular Disease Risk among Employees at a Portuguese Higher Education Institution.
This study aimed to estimate the prevalence of risk factors for cardiovascular disease (CVD) and to assess the CVD risk (CVDRisk) in a sample of workers at a specific workplace: a higher education institution in Portugal. Data were collected using a questionnaire (e.cuidHaMUs.QueST®) with 345 HEI workers from June 2017-June 2018 with a high response rate (93.3%). Two constructs of risks for CVD were considered: (i) metabolic risk and hypertension (CVDRisk1); and (ii) modifiable behavioural risk (CVDRisk2). Logistic regression analyses were used to establish a relationship between risk indexes/constructs (CVDRisk1 and CVDRisk2) and groups of selected variables. The most prevalent CVD risk factor was hypercholesterolaemia (43.2%). Sixty-eight percent of participants were in the construct CVDRisk1 while almost half of the respondents were in CVDRisk2 (45.2%). The consumption of soft drinks twice a week or more contributed to a significantly increased risk of CVD in CVDRisk1. Lack of regular exercise and lack of daily fruit consumption significantly increased the risk of CVD in CVDRisk2. The challenge to decision makers and the occupational medical community is to incorporate this information into the daily practices of health surveillance with an urgent need for health promotional education campaigns in the workplace.


Labeled stem cells transplantation to the myocardium of a patient with Chagas' disease.
Stem cell transplantation is a new therapy applied to produce cardiac regeneration through differentiation or increase of heart myocytes or neovascular proliferation in patients in the end stage of congestive heart failure secondary to dilated cardiomyopathy, but the results are still unknown.


Progress and prospects of biological approaches targeting PCSK9 for cholesterol-lowering, from molecular mechanism to clinical efficacy.
Cardiovascular disorders are one of the leading causes of mortality and morbidity worldwide. Recent advances showed a promising role of proprotein convertase subtilisin/kexin type 9 (PCSK9) as a critical player in regulating plasma LDL levels and lipid metabolism. This review addresses the molecular functions of PCSK9 with a vision on the clinical progress of utilizing monoclonal antibodies and other biological approaches to block PCSK9 activity. The successful clinical trials with monoclonal antibodies are reviewed. Recent advances in (pre)clinical trials of other biological approaches, such as small interfering RNAs, are also discussed. Discovery of PCSK9 and clinical use of its inhibitors to manage lipid metabolism is a step forward in hypolipidaemic therapy. A better understanding of the molecular activity of PCSK9 can help to identify new approaches in the inhibition of PCSK9 expression/activity. Whether if PCSK9 plays a role in other cardiometabolic conditions may provide grounds for further development of therapies.


Vaccines made from recombinant yeast cells.
Production of polypeptide and protein antigens through recombinant DNA technology in prokaryotic and certain eukaryotic cells in culture is facilitating the development of new vaccines that are safe, efficacious, and economically feasible to manufacture. A current example is that of human hepatitis B vaccine that, to the present, has been produced commercially using hepatitis B viral surface antigen (HBsAg) purified from the plasma of human carriers chronically infected with the virus. Production of plasma-derived vaccine is limited by the available supply of suitable carrier plasma and by the need to apply highly technical procedures to purify the antigen as well as to ensure inactivation of all infectious agents that might be present in human plasma.


Effect of statins on oxidative DNA damage in diabetic polyneuropathy.
Oxidative stress induces nerve damage in type 2 diabetes mellitus and leads to diabetic polyneuropathy (DPN) and can affect the DNA and antioxidant status. Statins have pleiotropic, protective effects on the peripheral nerves of patients with diabetes. The aim of this study was to determine the effects of ezetimibe/simvastatin and rosuvastatin on DNA damage in patients with DPN. This randomized, double-blind, placebo-controlled, clinical trial comprised outpatients from Guadalajara, Mexico. The inclusion criteria were either gender, age 35-80 years, type 2 diabetes, glycated hemoglobin ≤10%, diabetic polyneuropathy stage 1/2, and signed informed consent. Patients who were taking antioxidant therapy or statins, had hypersensitivity to drugs, experienced organ failure, were pregnant or breastfeeding, or had other types of neuropathy were excluded. We assigned patients to placebo, ezetimibe/simvastatin 10/20 mg, or rosuvastatin 20 mg, and the primary outcomes were 8-hydroxy-2'-deoxyguanosine (8-OHdG) for DNA damage, 8-oxoguanine-DNA-N-glycosilase (hOGG1) for DNA repair, and superoxide dismutase (SOD). Seventy-four patients were recruited. Nine patients were included as negative controls. There were no differences in 8-OHdG between the healthy subjects (4.68 [3.53-6.38] ng/mL) and the DPN patients (4.51 [1.22-9.84] ng/mL), whereas the hOGG1 level was 0.39 (0.37-0.42) ng/mL in the healthy subjects and 0.41 (0.38-0.54) ng/mL in patients with DPN at baseline (p = 0.01). SOD decreased significantly in patients with DPN (5.35 [0.01-17.90] U/mL) compared with the healthy subjects (9.81 [8.66-12.61] U/mL) at baseline (p < 0.001). No significant changes in DNA biomarkers were observed in any group between baseline and final levels. We noted a rise in hOGG1 in patients with DPN, without modifications after treatment. There was a slight, albeit insignificant, increase in SOD in patients who were on statins.


Thermal quantitative sensory testing as a screening tool for cardiac autonomic neuropathy in patients with diabetes mellitus.
Electrophysiological diagnosis of cardiac autonomic neuropathy (CAN) is based on the evaluation of cardiovascular autonomic reflex tests (CARTs). CARTs are relatively time consuming and must be performed under standardized conditions. This study aimed to determine whether thermal quantitative sensory testing (TQST) can be used as a screening tool to identify patients with diabetes at a higher risk of CAN. Eighty-five patients with diabetes and 49 healthy controls were included in the study. Neurological examination, CARTs, TQST, biochemical analyses, and neuropathy symptom questionnaires were performed. CAN was diagnosed in 46 patients with diabetes (54%). CAN-positive patients with diabetes had significantly higher warm detection thresholds (WDT) and significantly lower cold detection thresholds (CDT) in all tested regions (thenar, tibia, and the dorsum of the foot). CDT on the dorsum < 21.8°C in combination with CDT on the tibia < 23.15°C showed the best diagnostic ability in CAN prediction, with 97.4 % specificity, 60.9% sensitivity, 96.6% positive predictive value, and 67.3% negative predictive value. TQST can be used as a screening tool for CAN before CART.


Multiple active X chromosomes in myelofibrosis with myeloid metaplasia.
A woman with myelofibrosis and myeloid metaplasia had a karyotype of 47,X,del(X)(q22),+del(X)(q22) in unstimulated peripheral blood and bone marrow aspirate cultures. The normal X chromosome was late replicating, and the two deleted X chromosomes always replicated early and synchronously. The karyotype from phytohemagglutin-stimulated peripheral blood cultures was uniformly 46,XX. Structurally abnormal X chromosomes are exceedingly rare in myeloproliferative disease. The abnormal karyotype very likely reflects monoclonal proliferation of an abnormal myeloid cell line. The X chromosome inactivation process, which acts upon embryonic somatic cells of all mammals, apparently does not react to postembryonic nondisjunction of the active X chromosome.


Modulation of the reactivity of the guinea-pig isolated trachealis by respiratory epithelium: effects of cooling.
1. Examination has been made of the effects of epithelium removal on the reactivity of guinea-pig trachealis to methacholine at 37 degrees C and 22 degrees C, and on responses to activation of the Na+/K(+)-pump by abrupt temperature increase from 22 degrees C to 37 degrees C. 2. At 37 degrees C, epithelium removal increased the sensitivity of isolated tracheal strips to methacholine without affecting the maximum isometric contractile response. Epithelium removal resulted at 22 degrees C in a decrease in sensitivity to methacholine, i.e. an effect opposite to that seen at 37 degrees C. While the maximum response of intact strips to methacholine was enhanced at 22 degrees C, the maximum response of denuded preparations was decreased. 3. The increase in sensitivity to methacholine at 37 degrees C after epithelium removal was mimicked in intact preparations by indomethacin (1 microM). Indomethacin did not mimic the decrease in methacholine sensitivity and maximum response caused by epithelium removal at 22 degrees C. 4. Following incubation at 22 degrees C, abrupt increase in temperature to 37 degrees C elicited relaxation in both epithelium-containing and epithelium-denuded tracheal strips. In epithelium-containing preparations the relaxation was more pronounced and followed by contraction. Ouabain (1 microM) converted the relaxation of denuded preparations to contraction, but was ineffective in intact strips. The relaxation of intact strips was, however, inhibited by a greater ouabain concentration (10 microM). 5. These findings indicate that the modulatory effect of the epithelium is temperature-dependent. In cooled preparations, the epithelium enhances reactivity. At 37 degrees C, an epithelium-derived factor reduces reactivity, and this may partially be due to activation of the electrogenic Na+/K+-pump.


[Corneal epitheliopathy following trabeculectomy with postoperative adjunctive 5-fluorouracil].
The success of trabeculectomy in glaucoma not sufficiently controlled by maximal medical therapy substantially depends on postoperative scarring of the filtering bleb. This process of scarring can be inhibited by antimetabolites like mitomycin C (MMC) and 5-fluorouracil (5-FU). The aim of this study is the evaluation of incidence and long-term outcome of corneal surface defects and intraocular pressure following MMC- or 5FU-trabeculectomy using different doses of postoperative 5FU. A retrospective, non-randomised comparative study of 381 patients undergoing trabeculectomy with intraoperative application of either 5FU (group A, n = 169) or MMC (group B, n = 212) was performed. Based on the Wuerzburg bleb classification score (WBCS) for postoperative wound healing evaluation, 30 of these operations of group A (group B: n = 26) did not receive 5 FU postoperatively (controls), 67 (93) received up to 7 postoperative injections of 5 mg 5 FU (normal dosage group), and 72 (93) received more than 7 injections (high dosage group). Surface epithelial defects were routinely assessed by slit-lamp microscopy and fluorescein staining. Intraocular pressure (IOP) was measured by Goldmann applanation tonometry. In the normal dosage group the mean total dose of 5 FU was 25.8 ± 9.1 mg in group A (group B: 28.4 ± 7.5 mg) and in the high dosage group 54.2 ± 10.9 mg 5 FU (51.7 ± 11.8 mg), respectively. Increased doses of postoperative 5 FU induced more frequent corneal erosions in both groups. Corneal erosions were seen in controls in 16.7 % (26.9 %), in the normal dosage group in 55.2 % (47.3 %) and in the high dosage group in 77.8 % (59.1 %) in group A and group B, respectively. The incidence of a corneal erosion between group A and group B did not differ significantly (p = 0.074). The mean reduction of intraocular pressure in mmHg did not show a significant difference 12 months after trabeculectomy between controls and postoperative 5-FU operations. In eyes with beginning scarring of the filtering bleb after trabeculectomy the subconjunctival injection of 5-FU allows a similar reduction of intraocular pressure as in eyes without scarring. Corneal epitheliopathy following trabeculectomy and postoperative 5 FU is dose-dependent with higher doses leading to a higher incidence of corneal erosions. As serious corneal long-term complications are rare, risk-benefit analysis justifies the application of 5-FU after filtrating glaucoma surgery.


Involvement of CD45 in DNA fragmentation in apoptosis induced by mitochondrial perturbing agents.
CD45 is a type I transmembrane molecule with phosphatase activity which comprises up to 10% of the cell surface area in nucleated haematopoietic cells. We have previously demonstrated the absence of nuclear apoptosis in CD45-negative T cells after chemical-induced apoptosis. The aim of this study was to characterize the role of CD45 in nuclear apoptosis. In contrast to wild type CD45-positive T cells, the CD45-deficient T cell lines are resistant to the induction of DNA fragmentation and chromatin condensation following tributyltin (TBT) or H2O2 exposure, but not to cycloheximide-induced apoptosis. CD45 transfection in deficient cell lines led to the restoration of chromatin condensation and DNA fragmentation following TBT exposure. In both CD45-positive and negative T cell lines, TBT exposure mediates intracellular calcium mobilization, caspase-3 activation and DFF45 cleavage. Moreover, DNA fragmentation was also induced by TBT in cells deficient in expression of p56lck, ZAP-70 and SHP-1. Subcellular partitioning showed a decrease in nuclear localisation of caspase-3 and DFF40. Together, these results demonstrate for the first time, that CD45 expression plays a key role in internucleosomal DNA fragmentation and chromatin condensation processes during apoptosis. CD45 activity or its substrates' activity, appears to be located downstream of caspase-3 activation and plays a role in retention of DFF40 in the nucleus.


Partial myocutaneous gluteal flap for perineal reconstruction of extralevator abdominoperineal defects. A single surgeon series of 49 cases in 8 years, and a modification of the technique.
Extralevator abdominoperineal excision (ELAPE) for low rectal tumours necessitates a reliable method of reconstructing the perineum. The senior author developed the partial myocutaneous gluteal (PMG) flap. We present 49 consecutive reconstructions with the refinement of the original procedure. We conducted a retrospective observational review of patients undergoing ELAPE and PMG reconstruction from 2012 to 2019, with at least 1 year follow-up. The procedure was modified iteratively following our original series, to minimise perineal herniation, specifically by greater mobilisation of the inferior gluteus maximus muscle and separation of the muscle and fasciocutaneous components, allowing closure of the defect around the coccygeal remnant. Perineal herniation and wound complications were recorded. Laparoscopic and open resection techniques were compared, as were outcomes before and after modification of the flap. There were no flap failures in our cohort of 49 patients. Two patients (4%) required return to theatre acutely for perineal wound complications: one wound dehiscence and one flap-related haematoma. Five patients had evidence of perineal hernia, three prior to any modification of the flap and two following. Three had symptoms of which two required elective repair. The flap modifications were made in response to these cases. There were no significant differences in perineal outcomes for laparoscopic versus open, and before and after flap modification. Over the last 8 years, we have refined our perineal reconstruction technique following instances of perineal herniation and major wound dehiscence. We believe that the PMG flap provides robust and reliable option for the reconstruction of perineal extralevator abdominoperineal defects.


Superficial Circumflex Iliac Artery Perforator Flap in Advanced Head and Neck Reconstruction: From Simple to Its Chimeric Patterns and Clinical Experience with 22 Cases.
Head and neck tissue defects after ablative head and neck surgery often require complex and composite reconstructions. The superficial circumflex iliac artery perforator (SCIP) flap is an extremely versatile perforator-based flap with minimal donor-site morbidity. The authors present their experience with both simple and chimeric SCIP flap reconstructions for complex defects in various head and neck regions. Twenty-two patients undergoing ablative head and neck surgery for oncologic abnormalities were treated by means of a SCIP flap reconstruction. Patients' mean age was 62 years; 21 were men and one was a woman. Seventeen flaps were simple and five were chimeric reconstruction patterns. Indocyanine green perfusion imaging was performed in all cases. Twenty-one of 22 patients (95.5 percent) were successfully treated with good aesthetic and functional results. Two patients (9 percent) showed minor donor-site complications that were managed conservatively. The mean follow-up period was 5.3 months (range, 2 to 8 months). This case series demonstrates the reliability and versatility of the SCIP flap for head and neck reconstruction. The chimeric options combined with bone, double-skin paddle, and muscle offer a broad variety of functional reconstructive solutions for complex head and neck surgery. Intraoperative indocyanine green perfusion examinations are a valuable tool to assess and ascertain proper inset, vitality, and postanastomosis vessel patency in these complex microvascular flap reconstructions. . Therapeutic, IV.


Natural polyphenols convert proteins into histone-binding ligands.
Antioxidants are sensitive to oxidation and are immediately converted into their oxidized forms that can react with proteins. We have recently found that proteins incubated with oxidized vitamin C (dehydroascorbate) gain a new function as a histone-binding ligand. This finding led us to predict that antioxidants, through conversion to their oxidized forms, may generally have similar functions. In the present study, we identified several natural polyphenols as a source of histone ligands and characterized the mechanism for the interaction of protein-bound polyphenols with histone. Through screening of 25 plant-derived polyphenols by assessing their ability to convert bovine serum albumin into histone ligands, we identified seven polyphenols, including (-)-epigallocatechin-3-O-gallate (EGCG). Additionally, we found that the histone tail domain, which is a highly charged and conformationally flexible region, is involved in the interaction with the polyphenol-modified proteins. Further mechanistic studies showed the involvement of a complex heterogeneous group of the polyphenol-derived compounds bound to proteins as histone-binding elements. We also determined that the interaction of polyphenol-modified proteins with histones formed aggregates and exerted a protective effect against histone-mediated cytotoxicity toward endothelial cells. These findings demonstrated that histones are one of the major targets of polyphenol-modified proteins and provide important insights into the chemoprotective functions of dietary polyphenols.


Critical evaluation of YouTube videos on colostomy and ileostomy: Can these videos be used as learning resources?
We aimed at identifying and analyzing the accuracy of YouTube videos on colostomy and ileostomy. YouTube website was searched independently by researchers for videos on colostomy and ileostomy posted before the 18th of May, 2019. Based on predetermined inclusion and exclusion criteria, the videos matching the research objective were identified. Data related to each video were collected, and the videos were categorized using standardized criteria. A total of 357 videos were identified. Finally, 149 videos were included in the study. Of these, 52 (35%) were educationally useful, and 97 (65%) were not useful. None of the video parameters, including the number of viewers, duration, number of likes or dislikes, days on YouTube or number of comments, was able to differentiate between useful or not useful videos. The score of videos was 14.7 ± 0.6 for valuable videos and 11.0 ± 2.0 for not useful videos (p < 0.001). While there were a reasonably number of colostomy and ileostomy videos, there was a smaller number on the surgical procedure. Most non-educational videos were not consistent with clinical guidelines. YouTube videos on colostomy/ileostomy care can be an important educational resource to patients. However, a collaboration between patients, nurse educators and universities/hospitals is needed to produce high-quality videos.


Iris fluorescein angiography and Irvine Gass' syndrome.
Iris fluorescein angiography and fundus fluorescein angiography were performed three months to three years after cataract extraction in two series of aphakic eyes--32 eyes with vitreous adherence to the wound, and 32 with no vitreous adherence to the wound. In these series there is a significant correlation between dye leakage on iris fluorescein angiography and vitreous adherence to the corneal wound since dye leakage was observed in 40.6% of eyes with vitreous adherence to the wound and only 3.1% of eyes with no vitreous adherence to the corneal wound. On the other hand cystoïd macular edema was observed in 100% of eyes with vitreous adherence to the wound associated with dye leakage on iris fluorescein angiography and in only 10% of eyes with vitreous adherence to the wound but no dye leakage on iris fluorescein angiography.


Sensitive periods for abnormal patterning on a leg segment inDrosophila melanogaster.
The development of a leg segment of the fruitflyDrosophila melanogaster was analyzed in order to determine whether the orderliness of the segment's bristle pattern originates via waves of cellular interactions, such as those that organize the retina. Fly development was perturbed at specific times by either teratogenic agents (gamma rays, heat shock, or the drug mitomycin C) or temperature-sensitive mutations (l(1)63, l(1) Notchts1, orl(1) shibire ts1 ), and the resulting abnormalities (e.g., missing or extra structures) were mapped within the pattern area. If bristles develop in a linear sequence across the pattern, then they should show sensitivity to perturbations in the same order, and wavefronts of cuticular defects should result. Contrary to this prediction, the maps reveal no evidence for any directional waves of sensitivity. Nevertheless, other clues were uncovered as to the nature and timing of patterning events. Chemosensory bristles show earlier sensitivities than mechanosensory bristles, and longer bristles precede shorter ones. The types and sequence of cuticular abnormalities imply the following stages of bristle pattern development: (1) scattered inception of bristle mother cells, each surrounded by an inhibitory field, (2) alignment of the mother cells into rows, (3) differential mitoses, (4) assignment of cuticular fates to the mitotic progeny, (5) polytenization of the bristle cells, (6) fine-tuning adjustments in bristle spacing, and (7) signalling from bristle cells to adjacent epidermal cells, inducing them to form "bracts".


Evolutionary impact of human Alu repetitive elements.
Early studies of human Alu retrotransposons focused on their origin, evolution and biological properties, but current focus is shifting toward the effect of Alu elements on evolution of the human genome. Recent analyses indicate that numerous factors have affected the chromosomal distribution of Alu elements over time, including male-driven insertions, deletions and rapid CpG mutations after their retrotransposition. Unequal crossing over between Alu elements can lead to local mutations or to large segmental duplications responsible for genetic diseases and long-term evolutionary changes. Alu elements can also affect human (primate) evolution by introducing alternative splice sites in existing genes. Studying the Alu family in a human genomic context is likely to have general significance for our understanding of the evolutionary impact of other repetitive elements in diverse eukaryotic genomes.


An investigation of biooxidation ability of Acidithiobacillus ferrooxidans using NMR relaxation measurement.
NMR relaxation measurements can provide a simple means for understanding biological activity of cells in solution with known composition. It has the advantage that it is an in situ, non-intrusive technique, and the acquisition is fast. The iron oxidation ability of Acidithiobacillus ferrooxidans was investigated using NMR relaxation measurements. The transversal relaxation is characterized by a time constant, T₂, which is sensitive to the chemical environment. Fe³⁺ ion has more significant T₂ shortening than Fe²⁺ ion. In the presence of A. ferrooxidans in solutions containing Fe²⁺ ion, T₂ shortening was found with increasing time as the bacteria oxidize Fe²⁺ to Fe³⁺ ions. In the optimal growth medium, the bacteria concentration increased 80 times and high iron oxidation rate was found. In 10 mM K₂SO₄ medium, however, bacteria concentration remained almost unchanged and the iron oxidation rate was significantly lower.


Recovery of copper and water from copper-electroplating wastewater by the combination process of electrolysis and electrodialysis.
In this paper, a laboratory-scale process which combined electrolysis (EL) and electrodialysis (ED) was developed to treat copper-containing wastewater. The feasibility of such process for copper recovery as well as water reuse was determined. Effects of three operating parameters, voltage, initial Cu(2+) concentration and water flux on the recovery of copper and water were investigated and optimized. The results showed that about 82% of copper could be recovered from high concentration wastewater (HCW, >400mg/L) by EL, at the optimal conditions of voltage 2.5 V/cm and water flux 4 L/h; while 50% of diluted water could be recycled from low concentration wastewater (LCW, <200mg/L) by ED, at the optimal conditions of voltage 40 V and water flux 4 L/h. However, because of the limitation of energy consumption (EC), LCW for EL and HCW for ED could not be treated effectively, and the effluent water of EL and concentrated water of ED should be further treated before discharged. Therefore, the combination process of EL and ED was developed to realize the recovery of copper and water simultaneously from both HCW and LCW. The results of the EL-ED process showed that almost 99.5% of copper and 100% of water could be recovered, with the energy consumption of EL ≈ 3 kW h/kg and ED ≈ 2 kW h/m(3). According to SEM and EDX analysis, the purity of recovered copper was as high as 97.9%.


Effect of MDP-Based Primers on the Luting Agent Bond to Y-TZP Ceramic and to Dentin.
The aim of this study was to evaluate the influence of multimode MDP-based primers and different application protocols on the bond strength of a representative resin cement to an yttrium stabilized tetragonal zirconia (Y-TZP) ceramic. The occlusal dentin from 60 human molars was exposed. The teeth and zirconia cylinders (N = 60) (3 mm of diameter; 4 mm of height) were divided into six groups (n = 10) according to the ceramic surface conditioning: (1) air abraded with SiO2 particles; (2) Z-Prime Plus; (3) air abraded with SiO2 particles + Z-Prime Plus; (4) air abraded with SiO2 particles + All-Bond Universal; (5) air abraded with SiO2 particles + ScotchBond Universal Adhesive; and (6) untreated zirconia. The luting agent (Duo-Link cement) was applied on the treated dentin surface. Specimens were stored in water (37°C, 24 h) and tested in shear bond strength. Data were statistically analyzed using 2-way ANOVA and Post hoc Tukey tests (α = 0.05). Significant effects of ceramic conditioning were found (p < 0.0001). The specimens sandblasted with silica particles followed by the application of Z-Prime Plus or All-Bond Universal presented greater bond strength values. For the untreated zirconia, several specimens failed prematurely prior to testing. Sandblasting with silica particles combined with Z-Prime Plus increased the bond strength.


Distribution of fluoride in cortical bone of human rib.
We describe a detailed study of fluoride distribution with age in the human cortical rib bone. Human ribs were obtained from 110 subjects (M:68, F;42) aged 20-93 years. The fluoride distribution from the periosteal to endosteal surfaces of the ribs was determined by sampling each specimen using an abrasive micro-sampling technique, and the samples were analyzed using the fluoride electrode, as described by Weatherell et al. [1]. The concentration of fluoride was highest in the periosteal region, decreased gradually towards the interior of the tissue where the concentration of fluoride tended toward the plateau, and then rose again towards the endosteal surface. Patterns of fluoride distribution changed with age, and the difference between periosteal and endosteal fluoride levels increased with age. Although average fluoride concentrations increased with age in both sexes, there was a significant difference between males and females at the age of about 55 years (P < 0.05).


Endovascular Treatment of Deep Vein Thrombosis.
Venous thromboembolism (VTE) is associated with substantial morbidity and mortality. Conventional treatment with anticoagulation therapy may undertreat the condition. Patients with VTE are at risk for recurrence with increasing time passage. Endovascular approaches exist for treating VTE, including deep vein thrombosis, but it is unclear which patients are appropriate candidates for endovascular versus medical approaches. Many new endovascular technologies are in development, and new oral anticoagulants are also on the market. Clinicians must be mindful of these new products and use them appropriately to better manage VTE.


Improvement of carbon source composition reduces antibiotic resistance genes in the ectopic fermentation system.
Effectively reduce antibiotic resistance genes (ARGs) in ectopic fermentation system (EFS) is essential for practical production. In this study, three experiments were performed to explore how to remove ARGs in EFS effectively. Results demonstrated that ARGs were easily enriched in rice-husk-sawdust padding; simultaneous addition of laccase and cellulase suppressed the ARGs, mainly by increasing soluble carbohydrate concentration and promoting humic acid concentration; addition of corn stalks into rice-husk-sawdust decreased the abundance of ARGs by improving the carbon source structure and enhancing cellulase activity. In conclusion, the present study provides a guidance to reduce the threat of ARGs in EFS, which paved a potential pathway to safely utilize manure resources.


Central role of left atrial dynamics in limiting exercise cardiac output increase and oxygen uptake in heart failure: insights by cardiopulmonary imaging.
In heart failure (HF), the haemodynamic response to exercise in relation to left atrial (LA) dynamics is unexplored. We sought to define whether abnormal LA dynamics during exercise may play a role in cardiac output (CO) limitation and tested its ability to predict outcome. A total of 195 HF patients with reduced (n = 105), mid-range (n = 48), and preserved (n = 42) left ventricular ejection fraction (LVEF) and 46 non-cardiac dyspnoea (NCD) subjects underwent cardiopulmonary imaging with assessment of LA strain and strain rate (sra). HF patients, irrespective of LVEF, exhibited a significantly impaired LA strain and LA sra at rest, during exercise and recovery compared to NCD subjects with a blunted response in CO and right ventricular to pulmonary circulation coupling. LA strain and LA sra during exertion were significantly correlated with peak stroke volume index, peak CO and peak cardiac power output (R = 0.33, 0.48, 0.50 and R = 0.36, 0.51, 0.52 for LA strain and LA sra, respectively; all P < 0.001). In HF, after adjustment for age, gender, left atrial volume index, peak mitral regurgitation > 2, peak LVEF and peak heart rate, a higher LA strain (1% increase) during exercise was associated with a higher peak stroke volume index (mL/m2 ), CO (L/min) and cardiac power output (mmHg L/min) at multivariable analyses (β-coefficients ± standard error = 0.23 ± 0.07, 0.046 ± 0.014 and 0.012 ± 0.004, respectively; P < 0.05). The same associations were found also for LA sra (absolute value) (1/s increase, β-coefficients ± standard error = 1.91 ± 0.68, 0.43 ± 0.14 and 0.12 ± 0.04, respectively; P < 0.05). Exercise LA strain (adjusted hazard ratio 0.94, 95% confidence interval 0.92-0.97, P < 0.001) and LA sra (adjusted hazard ratio 0.60, 95% confidence interval 0.43-0.84, P = 0.003) were associated with a worse outcome after adjusting for age and gender. In HF, LA dynamics may play a key role in exercise CO increase due to an impaired forward (left ventricular filling) and backward (right ventricular to pulmonary circulation uncoupling) combination of mechanisms, irrespective of LVEF. The blunted LA strain and LA sra reserve during exercise are associated with a worse cardiopulmonary performance and outcome.


Gene-Environment Interactions in Attention-Deficit/Hyperactivity Disorder Symptom Dimensions: The Role of Unhealthy Food Habits.
Background: Dietary habits were investigated as environmental risk factors for Attention-Deficit/Hyperactivity Disorder (ADHD). However, no previous studies explored the effects of dietary factors on modifying the role of genetic factors on ADHD. Methods: Based on a Swedish population-based twin study with 1518 twin pairs aged 20-47 years, we tested whether the importance of genetic and environmental effects on ADHD varied as a function of dietary habits. Self-reported dietary habits and ADHD symptoms were collected. Twin methods were used to test the degree to which high-sugar and unhealthy food intake moderated the genetic and environmental influences on ADHD symptoms. Results: In middle-aged adults, genetic influences on inattention symptoms were statistically significantly higher among individuals with higher levels of high-sugar (45%, 95%CI: 25-54%) and unhealthy food intake (51%, 95%CI: 31-60%), compared with those with lower levels of consumption of high-sugar (36%, 95%CI: 25-47%) and unhealthy foods (30%, 95%CI: 20-41%). Similar patterns were also found for the associations between hyperactivity/impulsivity and high-sugar/unhealthy food intake, even though the moderation effects were not statistically significant. Conclusion The present study suggests that genetic factors play a more prominent role in individual differences of ADHD symptoms in the presence of the high consumption of sugar and unhealthy foods. Future longitudinal studies with multiple assessments of ADHD and dietary habits are needed to replicate our findings.


Application of an index derived from the area under a neutrophil curve as a predictor of surgical site infection after spinal surgery.
Patients with prolonged and intense neutrophilia after spinal surgery are at high risk of developing surgical site infection (SSI). To date, there is no standard method for the objective assessment of the intensity and duration of neutrophilia. Thus, this retrospective observational study aimed to test a new index (I-index), developed by combining the duration and intensity of neutrophilia, as a predictor of SSI. I-index was calculated based on the postoperative neutrophil percentage. A total of 17 patients with SSI were enrolled as cases, and 51 patients without SSI were selected as controls. The groups were matched at a ratio of 1:3 by age, sex, and surgery type. The differences in the I-index were compared between the groups. Moreover, we checked the cumulative I-index (c-I-index), which we defined as the area under the neutrophil curve from postoperative day 1 until the first clinical manifestation of SSI in each case. Furthermore, a cutoff for SSI was defined using the receiver operating characteristic curve. The median I-index-7, I-index-14, and c-I-index were significantly higher in the SSI group than those in the control group. For a cutoff point of 42.1 of the I-index-7, the sensitivity and specificity were 0.706 and 0.882, respectively. For a cutoff point of 45.95 of the I-index-14, the sensitivity and specificity were 0.824 and 0.804, respectively. For a cutoff point of 45.95 of the c-I-index, the sensitivity and specificity were 0.824 and 0.804, respectively. We devised a new indicator of infection, i.e., the I-Index and c-I-index, and confirmed its usefulness in predicting SSI.