Relationship and sexual satisfaction are associated with better disease self-management in persons with epilepsy.
Prior research has demonstrated that PWEs view intimate interpersonal relationships as personally important and as a substantive challenge in their lives. This is significant as high-quality intimate relationships have been linked with greater well-being and better healthcare self-management in other disease contexts. For persons with epilepsy (PWEs), self-management is critical for seizure control, lower mortality, and better quality of life. In the current study, we conducted the first known investigation into the quality of PWEs' intimate relationships and their self-management abilities. In a sample of 88 PWEs, using the Adult Epilepsy Self-Management Instrument, results demonstrate links between greater relationship satisfaction and sexual satisfaction with better self-management on seven of the eleven subscales: health communication, coping skills, social support, seizure tracking, seizure response, stress management, and wellness; satisfaction was unrelated to the treatment, safety, medical adherence, and proactivity subscales. Importantly, these results held while controlling for age, gender, social support, and presence of comorbidities. These findings provide some evidence of the importance of intimate relationships in understanding PWEs' healthcare management abilities. Given that intimate relationship dynamics have been shown to be highly amenable to intervention, this is an area of potential interest for improving self-management in PWEs.


Communication methods between outpatients with limited-English proficiency and ancillary staff: LASI study results.
Describe communication methods between primary care ancillary staff, including front desk administrative staff and medical assistants (MAs), and patients with limited-English proficiency (LEP). Patients with LEP completed a telephone survey after a primary care visit including questions about communication with ancillary staff (n = 1029). To inform practice improvements and lend qualitative perspective to these quantitative data, we subsequently conducted semi-structured interviews with ancillary staff and physicians. Professional interpreter use was minimal with ancillary staff (<4%). Among patients who did not use their preferred language with bilingual staff, about one-third reported using English to communicate, despite most (≥ 80%) speaking English 'not well' or 'not at all.' In semi-structured interviews, ancillary staff felt basic English sufficient for most patient communication. However, physicians reported taking on extra visit tasks to compensate for the communication barriers between ancillary staff and patients with LEP. Use of professional interpretation by front desk staff and MAs was minimal. This led many patients with LEP to 'get by' with limited English when communicating with ancillary staff, in turn increasing burden on the physician visit. Future interventions should focus on increasing use of professional interpretation by outpatient ancillary staff when communicating with LEP patients.


[Do digital technologies at work impact mental health of employees?]
Traditional work stress research identified a large number of stressors; however, technology as a source of stress was not the focus of interest for long time. This article describes the concept of technostress and investigates the impact of digital technologies at work on mental health. Narrative review. Conceptualization of technostress, potential mechanisms of action and summary of empirical results on the influence on mental health. Several domains of technostress have been defined so far. Although empirical studies are rare and subject to methodological limitations, results suggest that certain types of technostress at work may have an adverse effect on mental health. Notably, digital technologies may also have a positive impact on the psychological well-being of employees if, for example, they enable better work organization. The digitalization of work is related to specific risks for the mental health of employees but also to possible benefits. Implications for further research in this developing field are identified.


Single amino acid residue changes in subsite -1 of levansucrase from Zymomonas mobilis 10232 strongly influence the enzyme activities and products.
The -1 subsite of bacterial fructansucrases (FSs) (levansucrases and inulosucrases) plays an important role in the substrate recognition, binding and catalysis. Three residues (for example W47, W118 and R193, Zymomonas mobilis levansucrase numbering) at the -1 subsite are completely conserved among FSs. Site-directed mutational analysis showed that the substitutions of the three strictly conserved amino acid residues, W47N, W47H, W118N, W118H, R193K and R193H, significantly decreased enzyme activities and synthesis rates of levan, while the size of the synthesized oligosaccharides had been influenced. These experimental results, combined with 3D structure modeling, lead to our proposal that a single amino acid residue change in subsite -1 of levansucrase can influence change to the size and polarity of the sucrose binding pocket with a concomitant change to substrate binding and catalysis, and thus having an overall influence on the enzyme activities and products.


Stimulation of sulfate and thymidine incorporation into hypophysectomized rat cartilage by growth hormone and insulin-like growth factor-I in vitro: the somatomedin hypothesis revisited.
These studies were undertaken in an attempt to demonstrate sensitivity of cartilage from hypophysectomized rats to growth hormone (GH) in physiologic concentrations in vitro and to compare the actions of the hormone and extrinsic insulin-like growth factor-I (IGF-I). In a HEPES-buffered, amino acid-glucose nutrient medium with a low concentration of bovine serum albumin, costal cartilage explants from such animals were responsive to purified or recombinant bovine GH (bGH) and recombinant human GH (hGH) with a sensitivity of less than 100 ng/ml [corrected]. Sulfate incorporation into proteoglycans and thymidine incorporation into DNA were increased. The effect on sulfate incorporation was near maximal by 24 hours, but the peak effect on thymidine incorporation was delayed. Comparison of the dose-response relationships of bGH and IGF-I demonstrated a greater effect of IGF-I with increasing concentrations of each. The action of bGH was inhibited by an immunoglobulin G fraction of an IGF-I antiserum. These results are consistent with previously available evidence that IGF-I has an autocrine/paracrine action on cartilage, which is regulated by GH. However, the limited cartilage response to the direct action of GH supports the hypothesis of Daughaday that IGF-I also has an endocrine role in the stimulation of skeletal growth by the pituitary hormone.


Multifunctional nanoassemblies for vincristine sulfate delivery to overcome multidrug resistance by escaping P-glycoprotein mediated efflux.
Multifunctional nanoassemblies (MNAs) were successfully developed for controlled delivery of water-soluble cationic vincristine sulfate (VCR) to overcome multidrug resistance (MDR). The incorporation of anionic small molecule of phosphatidylserine (PS) significantly enhanced the encapsulation efficiency of VCR in MNAs up to 94.4% by electrostatic interaction. Obvious sustained-release characteristics were found in VCR-loaded MNAs (VCR-MNAs) as the cumulative release of VCR was 83.2% at 96 h, and burst-release was effectively diminished. In vivo pharmacokinetics in rats following intravenous administration demonstrated that VCR-MNAs had higher AUC and longer t(1/2) than VCR solution (VCR-Sol). To investigate the MDR reversal effect and clarify the possible mechanism induced by MNAs, the cytotoxicity, cellular uptake and uptake mechanism experiments were performed in MCF-7 and P-glycoprotein over-expressing MCF-7/Adr cells, respectively. Compared with VCR-Sol, VCR-MNAs efficiently enhanced the cytotoxicity to 36.5-fold by increasing the cellular accumulation of VCR (12.6-fold higher) in MCF-7/Adr cells. The results of endocytosis inhibition experiment proved that VCR-MNAs were uptaken into the resistant cancer cells by clathrin- and caveolae-mediated endocytosis pathways, which escaped the efflux induced by P-gp transporter and thereby overcame the MDR of VCR.


Aquaporin-4 expression after experimental contusional injury in an ovine impact-acceleration head injury model.
Cerebral contusions are one of the principal lesions of traumatic brain injury and the attendant oedema formation contributes substantially to the clinicopathological manifestations. While it is now recognised that the membrane channel protein aquaporin-4 (AQP-4) plays a major role in the development and resolution of cerebral oedema, assessments of its expression in and around contusions have produced conflicting results. We used an ovine impact-acceleration model of closed head injury to examine contusion-related AQP-4 expression and found that there was a heterogeneous AQP-4 response within contusions, with some astrocytes being nonviable and immunonegative, while others showed increased AQP-4 expression. Pericontusional astrocytes in the penumbra region generally showed more robust AQP-4 immunopositivity than intracontusional glia. Thus, manipulation of AQP-4 expression could have therapeutic applications in controlling cerebral oedema associated with contusions.


Increased mTOR and suppressed autophagic flux in the heart of a hypomorphic Pkd1 mouse model of autosomal dominant polycystic kidney disease.
Cardiac hypertrophy is common in autosomal dominant polycystic kidney disease (ADPKD) patients. We found increased heart weight in Pkd1RC/RC and Pkd2WS25/+ mouse models of ADPKD. As there is a link between increased heart weight and mammalian target of rapamycin (mTOR), the aim of the study was to determine mTOR complex 1 and 2 signaling proteins in the heart in the Pkd1RC/RC mouse model of PKD. In 70 day old Pkd1RC/RC hearts, on immunoblot analysis, there was a large increase in p-AMPKThr172, a known autophagy inducer, and an increase in p-AktSer473 and p-AktThr308, but no increase in other mTORC1/2 proteins (p-S6Ser240/244, p-mTORSer2448). In 150 day old Pkd1RC/RC hearts, there was an increase in mTORC1 (p-S6Ser240/244) and mTOR-related proteins (p-AktThr308, p-GSK3βSer9, p-AMPKThr172). As the mTOR pathway is the master regulator of autophagy, autophagy proteins were measured. There was an increase in p-Beclin-1 (BECN1), an autophagy regulator and activating molecule in Beclin-1-regulated autophagy (AMBRA1), a regulator of Beclin that play a role in autophagosome formation, an early stage of autophagy. There was a defect in the later stage of autophagy, the fusion of the autophagosome with the lysosome, known as autophagic flux, as evidenced by the lack of an increase in LC3-II, a marker of autophagosomes, with the lysosomal inhibitor bafilomycin, in both 70 day old and 150 day old hearts. To determine the role of autophagy in causing increased heart weight, Pkd1RC/RC were treated with 2-deoxyglucose (2-DG) or Tat-Beclin1 peptide, agents known to induce autophagy. 2-DG treatment from 150 to 350 days of age, a time period when increased heart weight developed, did not reduce the increased heart weight. Unexpectedly, Tat-Beclin 1 peptide treatment from 70 to 120 days of age resulted in increased heart weight. In summary, there is suppressed autophagic flux in the heart at an early age in Pkd1RC/RC mice. Increased mTOR signaling in older mice is associated suppressed autophagic flux. There was a large increase in p-AMPKThr172, a known autophagy inducer, in both young and old mice. 2-DG treatment did not impact increased heart weight and Tat-Beclin1 peptide increased heart weight.


The influence of caregivers' burden on the quality of life for caregivers of older adults with chronic illness in Nigeria.
This study investigated the impact of caregivers' burden on health-related quality of life (HRQoL) among the caregivers of older adults, and tested the predictive effect of burden and socio-demographic factors on HRQoL. The study employed a cross-sectional design. Three hundred and twenty-five caregivers of older adults with chronic illness were purposively selected. Data were collected using the Zarit Burden Interview and Short Form (SF-36) Health Survey. Data were analyzed descriptively and inferentially. Findings revealed that 59.1% of caregivers experienced severe burden. In measuring the HQRoL, respondents performed poorly in seven domains: Role limitation due to emotional problems (19.69 ± 9.46), Energy/fatigue (43.47 ± 16.46), Emotional well-being, (45.83 ± 13.93), Social functioning (49.09 ± 18.46), Role limitation due to physical function (43.33 ± 10.15), Physical functioning (43.6 ± 18.73), and General health (37.31 ± 12.09). Respondents, however, showed a higher score in the pain domain (56.77 ± 35.79). Furthermore, findings revealed a positive correlation between caregivers' burden and General health (r = 0.342), Emotional well-being (r = 0.222), and Physical functioning (r = 0.083). Similarly, there is a negative correlation between caregivers' burden and Social functioning (r = -0.618), Role limitation due to physical activities (r = 0.459), Role limitation due to emotional well-being (r = -0.530), and Energy/fatigue domains (r = -0.509). In addition, burden of caregiving (β=-3.142119, p = 0.000) and age (β=0.612752, p = 0.011) are predictors of the quality of life of caregivers. This study concluded that there is a high prevalence of caregivers' burden resulting in poor HQRoL. In addition, burden and age are predictors of the quality of life of caregivers.


The mechanism of hydrating and solidifying green mine fill materials using circulating fluidized bed fly ash-slag-based agent.
This study focused on classifying and disposing Circulating fluidized bed (CFB) fly ashes from the level of its origin, and proposed an optimal formulation system for clinker-free cemented backfill materials. CFB fly ash-blast furnace slag (BFS)-based cemented backfill materials with unequal strength grades are used in different locations of the goaf that require more than 1 Mpa and 4 Mpa, respectively, and the leaching levels of all toxic components are lower than the underground III water quality standard limit when the additional amount of CFB fly ash does not exceed 60 wt.%. The stable S/S of Cl- is due to the combined effect of chemical fixation of HCC and physical adsorption of the C-S-H/C-A-S-H phase. B2(20 wt.% CFB fly ash) exhibits more functional hydration products and higher degree of polymerization with the hydration age extension. Ettringite is the major effective product of CFB fly ash-BFS-based cemented system due to low level of chlorine environment and HCC transformation. CFB fly ash with appropriate active Al2O3 can dissolve and promote [AlO4]5- to substitute [SiO4]4- to form the C-A-S-H phase with longer chains and higher degree of polymerization with increase in Al/Si ratio of C-A-S-H/C-S-H phase.


A Nationwide multicenter registry and biobank program for deep phenotyping of idiopathic and hereditary pulmonary arterial hypertension in Korea: the PAH platform for deep phenotyping in Korean subjects (PHOENIKS) cohort.
Pulmonary arterial hypertension (PAH) is a progressive, chronic disease without curative treatment. Large registry data of these patient populations have been published, although, phenotypic variants within each subtype of PAH have not been elucidated. As interest towards personalized medicine grows, the need for a PAH cohort with a comprehensive understanding of patient phenotypes through multiomics approaches, called deep phenotyping, is on the rise. The PAH Platform for Deep Phenotyping in Korean Subjects (PHOENIKS) cohort is designed to collect clinical data as well as biological specimens for deep phenotyping in patients with idiopathic PAH (IPAH) and heritable PAH (HPAH) in Korea. A total of 17 regional hospitals are currently working on enrolling up to 100 consecutive IPAH/HPAH patients for obtaining clinical data and biological specimens across Korea. The diagnosis of PAH is based on right heart catheterization. All clinical data is stored in a government-based online database. Each participating hospitals collect a whole blood sample from each patient, through which DNA, RNA, serum, plasma, and peripheral blood mononuclear cells will be extracted from the buffy coat layer for further multiomics analysis. Not applicable. The PHOENIKS cohort is enrolling IPAH and HPAH patients across Korea to determine the prognosis and drug response in different phenotypic variant. The data generated by this cohort are expected to open new doors for personalized medicine in PAH patients of South Korea. ClinicalTrials.gov NCT03933579. Registered on May 1st, 2019.


Assays for S-adenosylmethionine (AdoMet/SAM)-dependent methyltransferases.
Modification of small molecules and proteins by methyltransferases impacts a wide range of biological processes. Here we report two methods for measuring methyltransferase activity. First we describe an enzyme-coupled continuous spectrophotometric assay used to quantitatively characterize S-adenosyl-L-methionine (AdoMet or SAM)-dependent methyltransferase activity. In this assay, S-adenosyl-L-homocysteine (AdoHcy or SAH), the transmethylation product of AdoMet-dependent methyltransferase, is hydrolyzed to S-ribohomocysteine and adenine by recombinant AdoHcy nucleosidase. Subsequently, the adenine generated from AdoHcy is further hydrolyzed to homoxanthine and ammonia by recombinant adenine deaminase. This deamination is associated with a decrease in absorbance at 265 nm that can be monitored continuously. Secondly, we describe a discontinuous assay that follows radiolabel incorporation into the methyl receptor. An advantage of both assays is the destruction of AdoHcy by AdoHcy nucleosidase, which alleviates AdoHcy product feedback inhibition of S-adenosylmethionine-dependent methyltransferases. Importantly both methods are inexpensive, robust, and amenable to high throughput.


Geriatric depression, antidepressant treatment, and healthcare utilization in a health maintenance organization.
To assess the separate effects of depressive symptoms and antidepressant treatment on healthcare utilization and cost. Social Health Maintenance Organization (HMO) at HealthPartners in Minnesota. Geriatric Social HMO enrollees were screened for depressive symptoms using the 30-item Geriatric Depression Scale. A stratified sample was created, composed of geriatric enrollees with depressive symptoms, with antidepressant prescriptions, or with neither (n = 516). Regression analyses were conducted with separate equations for utilization and charge outcome variables, both outpatient and inpatient (log-transformed). The Charlson Comorbidity Index, age, and gender served as covariates. Depressive symptoms were identified through the Diagnostic Interview Schedule. Antidepressant treatment was determined from the HMO pharmacy database. Having depressive symptoms was associated with a 19 increase in the number of outpatient encounters and a 30 increase in total outpatient charges. Antidepressant treatment was associated with a 32 increase in total outpatient charges but was not significantly associated with number of outpatient encounters. Depressive symptoms and antidepressant therapy were not significantly associated with inpatient utilization or charges. This study found that patients with depressive symptoms generated more outpatient health care and higher charges but not necessarily more inpatient care. Our findings suggest that programs targeted to geriatric patients whose depression is comorbid with other chronic medical conditions might be cost-effective and particularly appropriate for geriatric care.


A simple procedure for the preparation of pure kinetoplast DNA network free of nuclear DNA from the kinetoplast hemoflagellate Leishmania donovani.
A simple, inexpensive procedure for preparing pure kinetoplast DNA network from Leishmania donovani is described. L. donovani promastigotes were lysed by incubating with pronase in presence of sodium dodecylsulfate. Crude kinetoplast DNA networks were obtained by centrifugation of the lysate through a 20% sucrose solution. The pellet containing kinetoplast DNA was deproteinized by phenol extraction. Contaminating nuclear DNAs were removed by denaturation with alkali, neutralization, and addition of polyethylene glycol-8000 to a concentration of 10% to facilitate precipitation of kinetoplast DNA. kDNA isolated after centrifugation was deproteinized several times with phenol and finally precipitated with ethanol. The average yield by this procedure is 30-50 micrograms of kDNA per gram of wet cells. By slot-blot hybridization with a nuclear DNA probe, no nuclear DNA contamination of the kDNA networks could be detected.


Glycated albumin suppresses glucose-induced insulin secretion by impairing glucose metabolism in rat pancreatic β-cells.
Glycated albumin (GA) is an Amadori product used as a marker of hyperglycemia. In this study, we investigated the effect of GA on insulin secretion from pancreatic β cells. Islets were collected from male Wistar rats by collagenase digestion. Insulin secretion in the presence of non-glycated human albumin (HA) and GA was measured under three different glucose concentrations, 3 mM (G3), 7 mM (G7), and 15 mM (G15), with various stimulators. Insulin secretion was measured with antagonists of inducible nitric oxide synthetase (iNOS), and the expression of iNOS-mRNA was investigated by real-time PCR. Insulin secretion in the presence of HA and GA was 20.9 ± 3.9 and 21.6 ± 5.5 μU/3 islets/h for G3 (P = 0.920), and 154 ± 9.3 and 126.1 ± 7.3 μU/3 islets/h (P = 0.046), for G15, respectively. High extracellular potassium and 10 mM tolbutamide abrogated the inhibition of insulin secretion by GA. Glyceraldehyde, dihydroxyacetone, methylpyruvate, GLP-1, and forskolin, an activator of adenylate cyclase, did not abrogate the inhibition. Real-time PCR showed that GA did not induce iNOS-mRNA expression. Furthermore, an inhibitor of nitric oxide synthetase, aminoguanidine, and NG-nitro-L-arginine methyl ester did not abrogate the inhibition of insulin secretion. GA suppresses glucose-induced insulin secretion from rat pancreatic β-cells through impairment of intracellular glucose metabolism.


Multicystic Dysplastic Kidney: Prenatal Compensatory Renal Growth Pattern.
To assess the prenatal growth pattern of the normal kidney contralateral to a multicystic dysplastic kidney (MCDK). A retrospective study was conducted in a single referral center over 4 years. Cases diagnosed prenatally as MCDK and confirmed postnatally constituted the study group. For creation of nomograms, only isolated cases of MCDK were included. Sixty-one fetuses had a diagnosis of an MCDK during the study period. After exclusion of cases with associated malformations, 47 fetuses remained, providing 94 measurements for creation of nomograms. The growth pattern of the normal kidney contralateral to an MCDK was linear throughout gestation (percentile = 20.01 + 1.5 gestational age; linear R2 = 0.753; r = 0.868) and was significantly higher during the third trimester (29-38 weeks' gestation) compared to the second trimester (22-28 weeks' gestation; P < .001). A comparison of the growth pattern of the normal kidney contralateral to the MCDK to the growth pattern of a solitary kidney revealed a significant higher compensatory trend during the third trimester (P < .0001). The mean kidney lengths at 22 and 38 weeks' gestation correlated with the 52nd and 88th and with the 84th and 90th percentiles for the normal kidney contralateral to the MCDK and a solitary kidney, respectively. According to our study, the normal kidney contralateral to an MCDK has a unique growth pattern during intrauterine life, with dominant growth during the third trimester. The exact mechanism for this pattern, in comparison to early renal hypertrophy shown in solitary kidneys, is currently not clear. These data provide relevant information for the multidisciplinary prenatal counseling of future parents regarding the future renal outcome.


A practical guide to photoswitching optoacoustics tomography.
Photochromic proteins and photoswitching optoacoustics (OA) are a promising combination, that allows OA imaging of even small numbers of cells in whole live animals and thus can facilitate a more wide-spread use of OA in life-science and preclinical research. The concept relies on exploiting the modulation achieved by the photoswitching to discriminate the agents' signal from the non-modulating background. Here we share our analysis approaches that can be readily used on data generated with commercial OA tomography imaging instrumentation allowing-depending on the used photoswitching agent and sample-routine visualizations of as little as several hundreds of transgene labeled cells per imaging volume in the live animal.


Discovery of the cardiovascular system: from Galen to William Harvey.
The goal of this review is to examine the events that led to discovery of blood circulation. The Ancient Greeks, including Hippocrates and Galen viewed the cardiovascular system as comprising two distinct networks of arteries and veins. Galen claimed that the liver produced blood that was then distributed to the body in a centrifugal manner, whereas air or pneuma was absorbed from the lung into the pulmonary veins and carried by arteries to the various tissues of the body. Arteries also contained blood, which passed from the venous side via invisible pores in the interventricular septum and peripheral anastomoses. This was an open-ended system in which blood and air simply dissipated at the ends of veins and arteries according to the needs of the local tissue. Blood was not seen to circulate but rather to slowly ebb and flow. This view would hold sway for 15 centuries until 1628 when William Harvey published his momentous 72-page book, On the Motion of the Heart and Blood in Animals. Harvey employed experiment and deductive logic to show that arteries and veins are functionally, if not structurally, connected in the lung and the peripheral tissues, and that blood circulates. The mechanical force of the heart replaced Galen's elusive attractive powers. Ultimately, Galenism would collapse under the weight of Harvey's evidence, and a new paradigm of blood circulation would prevail.


Phenolic derivatives from Blaps japanensis and their biological evaluation.
This study was designed to characterize compounds from two thousands of insects of Blaps japanensis. With this purpose, pipajiains A-C (1-3), three novel phenolic derivatives, pipajiains D (4) and E (5), two new natural occurring compounds, and four known substances were isolated thereof. Their structures were identified by spectroscopic methods. Biological activities of all these compounds towards EV71, tuberculosis, COX-2, ROCK1/2, and JAK3 kinases were evaluated.


Glutathione S-transferases in human ovarian follicular fluid.
To study the levels of glutathione S-transferase Alpha 1-1 and glutathione S-transferase Pi 1-1 in human preovulatory ovarian follicular fluid (FF) and pooled granulosa and cumulus cells. The relation of glutathione S-transferase Alpha 1-1 and glutathione S-transferase Pi 1-1 with P and 17 beta-E2 concentrations were studied. The Department of Obstetrics and Gynecology, the Department of Gastroenterology, and the Laboratory of Endocrinology and Reproduction of the University Hospital Nijmegen in Nijmegen, the Netherlands. Infertile women participating in an IVF program. Detectable amounts of glutathione S-transferase Alpha 1-1 and glutathione S-transferase Pi 1-1 were found in ovarian FF and pooled cumulus and granulosa cells. Concentrations of glutathione S-transferase Alpha 1-1 were always much higher than those of glutathione S-transferase Pi 1-1. Both ovarian FF concentrations of glutathione S-transferase Alpha 1-1 and glutathione S-transferase Pi 1-1 did not correlate with ovarian FF concentrations of 17 beta-E2 and P. The high FF concentrations of glutathione S-transferase Pi 1-1 and especially of glutathione S-transferase Alpha 1-1 suggest that these enzymes may play an important role in the detoxification processes in the follicles. The lack of correlation between follicular P and 17 beta-E2 and glutathione S-transferase Alpha 1-1 and glutathione S-transferase Pi 1-1 indicates that both enzymes presumably are not present as a result of the high steroid levels.


Practical applications of energy dispersive X-ray microanalysis in diagnostic oral pathology.
Energy dispersive X-ray microanalysis is a powerful tool that can reveal the presence and relative quantities of elements in minute particles in biologic materials. Although this technique has been used in some aspects of dental research, it has rarely been applied to diagnostic oral pathology. The purpose of this paper is to inform practicing dentists and oral specialists about the diagnostic potential of this procedure by presenting three case reports. The first case involved the identification of flakes of a metallic material claimed by a 14-year-old girl to appear periodically between her mandibular molars. In the second case, a periodontist was spared a lawsuit when a freely mobile mass in the antrum of his patient was found to be a calcium-phosphorus compound not related to the periodontal packing that had been used. The third case involved the differential diagnosis of amalgam tattoo and graphite tattoo in a pigmented lesion of the hard palate mucosa. The results of the analyses were significant and indicate a role for this technique in the assessment of selected cases. Potential for wider use of energy dispersive X-ray microanalysis in diagnostic oral pathology exists as research progresses.


[Immunocorrective effect of hemosorption in the comprehensive therapy of malignant tumors in children].
In 25 children with malignant tumours of the retroperitoneal space and mediastinum, hemosorption was performed before and after operation in combination with chemotherapy with the aim of immunocorrection and detoxication of an organism. Under the influence of hemosorption, the general state of the patients improved, their immune status normalized permitting not to interrupt a course of chemotherapy.


High-Density Lignin-Derived Carbon Nanofiber Supercapacitors with Enhanced Volumetric Energy Density.
Supercapacitors are increasingly used in short-distance electric transportation due to their long lifetime (≈15 years) and fast charging capability (>10 A g-1 ). To improve their market penetration, while minimizing onboard weight and maximizing space-efficiency, materials costs must be reduced (<10 $ kg-1 ) and the volumetric energy-density increased (>8 Wh L-1 ). Carbon nanofibers display good gravimetric capacitance, yet their marketability is hindered by their low density (0.05-0.1 g cm-3 ). Here, the authors increase the packing density of low-cost, free-standing carbon nanofiber mats (from 0.1 to 0.6 g cm-3 ) through uniaxial compression. X-ray computed tomography reveals that densification occurs by reducing the inter-fiber pore size (from 1-5 µm to 0.2-0.5 µm), which are not involved in double-layer capacitance. The improved packing density is directly proportional to the volumetric performances of the device, which reaches a volumetric capacitance of 130 F cm-3 and energy density of 6 Wh L-1 at 0.1 A g-1 using a loading of 3 mg cm-2 . The results outperform most commercial and lab-scale porous carbons synthesized from bioresources (50-100 F cm-3 , 1-3 Wh L-1 using 10 mg cm-2 ) and contribute to the scalable design of sustainable electrodes with minimal 'dead volume' for efficient supercapacitors.


Lipid peroxidation products as a mediator of toxicity and adaptive response - The regulatory role of selenoprotein and vitamin E.
Lipid peroxidation and its products have been investigated extensively and their biological importance, particularly in relation to physiological and pathophysiological conditions, has received considerable attention. Lipids are oxidized by three distinct mechanisms, i.e., enzymatic oxidation, nonenzymatic, free radical-mediated oxidation, and nonenzymatic, nonradical-mediated oxidation, which respectively yield specific products. Lipid hydroperoxides are the major primary products formed and are reduced to the corresponding hydroxides by antioxidative enzymes such as selenoproteins, and/or undergo secondary oxidation, generating various products with electrophilic properties, such as 4-hydroxy-2-nonenal. Lipid peroxidation induces a loss of fine structure and natural function of lipids, and can produce cytotoxicity and/or novel biological activity. This review broadly discusses the mechanisms of lipid peroxidation and its products, its utility as a biomarker for oxidative stress, the biological effects of lipid peroxidation products, including their action as a mediator of the adaptive response, and the role of the antioxidant system, particularly selenoproteins and vitamin E, in preventing lipid peroxidation and ferroptosis.


Molecular genotyping reveals inter-regional relatedness among antimicrobial resistant Salmonella Minnesota strains isolated from poultry farm and humans, Brazil.
Genetic profiles of Salmonella Minnesota isolates were analyzed using pulsed-field gel electrophoresis (PFGE). In total, 13 isolates obtained from the broiler industry collected in the states of Minas Gerais (11) and São Paulo (2), as well as five recovered from cases of foodborne infections in humans in the states of Minas Gerais (2), Santa Catarina (1), and Rio Grande do Sul (2), were submitted to PFGE. These 18 S. Minnesota isolates together with other 12 of poultry origin were also subjected to antimicrobial susceptibility testing. The PFGE analysis of 18 strains of S. Minnesota generated a dendrogram that grouped the isolates with 83-90% similarity into four main clusters. Among them, cluster "A" grouped the majority of isolates (13), including two of human origin that showed 90% similarity with a broiler isolate, both recovered in Minas Gerais. The S. Minnesota isolates showed resistance to tetracycline (80%), cefoxitin (80%), ceftazidime (46.7%), nalidixic acid (23.3%), ciprofloxacin (13.3%), and streptomycin (10%). No resistance to gentamicin, chloramphenicol, meropenem, nitrofurantoin, and sulfamethoxazole-trimethoprim was found. Moreover, 23.3% of the evaluated isolates presented multi-resistance profile, all from Minas Gerais. The results highlight the importance of further studies involving S. Minnesota, which is prevalent in the Brazilian broiler flocks and could provoke foodborne infection in humans.


Production of Polysaccharides and Single-Cell Protein by Some Local Isolates of Trichoderma spp.
Background and Objective: Polysaccharides and Single-cell protein are one of the best essential natural products of microorganisms, they are excreted by different microorganisms such as yeast, fungi, bacteria and algae. This study was carried out to detect the ability of four local fungal isolates of Trichoderma spp. to produce polysaccharides and Single-cell protein. Materials and Methods: Standard Czapek Dox Broth Medium was used to detect the ability of fungal isolates to produce polysaccharides and Single-cell protein, with modified the components of medium for improved production using banana peels as a source of carbon and different nitrogen sources at different concentrations and the factorial experiment was carried out using a completely randomized design Results: The highest dry weight and polysaccharides production and protein content have been achieved for the fungus T. reesei with rates of (2.15, 0.276 and 0.94) g/100 mL, respectively, in comparison with the other treatments, the use of ammonium phosphate at concentration 0.6 g L1 has given the highest dry weight and production of polysaccharides and protein content with rates of (3.75, 0.364 and 2.77) g/100 mL, respectively, also the use of banana peels extract at concentration 40 mL L1 has given the highest dry weight and production of polysaccharides and protein content with rates of (5.21, 0.539 and 3.63) g/100 mL, respectively. Conclusion: The possibility of using the local isolate of T. reesei in the production of polysaccharides and Single-cell protein using some cheap agricultural waste such as banana peels as a carbon source instead of throwing them as waste and pollutants for the environment.


Bactericidal activity of tinidazole. An in vitro comparison of the effects of tinidazole and metronidazole against Bacteroides fragilis and other Anaerobic bacteria.
The new antiprotozoal agent, tinidazole, was found to be bactericidal against all 52 isolates of obligate anaerobic bacteria tested, 42 Bacteroides fragilis, 4 clostridia and 6 peptostreptococci. The minimum bactericidal concentrations of tinidazole for B. fragilis ranged from 0.25 to 4 mug/ml, and those of metronidazole from 0.25 to 8 mug/ml, i.e. several times lower than the serum concentrations achievable after oral administration. In most cases the MIC was identical with MBC or half of it. On the average, tinidazole was slightly more effective against B. fragilis than metronidazole. Although essentially the activities of the two drugs were positively correlated, there was a fourfold difference in their MBC for 10 of the 42 B. fragilis.


Acute phencyclidine poisoning in the unanesthetized dog: pathophysiologic profile of acute lethality.
Phencyclidine HCl was infused intravenously (1.0 mg/kg/min) to unanesthetized mongrel dogs until death. All animals experienced tonic-clonic convulsions (mean convulsive dose: 4.7 +/- 0.3 mg/kg) which lasted until shortly before death (mean lethal dose: 49.8 +/- 2.5 mg/kg). Significant increases in heart rate, arterial blood pressures, cardiac output, body temperature, and arterial pCO2 were observed in all animals. Significant reductions from pre-drug control values were observed in total peripheral resistance, arterial pH, arterial pO2, and respiratory minute volume. Blood lactate, oxygen uptake, and plasma glucose levels rose to values significantly higher than pre-drug control values then declined during the latter phase of the experiment, glucose levels decreased to final values lower than control. Animals appeared to die of primary respiratory failure, which was exacerbated by hyperthermia, and which resulted in final cardiovascular collapse.


Synthesis and antifungal activities of natural and synthetic biflavonoids.
The synthesis of some natural and synthetic biflavonoids was performed in good overall yields starting from readily available materials via high yielding aldol and Ullmann condensations. Some of these compounds, especially bichalcones, display an interesting activity against fungi, higher than that of the corresponding monomers.


Examining daily parent involvement in caregivers of children with ADHD using electronic diaries.
Limited research has examined the associations between child ADHD symptoms and parent involvement and has generally relied on the use of parents' retrospective reports of parent involvement and ADHD symptoms. Using daily reports, the current study explored the pathways between child ADHD symptoms and home-based parental involvement beliefs and behaviors. Data were collected daily from 26 parent participants over a 2-week period for a total of 315 time points. Daily surveys asked parents to report on child ADHD symptoms, parental self-efficacy, parental time/energy, and home-based involvement quality. Results indicated that parental self-efficacy mediated the association between children's inattentive symptoms and parental home-based involvement quality. Children's hyperactive/impulsive symptoms moderated the association between parental time/energy and parental home-based involvement quality. These results suggest that parental self-efficacy is an important factor in explaining how children's inattention is associated with parental quality of home-based involvement. In addition, the association between parental time/energy and home-based involvement quality was lower when parents perceived their child to have higher levels of symptoms.


Non-invasive technique for examining the respiratory proprioceptor system in man.
Our technique enables non-invasive experiments to be conducted on the proprioceptor part of respiratory control, while eliminating misleading responses due to interaction with the chemoreceptor system; interaction was prevented by stabilizing arterial PO2 and PCO2 with the aid of an optimal regulator based on a mini-computer which controlled the inspired gas mixture. The proprioceptor system in a human was disturbed by applying positive pressure pulses at the mouth, responses were derived from continuous air-flow measurement. The classical inflation inhibiting reflex and an effect akin to Head's paradoxical reflex were demonstrated.


Clinical approach to patients with an ileal pouch.
Restorative proctocolectomy with ileal pouch-anal anastomosis is the procedure of choice to maintain intestinal continuity when a total proctocolectomy is a required. It is a technically challenging operation that may be burdened by several nuanced complications both in the immediate postoperative period and in the long term. Most patients with a pouch and any kind of complication will undergo radiological studies, thus multidisciplinary collaboration between surgeons, gastroenterologists, and radiologists is paramount to their timely and accurate diagnosis. When treating pouch patients, radiologists should be familiar with regular pouch anatomy and its appearance in imaging studies, as well as with the most common complications that can occur in this population. In this review, we examine the clinical decision-making process at each step before and after pouch creation, as well as the most common complications associated with pouch surgery, their diagnosis, and their management.


Slow pyrolysis of wood barks from Pinus brutia Ten. and product compositions.
Biomass in the form of pine bark (Pinus brutia Ten.) was pyrolysed in an externally heated fixed-bed reactor. The effects of temperature and heating rate on the yields and compositions of the products were investigated. Pyrolysis runs were performed using reactor temperatures between 300 and 500 degrees C with heating rates of 7 and 40 degrees Cmin(-1). The product yields were significantly influenced by the process conditions. The bio-oil obtained at 450 degrees C, at which the liquid product yield was maximum, was analysed. It was characterized by Fourier transform infrared spectroscopy. In addition, the solid and liquid products were analysed to determine their elemental composition and calorific value. Chemical fractionation of bio-oil showed that only low quantities of hydrocarbons were present, while oxygenated and polar fractions dominated. The empirical formula of the bio-oil with heating value of 31.03 MJkg(-1) was established as CH(1.43)O(0.332)N(0.0013).


Development and validation of prognostic model for predicting mortality of COVID-19 patients in Wuhan, China.
Novel coronavirus 2019 (COVID-19) infection is a global public health issue, that has now affected more than 200 countries worldwide and caused a second wave of pandemic. Severe adult respiratory syndrome-CoV-2 (SARS-CoV-2) pneumonia is associated with a high risk of mortality. However, prognostic factors predicting poor clinical outcomes of individual patients with SARS-CoV-2 pneumonia remain under intensive investigation. We conducted a retrospective, multicenter study of patients with SARS-CoV-2 who were admitted to four hospitals in Wuhan, China from December 2019 to February 2020. Mortality at the end of the follow up period was the primary outcome. Factors predicting mortality were also assessed and a prognostic model was developed, calibrated and validated. The study included 492 patients with SARS-CoV-2 who were divided into three cohorts: the training cohort (n = 237), the validation cohort 1 (n = 120), and the validation cohort 2 (n = 135). Multivariate analysis showed that five clinical parameters were predictive of mortality at the end of follow up period, including advanced age [odds ratio (OR), 1.1/years increase (p < 0.001)], increased neutrophil-to-lymphocyte ratio [(NLR) OR, 1.14/increase (p < 0.001)], elevated body temperature on admission [OR, 1.53/°C increase (p = 0.005)], increased aspartate transaminase [OR, 2.47 (p = 0.019)], and decreased total protein [OR, 1.69 (p = 0.018)]. Furthermore, the prognostic model drawn from the training cohort was validated with validation cohorts 1 and 2 with comparable area under curves (AUC) at 0.912, 0.928, and 0.883, respectively. While individual survival probabilities were assessed, the model yielded a Harrell's C index of 0.758 for the training cohort, 0.762 for the validation cohort 1, and 0.711 for the validation cohort 2, which were comparable among each other. A validated prognostic model was developed to assist in determining the clinical prognosis for SARS-CoV-2 pneumonia. Using this established model, individual patients categorized in the high risk group were associated with an increased risk of mortality, whereas patients predicted to be in the low risk group had a higher probability of survival.


Behçet's syndrome and factor XII deficiency.
Several mechanisms have been proposed to explain thrombotic tendency in Behçet's syndrome. We report the case of a 43-year old woman presenting retinal-vein thrombosis, factor XII deficiency and Behçet's syndrome. This kind of association has thus far never been reported. Factor XII deficiency is known to possibly induce various types of thrombosis and might explain the prevalence of ocular symptoms in our patient.


Challenges and issues in new vaccine development.
The Euroconference on Vaccines of the Future: from Rational Design to Clinical Development was held at the Pasteur Institute, Paris, France from 17-19 October 2001.


Worries, attitudes, and mental health of older adults during the COVID-19 pandemic: Canadian and U.S. perspectives.
Differences in older adults' worry, attitudes, and mental health between high-income countries with diverging pandemic responses are largely unknown. We compared COVID-19 worry, attitudes towards governmental responses, and self-reported mental health symptoms among adults aged ≥55 in the United States and Canada early in the COVID-19 pandemic. Online cross-sectional survey administered between April 2nd and May 31st in the United States and between May 1st and June 30th, 2020 in Canada. Nationally in the United States and Canada. Convenience sample of older adults aged ≥55. Likert-type scales measured COVID-19 worry and attitudes towards government support. Three standardized scales assessed mental health symptoms: the eight-item Center for Epidemiological Studies Depression Scale, the five-item Beck Anxiety Inventory, and the three-item UCLA loneliness scale. There were 4453 U.S. respondents (71.7% women; mean age 67.5) and 1549 Canadian (67.6% women; mean age 69.3). More U.S. respondents (71%) were moderately or extremely worried about the pandemic, compared to 52% in Canada. Just 20% of U.S. respondents agreed or strongly agreed that the federal government cared about older adults in their COVID-19 pandemic response, compared to nearly two-thirds of Canadians (63%). U.S. respondents were more likely to report elevated depressive and anxiety symptoms compared to Canadians; 34.2% (32.8-35.6) versus 25.6% (23.3-27.8) for depressive and 30.8% (29.5-32.2) versus 23.7% (21.6-25.9) for anxiety symptoms. The proportion of United States and Canadian respondents who reported loneliness was similar. A greater proportion of women compared to men reported symptoms of depression and anxiety across all age groups in both countries. U.S. older adults felt less supported by their federal government and had elevated depressive and anxiety symptoms compared to older adults in Canada during early months of the COVID-19 pandemic. Public health messaging from governments should be clear, consistent, and incorporate support for mental health.


Perioperative surgery in the twenty-first century--two case studies.
Comprehensive perioperative information technology (IT) systems can help health care organizations and their ORs reduce costs, increase revenues, improve processes, and enhance caregiver and patient satisfaction. This article examines what perioperative IT systems have done for two health care organizations and details implementation, the benefits these hospitals derived, next steps, and lessons learned.


The energetic costs of case construction in the caddisfly Limnephilus rhombicus: direct impacts on larvae and delayed impacts on adults.
Caddisflies, whose aquatic larvae build a portable case with silk, are a suitable model organism to test the impacts of resource allocation trade-off during development and examine the evolution of life-history strategies. In the caddisfly Limnephilus rhombicus, adult feeding is minimal. Therefore, the whole resources are acquired during the larval phase and must be allocated to case construction, growth and reproduction. In this study, the larval energetic reserves of L. rhombicus were manipulated by forcing larvae to rebuild their cases in the final larval stage. This allowed us to measure the physiological cost of construction. First, we recorded oxygen consumption during case reconstruction. Second, we measured the sugar, protein and lipid contents of larvae forced to rebuild their case and of larvae required only to re-enter on their case. Larvae had their sugar, protein and lipid content measured after the rebuilding event and 72 h later. The same analyses were carried out with adults immediately after emergence. We found that larvae forced to rebuild a case consumed 1.5 times more oxygen than control larvae. This energy expenditure generated a cost that was estimated to be a loss of larval protein of approximately 35%. Insects were unable to compensate for this loss of proteins during the end of the larval stage, and their metamorphosis to adults was also impacted. Therefore, we suggest that loss of larval protein is linked to silk production and may alter fitness.


Verification of Therapeutic Effect through Accelerator Mass Spectrometry-Based Single Cell Level Quantification of hESC-Endothelial Cells Distributed into an Ischemic Model.
As the potential of pluripotent stem cell-derived differentiated cells has been demonstrated in regenerative medicine, differentiated vascular endothelial cells (ECs) are emerging as a therapeutic agent for the cardiovascular system. To verify the therapeutic efficacy of differentiated ECs in an ischemic model, human embryonic stem cells (hESCs) are induced as EC lineage and produce high-purity ECs through fluorescence-activated cell sorting (FACS). When hESC-ECs are transplanted into a hindlimb ischemic model, it is confirmed that blood flow and muscle regeneration are further improved by creating new blood vessels together with autologous ECs than the primary cell as cord blood endothelial progenitor cells (CB-EPCs). In addition, previously reported studies show the detection of transplanted cells engrafted in blood vessels through various tracking methods, but fail to provide accurate quantitative values over time. In this study, it is demonstrated that hESC-ECs are engrafted approximately sevenfold more than CB-EPCs by using an accelerator mass spectrometry (AMS)-based cell tracking technology that can perform quantification at the single cell level. An accurate quantification index is suggested. It has never been reported in in vivo kinetics of hESC-ECs that can act as therapeutic agents.


A qualitative exploration of university student perspectives on mindfulness-based stress reduction exercises via smartphone app in Bangladesh.
Mental health problems are proliferating, and access to mental health care is difficult due to barriers imposed by the COVID-19 pandemic in low-income countries such as Bangladesh. University students are susceptible to mental health concerns, given their unique stressors (i.e., academic pressure, new social environment). Mindfulness techniques can promote mental health , yet their acceptability has not been examined among Bangladeshi university students. These techniques can be used on a digital app, to decrease barriers to use.Qualitative methods were used to examine the acceptability of mindfulness among university students in Bangladesh. In-depth interviews (n = 12) were conducted to examine student reactions to linguistically (Bangla) and culturally adapted mindfulness exercises. Thematic analysis generated three themes (1) previous experience with mindfulness (2) positive responses to and (3) improvements to mindfulness exercises. The results showed favourable attitudes towards the mindfulness content; students expressed positive psychological and physiological reactions. Students welcomed the concept of using these exercises on an app and felt it could overcomepast barriers to help-seeking. This evidence suggests the value of exploring the acceptability of an app with mindfulness exercises for mental health promotion through a larger-scale pilot study in university students in Bangladesh.


Rapid Cortical Bone Loss at the Distal Radius Is Associated With Higher Risk of Fracture in Older Men - The STRAMBO Study.
Rapid loss of areal bone mineral density (aBMD) is associated with higher fracture risk after adjustment for confounders including initial aBMD. However, the link between bone microarchitecture decline and fracture is not clear. We studied the association between bone microarchitecture deterioration assessed prospectively over 4 years and the subsequent fracture risk in older men. Bone microarchitecture at the distal radius and tibia was assessed by high-resolution peripheral QCT (HR-pQCT; XtremeCT, Scanco Medical) (baseline, 4 years) in 732 men aged 60-87 years. During the 8-year follow-up, 109 men had fragility fractures. Areal BMD was assessed by dual-energy X-ray absorptiometry. After adjustment for age, weight, prior falls and fractures, distal radius aBMD (baseline, slope), and baseline distal radius total volumetric BMD (Tt.BMD), a faster decrease in distal radius Tt.BMD was associated with higher fracture risk (hazard ratio [HR] = 1.54/SD, 95% confidence interval: 1.20-1.95, p < .005). Rapid cortical bone loss was associated with higher fracture risk (cortical thickness: HR = 1.48; 1.15-1.90, p < .01; cortical BMD: HR = 1.38; 1.11-1.72, p < .01). The rate of trabecular bone loss at the distal radius and the rate of bone microarchitecture decline at the distal tibia were not associated with fracture risk. After adjustment for aBMD and distal radius HR-pQCT measures assessed after 4 years, changes in Tt.BMD were associated with higher fracture risk (e.g., Tt.BMD: HR = 1.37; 1.11-1.69, p < .005). Compared with the reference model (age, weight, prior fractures and falls, baseline and slope of aBMD, baseline HR-pQCT value), further addition of the slope of the HR-pQCT measure did not improve the fracture prediction. Thus, rapid cortical bone loss at the distal radius is associated with higher fracture risk in the multivariable models including baseline values of the HR-pQCT measure. However, repeated HR-pQCT measurements did not improve the assessment of the fracture risk in older men (compared with the reference model defined earlier). © 2023 American Society for Bone and Mineral Research (ASBMR).


Epidemiology of De Novo Metastatic Breast Cancer.
Most cases of metastatic breast cancer (MBC) arise as a recurrence of a previously treated early breast cancer. Distinct from recurrent MBC is de novo MBC (dnMBC), which describes patients who present with distant sites of disease at initial diagnosis and is reviewed here. dnMBC represents approximately 3% to 6% of new breast cancer diagnoses in high-income countries. This incidence has not declined despite decades of widespread use of population-based mammography screening. Overrepresentation of both biologically aggressive tumors and patients negatively impacted by social determinants of health are characteristics of dnMBC. Survival has generally been superior for patients with dnMBC compared with those with recurrent MBC, although it is similar to that for patients with recurrent MBC with long disease-free intervals. Subgroups of patients with dnMBC who experience prolonged survival include those with human epidermal growth factor receptor-2-positive disease or hormone receptor-positive bone-only disease. Opportunities to decrease dnMBC presentation may include novel screening modalities suited for biologically aggressive breast tumors and improved access to health care. Recognizing that there will remain some women diagnosed with dnMBC, refining our ability to identify those likely to be long-term survivors could allow for appropriate escalation or de-escalation of care. Finally, evaluation of tumor genomics in robust sample sizes has the potential to advance our knowledge of the biology of dnMBC as an entity distinct from recurrent MBC.


The influence of awareness of terminal condition on spiritual well-being in terminal cancer patients.
We developed a Spirituality Transcendence Measure (STM) and studied whether awareness of terminal illness affects spiritual well-being in terminal cancer patients. Three sources of spiritual transcendence--the situational, the moral and biographical, and the religious aspect--were assessed in the STM. Cronbach's alpha of the STM was 0.95, and the principle axis factor analysis extracted only one factor. Thirty-seven terminal cancer patients with male predominance (59.5%) were studied. Awareness of terminal illness was associated with a higher total STM score (Z = -2.21, P = 0.027), along with the individual scores for each of the three transcendences (Z = -2.39, P = 0.017; Z = -2.71, P = 0.007; and Z = -1.96, P = 0.050). Acceptance of death was associated with a higher situational score (Z = 2.01, P = 0.046) and a higher religious score (Z = -2.27, P = 0.023). Announcement of testament was associated with a higher situational score (Z = -2.30, P = 0.021). We conclude that awareness of terminal illness is associated with spiritual well-being. Telling the complete truth is necessary even when dealing with terminal conditions.


Diagnosis and management of tuberculosis by private practitioners in Manila, Philippines.
Private for-profit health care providers are prominent in the health system of the Philippines. To examine the practices of the private practitioners in Malabon, Metropolitan Manila, Philippines, concerning diagnosis and treatment of tuberculosis (TB). Forty-five private practitioners of Malabon who treat adult TB patients were interviewed. For diagnosis, most private practitioners relied on the clinical presentation and result of an X-ray. Only 13% of the respondents routinely also asked for sputum examination. Ninety-six percent used X-ray as a tool to monitor treatment. Sixty percent of the respondents prescribed a regimen consisting of isoniazid, rifampicin, pyrazinamide, and ethambutol. Except for rifampicin, over-dosage was common. For re-treatment cases, none prescribed the WHO-recommended re-treatment regimen. The private practitioners perceived the main reasons for patient non-adherence to be the patients' lack of finances to buy drugs and patients' perceived well being after a certain period of treatment. Patients' lack of money was seen as the main obstacle to compliance. The only case holding mechanism mentioned was occasional clinic appointments of the TB patients. Private practices for diagnosis and treatment of TB typically deviate from guidelines. The quality of care among private practitioners needs improvement. Innovative strategies are required.


Risk of acute exacerbation of interstitial pneumonia after pulmonary resection for lung cancer in patients with idiopathic pulmonary fibrosis based on preoperative high-resolution computed tomography.
In patients with lung cancer accompanied by idiopathic pulmonary fibrosis (IPF), acute exacerbation of the IPF often occurs after pulmonary resection; however, few studies have been done to identify its preexisting risk factors. We analyzed the high-resolution computed tomography (HRCT) findings of IPF to identify the radiological characteristics of IPF susceptible to acute exacerbation after lung cancer surgery. We reviewed retrospectively 28 lung cancer patients with IPF who underwent pulmonary resection. Clinical data, respiratory function, HRCT findings, and historical features were compared between the acute exacerbation (n = 9) and nonexacerbation (n = 19) groups. The classification of radiological findings of IPF on HRCT was done using a scoring system of seven factors related to the interstitial shadow, including fibrosis, ground-glass opacity, and low-attenuation area. There were no significant differences in clinical background, respiratory function, composite physiologic index, or pathological features between the groups; however, the degree of fibrosis on preoperative HRCT was significantly higher in the exacerbation group (P < 0.003). The fibrosis score was higher on the opposite side to the lung cancer in the exacerbation group (P < 0.05). Although it is difficult to predict postoperative acute IPF exacerbation, the degree and laterality of co-existing fibrosis seem to be predictors.


Dynamic modification of microtubule-dependent transport by effector proteins of intracellular Salmonella enterica.
Intracellular Salmonella enterica translocate effector proteins that modify microtubule-dependent transport processes of the host cell and modulate the biogenesis of the Salmonella-containing vacuole (SCV). One functional consequence is the induction of tubular aggregates of endosomal membranes, termed Salmonella-induced filaments or SIFs, and further tubular membrane compartments have recently been described. SIFs are unique, highly dynamic compartments that form by modification of vesicular transport on microtubules. The molecular mechanism of the interference of intracellular Salmonella with host cell vesicular transport is still elusive, but recent studies demonstrate the complexity of pathogenic activities and the intricacy of manipulating host cell functions.


Silver nanoparticles synthesized by Nigrospora oryzae showed antifungal activity.
In this investigation, an alternate green-route based on myco-synthesised silver nanoparticles (Ag NPs) was evaluated to control plant disease to reduce the usage of synthetic chemicals. Here, we described biologically synthesised Ag NPs using the corn grain contaminant, Nigrospora oryzae, and were well-characterised by UV-visible spectrophotometer, X-ray powder diffraction (XRD), transmission electron microscopy (TEM), Energy Dispersive Spectroscopy (EDS) and particle size analyzer. The pathogenic behaviour of the Fusarium spp. were checked on Giza 86 and Giza 90 cultivars under greenhouse conditions. F. moniliforme and F. oxysporum exhibited high pathogenecity against Giza 90 and Giza 86 cultivars respectively. The antifungal activity of biosynthesised Ag NPs was evaluated against eight species of Fusaria causing damping-off of cotton seedlings. In vitro treatments with different concentrations of Ag NPs were achieved on Czapek Dox agar and Potato dextrose agar plates. Fungal growth was drastically retarded from 25 to 200 ppm of Ag NPs interaction. The antifungal activity of Ag NPs against the Fusarium spp. was clearly proven.


Shape from projections via differentiable forward projector for computed tomography.
In computed tomography, the reconstruction is typically obtained on a voxel grid. In this work, however, we propose a mesh-based reconstruction method. For tomographic problems, 3D meshes have mostly been studied to simulate data acquisition, but not for reconstruction, for which a 3D mesh means the inverse process of estimating shapes from projections. In this paper, we propose a differentiable forward model for 3D meshes that bridge the gap between the forward model for 3D surfaces and optimization. We view the forward projection as a rendering process, and make it differentiable by extending recent work in differentiable rendering. We use the proposed forward model to reconstruct 3D shapes directly from projections. Experimental results for single-object problems show that the proposed method outperforms traditional voxel-based methods on noisy simulated data. We also apply the proposed method on electron tomography images of nanoparticles to demonstrate the applicability of the method on real data.


Formation and rearrangement of homoserine depsipeptides and depsiproteins in the α-ketoacid-hydroxylamine ligation with 5-oxaproline.
The primary products of the chemical ligation of α-ketoacids and 5-oxaproline peptides are esters, rather than the previously reported amides. The depsipeptide product rapidly rearranges to the amide in basic buffers. The formation of esters sheds light on possible mechanisms for the type II KAHA ligations and opens an avenue for the chemical synthesis of depsiproteins.


Trials of the detection of semen and vaginal fluid RNA using the genome profiling method.
The identification of sperm at the scene of a sexual crime is important evidence that can be used to prove that a crime took place. We used the new genome profiling (GP) method in this study to identify sperm and vaginal fluid from RNA extracted from bodily fluids. We randomly amplified genes via a PCR approach from these semen and vaginal fluid samples and performed temperature gradient gel electrophoresis between 15-65°C. We identified specific species identification dots (spiddos) for semen and vaginal fluid. The results showed that the GP method is effective for the identification of bodily fluids at the scene of a sex crime.


Concerted stimulation of rat granulosa cell deoxyribonucleic acid synthesis by sex steroids and follicle-stimulating hormone.
Although follicle-stimulating hormone (FSH) and estrogens are known to be the main physiological stimuli for the development of the ovarian follicle in mammals, their growth-promoting activity has not been clearly established "in vitro". Furthermore, experimental evidence indicates that FSH and estradiol can independently inhibit granulosa cell proliferation. The present study was aimed at examining the effect of sex steroids in combination with FSH, on DNA synthesis in rat granulosa cells cultured in completely defined medium. Estradiol and FSH, when added separately, produced a significant inhibition of [3H] thymidine incorporation. In contrast, a combination of a low dose of FSH (20 ng/ml) with estradiol (100 ng/ml) produced a shift in the period of maximal DNA synthesis from 96 to 48 h after plating. Dose response studies showed that estradiol effects were produced at physiological intraovarian concentrations (1-100 ng/ml), whereas the effects of FSH were biphasic, with high doses (200 ng/ml) being inhibitory. A similar biphasic dose response curve was observed with increasing concentrations of a cAMP derivative in the presence of maximally effective doses of either an aromatizable steroid (androstenedione), insulin or insulin-like growth factor I. Non-aromatizable androgens (5alpha-dihydrotestosterone, 5alpha-androstane 3alpha-17beta diol and androsterone) showed a potency comparable to that of estradiol. The effect of 5alpha-dihydrotestosterone was completely blocked by a specific antiandrogen (hydroxy-flutamide), indicating that it was mediated by the androgen receptor. The effects of estradiol and androgens were not additive. The interaction between estradiol and FSH was further amplified in the presence of a maximally effective dose of insulin. Data presented herein indicate that both estrogens and androgens are able to elicit a mitogenic response in purified granulosa cells, cultured in a completely defined medium, provided the cells are stimulated by a physiological dose of FSH. These results suggest that, during follicular development, the stimulus for granulosa cell proliferation is given by the concerted action of steroid and peptide hormones acting through different signalling pathways.


The zinc finger protein Miz1 suppresses liver tumorigenesis by restricting hepatocyte-driven macrophage activation and inflammation.
Chronic inflammation plays a central role in hepatocellular carcinoma (HCC), but the contribution of hepatocytes to tumor-associated inflammation is not clear. Here, we report that the zinc finger transcription factor Miz1 restricted hepatocyte-driven inflammation to suppress HCC, independently of its transcriptional activity. Miz1 was downregulated in HCC mouse models and a substantial fraction of HCC patients. Hepatocyte-specific Miz1 deletion in mice generated a distinct sub-group of hepatocytes that produced pro-inflammatory cytokines and chemokines, which skewed the polarization of the tumor-infiltrating macrophages toward pro-inflammatory phenotypes to promote HCC. Mechanistically, Miz1 sequestrated the oncoprotein metadherin (MTDH), preventing MTDH from promoting transcription factor nuclear factor κB (NF-κB) activation. A distinct sub-group of pro-inflammatory cytokine-producing hepatocytes was also seen in a subset of HCC patients. In addition, Miz1 expression inversely correated with disease recurrence and poor prognosis in HCC patients. Our findings identify Miz1 as a tumor suppressor that prevents hepatocytes from driving inflammation in HCC.


X-ray Diffraction Mapping for Cultural Heritage Science: a Review of Experimental Configurations and Applications.
X-ray diffraction (XRD) mapping consists in the acquisition of XRD patterns at each pixel (or voxel) of an area (or volume). The spatial resolution ranges from the micrometer (μXRD) to the millimeter (MA-XRD) scale, making the technique relevant for tiny samples up to large objects. Although XRD is primarily used for the identification of different materials in (complex) mixtures, additional information regarding the crystallite size, their orientation, and their in-depth distribution can also be obtained. Through mapping, these different types of information can be located on the studied sample/object. Cultural heritage objects are usually highly heterogeneous, and contain both original and later (degradation, conservation) materials. Their structural characterization is required both to determine ancient manufacturing processes and to evaluate their conservation state. Together with other mapping techniques, XRD mapping is increasingly used for these purposes. Here, the authors review applications as well as the various configurations for XRD mapping (synchrotron/laboratory X-ray source, poly-/monochromatic beam, micro/macro beam, 2D/3D, transmission/reflection mode). On-going hardware and software developments will further establish the technique as a key tool in heritage science.


Robustness of ventilation systems in the control of walking-induced indoor fluctuations: Method development and case study.
Walking-induced fluctuations have a significant influence on indoor airflow and pollutant dispersion. This study developed a method to quantify the robustness of ventilation systems in the control of walking-induced fluctuation control. Experiments were conducted in a full-scale chamber with four different kinds of ventilation systems: ceiling supply and side return (CS), ceiling supply and ceiling return (CC), side supply and ceiling return (SC), and side supply and side return (SS). The measured temperature, flow and pollutant field data was (1) denoised by FFT filtering or wavelet transform; (2) fitted by a Gaussian function; (3) feature-extracted for the range and time scale disturbance; and then (4) used to calculate the range scale and time scale robustness for different ventilation systems with dimensionless equations developed in this study. The selection processes for FFT filtering and wavelet transform, FFT filter cut-off frequency, wavelet function, and decomposition layers are also discussed, as well as the threshold for wavelet denoising, which can be adjusted accordingly if the walking frequency or sampling frequency differs from that in other studies. The results show that for the flow and pollutant fields, the use of a ventilation system can increase the range scale robustness by 19.7%-39.4% and 10.0%-38.8%, respectively; and the SS system was 7.0%-25.7% more robust than the other three ventilation systems. However, all four kinds of ventilation systems had a very limited effect in controlling the time scale disturbance.


Genes and proteins associated with the risk for cancer-associated thrombosis.
Cancer patients have a four- to sevenfold increased risk of developing cancer-associated thrombosis (CAT), which is associated with a strong increase in morbidity and mortality. Not all cancer patients receive thromboprophylaxis as this may lead to adverse events in a cancer population that is already at increased risk for major bleedings. Different risk prediction models have been developed to identify cancer patients at high risk of developing CAT that may be selected for thromboprophylaxis. However, risk models using the currently established biomarkers and clinical parameters perform poorly, particularly when validated in independent cohorts. Discovery of new and better biomarkers are therefore urgently needed. This review describes how aberrations in the genetic profile of the tumor and host influence a hypercoagulable state, and explores how these can be used as novel biomarker to improve CAT risk prediction.


A new approach of probe sonication assisted ionic liquid conversion of glucose, cellulose and biomass into 5-hydroxymethylfurfural.
5-Hydroxymethylfurfural (HMF) has been identified as a promising biomass-derived platform chemical. In this study, one pot production of HMF was studied in ionic liquid (IL) under probe sonication technique. Compared with the conventional heating technique, the use of probe ultrasonic irradiation reduced the reaction time from hours to minutes. Glucose, cellulose and local bamboo, treated with ultrasonic, produced HMF in the yields of 43%, 31% and 13% respectively, within less than 10min. The influence of various parameters such as acoustic power, reaction time, catalysts and glucose loading were studied. About 40% HMF yield at glucose conversion above 90% could be obtained with 2% of catalyst in 3min. Negligible amount of soluble by-product was detected, and humin formation could be controlled by adjusting the different process parameters. Upon extraction of HMF, the mixture of ionic liquid and catalyst could be reused and exhibited no significant reduction of HMF yield over five successive runs. The purity of regenerated [C4C1im]Cl and HMF was confirmed by NMR spectroscopy, indicating neither changes in the chemical structure nor presence of any major contaminants during the conversion under ultrasonic treatment. 13C NMR suggests that [C4C1im]Cl/CrCl3 catalyses mutarotation of α-glucopyranose to β-glucopyranose leading to isomerization and finally conversion to HMF. The experimental results demonstrate that the use of probe sonication technique for conversion to HMF provides a positive process benefit.


A case of mesenchymal chondrosarcoma of the orbit.
A case of mesenchymal chondrosarcoma occurring in the right orbit of a 84-year-old Japanese female was reported. The ultrastructural findings of tumour are composed of three cell types: well-differentiated cartilaginous cells, undifferentiated cells and transitional cells. The well-differentiated cells showed scalloped cytoplasmic membranes, numerous mitochondria showing dense electron matrix, various size of lipid granules, and abundant amount of extracellular matrix. The extracellular matrix were collagen fibres and ground substances and matrix vesicle. The undifferentiated cells showed smooth cytoplasmic membranes, large nuclei resembling primitive mesenchymal cells.


Edwards FloTrac sensor and Vigileo monitor: easy, accurate, reliable cardiac output assessment using the arterial pulse wave.
Edwards Lifesciences has recently introduced the FloTrac sensor and Vigileo monitor system for monitoring cardiac output continuously. It does not require thermodilution or dye dilution, but rather bases its calculations on arterial waveform characteristics in conjunction with patient demographic data. It is unique among arterial waveform cardiac output systems in that it does not require calibration with another method. Studies thus far indicate that it is robust and accurate over a wide range of cardiac output and clinical conditions. It will be valuable in the care of many patients, such as those with critical illness, cardiovascular dysfunction, trauma or undergoing major surgery.


Atopy and contact hypersensitivity: a reassessment of the relationship using objective measures.
There is a big contradiction in the medical literature regarding the relationship between atopy and contact hypersensitivity. Some researchers believe that atopy would prevent, whereas others believe that it would promote, the development of contact allergy. Possible causes of this confusion range from different study populations to different definitions of atopy. To evaluate the relationship between atopy and contact hypersensitivity in a well-defined general population sample using objectively measurable markers. I studied 135 randomly selected students from 5 vocational schools: 73 women and 62 men aged 18 to 19 years. The following atopy markers were tested: positive skin prick test results, positive Phadiatop test results, and total IgE levels greater than 120 kU/L. Contact hypersensitivity was detected by using patch tests. Statistical analyses included the Fisher exact test, the Mann-Whitney U test, and calculation of odds ratios. At least 1 positive skin prick test result was found in 23.7% (95% confidence interval [CI], 16.5%-30.9%) of study participants, positive Phadiatop test results were found in 20.0% (95% CI, 13.3%-26.7%), and total IgE levels greater than 120 kU/L were found in 23.7% (95% CI, 16.5%-30.9%). Positive patch test reactions were found in 28.1% (95% CI, 20.6%-35.7%) of participants, most frequently to thimerosal (18.5%; 95% CI, 12.0%-25.1%) and nickel (9.6%; 95% CI, 4.6%-14.6%). For persons with atopy markers, odds ratios for contact hypersensitivity ranged from 1.0 to 3.2, the highest being for nickel hypersensitivity among those with total IgE levels greater than 120 kU/L. None of these relationships were statistically significant. Atopy and contact hypersensitivity are independent phenomena.


Informative predictors of pregnancy after first IVF cycle using eIVF practice highway electronic health records.
The aim of this study is to determine the most informative pre- and in-cycle variables for predicting success for a first autologous oocyte in-vitro fertilization (IVF) cycle. This is a retrospective study using 22,413 first autologous oocyte IVF cycles from 2001 to 2018. Models were developed to predict pregnancy following an IVF cycle with a fresh embryo transfer. The importance of each variable was determined by its coefficient in a logistic regression model and the prediction accuracy based on different variable sets was reported. The area under the receiver operating characteristic curve (AUC) on a validation patient cohort was the metric for prediction accuracy. Three factors were found to be of importance when predicting IVF success: age in three groups (38-40, 41-42, and above 42 years old), number of transferred embryos, and number of cryopreserved embryos. For predicting first-cycle IVF pregnancy using all available variables, the predictive model achieved an AUC of 68% + /- 0.01%. A parsimonious predictive model utilizing age (38-40, 41-42, and above 42 years old), number of transferred embryos, and number of cryopreserved embryos achieved an AUC of 65% + /- 0.01%. The proposed models accurately predict a single IVF cycle pregnancy outcome and identify important predictive variables associated with the outcome. These models are limited to predicting pregnancy immediately after the IVF cycle and not live birth. These models do not include indicators of multiple gestation and are not intended for clinical application.


Comparison of a rapid commercial test, Enterocheck WB(®), with automated blood culture for diagnosis of typhoid fever.
Rapid diagnosis of typhoid fever is very important in the timely initiation of therapy. To evaluate the sensitivity and specificity of the Enterocheck WB(®) test. In a prospective study, the sensitivity and specificity of Enterocheck WB(®) that detects IgM antibodies to Salmonella typhi were compared with blood culture using BacT/Alert. Four hundred and fifty patients with suspected typhoid fever were assessed both by blood culture and Enterocheck WB(®); 100 of them were either Enterocheck WB(®)-positive or blood culture-positive or both for S. typhi. Both tests were positive in 47 of the 100 patients. In 45 patients, Enterocheck WB(®) was positive but blood culture was negative. In eight cases, Enterocheck was negative but blood culture was positive. Using blood culture as the gold standard, the sensitivity of Enterocheck WB(®) was 85.5%, specificity 88.6%, negative predictive value 97.7% and positive predictive value 51.1%. The Enterocheck WB(®) test can be performed at the bedside in 15 minutes and is a useful rapid method for diagnosis of typhoid fever.


Tiagabine.
Tiagabine is a novel antiepileptic drug that was designed to block gamma-aminobutyric acid uptake by presynaptic neurons and glial cells. It has been shown to be effective against partial seizures in adults and adolescents. Preliminary pediatric data are also encouraging. This article reviews the available animal and human data on the pharmacokinetics, efficacy, and safety of tiagabine.


Reactive oxygen species / photothermal therapy dual-triggered biomimetic gold nanocages nanoplatform for combination cancer therapy via ferroptosis and tumor-associated macrophage repolarization mechanism.
With the continuous development of cancer nanotechnology, an important trend in the research is to combine the broad application prospects of functional nanomaterials with recent biological discoveries and technological advances. Herein, a cancer cell membrane-camouflaged gold nanocage loading doxorubicin (DOX) and l-buthionine sulfoximine (BSO) (denoted as m@Au-D/B NCs) was constructed as an innovative nanoplatform to confer promising cancer combination therapy by evoking effective ferroptosis and immune responses. Briefly, the loading of BSO and DOX could induce ferroptosis through simultaneous effective glutathione (GSH) consumption and reactive oxygen species (ROS) accumulation. Gold nanocages (AuNCs) with distinct anti-tumor application performance was utilized as ideal nanocarrier for drug loading, evoking photothermal effects and photochemical catalysis to generate more ROS under near-infrared (NIR) irradiation. Moreover, m@Au-D/B NCs-mediated photothermal therapy (PTT) combined with ROS production could repolarize the tumor-associated macrophages (TAMs) from pro-tumor (M2) phenotype to anti-tumor (M1) phenotype, thus improving tumor-suppressive immune environment and then promoting the activation of effector cells and release of pro-inflammatory cytokines, in which the antitumor responses were evoked robustly in a methodical approach. The anti-tumor effects in vivo implied that m@Au-D/B NCs could significantly inhibit tumor growth without severe toxicity. Hence, this homotypic targeting nanosystem could offer an auspicious anticancer access by triggering combination cancer therapy via ferroptosis and tumor-associated macrophage repolarization mechanism.


The origins of music in (musi)language.
The view of music as a byproduct of other cognitive functions has been deemed incomplete or incorrect. Revisiting the six lines of evidence that support this conclusion, it is argued that it is unclear how the hypothesis that music has its origins in (musi)language is discarded. Two additional promising research lines that can support or discard the byproduct hypothesis are presented.


Molecular cloning and characterization of the human VGF promoter region.
The VGF gene encodes a secretory protein that is expressed in a cell type-restricted pattern in neuroendocrine cells and is up-regulated by nerve growth factor (NGF) in the rat pheochromocytoma PC12 cell line. Here we report the isolation and characterization of the 5'-terminal region of the human VGF gene. In addition to a TATA box and a CCAAT box located at canonical distances from the transcription start site, the human VGF promoter contains several consensus sequences for different transcription factors, including a cyclic AMP response element and an AP-1 element, several GC boxes, and sequences homologous to other neuronal promoters. Transient transfection analysis demonstrates that 2.3 kb of the 5'-flanking sequence acts as a tissue-specific promoter, efficiently used only by neuronal cells that express endogenous VGF. Deletion analysis reveals that a positive regulatory region is located between nucleotides -458 to -204. Negative cis-acting elements that repress promoter activity in cell lines that do not normally express VGF are located between nucleotides -2,305 and -573 and between -458 and -204. The 5'-flanking region of the human VGF gene confers responsiveness to NGF, cyclic AMP, and phorbol ester treatment.


OsIAA20, an Aux/IAA protein, mediates abiotic stress tolerance in rice through an ABA pathway.
In plants, auxin and ABA play significant roles in conferring tolerance to environmental abiotic stresses. Earlier studies have been shown that some Aux/IAA genes, with important signaling factors in the auxin pathway, were induced in response to drought and other abiotic stresses. However, the mechanistic links between Aux/IAA expression and general drought response remain largely unknown. In this study, OsIAA20, a rice Aux/IAA protein, shown with important roles in abiotic stress. Phenotypic analyses revealed that OsIAA20 RNAi transgenic rice reduced drought and salt tolerance; whereas, OsIAA20 overexpression plants displayed the opposite phenotype. Physiological analyses of OsIAA20 RNAi rice grown under drought or salt stress showed that proline and chlorophyll content significantly decreased, while malondialdehyde content and the ratio of Na+/ K+ significantly increased. In addition, OsIAA20down-regulation reduced stomatal closure and increased the rate of water loss, while transgenic plants overexpressing OsIAA20 exhibited the opposite physiological responses. Furthermore, an ABA-responsive gene, OsRab21, was down-regulated in OsIAA20 RNAi rice lines and upregulated in OsIAA20 overexpression plants. Those results means OsIAA20 played an important role in plant drought and salt stress responses, by an ABA dependent mechanism, and it will be a candidate target gene used to breed abiotic stress tolerance.


A Call to Action to Track Generic Drug Quality Using Real-World Data and the FDA's Sentinel Initiative.
The author reports funding from the U.S. Food and Drug Administration to study real-world data approaches to detect generic drug quality issues. There are no further conflicts or disclosures.


Alterations in serum prolactin heterogeneity by provocative tests in a patient with a pituitary tumour.
The proportion of serum prolactin heterogeneity were investigated in a patient with a pituitary adenoma producing both prolactin and growth hormone. Glucose tolerance (GTT) and insulin tolerance (ITT) tests were performed alone and in combination with chlorpromazine both before and after hypophysectomy. Serum prolactin multiple forms were separated by Sephadex G-100 column chromatography at 3 degrees C. None of the provocative tests altered the already elevated serum prolactin either before (300 ng/ml) or after (100 ng/ml)hypophysectomy. Chlorpromazine or ITT did not alter the proportion of prolactin heterogeneity; GTT, whether in conjunction with chlorpromazine or alone and both before and after hypophysectomy, increased the proportions of the larger molecular species. In five tests in which the GTT was not performed the prolactin heterogeneity was as follows: 'void volume', 4.9%; 'big', 13.1%; 'little', 82.1%; in those experiments in which the GTT was performed the proportions of prolactin heterogeneity were: 'void volume', 13.5%, 'big', 19.2%; 'little', 67.3%.


Review of 1.75 million referrals over 34 months identifies the disruptive impact of the SARS-CoV-2 pandemic on oral surgery care in England: a service evaluation.
Aims This study aimed to use electronic referral management system (eRMS) oral surgery data across multiple sites in England to evaluate the service over a 34-month period in relation to: 1) pre- and post-pandemic referral rates in oral surgery; 2) examining the data for signs of inequality in obtaining a referral for oral surgery; and 3) considering the impact on service provision for oral surgery in England.Methods Oral surgery referral data were available from an eRMS for areas of England covered by this service for the 34-month period of March 2019 to December 2021 (inclusive), which included 12 months of pre-pandemic data and the first 22 months of the pandemic. The data were from the following regions in England: Central Midlands; Cheshire and Merseyside; East Anglia and Essex; Greater Manchester; Lancashire; Thames Valley; and Yorkshire and the Humber.Results The total number of referrals received was 1,766,895 during this 34-month period, with pre-pandemic referral levels averaging at 25,498 per month, with a reduction to 698 per month in April 2020. Referrals have risen to a peak of 217,646 for the month of November 2021. An average of 1.5% of referrals were rejected pre-pandemic, compared with 2.7% per month post-pandemic.Discussion Pre-pandemic referral numbers were predictably stable within a narrow range which have then increased dramatically post-pandemic. The variations in oral surgery referral patterns place significant strain on oral surgery services across England. This not only has consequences on the patient experience, but also on workforce and workforce development, to ensure that there is not a long-term destabilising impact.Conclusion Analysis of 1.75 million referrals to oral surgery services in England has highlighted the ongoing impact of the pandemic and the need to actively minimise adverse impacts on patients, NHS services and the workforce.


Subdural block complicating spinal anesthesia?
Features suggestive of subdural block appeared after an apparently normal subarachnoid block. The long bevel of the reusable Quincke-type spinal needle may have contributed to the development of this complication. We propose that spinal needles should have a smaller bevel to minimize the possibility of such a complication.


Difference in protein synthesis of ovaries indicates predetermined sex inChrysomya rufifacies (Diptera, Calliphoridae).
Sex in the monogenic blowflyChrysomya rufifacies is under the control of a germ-line autonomous maternal effect sex realizer. In order to identify the ovarian poly(A)+RNA that might be related to sex predetermination, we analysed the patterns of cell-free translation products of total poly(A)+RNA from female and male predetermined ovaries and oocytes. During vitellogenesis we observed one transient sex-linked difference in a stable pattern composed of more than 800 in vitro translated proteins. This difference, however, was no longer detectable in mature oocytes.


Preattentive facilitation of target trajectories in a dragonfly visual neuron.
The ability to pursue targets in visually cluttered and distraction-rich environments is critical for predators such as dragonflies. Previously, we identified Centrifugal Small-Target Motion Detector 1 (CSTMD1), a dragonfly visual neuron likely involved in such target-tracking behaviour. CSTMD1 exhibits facilitated responses to targets moving along a continuous trajectory. Moreover, CSTMD1 competitively selects a single target out of a pair. Here, we conducted in vivo, intracellular recordings from CSTMD1 to examine the interplay between facilitation and selection, in response to the presentation of paired targets. We find that neuronal responses to both individual trajectories of simultaneous, paired targets are facilitated, rather than being constrained to the single, selected target. Additionally, switches in selection elicit suppression which is likely an important attribute underlying target pursuit. However, binocular experiments reveal these results are constrained to paired targets within the same visual hemifield, while selection of a target in one visual hemifield establishes ocular dominance that prevents facilitation or response to contralaterally presented targets. These results reveal that the dragonfly brain preattentively represents more than one target trajectory, to balance between attentional flexibility and resistance against distraction.


A Wulff-type boronate for boronate affinity capture of cis-diol compounds at medium acidic pH condition.
A new Wulff-type boronate was designed and synthesized. Upon immobilization on a polymeric monolith and acidified as boronic acid, the ligand exhibited specific boronate affinity to cis-diol compounds at medium acidic pH condition.


Different Suture Materials for Arthroscopic Transtibial Pull-out Repair of Medial Meniscal Posterior Root Tears: A Human Biomechanical Study.
Transtibial pull-out repair of the medial meniscal posterior root (MMPR) has been largely assessed through biomechanical studies. Biomechanically comparing different suture types would further optimize MMPR fixation and affect clinical care. The purpose of this study was to determine the optimal suture material for MMPR fixation. It was hypothesized that ultra high-molecular weight polyethylene (UHMWPE) suture tape would be biomechanically superior to UHMWPE suture and standard suture. Controlled laboratory study. The MMPR attachment was divided in 24 human cadaveric knees and randomly assigned to 3 repair groups: UHMWPE suture tape, UHMWPE suture, and standard suture. Specimens were dissected down to the medial meniscus, and the posterior root attachments were sectioned off the tibia. Two-tunnel transtibial pull-out repair with 2 sutures, as determined by the testing group, was performed. The repair constructs were cyclically loaded between 10 and 30 N at 0.5 Hz for 1000 cycles to mimic the forces experienced on the medial meniscus during postoperative rehabilitation. Displacement was recorded at 1, 50, 100, 500, and 1000 cycles. Ultimate failure load, displacement at failure, and load at 3 mm of displacement (clinical failure) were also recorded. UHMWPE suture tape had significantly less displacement of the medial meniscus when compared with standard suture at 1 (-0.22 mm [95% CI, -0.41 to -0.02]; P = .025) and 50 (-0.35 mm [95% CI, -0.67 to -0.03]; P = .029) cycles. There were no other significant differences observed in displacement between groups at any number of cycles. UHMWPE suture tape had significantly less displacement at the time of failure than standard suture (-3.71 mm [95% CI, -7.17 to -0.24]; P = .034). UHMWPE suture tape had a significantly higher load to reach the clinical failure displacement of 3 mm than UHMWPE suture (15.64 N [95% CI, 0.02 to 31.26]; P = .05). There were no significant differences in ultimate failure load between groups. The meniscal root repair construct with UHMWPE suture tape may be stronger and less prone to displacement than that with standard suture or UHMWPE suture. UHMWPE suture tape may provide better clinical results compared with UHMWPE suture and standard suture.


Risk of tuberculosis after endoscopic resection and gastrectomy in gastric cancer: nationwide population-based matched cohort study.
This study aimed to investigate the association between gastrectomy and endoscopic resection for gastric cancer and the subsequent tuberculosis incidence. We conducted a nationwide matched cohort study using data from the Korea National Health Insurance Service from 2013 to 2019. We created two cohorts: patients who underwent gastrectomy and those who had endoscopic resection. Each patient was matched 1:1 with an unexposed individual based on index year, age, sex, income, and various comorbidities. The primary outcome was the incidence of tuberculosis during the follow-up period. Our study comprised 90,886 gastrectomy patients and 46,759 endoscopic resection patients. The tuberculosis incidence was significantly higher in the gastrectomy group compared to its matched non-gastrectomy group (IRR 1.69, 95% CI 1.43-1.99, p < .001). In contrast, there was no significant difference in tuberculosis incidence between the endoscopic resection group and its matched non-resection group (IRR 0.95, 95% CI 0.75-1.19, p = 0.627). The Kaplan-Meier cumulative incidence also did not differ between the two groups. However, tuberculosis incidence significantly increased in the first year after endoscopic resection. Gastrectomy for gastric cancer is associated with a higher incidence of subsequent tuberculosis, while no significant association was observed for endoscopic resection. However, tuberculosis incidence increases significantly during the first year after endoscopic resection.


A new species of Leucocytozoon Berestneff, 1904 (Apicomplexa: Leucocytozoidae) from the avian family Artamidae.
A new species of the apicomplexan genus Leucocytozoon Berestneff, 1904, L. artamidis n. sp., is described from the Australian avian family Artamidae. Gametocytes and endogenous stages of the life-cycle are described together with early erythrocytic and leucocytic developing forms rarely described for species of this genus.