Potential environmental benefits of direct electric heating powered by waste-to-energy processes as a replacement of solid-fuel combustion in semi-rural and remote areas.
The combustion of wood-based biomass for domestic heating, which is common in rural and mountainous regions of Europe, entails significant local impacts on air quality. Worse conditions occur in low-income countries where the use of coal in household stoves is a common practice. The present paper aims at demonstrating that the combination of waste-to-energy (WtE) plants (based on direct or indirect waste combustion technologies) and direct electric heating (DEH) would be beneficial to reduce air pollution and, meanwhile, optimize the local waste management. Specifically, a WtE plant powering a DEH network will be compared with two reference scenarios of domestic heating: the use of wood/pellet stoves and coal stoves. The results show that shifting to a DEH system, powered by the nearby WtE plant, would reduce the emissions of total suspended particles, NOx, CO, VOCs, dioxins, PAHs and heavy metals by >99%, 27%, 97%, 96%, 93%, 94% and 32%, respectively, with respect to the use of solid fuel in household stoves. In addition, the higher degree of atmospheric dispersion of the off-gas from the stack of the WtE plant is expected to further reduce the impacts in terms of air quality, as estimated by an approach based on the concept of dilution factors. The avoided transportation of waste to other waste facilities outside the region would reduce the greenhouse gas emissions with respect to coal combustion and biomass burning, by 63% and 3%, respectively. The integration of local WtE and DEH could be also "mild", opening to scenarios that could improve the local air quality without renouncing totally to the habits of domestic wood combustion in mountainous regions. Mild-DEH could be designed to integrate the domestic use of wood with electrical heaters, reducing fuel use and air pollution.


Novel missense mutation resulting in the substitution of tyrosine by cysteine at codon 597 of the type X collagen gene associated with Schmid metaphyseal chondrodysplasia.
Schmid metaphyseal chondrodysplasia (SMCD) is one of the most common forms of the osteochondrodysplasias. Mutations or deletions in the COL10A1 gene that encodes type X collagen have been shown to cause this disorder. Most of the gene mutations and deletions are located in the non-collagenous carboxy (C)-terminal (NC1) domain. We describe a novel missense mutation in a patient with SMCD that leads to the substitution of Tyr at codon 597 by Cys in the NC1 domain. Sequence analysis indicated that the proband was heterozygous for the mutation. Her parents were homozygous for the normal sequence, indicating the de-novo occurrence of this mutation.


Advancing interfacial properties of carbon cloth via anodic-induced self-assembly of MOFs film integrated with α-MnO2: A sustainable electrocatalyst sensing acetylcholine.
The metal organic frameworks (MOFs) with tunable composition, modified structure, and morphologically controlled nanoarchitectures are quite imperative to improve the electrochemical (EC) performances of sensing platforms. Herein, EC control over the fabrication of HKUST-1 (Cu-MOFs) nanocrystals is achieved via anodic-induced electrodeposition approach following the mixing of Cu2+ salt precursor in the vicinity of benzene-1,3,5-tricarboxylate (BTC3-) ligands. The problem of controlled mass transfer and slow dispersal of MOFs is resolved by EC deposition of pyramidal-octagonal MOFs on a highly conductive and flexible carbon substrate (activated carbon cloth, ACC) wrapped with rGO layers (ACC-rGO@Cu(BTC). Further, α-MnO2 is integrated on ACC-rGO@Cu(BTC) to achieve the synergistic effect of ternary structure interfaces. The novel ACC-rGO@Cu(BTC)@MnO2 based flexible electrode exhibits striking EC performance toward non-enzymatic sensing of acetylcholine (ACh) including wide linear range (0.1 µM - 3 mM), lowest detection limit (5 nM, S/N = 3), high selectivity, and long-term stability. Moreover, the developed sensing system has been applied for real-time detection of ACh efflux released from three different cell lines and biological matrices. Our work unlocks a new prospect of precisely structured MOFs with extensive functionalities and scaled-up fabrication methods via selection of nanoscale reaction centers to develop flexible sensing devices.


Charnley femoral cemented stem with a permeable and resorbable cement restrictor and low-viscosity cement - Clinical and radiographical evaluation of 100 cases at a mean follow-up of 6.55 years.
In 1979, in his first book dealing with low-friction arthroplasty (LFA), Charnley highlighted the use of a cement restrictor. Breusch and Malchau described in 2005 the "second-generation cementing technique." The main objective of this study was to report on the clinical survival of 100 cases of Charnley femoral component implanted in 2007 and 2008 using a permeable and resorbable cement restrictor and a low-viscosity antibiotic-loaded cement. The secondary objectives were to analyze the complications and side effects and the accuracy of the device positioning. This was a monocentric retrospective review of a prospectively compiled database. Diaphyseal restrictor was biodegradable and permeable to gas, blood, and fluids to avoid intramedullary over pression during cementation. The cement was a low-viscosity antibiotic-loaded cement. Among 3555 patients, we selected the first continuous 100 cases of patients where we implanted the device. Survival probability was computed according to Kaplan-Meier method. Mean follow-up was 6.55 ± 2.6 (range 1-11). Considering femoral component revision as the endpoint, survival rate was 100%. No patients died intraoperatively, none in the first month and the first year after surgery. No early periprosthetic fractures have been reported. As described initially by Charnley, the use of a cement restrictor was highly recommended through the different generations of cementing techniques. Hypotensive episodes and cardiac arrest have been reported during cement insertion. In our series, we did not deplore any adverse effect related to the cementation. Our study demonstrates a 100% survival rate of a cemented femoral component without adverse effects when using routinely a resorbable and permeable cement restrictor and a low-viscosity cement. Bone cement is still a fantastic ally for the surgeon and the patients.


Application of the hsp65 PRA method for the rapid identification of mycobacteria isolated from clinical samples in Belgium.
Biochemical identification of mycobacteria is slow and many times fail to produce correct results. We compared PCR-restriction fragment length polymorphism analysis (PRA) of hsp65 and biochemical methods for the identification of mycobacteria from human samples in Belgium. PRA was found useful in the identification of mycobacteria and simple to implement as a quick method in the laboratory.


Detection of type III collagen in skin fibroblasts from patients with Ehlers-Danlos syndrome type IV by immunofluorescence.
Immunofluorescence showed that cultured skin fibroblasts from 15 out of 17 patients with Ehlers-Danlos syndrome type IV retained abnormal amounts of type III collagen within the cytoplasm. This was not shown by fibroblasts from normal subjects or from patients with other inherited connective tissue diseases. The diagnosis of Ehlers-Danlos syndrome type IV may be facilitated by this finding.


Research Progress on Pyroptosis in Hematological Malignancies.
Pyroptosis is a kind of programmed cell death dependent on the caspase pathway that is different from apoptosis and necrosis. Recent studies have shown that pyroptosis can be involved in the pathological processes of many diseases, such as cancers, atherosclerosis, diabetic nephropathy, and blood diseases. However, the specific mechanisms by which pyroptosis participates in the occurrence and development of hematological malignant tumors still need further exploration. This article reviews the characteristics of pyroptosis and the regulatory mechanisms promoting or inhibiting pyroptosis and discusses the role of pyroptosis in hematological malignant tumors, which could provide ideas for the clinical treatment of such tumors in the future.


Functionalization of gold nanoparticles as antidiabetic nanomaterial.
In the present investigation, functionalization of gold nanoparticles synthesized using propanoic acid 2-(3-acetoxy-4,4,14-trimethylandrost-8-en-17-yl) (PAT) an active biocomponent isolated from Cassia auriculata is studied in detail. On reaction of PAT with aqueous HAuCl4, rapid formation of stable gold nanoparticles was achieved. Formation of gold nanoparticles was confirmed by UV-vis spectroscopy, XRD, GC-MS,FTIR, TEM and SEM with EDAX. Gold nanoparticles mostly were monodisperse, spherical in shape and ranged in size 12-41 nm. Gold nanoparticles synthesised using PAT was administered to alloxan (150 mg/kg body weight) induced diabetic male albino rats at different doses (0.25, 0.5, 0.75 and 1.0mg/kg body weight) for 28 days. Plasma glucose level, cholesterol and triglyceride were significantly (p<0.001) reduced in experimental animals treated with gold nanoparticles at dosage of 0.5mg/kg body weight and plasma insulin increased significantly. The newly genre green gold nanoparticles exhibit remarkable protein tyrosine phosphatase 1B inhibitory activity.


Rapid effects of 17beta-estradiol on cell signaling and function of Mytilus hemocytes.
Estrogens affect the functioning of several non-reproductive tissues, the immune system in particular. In mammalian immunocytes, 17beta-estradiol (E2) has both dose- and cell-type specific effects and the responses to E2 seem to be mediated by rapid, non-genomic mechanisms; these may be initiated at either membrane or cytosolic locations, and can result in both direct local effects, such as modification of ion fluxes, and regulation of gene transcription secondary to activation of different kinase cascades, including mitogen activated protein kinases (MAPKs). In this work, the short-term effects of E(2) and the possible mechanisms of estrogen-mediated cell signaling were investigated in the hemocytes, the immune cells of the bivalve mollusc, the mussel Mytilus galloprovincialis Lam. The results show that E2 (25nM) caused a rapid and significant increase in hemocyte cytosolic [Ca2+]; lower concentrations (5 nM) showed a smaller, not significant effect. Both E2 concentrations affected the phosphorylation state of the components of tyrosine kinase-mediated signal transduction MAPK- and STAT- (signal transducers and activators of transcription) like proteins within 5-15 min from E2 addition. A greater effect and clearer time course were observed with 25 nM E2: in particular, E2 induced a transient increase in p-ERK2 MAPK and a persistent increase in p-p38 MAPK. Moreover, both STAT3 and STAT5 were tyrosine phosphorylated in response to E2. E2 (5 nM) induced both morphological (as evaluated by SEM) and functional changes (such as extracellular release of hydrolytic enzymes, lysosomal membrane destabilisation, and stimulation of the bactericidal activity) within 10-30 min from addition. Lysosomal membrane destabilisation induced by both E2 concentrations was abolished by hemocyte preincubation with the p38 MAPK inhibitor SB203580, and significantly reduced by PD98059 and Wortmannin (inhibitors of ERK MAPK and PI3-K, respectively), this suggesting that rapid activation of kinase cascades is involved in mediating the effects of E2 in mussel hemocytes. The antiestrogen Tamoxifen prevented or strongly reduced most, but not all, the effects of E2. Western blotting with heterologous anti-ERalpha-anti-ERbeta-antibodies revealed the presence of immunoreactive ERalpha- and ERbeta-like proteins in hemocyte protein extracts. Overall, our data support the hypothesis that the rapid effects and mechanisms of action of 17beta-estradiol are extremely conserved and that they may play a crucial role in endocrine-immune interactions in invertebrates.


[Construction of eukaryotic expression vector and package of lentivirus vector encoding human leukocyte antigen-G5].
To construct a lentiviral expression vector carrying HLA-G5. The CDs region of HLA-G5 gene was cloned into the lentiviral vector by restriction endonuclease Nhe I/Not I digestion and T4DNA ligase ligation. After transformation into completent E.coli cells, the candidate clones were identified by PCR and kidney cell line 293T cells by lipofectamine 2000 to produce the lentiviral particles, and the viral titer was determined. The lentiviral vector pCDH-CMV-MCS-EF1-copGFP Vector for HLA-G5 was constructed successfully, and the virus in the supernatant reached a titer of TU/mL. This research completed the package of lentivirus vector encoding HLA-G5 as a tool for further study.


Bag valve mask failure during HEMS intubated stretcher winch.
An intubated prehospital trauma patient was undergoing bag valve mask (BVM) ventilation during a stretcher winch in an AW 139 helicopter. On approach to approximately 50 feet under the rotor disc, the bag valve mask failed, with no adverse outcome. External pressure obstructing reinflation from rotor downwash was thought to be the cause. We tested two BVMs with differing compliances under similar conditions in a manikin model and found the original, more compliant BVM failed again. The stiffer, less compliant BVM did not fail. This has led to a change in the type of BVM used for helicopter emergency medical services (HEMS) in our service.


LiverAtlas: a unique integrated knowledge database for systems-level research of liver and hepatic disease.
A large amount of liver-related physiological and pathological data exist in publicly available biological and bibliographic databases, which are usually far from comprehensive or integrated. Data collection, integration and mining processes pose a great challenge to scientific researchers and clinicians interested in the liver. To address these problems, we constructed LiverAtlas (http://liveratlas.hupo.org.cn), a comprehensive resource of biomedical knowledge related to the liver and various hepatic diseases by incorporating 53 databases. In the present version, LiverAtlas covers data on liver-related genomics, transcriptomics, proteomics, metabolomics and hepatic diseases. Additionally, LiverAtlas provides a wealth of manually curated information, relevant literature citations and cross-references to other databases. Importantly, an expert-confirmed Human Liver Disease Ontology, including relevant information for 227 types of hepatic disease, has been constructed and is used to annotate LiverAtlas data. Furthermore, we have demonstrated two examples of applying LiverAtlas data to identify candidate markers for hepatocellular carcinoma (HCC) at the systems level and to develop a systems biology-based classifier by combining the differential gene expression with topological features of human protein interaction networks to enhance the ability of HCC differential diagnosis. LiverAtlas is the most comprehensive liver and hepatic disease resource, which helps biologists and clinicians to analyse their data at the systems level and will contribute much to the biomarker discovery and diagnostic performance enhancement for liver diseases.


Reslizumab Compared with Benralizumab in Patients with Eosinophilic Asthma: A Systematic Literature Review and Network Meta-Analysis.
The interaction of IL-5 with its receptor on eosinophils increases the activation and maintenance of eosinophils; blocking this interaction reduces asthma symptoms in patients with the eosinophilic phenotype. Reslizumab, which binds to IL-5, and benralizumab, which targets the IL-5 receptor α subunit, have not been compared in head-to-head trials. To indirectly compare reslizumab with benralizumab in similar patient populations using a network meta-analysis. A systematic literature review was conducted and a network meta-analysis was performed on eligible studies using the Markov Chain Monte-Carlo simulation method and a Bayesian statistical framework. Eleven studies were identified, 4 of which evaluated clinically relevant doses and had outcomes at similar time points. To control for population differences, subgroups were selected for the base-case efficacy analysis: a benralizumab subgroup with blood eosinophil levels of greater than or equal to 300 cells/μL (n = 1537) and a reslizumab subgroup in Global Initiative for Asthma step 4/5 with 2 or more previous exacerbations and greater than or equal to 400 eosinophils/μL (n = 318). Safety was analyzed in the full population (N = 3462). Reslizumab significantly improved Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ) scores compared with benralizumab once every 4 weeks and there were reasonably high posterior probabilities that reslizumab is superior to benralizumab once every 4 weeks and once every 8 weeks for ACQ score, AQLQ score, FEV1, and clinical asthma exacerbations. This indirect comparison suggests that reslizumab may be more efficacious than benralizumab in patients with eosinophilic asthma in Global Initiative for Asthma step 4/5 with elevated blood eosinophil levels (benralizumab, ≥300/μL; reslizumab, ≥400/μL) and 2 or more exacerbations in the previous year.


In vitro immunization for the production of antigen-specific lymphocyte hybridomas.
Antigen-specific lymphocyte hybridomas have been produced by a simple in vitro immunization procedure. Non-immune spleen cells have been activated in vitro, and the B-cell blasts have subsequently been used for somatic cell hybridization. Hybrids secreting monoclonal antibodies to human myoglobin, pig insulin, and benzo(a)pyrene were obtained with splenocytes that had been immunized 5 days in culture before the hybridization. The frequency of specific hybridomas was the same as or higher than that of hybridomas produced from in vivo-immunized cells, showing the versatility of the procedure when making monoclonal antibodies to haptens and proteins with a conserved structure or to small amounts of antigen. Monoclonal antibodies of both IgG and IgM isotypes could be isolated.


Quantitative prediction of spinal cord drift after cervical laminectomy and arthrodesis.
Retrospective review of radiographic parameters. To identify preoperative radiographic parameters that may be quantitatively predictive of postoperative spinal cord drift after cervical laminectomy and arthrodesis. Cervical laminectomy and arthrodesis can be an effective method to treat anterior compressions of the spinal cord if there is a sufficient posterior spinal cord drift after surgery. Preoperative cervical alignment has shown some correlations to the degree of spinal cord shift, but whether this and other preoperative radiographic parameters can be used to quantitatively predict the amount of spinal cord drift is unclear. Preoperative and postoperative radiographs (radiographs, MRIs, and CT) of patients who had cervical laminectomy and arthrodesis were reviewed retrospectively. Various radiographic parameters, including sagittal alignment, longitudinal distance index, space available for the spinal cord at cephalad or caudad levels, and distance from apex of the lordosis to the C2-C7 vertical line were measured. In the first cohort of patients, these parameters were correlated with mean postoperative spinal cord shift to identify any relationships. In the second cohort of patients, the identified association was used on preoperative imaging studies to attempt quantitative prediction of the postoperative spinal cord shift. Space available for the spinal cord at the level immediately cephalad to the laminectomized segments had high correlations (R = 0.94) to the postoperative spinal cord shift. This association was used to quantitatively predict postoperative spinal cord shift within 11% +/- 6% of the measured value. If 4 mm of mean postoperative spinal cord shift is desired, the ratio to the available space and anterior posterior diameter of the spinal cord should be approximately 2.0. Relative stenosis at the level directly cephalad to the laminectomized level can affect the degree of postoperative spinal cord shift. Preoperative axial imaging studies should be closely scrutinized to ensure that adequate space is available at the cephalad adjacent level to allow sufficient cord shift after decompressive laminectomy and arthrodesis.


Microextraction based on microplastic followed by SERS for on-site detection of hydrophobic organic contaminants, an indicator of seawater pollution.
Microplastics (MPs) have been proven to concentrate hydrophobic organic contaminants (HOCs) from seawater as the sorbent phase, and the concentration of HOCs in aqueous solutions could be estimated from MPs preloaded with HOCs by equilibrium partition coefficient. This study firstly proposed to in situ quantify fluoranthene (a representative HOCs) pre-concentrated on MPs using surface enhance raman scattering (SERS) in combination with mathematical models, as an efficient monitoring tool for fluoranthene pollution in the aquatic environment. AgNPs-coated quartz (AgNPs@SiO2) substrate was fabricated. The SERS substrate was tested using fluoranthene standard solution with the minimal detectable concentration of 1 ng/mL achieved. Applying SERS for the detection of fluoranthene sorbed on MPs, the detection limit of fluoranthene on MPs was 3.3 ng/g, where the concentration in the corresponding equilibrium seawater was 0.97 ng/mL. Since more than one fluoranthene peak was observed, the quantitative detection was investigated by interval partial least square model. Eight characteristic peak ranges were selected to develop the model for predicting fluoranthene concentration, with R2c and R2v of 0.90 and 0.82, respectively. The study provides a promising solution to monitor trace level of contaminations in aquatic environment, using MPs as the passive sampler.


The time-course of intraocular pressure in timolol-treated and untreated glaucoma suspects.
We studied the behavior of intraocular pressure in glaucoma suspects randomly selected to receive either topical timolol or no treatment over the course of a long-term prospective follow-up study. All patients who after six years of follow-up showed no localized field defects or disk changes, or whose pressures were not dangerously increased (24 treated and 22 untreated patients), were included in the present study. Overall, the two groups showed an increase in pressure followed by a gentle leveling off and a decrease toward the end of the follow-up period. The pressure-time curves of the two groups were parallel and vertically separated by 4.94 mm Hg. When pressure-time relationships were determined in individual patients, the categorical group differences were not statistically significant. Our results suggest that most glaucoma suspects did not exhibit a random time-course of intraocular pressure and that the effect of treatment was simply to lower the pressure-time curve of the treated group by a fixed level throughout the six-year follow-up period.


Identification of seed dormancy mutants by activation tagging.
Activation tagging is an important tool for gene discovery in plants. This method utilizes a T-DNA sequence that contains four tandem copies of the cauliflower mosaic virus 35S enhancer sequence or promoters oriented outward to the T-DNA border sequences. These elements enhance the expression of genes neighboring on either side of the randomly integrated T-DNA, resulting in gain-of-function phenotypes. Activation tagging has identified a number of genes, including those fundamental to plant development, such as the floral inducer gene, FLOWERING LOCUS T (FT ). The methods surrounding activation-tagging approaches are described in this chapter. While seeds have generally not been the targets of these methods in the past, activation tagging provides a powerful approach to uncover genes involved in seed dormancy and germination, including those that mediate hormone signal transduction.


Long-term function of duct-ligated and free-duct whole pancreas transplants.
This report compares endocrine and exocrine responses of "free-duct" and "duct-ligated" whole pancreas isografts in Lewis diabetic rats during a 1-year period of observation. Fasting blood sugar, serum amylase, serum insulin, pancreozymin-secretin test, and L-arginine tolerance test assays were performed prior to and at periodic intervals after transplantation. Histological examinations of transplanted and native pancreas were performed monthly on animals in each group. Whole pancreas transplantations led to immediate and sustained normalization of FBS and insulin levels. In the "duct-ligated" group there was a gradual but insignificant decrease of serum insulin levels after 9 months. Depressed serum amylase levels in diabetic rats were reversed in both groups. Isolated islet iso- and allografts also reversed depressed amylase levels. The results of pancreozymin-secretin tests in islet isografted animals supported the postulated trophic effect of endocrine pancreas on exocrine pancreas. Although both whole-pancreas transplant groups showed a normal response to GTT for 12 months after transplantation, the "duct-ligated" group showed a significantly lower response to L-arginine tolerance test than the "free duct" model as early as 4 months after transplantation, suggesting a defect in B-cell function in long-term "duct-ligated" graft. Serial histological examinations of transplanted pancreases revealed more rapid atrophy and more intense fibrosis of acinar tissue in the "duct-ligated" group than in the "free duct" group. These results suggest that a "free duct" pancreatic isograft maintains a more stable endocrine function in a long-term study than does the "duct-ligated" pancreas, and that exocrine dysfunction in diabetic rats may be related to the endocrine disorder which can be reversed by both islet cell and whole-organ pancreatic transplantation.


Cryopreservation of articular cartilage.
Cryopreservation has numerous practical applications in medicine, biotechnology, agriculture, forestry, aquaculture and biodiversity conservation, with huge potentials for biological cell and tissue banking. A specific tissue of interest for cryopreservation is the articular cartilage of the human knee joint for two major reasons: (1) clinically, there exists an untapped potential for cryopreserved cartilage to be used in surgical repair/reconstruction/replacement of injured joints because of the limited availability of fresh donor tissue and, (2) scientifically, successful cryopreservation of cartilage, an avascular tissue with only one cell type, is considered a stepping stone for transition from biobanking cell suspensions and small tissue slices to larger and more complicated tissues. For more than 50years, a great deal of effort has been directed toward understanding and overcoming the challenges of cartilage preservation. In this article, we focus mainly on studies that led to the finding that vitrification is an appropriate approach toward successful preservation of cartilage. This is followed by a review of the studies on the main challenges of vitrification, i.e. toxicity and diffusion, and the novel approaches to overcome these challenges such as liquidus tracking, diffusion modeling, and cryoprotective agent cocktails, which have resulted in the recent advancements in the field.


Conversion of the cleavage specificity of subtilisin YaB on oxidized insulin chains to an elastase-like specificity by replacement of Gly124 with Ala.
Replacement of Gly124 on the S1 pocket of subtilisin YaB with Ala changed the cleavage pattern on oxidized insulin B-chain from the subtilisin type to the elastase type. The initial cleavage site in the B-chain shifted from L15-Y16 for wild-type YaB to A14-L15 for the G124A mutant. Upon complete hydrolysis with the G124A mutant, four of the six major cleavage sites on the B-chain were identical to porcine pancreatic elastase cleavage sites.


Enzyme-linked immunosorbent assay for determination of plasma thyroglobulin and its application to post-mortem diagnosis of mechanical asphyxia.
A high sensitive enzyme-linked immunosorbent assay (ELISA) for determination of plasma thyroglobulin was devised and applied to the postmortem diagnosis of mechanical asphyxia. The sensitivity of the present ELISA was 5 ng/ml. All of the 15 victims who died from causes other than mechanical asphyxia showed plasma thyroglobulin levels lower than 200 ng/ml (99.8 +/- 37.9 ng/ml), while 12 out of 14 victims of mechanical asphyxia showed the levels higher than 200 ng/ml (2100 +/- 3450 ng/ml in 14 victims). Thus, the present ELISA appears to be useful for postmortem diagnosis of mechanical asphyxia.


[Handbook for the preparation of evidence-based documents. Tools derived from scientific knowledge].
This handbook is intended to be an accessible, easy-to-consult guide to help professionals produce or adapt Evidence-Based Documents. Such documents will help standardize both clinical practice and decision-making, the quality always being monitored in such a way that established references are complied with. Evidence-Based Health Care Committee, a member of "Virgen del Rocío" University Hospital quality structure, proposed the preparation of a handbook to produce Evidence-Based Documents including: a description of products, characteristics, qualities, uses, methodology of production, and application scope of every one of them. The handbook consists of seven Evidence-Based tools, one chapter on critical analysis methodology of scientific literature, one chapter with internet resources, and some appendices with different assessment tools. This Handbook provides general practitioners with a great opportunity to improve quality and as a guideline to standardize clinical healthcare, and managers with a strategy to promote and encourage the development of documents in an effort to reduce clinical practice variability, as well as giving patients the opportunity of taking part in planning their own care.


Unseen food images capture the attention of hungry viewers: Evidence from event-related potentials.
Motivationally relevant visual targets appear to capture visuospatial attention. This capture is evident behaviorally as faster and more accurate responses, and neurally as an enhanced-amplitude of the N2pc - an index of spatial attention allocation, which is observed even when observers are unaware of the target. In the case of reinforcers such as food or substances of dependence, it is likely that the motivational state of craving accompanying deprivation potentiates this capture. The automaticity of such attentional capture by reward-associated stimuli, as well as its possible interaction with craving, is as yet not completely understood, though it is likely a major explanatory factor in motivated behaviors. For the present experiment, participants completed two EEG recording sessions: one just after eating lunch (sated/non-craving), and the other following a minimum 12-h period of fasting (hungry/craving). For both sessions, participants identified food- and clothing-related targets embedded in an object-substitution masking paradigm, which yielded trials of full target visibility, as well as trials for which targets were present but undetected. Although masking equally disrupted visual awareness of both classes of targets as measured behaviorally, a three-way hunger by visibility by target interaction was observed in the neural data, with unseen food targets eliciting an enhanced N2pc. Interestingly, this subliminal attentional capture by food-related items was observed only during the "hungry" session. No such capture was evident under conditions of full visibility. These findings indicate that attentional capture by food-related images, and reflected in enhancements of the N2pc, is spurred by hunger, and that this effect can be viewed as automatic, or independent of explicit awareness of food-relevant target content.


In vitro studies on the evaluation of mycotoxin decontaminating agents.
The ability of 6 commercially available decontaminating agents and cholestyramine to adsorb deoxynivalenol and zearalenone was testedin vitro. All of the products showed poor adsorbtion abilities for deoxynivalenol. For zearalenone adsorbtion great differences were found between the tested products. Using the Langmuir equation the amount of adsorbing agent necessary for a 50% binding of zearalenone, assuming a diet containing 1mg/kg zearalenone, could be estimated for cholestyramine at 0.1 kg/t feedstuff, for Toxisorb® at 1.2 kg/t and for Mykosorb® Extra at 7.6 kg/t underin vitro conditions. The results need to be verifiedin vivo.


Effects of Nigella sativa Extracts on the Lipid Profile and Uncoupling Protein-1 Gene Expression in Brown Adipose Tissue of Mice.
Uncoupling protein-1 (UCP-1) is the index protein of the brown adipose tissue (BAT), used in the obesity studies. We evaluated the effects of thymoquinone (TQ), hydroalcoholic, and hexane extracts of Nigella sativa, on the UCP-1 gene expression in BAT, and also on the recovery from oxidative stress, due to a high-fat diet. Fifty mice were divided into five groups: the first group was fed with a usual diet and the second, third, fourth, and fifth groups with a high-fat diet, hydroalcoholic extract, hexane extract, and TQ, respectively. After completing the course, the lipid profile, paraoxonase 1 (PON1), serum total antioxidant capacity (TAC), and malondialdehyde (MDA) were measured. UCP-1 expression in BAT was evaluated at the gene and protein level. The weight of mice, receiving TQ, hydroalcoholic, and hexane extracts, was decreased (P < 0.05), compared to the second group (P < 0.05). MDA was increased in the second group, compared to the first group (P < 0.05); however, TAC, liver catalase enzyme, and PON1 were decreased (P < 0.05). Furthermore, MDA of the third, fourth, and fifth groups had decreased, and the activity of PON1, liver catalase enzyme, and the amount of TAC was increased (P < 0.05). UCP-1 expression of the third and fourth groups was increased, compared to the second group (P < 0.05). The results suggest that TQ, hydroalcoholic, and hexane extracts of N. sativa have a protective and therapeutic role in the oxidative stress, caused by high-fat diets. The hydroalcoholic and hexane extracts can induce weight loss, by positively affecting UCP-1, at the gene and protein level.


Low density lipoprotein (LDL)-mediated suppression of cholesterol synthesis and LDL uptake is defective in Niemann-Pick type C fibroblasts.
One characteristic of type C Niemann-Pick (NPC) disease is the substantial intracellular accumulation of unesterified cholesterol. The increased cholesterol content in NPC fibroblasts which are grown in the presence of low density lipoproteins (LDL) has been postulated to be due to a deficiency in cellular cholesterol esterification. We have examined several aspects of LDL metabolism in NPC fibroblasts. We observe that LDL binding, internalization, and lysosomal hydrolysis of LDL cholesteryl esters are normal in NPC cells. As reported by Pentchev et al. (Pentchev, P. G., Comly, M. E., Kruth, H. S., Vanier, M. T., Wenger, D. A., Patel, S., and Brady, R. O. (1985) Proc. Natl. Acad. Sci. U. S. A. 82, 8247-8251), we find that LDL does not stimulate cholesterol esterification. However, we also show that LDL does not down-regulate cholesterol synthesis or LDL receptor activity as normal. In NPC cells, these processes are regulated normally by nonlipoprotein effectors, such as 25-hydroxycholesterol or mevalonate. Since NPC cells are not defective in lysosomal hydrolysis of LDL-derived cholesteryl esters, they must exhibit a different defect than Wolman's or cholesteryl ester storage diseases. We conclude that NPC cells are defective specifically in LDL-mediated regulation of cellular cholesterol metabolism. We suggest that the intracellular processing of LDL-derived cholesterol may be defective in NPC fibroblasts.


Retrogradation behavior of corn starch treated with 1,4-α-glucan branching enzyme.
The retrogradation behavior of corn starch treated with 1,4-α-glucan branching enzyme (GBE) was investigated using rheometry, pulsed nuclear magnetic resonance (PNMR), differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy (FTIR). Dynamic time sweep analysis confirmed that the storage modulus (G') of corn starch stored at 4 °C decreased with increasing GBE treatment time. PNMR analysis demonstrated that the transverse relaxation times (T2) of corn starches treated with GBE were higher than that of control during the storage at 4 °C. DSC results demonstrated that the retrogradation enthalpy (ΔHr) of corn starch was reduced by 22.3% after GBE treatment for 10h. Avrami equation analysis showed that GBE treatment reduced the rate of starch retrogradation. FTIR analysis revealed that GBE treatment led to a decrease in hydrogen bonds within the starch. Overall, these results demonstrate that both short- and long-term retrogradation of corn starch were retarded by GBE treatment.


Procalcitonin Differs in Children With Infection and Children With Disease Flares in Juvenile Idiopathic Arthritis.
Patients with juvenile idiopathic arthritis (JIA) often present with signs and symptoms suggestive of serious bacterial infection (SBI). Procalcitonin (PCT) is a biomarker that is elevated in SBI. We conducted a comparative cohort study to test the hypothesis that PCT levels will differ between active JIA, quiescent JIA, and bacteremic patients and healthy controls. From October 2016 to May2018, consecutive children 6 months to 18 years of age with (a) active untreated JIA, (b) quiescent JIA, and (c) healthy elective presurgical candidates were recruited from clinics at a musculoskeletal specialty hospital. Juvenile idiopathic arthritis was defined according to the International League of Associations for Rheumatology criteria. Clinical data and serum samples meeting the same criteria were included from a prior study. Consecutive bacteremic patients were identified over the same period. Procalcitonin and other common measures of inflammation were measured. Descriptive statistics and univariate logistic analyses were performed. Ninety-two study subjects were recruited. Erythrocyte sedimentation rate, C-reactive protein (CRP), and PCT levels were all elevated in bacteremic patients in comparison to the other groups. Erythrocyte sedimentation rate and CRP both had wide ranges that overlapped between groups; however, the PCT concentration was 0.15 μg/mL or greater in 1 of 59 patients with JIA, whereas it was 0.15 μg/mL or less in only 1 bacteremic patient. Our study indicates that serum erythrocyte sedimentation rate, CRP, and PCT levels are all biomarkers that can be used to distinguish SBI versus active JIA at presentation. However, PCT is the most accurate, with the least overlap between patients with infection and noninfectious inflammatory arthritis. This finding can help clinicians direct therapy.


Fluctuation of serum concentration of 1,25-dihydroxyvitamin D3 during the menstrual cycle.
The serum concentrations of total calcium and 1,25-dihydroxyvitamin D3 were measured in seven women during a menstrual cycle. A rise in the serum level of 1,25-dihydroxyvitamin D3 was observed on day 15 of the cycle without a detectable change in the serum calcium level. The level of 1,25-dihydroxyvitamin D3 on day 15 was double the value at days 1 and 8 of the cycle. The peak of 1,25-dihydroxyvitamin D3 on day 15 was not observed in five women ingesting oral contraceptives, suggesting that ovulation or its hormonal control was involved in the peak on day 15. A small but significant fall in the serum calcium concentration occurred in the women ingesting oral contraceptives. In view of these findings the serum concentrations of 1,25-dihydroxyvitamin D in women with functioning ovaries must be interpreted in the context of the stage of the menstrual cycle when the blood sample was obtained.


Developmental modifications of sheep kidney antigens.
We have used monoclonal antibodies to study the changes in the expression of four kidney antigens during organogenesis in the sheep. Two of these antibodies, EE24.6 and EJ30.1, label intensely only the adult kidney, whereas the other two, EK17.1 and EJ15.1, bind to the extracellular matrix of the embryonic kidney. For EJ15.1, the staining of the extracellular matrix decreases temporarily during the second half of intrauterine life, a period during which a light staining appears in the mesangium. For the other, EK17.1, the extracellular matrix staining in the stroma gradually decreases as the embryo grows, while staining of the mesangium and the arterial intima becomes evident. With EK17.1, fibronectin is identified in the extracellular matrix of the embryonic kidney and intracellularly in the mesangial cells after these cells have colonized the glomerulus. The mesonephros staining seems to be the same as that of the metanephros. In the adult, extraglomerular vascular endothelial cells bind EK17.1, whereas intraglomerular endothelial cells do not express fibronectin, which suggests a functional difference between endothelial cells in these two localizations.


Probing the role of Proline in the antimicrobial activity and lipopolysaccharide binding of indolicidin.
Indolicidin (ILPWKWPWWPWRR-NH2), an antimicrobial peptide from bovine neutrophils, possesses significant antibacterial activity. An interesting feature of indolicidin is its unusually high content of Tryptophan and Proline residues. While the involvement of Tryptophan has been studied for its hemolytic and antibacterial activity, little is known about the roles played by Proline in these aspects. We herein investigate the structure and biological activities of indolicidin, where Proline at either one or more of the 3rd, 7th, 10th positions has been replaced by Alanine to better understand its structure and biological function. Structural aspects of Proline residues of indolicidin and its effect on antimicrobial activity were elucidated by replacing Proline residues with Alanine. Minimum inhibitory concentration (MIC) and scanning electron microscopy (SEM) experiments provide substantial evidence for the importance of Proline residues for antimicrobial activity and cell wall disintegration. Binding affinity of the peptides to Lipopolysaccharide (LPS) was investigated using fluorescence spectroscopy and dynamic light scattering (DLS) in conjunction with (31)PNMR spectroscopy and confirmed the disintegration of LPS layer. Our study reveals that Proline residues are necessary for interaction of indolicidin with LPS and establishes the significance of the third and tenth Proline residues for its antimicrobial activity. We believe that the presence of so many Proline residues provides the molecule a selective advantage of adopting different conformations varying from a globular, closed conformation to an open extended conformation, and even to a wedge-shaped conformation, which account for the diverse mechanisms of action of indolicidin.


Real-world evaluation of linezolid-associated serotonin toxicity with and without concurrent serotonergic agents.
The risk of linezolid-associated serotonin toxicity remains unclear. This study sought to evaluate the incidence of serotonin toxicity among hospitalized patients who received linezolid with or without concurrent serotonergic agents (SAs). Secondary outcomes were to assess the dose, agent selection and number of SAs. A single-centre, retrospective cohort study of hospitalized patients aged ≥18 years who received at least one dose of linezolid with or without SAs between 1 January 2014 and 30 June 2021 was performed. Patients were excluded if they were aged <18 years, had linezolid ordered but not administered, were pregnant or were incarcerated. Up to five concurrent SAs were assessed, and dose category was classed as low, moderate or high (dose <33%, 33-66% or >66% of maximum daily dose, respectively). Serotonin toxicity was identified by searching patients' electronic medical records. If identified, the Sternbach criteria and Hunter criteria were applied. Of 2022 patients screened, 1743 were included in this study. Mean age, weight and linezolid duration were 58.5 years, 90.7 kg and 3.8 days, respectively. Approximately 67% (1168/1743) of patients received linezolid with at least one SA, and several patients received multiple SAs. Most patients (53.8%; 616/1144) received moderate- and/or high-dose SAs. Only two patients (0.11%) were identified as possible cases of serotonin toxicity based on the electronic medical record search. However, the incidence of serotonin toxicity was 0.06% (1/1743) based on the Sternbach criteria and 0% (0/1743) based on the Hunter criteria. Serotonin toxicity among hospitalized patients who received linezolid with or without SAs was exceedingly rare, even among those who received multiple and high-dose SAs.


Supporting elimination of lymphatic filariasis in Samoa by predicting locations of residual infection using machine learning and geostatistics.
The global elimination of lymphatic filariasis (LF) is a major focus of the World Health Organization. One key challenge is locating residual infections that can perpetuate the transmission cycle. We show how a targeted sampling strategy using predictions from a geospatial model, combining random forests and geostatistics, can improve the sampling efficiency for identifying locations with high infection prevalence. Predictions were made based on the household locations of infected persons identified from previous surveys, and environmental variables relevant to mosquito density. Results show that targeting sampling using model predictions would have allowed 52% of infections to be identified by sampling just 17.7% of households. The odds ratio for identifying an infected individual in a household at a predicted high risk compared to a predicted low risk location was 10.2 (95% CI 4.2-22.8). This study provides evidence that a 'one size fits all' approach is unlikely to yield optimal results when making programmatic decisions based on model predictions. Instead, model assumptions and definitions should be tailored to each situation based on the objective of the surveillance program. When predictions are used in the context of the program objectives, they can result in a dramatic improvement in the efficiency of locating infected individuals.


Validation of 3D documentation of palatal soft tissue shape, color, and irregularity with intraoral scanning.
The purpose of this study was to assess the feasibility of 3D intraoral scanning for documentation of palatal soft tissue by evaluating the accuracy of shape, color, and curvature. Intraoral scans of ten participants' upper dentition and palate were acquired with the TRIOS® 3D intraoral scanner by two observers. Conventional impressions were taken and digitized as a gold standard. The resulting surface models were aligned using an Iterative Closest Point approach. The absolute distance measurements between the intraoral models and the digitized impression were used to quantify the trueness and precision of intraoral scanning. The mean color of the palatal soft tissue was extracted in HSV (hue, saturation, value) format to establish the color precision. Finally, the mean curvature of the surface models was calculated and used for surface irregularity. Mean average distance error between the conventional impression models and the intraoral models was 0.02 ± 0.07 mm (p = 0.30). Mean interobserver color difference was - 0.08 ± 1.49° (p = 0.864), 0.28 ± 0.78% (p = 0.286), and 0.30 ± 1.14% (p = 0.426) for respectively hue, saturation, and value. The interobserver differences for overall and maximum surface irregularity were 0.01 ± 0.03 and 0.00 ± 0.05 mm. This study supports the hypothesis that the intraoral scan can perform a 3D documentation of palatal soft tissue in terms of shape, color, and curvature. An intraoral scanner can be an objective tool, adjunctive to the clinical examination of the palatal tissue.


Functional and aesthetic recovery of the second toe defect using a wrap-around pedicled flap from the great toe.
We report the results of using a fibula-sided digital artery pedicled flap from the great toe to cover the second toe free flap donor site, which avoids delayed wound healing, and prevents pain and skin ulceration. This study included 15 patients who had second toe wrap-around free flaps to reconstruct thumb and finger defects. All 15 pedicled flaps used to cover the defect healed uneventfully. All patients were able to stand and walk and were satisfied with the postoperative aesthetic outcome at the 6-month follow-up. We conclude that this an effective procedure for preventing donor site defects after second toe wrap-around free flap transfer.Level of evidence: IV.


Release of primary microplastics from consumer products to wastewater in the Netherlands.
The authors estimate the release of primary microplastics from consumer products-cosmetics and personal care products, cleaning agents, and paint and coatings-via sewage effluent as an expected relevant route to the marine environment. Total estimated concentrations in the 3 scenarios are 0.2 μg/L, 2.7 μg/L, and 66 μg/L in sewage-treatment plant (STP) effluent, respectively. All product categories relevantly contribute. Predicted concentrations are compared with reported actual concentrations in STP effluents. Environ Toxicol Chem 2016;35:1627-1631. © 2015 SETAC.


Selection rules on initial structures in parallel cascade selection molecular dynamics affect conformational sampling efficiency.
Parallel cascade selection molecular dynamics (PaCS-MD) is a conformational sampling method for generating transition pathways from a given reactant to a product. In PaCS-MD, initial structures relevant to conformational transitions of proteins are selected and resampled by short-time MD simulations. As a general reaction coordinate, a root-mean-square deviation measured from the product (RMSD) is employed to rank the resampled configurations. Quantitatively, n initial structures are randomly selected from among the top X % of highly ranked configurations and resampled again. In PaCS-MD, the selection of initial structures and their conformational resampling are repeated as a cycle to promote the essential conformational transitions. Therefore, rules for selecting the initial structures might affect the conformational sampling efficiency. In the present study, to address the conformational sampling efficiency depending on the selection rule, the open-closed transition of di-ubiquitin was reproduced by PaCS-MD based on the resampling from the top X = 0.1, 1.0, 2.0, 5.0, 10.0, 25.0, 30.0, 40.0, and 50.0% of highly ranked configurations. Judging from broadness of sampled conformational area and required cycles, we conclude that the resampling from the top ∼2.0% of highly ranked configurations might be the most efficient for generating a set of transition pathways in PaCS-MD.


Cost-effectiveness analyses in shoulder arthroplasty: a critical review using the Quality of Health Economic Studies (QHES) instrument.
The purpose of this study was to perform a systematic review to identify cost-analysis studies pertaining to shoulder arthroplasty, provide a comprehensive review of published studies, and critically evaluate the quality of the available literature using the Quality of Health Economic Studies (QHES) instrument. A systematic review of the literature was performed to identify cost analyses examining shoulder arthroplasty. The inclusion criteria included studies pertaining to either shoulder hemiarthroplasty (HA), total shoulder arthroplasty (TSA), or reverse TSA. Articles were excluded based on the following: nonoperative studies, nonclinical studies, studies not based in the United States, and studies in which no cost analysis was performed. The quality of studies was assessed using the QHES instrument. One-sided Fisher exact testing was performed to identify predictors of both low-quality (ie, QHES score < 25th percentile) and high-quality (ie, QHES score > 75th percentile) cost analyses based on items within the QHES checklist. Of the 196 studies screened, 9 were included. Seven studies conducted cost analyses comparing reverse TSA vs. arthroscopic rotator cuff repair, HA, or total hip arthroplasty, and 2 studies examined TSA vs. HA for primary glenohumeral arthritis. The average QHES score among all studies was 86.22 ± 13.39 points. Failure to include an annual cost discounting rate was associated with a low-quality QHES score (P = .03). In addition, including a discussion of the magnitude and direction of potential biases was associated with a high-quality score (P = .03). Shoulder arthroplasty is a cost-effective procedure when used to treat a multitude of shoulder pathologies. The overall quality of cost analysis in shoulder arthroplasty is relatively good, with an average QHES score of 86.22 points. Studies failing to include an annual cost discounting rate are more likely to score below the 25th percentile, whereas those including a discussion of the magnitude and direction of potential biases are more likely to achieve a score in excess of the 75th percentile.


Advanced pulmonary drug delivery formulations for the treatment of cystic fibrosis.
Cystic fibrosis (CF), a fatal genetic condition, causes thick, sticky mucus. It also causes pancreatic dysfunction, bacterial infection, and increased salt loss. Currently available treatments can improve the patient's quality of life. Drug delivery aided by nanotechnology has been explored to alter the pharmacokinetics and toxicity of drugs. In this short review, we aim to summarize various conventional formulations and highlight advanced formulations delivered via the pulmonary route for the treatment of CF. There is considerable interest in advanced drug delivery formulations addressing the various challenges posed by CF. Despite their potential to be translated for clinical use, we anticipate that a significant amount of effort may still be required for translation to the clinic.


A method for obtaining object defocus information in the RC observation mode.
The micro-operation robot is widely used in micro-manipulations of biological cells in biological and medical experiments. It plans and controls micro-effector movement based on image feedback information to achieve micro-operations. However, the displacement information of the micro-effector on the x-y plane can be obtained from the image, but not the position information of the micro-effector in the z-axis direction. This makes the micro-effector movement in the z-axis direction discontinuous, which is time-consuming and reduces operational efficiency. In this study, starting from the optical imaging principle of Robert Hoffman modulation contrast method (RC), we propose a defocus detection method for the RC observation mode of an optical microscope. Our method can determine the direction of defocus, which is not available in previous defocusing detection methods. Utilizing this method, we achieve rapid focus for the micro-effector while it is moving along the z-axis direction.


Pharmacology of adriamycin: the message to the clinician.
In attempting to describe the human pharmacology of ADR, one is aware of the gaps in our knowledge and shortcomings of the available data. Nevertheless, such information is essential if we are ever to be able to convert rationally in vitro observations into clinical pharmacologic effect or, as is more often the case, explain why the desired effect has not been produced. Clinical pharmacokinetic studies to-date suggest that there is a clear relationship between ADR blood levels and toxicity. No such relationship between ADR blood levels and therapeutic response has been shown. The 7-deoxyaglycone tissue metabolites of ADR, which also appear in blood, may be more closely related to ADR cardiotoxicity and therefore may provide a better pharmacokinetic marker of its development. It appears that the only accurate pharmacokinetic indicator of response is the level of drug in the tumour itself.


Meta-analysis of the use of hyaluronic acid gel to prevent intrauterine adhesions after miscarriage.
Intrauterine adhesions are a severe complication after miscarriage. Hyaluronic acid gel has been used to prevent intrauterine adhesions after miscarriage. To systematically evaluate the efficacy of adjuvant therapy with hyaluronic acid gel to prevent intrauterine adhesions after miscarriage. The Cochrane Library, Embase and PubMed databases were searched for articles published before 31 July 2018 using the terms: ('hyaluronic acid gel' or 'gel') and ('dilatation and curettage' or 'D&C' or 'abortion' or 'miscarriage' or 'hysteroscopic') and ('intrauterine adhesions' or 'Asherman syndrome' or 'IUA' or 'endometrial injury' or 'intrauterine adhesion'). Randomized controlled trials of hyaluronic acid gel therapy after miscarriage. Four studies were included in the meta-analysis (625 patients in total). Dichotomous outcomes were expressed as relative risk (RR) with 95 % confidence intervals (CI). Continuous variables were expressed as standardized mean differences (SMD). Hyaluronic acid gel reduced the intrauterine adhesion scores after miscarriage (SMD -0.68, 95 % CI -1.08~-0.28; p = 0.0008) and the incidence of postoperative intrauterine adhesions after miscarriage (RR 0.44, 95 % CI 0.29~0.67; p = 0.0001). Subgroup analysis found that hyaluronic acid gel reduced the incidence of moderate and severe intrauterine adhesions after miscarriage (RR 0.18, 95 % CI: 0.07~0.47; p = 0.0004), but had no effect on the incidence of mild intrauterine adhesions (RR 0.77, 95 % CI 0.42~1.19; p = 0.19). Hyaluronic acid gel also improved the pregnancy rate after miscarriage (RR 1.94, 95 % CI 1.46~2.60; p < 0.00001). Hyaluronic acid gel significantly reduced the incidence of moderate and severe intrauterine adhesions and significantly improved the pregnancy rate after miscarriage.


Illusory contour orientation discrimination.
Just noticeable differences (JNDs) in orientation for real lines and illusory contours were compared. JNDs in orientation of an illusory contour and of a real line differ by less than a factor two. JNDs in orientation of an illusory contour showed meridional variations similar to those obtained for a real line. By scaling measurements illusory contours are equally visible at all orientations, so meridional variations in illusory orientation discrimination reflect an anisotropy in orientation processing mechanisms. JNDs in orientation measured at an oblique reference orientation improve with practice for an illusory contour as well as for a real line. However while the effect of practice transfers from an illusory to a real contour, the reverse is not true. These results suggest that there are two paths for processing orientation: one activated only by real lines, the other concerned with both real and illusory contours.


The prognostic value of NRF2 in breast cancer patients: a systematic review with meta-analysis.
Nuclear factor E2-related factor 2 (NRF2) is a transcription factor that plays a major role in the regulation of intracellular antioxidant response. The effect of NRF2 overexpression in many malignancies is still unclear and recent meta-analysis correlated NRF2 overexpression with poor prognosis in a variety of human cancers. However, the effect of NRF2 overexpression in breast cancer is still unclear. Thus, the main goal of this work was to clarify the role of NRF2 expression in survival and relapse of breast cancer patients by performing a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement, followed by a meta-analysis. The electronic search was conducted in PubMed, Scopus, SciELO, Web of Science and Embase between November of 2017 and September of 2018. To be included, studies should evaluate NRF2 expression in breast cancer tissue, through immunohistochemistry and/or mRNA and had to report one or more of the following outcomes: overall survival (OS), disease-free survival (DFS), mean survival and median survival. For the meta-analysis, seven studies were included and NRF2 expression was correlated with OS and DFS. It was observed that compared to patients with low NRF2 expression, patients with NRF2 overexpression had poorer OS with a hazard ratio of 1.82 (95% CI 1.32-2.50; p value < 0.0001), and poorer DFS, with a hazard ratio of 1.79 (95% CI 1.07-3.01; p value = 0.03). These results suggest that tumours that overexpress NRF2 have a worse clinical outcome. Thus, NRF2 expression could be a marker for the prognostic of breast cancer patients and, in the future, it would be pertinent to focus on improving treatment efficacy for patients with NRF2 overexpression.


Luseogliflozin, a sodium-glucose cotransporter-2 inhibitor, reverses cerebrovascular dysfunction and cognitive impairments in 18-mo-old diabetic animals.
Diabetes mellitus (DM) is a leading risk factor for age-related dementia, but the mechanisms involved are not well understood. We previously discovered that hyperglycemia induced impaired myogenic response (MR) and cerebral blood flow (CBF) autoregulation in 18-mo-old DM rats associated with blood-brain barrier (BBB) leakage, impaired neurovascular coupling, and cognitive impairment. In the present study, we examined whether reducing plasma glucose with a sodium-glucose cotransporter-2 inhibitor (SGLT2i) luseogliflozin can ameliorate cerebral vascular and cognitive function in diabetic rats. Plasma glucose and HbA1c levels of 18-mo-old DM rats were reduced, and blood pressure was not altered after treatment with luseogliflozin. SGLT2i treatment restored the impaired MR of middle cerebral arteries (MCAs) and parenchymal arterioles and surface and deep cortical CBF autoregulation in DM rats. Luseogliflozin treatment also rescued neurovascular uncoupling, reduced BBB leakage and cognitive deficits in DM rats. However, SGLT2i did not have direct constrictive effects on vascular smooth muscle cells and MCAs isolated from normal rats, although it decreased reactive oxygen species production in cerebral vessels of DM rats. These results provide evidence that normalization of hyperglycemia with an SGLT2i can reverse cerebrovascular dysfunction and cognitive impairments in rats with long-standing hyperglycemia, possibly by ameliorating oxidative stress-caused vascular damage.NEW & NOTEWORTHY This study demonstrates that luseogliflozin, a sodium-glucose cotransporter-2 inhibitor, improved CBF autoregulation in association with reduced vascular oxidative stress and AGEs production in the cerebrovasculature of 18-mo-old DM rats. SGLT2i also prevented BBB leakage, impaired functional hyperemia, neurodegeneration, and cognitive impairment seen in DM rats. Luseogliflozin did not have direct constrictive effects on VSMCs and MCAs isolated from normal rats. These results provide evidence that normalization of hyperglycemia with an SGLT2i can reverse cerebrovascular dysfunction and cognitive impairments in rats with long-standing hyperglycemia, possibly by ameliorating oxidative stress-caused vascular damage.


Encapsulated nerve corpuscles in the human tympanic membrane.
Encapsulated nerve endings were found in both the subepidermal connective tissue and the lamina propria of a human tympanic membrane. The structure of the corpuscles was round or oval and contained a number of axon terminals with mitochondria and Schwann cell processes. Amorphous materials were present in the intercellular space. These features appear to be advantageous in transmitting mechanical forces on the capsule to the axon terminals and are comparable to the function of a mechanoreceptor. Resultant changes in the shape and stiffness of the tympanic membrane as the result of its dislocation indicate similar changes in the pressure on the corpuscle. The arrangement of the sensory corpuscles suggests that they may play a role in detecting pressure changes in the middle ear cavity.


Microfluidic heavy metal immunoassay based on absorbance measurement.
A simple and rapid flow-based multioperation immunoassay for heavy metals using a microfluidic device was developed. The antigen-immobilized microparticles in a sub-channel were introduced as the solid phase into a main channel structures through a channel flow mechanism and packed into a detection area enclosed by dam-like structures in the microfluidic device. A mixture of a heavy metal and a gold nanoparticle-labeled antibody was made to flow toward the corresponding metal through the main channel and make brief contact with the solid phase. A small portion of the free antibody was captured and accumulated on the packed solid phase. The measured absorbance of the gold label was proportional to the free antibody portion and, thus, to the metal concentration. Each of the monoclonal antibodies specific for cadmium-EDTA, chromium-EDTA, or lead-DTPA was applied to the single-channel microfluidic device. Under optimized conditions of flow rate, volume, and antibody concentration, the theoretical (antibody K(d)-limited) detection levels of the three heavy metal species were achieved within only 7 min. The dynamic range for cadmium, chromium, and lead was 0.57-60.06 ppb, 0.03-0.97 ppb, and 0.04-5.28 ppb, respectively. An integrated microchannel device for simultaneous multiflow was also successfully developed and evaluated. The multiplex cadmium immunoassay of four samples was completed within 8 min for a dynamic range of 0.42-37.48 ppb. Present microfluidic heavy metal immunoassays satisfied the Japanese environmental standard for cadmium, chromium and, lead, which provided in the soil contamination countermeasures act.


Mid-Term Outcomes of Metal-Backed Unicompartmental Knee Arthroplasty Show Superiority to All-Polyethylene Unicompartmental and Total Knee Arthroplasty.
Two commonly used tibial designs for unicompartmental knee arthroplasty (UKA) are all-polyethylene "inlay" and metal-backed "onlay" components. Biomechanical studies showed that the metal baseplate in onlay designs better distributes forces over the tibia but studies failed to show differences in functional outcomes between both designs at mid-term follow-up. Furthermore, no studies have compared both designs with total knee arthroplasty (TKA). The goal of this study was to compare outcomes of inlay UKA and onlay UKA at mid-term follow-up and compare these with TKA outcomes. In this retrospective study, 52 patients undergoing inlay medial UKA, 59 patients undergoing onlay medial UKA, and 59 patients undergoing TKA were included. Western Ontario and McMaster Universities Arthritis Index scores were collected preoperatively and at mean 5.1-year follow-up (range 4.0-7.0 years). Preoperatively, no differences were observed in patient characteristics or outcome scores. At mid-term follow-up, patients undergoing onlay medial UKA reported significant better functional outcomes than those of inlay medial UKA (92.0 ± 10.4 vs. 82.4 ± 18.7, p = 0.010) and when compared to TKA (92.0 ± 10.4 vs. 79.6 ± 18.5, p < 0.001) while no significant differences between inlay medial UKA and TKA were noted. No significant differences in revision rates were found. Functional outcomes following onlay metal-backed medial UKA were significantly better compared to inlay all-polyethylene medial UKA and to TKA. Based on the results of this study and on biomechanical and survivorship studies in the literature, we recommended using metal-backed onlay tibial components for unicompartmental knee arthroplasty.


Client engagement in home and community care services: The client and care coordinator perspective.
A recent study of two Community Care Access Centres in Ontario was conducted to look at how clients can be involved in their own care while, at the same time, enhance their experience overall. This article describes that study and looks at ways of developing a new client engagement strategy moving forward.


Analysis of immunoglobulin light-chain mRNA in gastric malignant lymphoma using new highly sensitive in situ hybridization method.
BACKGROUND: To analyze B-cell monoclonality, we need fresh materials for the Southern blotting method. In situ hybridization (ISH) for the detection of immunoglobulin light-chain mRNA can be used in formalin-fixed and paraffin-embedded tissues. However, it is difficult to detect low levels of mRNA copies. So we must develop new highly sensitive in situ hybridization methods to diagnose gastric malignant lymphoma.METHODS: We analyzed materials from 15 patients with gastric malignant lymphoma, using a new highly sensitive ISH method, and compared the results with those of a conventional method.RESULTS: With this new method, 13 of 15 cases were shown to have monotypic cytoplasmic signals, and monoclonality was detected in 3 of 4 cases of mucosa-associated lymphoid tissue (MALT) lymphoma.CONCLUSIONS: The accuracy of endoscopic biopsies is not satisfactory. However, the detection of immunoglobulin light chain mRNA, using the new highly sensitive ISH method with a non-radioactive isotope oligonucleotide probe, can be used to diagnose gastric malignant lymphoma even when conventional immunoglobulin light-chain mRNA or proteins alone cannot demonstrate the clonality.


[IL-33 enhances cytokine secretion and killing function of peripheral blood mononuclear cells in vitro].
To investigate whether interleukin 33 (IL-33) can enhance cytokine secretion and killing activity of peripheral blood mononuclear cells (PBMCs) in vitro. PBMCs were harvested from healthy volunteers and stimulated with different combination of cytokines (CD3 mAb/CD28 mAb/IL-2, CD3 mAb/CD28 mAb/IL-2/IL-12, CD3 mAb/CD28 mAb/IL-2/IL-12/IL-33) in vitro. The cells of each group were collected after 72 hours. Total RNA were extracted and assayed by real-time quantitative PCR (qRT-PCR) for the levels of interferon γ (IFN-γ) and granzyme B. The cytotoxic activity of the cells targeting A549 human lung adenocarcinoma cells was detected by CCK-8 assay. The levels of programmed death-1 (PD-1) and IFN-γ were determined by flow cytometry. There was no significant difference in cell morphology observed by microscope among the three groups. In the cells stimulated in the presence of IL-33, the levels of IFN-γ and granzyme B mRNAs were significantly elevated, cell killing ability was strengthened, and the level of IFN-γ increased significantly, PD-1 level decreased when compared with the other two groups. IL-33 might enhance the function of PBMCs and then promote adaptive anti-tumor immune response.


Maternal plasma levels of cytokines in normal and preeclamptic pregnancies and their relationship with diastolic blood pressure and fibronectin levels.
To determine the plasma concentrations of placental growth factor (PLGF), vascular endothelial growth factor (VEGF), transforming growth factor-beta1 (TGF-beta1), soluble tumor necrosis factor alpha receptor (sTNFp55), interleukin-2 receptor (IL-2R), and interleukins 6 and 10 (IL-6, IL-10) in normotensive and preeclamptic women, and to evaluate the correlations between these cytokines and the diastolic blood pressure and fibronectin levels. A prospective case-control study. Thirty-five women with preeclampsia were compared with 34 healthy women with uncomplicated pregnancies. Peripheral venous blood samples were obtained and plasma levels of PLGF, VEGF, TGF-beta1, sTNFp55, IL-2R, IL-6 and IL-10 were measured by an enzyme-linked immunoassay and fibronectin by a radial immundiffusion technic. In preeclampsia PLGF and VEGF levels were significantly lower, and TGF-beta1, sTNFp55, IL-2R, IL-6 and IL-10 levels were significantly higher than in normotensive pregnancy (p < 0.001). The plasma levels of PLGF and VEGF significantly decreased, whereas TGF-beta1, sTNFp55, IL-2R, IL-6 and IL-10 levels significantly increased with the increments in diastolic blood pressure and fibronectin levels (p < 0.001). Altered concentrations of various cytokines might explain the shallow placentation and endothelial cell dysfunction described in preeclampsia. The clinical severity of preeclampsia seems to correlate with the severity of the cytokine abnormalities.


Increased fitness and realized heritability in emamectin benzoate-resistant Chrysoperla carnea (Neuroptera: Chrysopidae).
The common green lacewing Chrysoperla carnea is a key biological control agent employed in integrated pest management (IPM) programs for managing various insect pests. A field collected population of C. carnea was selected for emamectin benzoate resistance in the laboratory and fitness costs and realized heritability were investigated. After five generations of selection with emamectin benzoate, C. carnea developed a 318-fold resistance to the insecticide. The resistant population had a relative fitness of 1.49, with substantially higher emergence rate of healthy adults, fecundity and hatchability and shorter larval duration, pupal duration, and development time compared to the susceptible population. Mean population growth rates; such as the intrinsic rate of natural population increase and biotic potential were higher for the emamectin benzoate selected population compared to the susceptible population. The realized heritability (h(2)) value of emamectin benzoate resistance was 0.34 in emamectin benzoate selected population of C. carnea. Chrysoperla species which show resistance to insecticides makes them compatible with those IPM systems where emamectin benzoate is employed.


Potential use of a novel actinobacterial species to ameliorate tungsten nanoparticles induced oxidative damage in cereal crops.
Tungsten nanoparticles (WNPs) could induce hazard impact on plant growth and development; however, no study investigated their phytotoxicity. On the other hand, plant growth-promoting bacteria (PGPB) can effectively reduce WNPs toxicity. To this end, Nocardiopsis sp. was isolated and employed to mitigate the phytotoxic effect of WNPs on three crops (wheat, barley, and oat). Soil contamination with WPNs induced the W accumulation in all tested crops, inhibited both growth and photosynthesis and induced oxidative damage. On the other hand, pre-inoculation with Nocardiopsis sp. significantly reduced W level in treated plants. Concomitantly, Nocardiopsis sp. strikingly mitigated the inhibitory effect of WNPs by augmenting both growth and reactive oxygen species (ROS) homeostasis. To cope with heavy metal stress, all the tested species orchestrated their antioxidant homeostasis through enhancing the production of antioxidant metabolites (e.g., phenolics, flavonoids and tocopherols) and elevated the activities of ROS-scavenging enzymes (e.g., APX, POX, CAT, as well as the enzymes involved in AsA/GSH cycle). Moreover, pre-inoculation with Nocardiopsis sp. improved the detoxification metabolism by enhancing the accumulation of phytochelatins (PCs), metallothionein (MTC) and glutathione-S-transferase (GST) in grasses grown in WNPs-contaminated soils. Overall, restrained ROS homeostasis and improved WNPs detoxification systems were the bases underlie the WNPs stress mitigating impact of Nocardiopsis sp treatment.


Effectiveness of ChAdOx1 vaccine in older adults during SARS-CoV-2 Gamma variant circulation in São Paulo.
A two-dose regimen of the Oxford-AstraZeneca (ChAdOx1) Covid-19 vaccine with an inter-dose interval of three months has been implemented in many countries with restricted vaccine supply. However, there is limited evidence for the effectiveness of ChAdOx1 by dose in elderly populations in countries with high prevalence of the Gamma variant of SARS-CoV-2. Here, we estimate ChAdOx1 effectiveness by dose against the primary endpoint of RT-PCR-confirmed Covid-19, and secondary endpoints of Covid-19 hospitalization and Covid-19-related death, in adults aged ≥60 years during an epidemic with high Gamma variant prevalence in São Paulo state, Brazil using a matched, test-negative case-control study. Starting 28 days after the first dose, effectiveness of a single dose of ChAdOx1 is 33.4% (95% CI, 26.4-39.7) against Covid-19, 55.1% (95% CI, 46.6-62.2) against hospitalization, and 61.8% (95% CI, 48.9-71.4) against death. Starting 14 days after the second dose, effectiveness of the two-dose schedule is 77.9% (95% CI, 69.2-84.2) against Covid-19, 87.6% (95% CI, 78.2-92.9) against hospitalization, and 93.6% (95% CI, 81.9-97.7) against death. Completion of the ChAdOx1 vaccine schedule affords significantly increased protection over a single dose against mild and severe Covid-19 outcomes in elderly individuals during widespread Gamma variant circulation.


Frequency and level of self-efficacy predict the effectiveness of therapist- and self-guided exposure in obsessive compulsive disorder.
While exposure and response prevention (ERP) is the most effective treatment for obsessive compulsive disorder (OCD), less is known about the specific mechanisms underlying symptom change after ERP. We tested the hypothesis that the frequency of self- and therapist-guided ERP related to the extent of symptom reduction and that this link is mediated by increased self-efficacy. In a sample of 377 in-patients with a primary diagnosis of OCD receiving in-patient CBT, we assessed symptoms (YBOCS-SR) and self-efficacy (General Self-Efficacy Scale), before and after treatment, as well as the frequency of therapist- and self-guided ERP sessions. Patients with more therapist-guided ERP sessions during treatment showed more symptom reduction and the association of self-guided ERP on outcome was mediated by enhanced self-efficacy. These findings highlight the importance of both therapist- and self-guided ERP sessions and suggest that therapists should conduct a sufficient number of ERP sessions to optimise treatment.


Inflammatory pseudotumour secondary to spilled intra-abdominal gallstones.
Spillage of calculi in the abdomen is frequent during Laparoscopic Cholecystectomy (LC). Though uncommon, these stones may lead to early or late complications. We describe a rare case of spilled gallstone presenting four years after the index procedure, with a mass in the parietal wall mimicking a neoplastic lesion. A 50 year old male presented with a mass in the right upper quadrant for the past 2 years. His past surgical history included a LC done four years ago. Intraoperative procedural details of the surgery were not available. A Computed Tomography (CT) scan showed an extrahepatic mass in the subdiaphragmatic space extending onto the soft tissues of the parietal wall. He underwent laparoscopic piecemeal excision of this organized mass. His post operative period was uneventful and he was pain-free on follow up. Gallbladder perforation can occur due to excessive traction during retraction or during dissection from the liver bed. It can also occur during extraction from the abdomen. Infected bile, pigment gallstones, male gender, advanced age, perihepatic location of spilled gallstones, more than 15 gallstones and an average size greater than 1.5cm have been identified as risk factors for complications. Definitive treatment is surgery with excision of the organized inflammatory mass and extraction of gallstones to avoid future recurrence. Spilled gallstones can be a diagnostic challenge and can cause significant morbidity to the patient. Clear documentation of spillage and explanation to the patient is of utmost importance, as this will enable prompt recognition and treatment of any complications. Prevention of spillage is the best policy.


[Results of EGFR Mutations Detected in Pleural Effusion and Its Clinical Significance in 132 Patients with Advanced Non-small Cell Lung Cancer: A Retrospective Study in A Single Center].
The lack of pathological quality control standard in detecting epidermal growth factor receptor (EGFR) gene mutation in malignant pleural effusion leads to confusion in the interpretation of detection results and the clinical use of EGFR-tyrosine kinase inhibitor (TKI). Therefore, it is very important to propose quality control standards and guide the detection of EGFR mutation in pleural effusion. The aim of this study is to retrospectively analyze the results of EGFR gene mutation in pleural effusion sediment section according to strict pathological quality control standards, and the therapeutic effect of EGFR-TKIs guided by this detection results. From January 2012 to June 2018, the clinical data of patients with pleural effusion collected from Department of Pathology of Peking Union Medical College Hospital were analyzed retrospectively. Among them, 132 patients with relatively complete clinical data and with EGFR gene mutation detection of paraffin-embedded pleural effusion sediment section according to the established quality control standard were included. According to the results of EGFR gene mutation, it was divided into positive group and negative group, and the efficacy of EGFR-TKIs in different groups was compared. After the centrifugation of pleural effusion, the sediment was embedded in paraffin, sectioned, and observed under the microscope after HE staining. If the number of tumor cells ≥100, it met the pathological quality control standard, and it could be used for subsequent EGFR gene mutation detection. EGFR gene mutations were detected in 72 (54.5%) of 132 patients. EGFR-TKIs were used in 69 of 72 mutation positive patients. Of 60 EGFR mutation negative patients, only 15 used EGFR-TKIs. In EGFR mutation positive group, the disease control rate (DCR) was 95.8%, and the median progression-free survival (PFS) was 11 months. In EGFR mutation negative group, the DCR was 0%, and the median PFS was 1 month. The DCR and PFS were significantly different between the two groups (P<0.05). According to the pathological quality control standards, the embedded section of pleural fluid sediment can be used to detect EGFR gene mutation, and the results can be used to guide the clinical use of EGFR-TKIs.


Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis.
The presence of a notch at the inferior part of the scapular neck is a common radiographic finding in patients treated with a reverse Delta III shoulder prosthesis. It is thought that this notch is a result of mechanical contact between the polyethylene cup of the humeral implant and the inferior glenoid pole during adduction of the arm. This in vitro study assessed the effect of glenoid component positioning on glenohumeral range of motion in 8 shoulder specimens. Four different positions of the glenosphere were tested: glenosphere centered on the glenoid, leaving the inferior glenoid rim uncovered (configuration A); glenosphere flush with the inferior glenoid rim (configuration B); glenosphere extending beyond the inferior glenoid rim (configuration C); and glenosphere tilted downward 15 degrees (configuration D). The respective mean adduction and abduction angles in the scapular plane were -25 degrees and 67 degrees for configuration A, -14 degrees and 68 degrees for configuration B, -1 degrees and 81 degrees for configuration C, and -9 degrees and 75 degrees for configuration D. Placing the glenosphere distally (test configuration C) significantly improved adduction and abduction angles compared with all other test configurations (P < .001).


Spontaneous polymerization of the antibiotic peptide magainin 2.
We describe here the ability of the magainin 2 peptide to assemble spontaneously into characteristic 13-nm diameter filaments having a 30 nm periodic helical substructure. Optimal conditions for extensive polymerization into filaments of several hundred microns required low pH and high ionic strength. Polymerization of the magainin 2 peptide may be involved in its recently described in vitro membrane-disrupting and antibiotic activities.


Antagonists of growth hormone releasing hormone and bombesin inhibit the expression of EGF/HER receptor family in H-69 small cell lung carcinoma.
Effects of in vivo treatment with antagonists of growth hormone-releasing hormone (GHRH), JV-1-65 and MZ-J-7-110, and bombesin/gastrin-releasing peptide antagonist RC-3940-II, on the EGF receptor (EGFR) family, were investigated in H-69 SCLC. Tumors were analyzed by RT-PCR, immunoblotting and binding assays. Treatment with these analogs reduced the binding capacity of EGFR by 18-64%, and inhibited the mRNA expression for EGFR, HER-2 and -3 by 27-75.4, 17-26.3, and 13.8-46.6%, respectively. The antagonists also decreased the protein levels for EGFR by 21-34%, HER-2 by 36-68% and HER-3 by 43-49%. This is the first demonstration that antiproliferative effects of GHRH antagonists are associated with a downregulation of EGF/HER receptors.


Vasoactive intestinal peptide modulates luteinizing hormone subunit gene expression in the anterior pituitary in female rat.
The direct monosynaptic pathway which exists between vasoactive intestinal peptide (VIP) and GnRH neurons in the hypothalamic preoptic area provides a neuroanatomical background for the modulatory effects of VIP exerted on GnRH neurons activity. Though central microinjection of VIP revealed its involvement in the modulation of LH release pattern, there is a lack of data concerning a possible VIP influence on the alpha and LHbeta subunit gene expression in the pituitary gland. Using a model based on intracerebroventricular pulsatile peptide(s) microinjections (1 pulse/h [10 microl/5 min] over 5 h) the effect of exogenous VIP (5 nM dose) microinjection on subunits mRNA content in ovariectomized/oestrogen-pretreated rats was studied. Subsequently, to obtain data concerning the involvement of GnRH and VIP receptor(s) in the regulation of alpha and LHbeta subunit mRNA expression, OVX/estrogen-primed rats received a pulsatile microinjections of 5 nM VIP with 3 nM antide (GnRH receptor antagonist) or 5 nM VIP with 15 nM VIP 6-28 (VIP receptor antagonist). In this case, substances were given separately with a 30 min lag according to which each antagonist pulse preceded a VIP pulse. Northern-blot analysis revealed that VIP microinjection resulted in a decreased alpha and LHbeta mRNA content in pituitary gland and this effect was dependent on GnRH receptor activity. Moreover, obtained results indicated that centrally administered VIP might operate through its own receptor(s) because a receptor antagonist, VIP 6-28, blocked the inhibitory effect of VIP exerted on both LH subunit mRNA content and LH release.


Photobiomodulation on trigeminal neuralgia: systematic review.
Trigeminal neuralgia is a recurrent episode of facial pain, that may be associated with other conditions such as multiple sclerosis, neoplasms, and nerve compromises or may occur due to an unknown cause. The available treatments are pharmacotherapy or surgery; however, both are susceptible to develop side effects. Photobiomodulation could be a promising alternative therapy for trigeminal neuralgia. A systematic review of literature was carried out using the PRISMA protocol, in the PubMed/MEDLINE, Embase, and Web of Science databases. Risk of bias by ROB 2.0 protocol was performed in included studies. Initially, 20 identified articles were collected varying between the years of 1983-2018, from which 6 were included. A total of 193 patients were evaluated; photobiomodulation was compared to conventional therapies, TENS, and therapy combinations with pharmacotherapy. The overall risk of bias was low, with some concerns in the randomization and double-blinding process; moreover, there are few reports in the literature. Photobiomodulation appears to be as effective as conventional therapies, being a coadjutant therapeutic opportunity for the treatment of trigeminal neuralgia.


A bug's smell--research into insect olfaction.
The olfactory system has become an important model system for neurobiological function and sensory processing. In insects, odours play a vital role in all aspects of life. From the late 1950s until very recently, research into the structure and function of the insect olfactory system has often preceded similar investigations in vertebrates and has been important in the formulation of general principles.


Arteriovenous fistula as a complication of renal biopsy.
We evaluated the incidence and history of arteriovenous fistula (AVF) after kidney biopsy and assessed the use of superselective embolisation for treatment. Case report of a 10-year-old boy with nephrotic syndrome. Renal biopsy (RB) in this patient was complicated with AVF. Immediately after RB was undertaken, microscopic haematuria was observed, within 48 hours after the biopsy life-threatening haematuria due to pseudoaneurysm started. Renal angiography was carried out, which demonstrated a hyperthrophic aberrant artery in the region of the bottom pole of the left kidney, from which blood was instantaneously flowing through a high-flow arteriovenous fistula (AVF). Embolization was carried out using small platinum coils (MWCE-18S-3/2, -18S-4/2, -18S-5/2TORNADO Embolization Microcoil) and the tissue adhesive Histoacryl. The technique of superselective embolisation using coaxial catheter is a safe method in the treatment of post biopsy AVFs and pseudoaneurysm (Fig. 3, Ref. 6).


Pilot study of directional airflow and containment of airborne particles in the size of Mycobacterium tuberculosis in an operating room.
Containment of airborne microorganisms to prevent transmission in a positively pressured operating room (OR) is challenging. Occupational transmission of Mycobacterium tuberculosis (M tuberculosis) to perioperative personnel has occurred, but protection of the surgical site is of equal importance. High-efficiency particulate air (HEPA) filters can mitigate occupational exposure and improve air quality. Smoke plumes and submicron particulates were released to simulate aerobiology of M tuberculosis and assess impact and efficacy of particle removal in an OR suite using different HEPA filtration units and configurations. My objectives were to compare the impact of freestanding HEPA filter units, which are currently more commonly deployed inside the OR, with a novel portable anteroom system (PAS)-HEPA combination unit (PAS-HEPA) placed outside the OR and assess the efficiency of removal of particulates from an OR. Smoke plume and submicron particles were generated inside an OR. Plume behavior was observed during deployment of 3 different configurations of HEPA units. Two of these involved different models of freestanding HEPA filtration units inside the OR, and the third was the PAS-HEPA unit located outside the OR. The concentration of submicron airborne particles was quantified for each configuration of freestanding HEPA and PAS-HEPA units. In addition to measurement of submicron airborne particulates, a high concentration of these was generated in the OR, and time for removal was quantified. Observations of released plumes, using the PAS-HEPA unit revealed a downward evacuation, away and toward the main entry door from the sterile field. By contrast, when portable freestanding HEPA units were placed inside the OR, plumes moved vertically upward and directly into the breathing zone of where the surgical team would be stationed during a procedure. The PAS-HEPA unit, working in tandem with the OR heating, ventilation, and air conditioning system, was confirmed to have removed over 94% of an initial release of at least 500,000 submicron particles/ft(3) within 20 minutes after release. This pilot study clearly indicates that avoiding the use of freestanding HEPA filters inside an OR during a surgical procedure is prudent and consistent with Centers for Disease Control and Prevention guidelines. A PAS-HEPA unit is effective in removing submicron particles and will enhance safety of care of a patient with an airborne infection requiring surgery.


Clinical and diagnostic approach of male pseudo hermaphroditism with os-clitoris in French bulldog: A case report.
Hermaphroditism is less frequently reported in dogs and is often associated with infertility. An 8-month-old French bulldog weighing 5 kg with an enlarged structure protruding from the vulva was clinically diagnosed with hermaphroditism. Physical, hormonal assay, computed tomography, and gross and histological studies were done in addition to successfully detailed surgical correction. On physical examination, the dog showed the presence of an os-clitoris protruded from the vulvar labia. Hormonal levels of estradiol, testosterone, and progesterone were 6.39 pg/ml, 0.4 ng/ml, and 8.67ng/ml, respectively. Surgical removal of internal gonadal tissues and os clirectomy operations were conducted after the exploratory laparotomy. The removed gonadal tissues were identical to that of a female with testicles instead of ovaries, according to a gross examination. Histological examination confirmed gonads as testis, with inactive seminiferous tubules and epididymis attached to uterine horns. The congenital anomalies in the present case were diagnosed as male pseudohermaphroditism (MPH). Surgical correction was performed, and the owner's satisfaction was achieved.


Monolayered Platinum Nanoparticles as Efficient Electrocatalysts for the Mass Production of Electrolyzed Hydrogen Water.
High-performance/low-cost platinum (Pt)-based electrocatalysts have been established by top-coating both sides of a titanium plate with Pt nanoparticles. The average diameter of the Pt nanoparticles used in this study is approximately 100 nm. Three types of Pt top-coated Pt/Ti electrocatalysts, each having different top-coated Pt layer thicknesses, are prepared. Type I is a monolayered Pt top-coated type, in which the thickness of the top-coated Pt layer is approximately 100 nm; Type II is a few-layered type with a top-coated Pt layer thickness of approximately 200 nm, and Type III is a multilayered type with a top-coated Pt layer thickness of approximately 750 nm. The mass loading of Pt is 0.0215 mg cm-2 for Type I, 0.043 mg cm-2 for Type II, and 0.161 mg cm-2 for Type III. The electrocatalytic activities of each type of Pt/Ti electrocatalyst are evaluated through the electrolysis of acidic water and tap water. Type I gives the highest electrocatalytic efficiencies, which are comparable or even better than the electrocatalytic efficiencies of the state-of-the-art commercially available Pt/C electrode and other metal-/carbon-based HER catalysts. For example, in the case of the electrolysis of acidic water at an overpotential of 0.15 V, Type I shows a Tafel slope of 29 mV dec-1 and a current density of 27.5 mA cm-2. Even in the case of the electrolysis of tap water, Type I gives an HER Faradaic efficiency of 92%. A model of water (H2O), hydronium ions (H3O+), and hydroxyl ions (OH-) properly adsorbing on the Pt (111) facet is proposed to explain the electrocatalytic mechanism. New insights into the distinguishing properties of the resultant electrolyzed hydrogen water (EHW), namely, the healthy beneficial effects of EHW, are also described, and a new concept of storing and carrying reductive hydrogen (H*) by free Pt nanoparticles is proposed.


Decline of Systolic and Diastolic 2D Strain Rate During Follow-Up of HLHS Patients After Fontan Palliation.
Accurate assessment of ventricular function is particularly important in children with hypoplastic left heart syndrome (HLHS) after completion of the total cavopulmonary connection (TCPC). For this purpose, two-dimensional speckle tracking (2DST) is a promising technique as it does not depend on the angle of insonation or the geometry of the ventricle. The objective of this study was to assess changes in systolic and diastolic right ventricular (RV) function within a 5-year follow-up period of HLHS patients after TCPC using conventional and 2DST echocardiography. RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), E/A, E/e' and 2DST parameters [global longitudinal peak systolic strain (GS) and strain rate (GSRs), global strain rate in early (GSRe) and late (GSRa) diastole] of 40 HLHS patients were compared at 1.6 and at 5.1 years after TCPC. RVFAC, E/A, E/e' and GS did not change, whereas TAPSE (13.7 ± 3.2 vs. 10.5 ± 2.4 mm/m(2), p < 0.001), GSRs (-1.56 ± 0.28 vs. -1.35 ± 0.31 1/s, p < 0.001), GSRe (2.22 ± 0.49 vs. 1.96 ± 0.44 1/s, p = 0.004) and GSRa (1.19 ± 0.39 vs. 0.92 ± 0.39 1/s, p < 0.001) decreased significantly. Systolic and diastolic RV function parameters of HLHS patients decreased from 1.6 to 5.1 years after TCPC in our patients. Changes in global strain rate parameters may be signaling early RV dysfunction that is not detectable by traditional echocardiography. Further study is needed to verify this and to determine whether these changes are clinically relevant.


A new HPLC fluorimetric method to monitor urinary delta-aminolevulinic acid (ALA-U) levels in workers exposed to lead.
A new sensitive HPLC method for the determination of urinary delta-aminolevulinic acid (ALA-U) was used to evaluate the relationship between blood-lead (Pb-B) and ALA-U levels in male workers exposed to lead. The differences between the ALA-U levels determined by this method (ALA-U-HP) and by a colorimetric method (ALA-U-CL) are discussed. The HPLC method gave values similar to the ALA-U-CL values at high ALA-U level. However, at low blood-lead levels (58 +/- 22 micrograms/l, n = 23), the mean ALA-U-HP level corrected by urinary creatinine level was one-third of the corrected ALA-U-CL level (0.83 +/- 0.14 and 2.4 +/- 0.5 mg/g creatinine, respectively). A significant increase of the mean corrected ALA-U-HP level was observed at 162 +/- 22 micrograms/l Pb-B (P less than 0.05, n = 26), while that of ALA-U-CL was observed at 245 +/- 30 micrograms/l Pb-B (P less than 0.01, n = 37). The regression equation based on the logistic model fitted well to the relationship data between the Pb-B level and the percentage of the subjects with corrected ALA-U-HP above the cut-off point (1.12 mg/g creatinine) and the expected Pb-B level for 50% response was 270 micrograms/l Pb-B, while it did not fit well to the relationship data between Pb-B level and the percentage of the subjects with corrected ALA-U-CL above the cut-off point (3.5 mg/g creatinine).(ABSTRACT TRUNCATED AT 250 WORDS)


Synthesis of 1-(N-ethoxycarbonylamino)alkylphosphonic monoesters.
A series of 1-(N-ethoxycarbonylamino)alkylphosphonic monoesters were synthesized via three-component Mannich-type condensation of ethyl carbamate, aldehydes and dichlorophosphites in benzene, followed by hydrolysis.