Longer-Term Efficacy of a Digital Life-Skills Training for Substance Use Prevention.
The main objective of this study was to test the longer-term and differential efficacy of a mobile phone‒based life-skills training program designed to prevent substance use among adolescents. A 2-arm, parallel-group, cluster RCT with assessments at baseline and follow-up after 6 and 18 months was conducted. The efficacy of the intervention was compared with that of an assessment-only control condition. A total of 1,473 students with a mean age of 15.4 years were recruited in 2019/2020 within 89 Swiss secondary and upper secondary school classes. The automated intervention program included online feedback and individually tailored text messages provided over 22 weeks. The contents were based on social cognitive theory and addressed self-management, social, and substance use resistance skills. Primary outcomes included 30-day prevalence rates for problem drinking and tobacco use. The 18-month follow-up assessments were completed by 1,232 study (83.6%) participants. Those in the intervention group reported lower tobacco-smoking prevalence than the controls (OR=0.67; 95% CI=0.47, 0.96), but no significant difference in problem drinking (OR=0.84; 95% CI=0.61, 1.17) was observed. Among secondary outcomes, the intervention was effective at reducing cannabis-smoking prevalence (OR=0.55; 95% CI=0.39, 0.76) and cannabis use days (Cohen's d= -0.19; 95% CI= -0.29, -0.09), whereas no effects were observed for quantity of alcohol use, quantity of cigarettes smoked, well-being, or social skills. No significant moderators of the primary outcomes were observed. An automated mobile phone‒based life-skills training program produced longer-term effectiveness in preventing tobacco smoking and cannabis use, whereas no effects were observed for problem drinking. These results suggest that digitally delivered life-skills training programs are similarly effective and are an easy-to-implement alternative to training conducted within a school curriculum. This study is registered at ISRCTN41347061 (registration date: 21/07/2018).


Perforated small bowel diverticulosis. Case report.
Three patients who presented with perforated small bowel diverticulosis were healed by resection of the perforated segment and primary anastomosis. Clinical awareness of this disease may reduce the relatively high mortality reported by most authors.


A comparison of cocaine and its metabolite norcocaine: effects on locomotor activity.
Intraventricular and intraperitoneal administration of cocaine and its metabolite norcocaine were studied in adult male rats. Norcocaine (10-100 micrograms) had no behavioral activity following central infusion but proved to be toxic at high doses (50-100 mg/kg) when given peripherally. Cocaine at high doses (100 micrograms), produced possible hypoactivity after central injections but produced significant hyperactivity after peripheral administration (20 mg/kg).


The 10-year course of Alcoholics Anonymous participation and long-term outcomes: a follow-up study of outpatient subjects in Project MATCH.
This study investigates the 10-year course and impact of Alcoholics Anonymous (AA)-related helping (AAH), step-work, and meeting attendance on long-term outcomes. Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post treatment. Alcohol consumption, AA participation, and other-oriented behavior were assessed at baseline, end of the 3-month treatment period, and 1, 3, and 10 years post treatment. Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved other-oriented interest.


Dominantly inherited early-onset non-progressive cerebellar ataxia syndrome.
A mother and daughter with suspected dominantly inherited, early-onset, non-progressive cerebellar ataxia syndrome have been reported. A review of the literature and the clinical features of the present cases revealed the nosologic features of this rare disorder, possibly dominant inheritance, floppiness and delayed milestones preceding early-onset mild cerebellar ataxia, non-progressive clinical course, retained or even brisk tendon reflexes without pyramidal tract involvement, normal or slightly delayed intelligence, and occasional nystagmus. Neuroimaging reveals selective involvement of the cerebellum, which is prominent in the vermis and the anterior part of the hemispheres.


Antinociceptive effects of the novel opioid peptide BW443C compared with classical opiates; peripheral versus central actions.
1. To investigate peripherally mediated antinociceptive effects of opioids, the activity of a novel polar enkephalin analogue H-Tyr-D-Arg-Gly-Phe (4-NO2)-Pro-NH2 (BW443C) has been compared with those of classical tertiary opiates against different nociceptive stimuli in the mouse. 2. In chemically-induced writhing models BW443C, administered subcutaneously, demonstrated dose-related antinociceptive effects less potent than morphine and of a similar order to pethidine and D-propoxyphene. In assays using heat as the noxious stimulus BW443C was markedly less potent than any of the opiates tested. 3. In heat-induced assays, but not in chemically-induced writhing assays, BW443C demonstrated a 'U'-shaped dose-time response relationship. Morphine, pethidine and D-propoxyphene showed simple, approximately linear, dose-time effects in all assays. 4. When given subcutaneously, the inhibitory effects of BW443C and morphine in chemically-induced writhing were antagonized by naloxone given intraperitoneally. The inhibitory effects on writhing of BW443C, but not those of morphine, were also antagonized by prior intraperitoneal administration of the quaternary opioid antagonist N-methyl nalorphine. When this antagonist was administered intracerebroventricularly, the antinociceptive effects in writhing of both BW443C and morphine were antagonized. 5. It is concluded that BW443C, being only poorly able to cross the blood brain barrier, demonstrates peripherally mediated opioid antinociceptive effects in chemically-induced writhing models. In heat-induced models, that detect centrally acting opioids, BW443C is effective only at high doses and at time intervals after dosing sufficient to allow slow penetration of drug into the CNS. It is suggested that the peripheral antinociceptive actions of BW443C are mediated by inhibition of sensory neurones.


Loci for human U1 RNA: structural and evolutionary implications.
Three clones U1-1, U1-6, and U1-8 containing sequences related to human U1 RNA have been studied by sequence analysis. The results show that each of the three clones represents a distinct locus. The U1-6 locus is closely related to the HU1-1 locus, which is believed to represent a functional U1 gene. The U1-1 and U1-8 loci are pseudogenes by definition, since they contain sequences that are closely related to but not identical with the human U1 RNA sequence. The U1-6 locus contains the sequence T-A-T-A-T close to the 5'-end of the U1 sequence but it is unclear if this represents the promoter. When the U1-8 locus was compared to the U1-6 locus, it was observed that the 5'-flanking sequences, except in the immediate vicinity of the pseudogene, are as well-conserved as the U1-related sequence itself, at least up to position -220. The high degree of homology in the 5'-flanking region suggests that U1 genes have a much more strict sequence requirement with regard to 5'-flanking sequences than most other eukaryotic genes. The U1-6 and U1-8 loci contain the sequence T-A-T-G-T-A-G-A-T-G-A between positions -211 and -221. An identical sequence is present in the equivalent position in the HU1-1 locus, and may represent the promoter. The high degree of conservation in the postulated promoter region indicates that pseudogenes like U1-8 possibly could be expressed. A truncated U1-related sequence is present between 106 to 150 nucleotides upstream from the U1 gene/pseudogene in the U1-6, the U1-8 and the HU1-1 loci, suggesting that the U1 genes may have been clustered early in evolution. The U1-1 locus has a strikingly different structure from the U1-8 locus; the pseudogene itself is as closely related to the U1 RNA sequence as is the U1-8 pseudogene but the flanking sequences, both on the 5' and the 3' side, share no detectable homology with the corresponding regions in the U1-6 or U1-8 loci. It may therefore be postulated that small nuclear RNA pseudogenes are created by several different mechanisms.


Deep learning in CT image segmentation of cervical cancer: a systematic review and meta-analysis.
This paper attempts to conduct a systematic review and meta-analysis of deep learning (DLs) models for cervical cancer CT image segmentation. Relevant studies were systematically searched in PubMed, Embase, The Cochrane Library, and Web of science. The literature on DLs for cervical cancer CT image segmentation were included, a meta-analysis was performed on the dice similarity coefficient (DSC) of the segmentation results of the included DLs models. We also did subgroup analyses according to the size of the sample, type of segmentation (i.e., two dimensions and three dimensions), and three organs at risk (i.e., bladder, rectum, and femur). This study was registered in PROSPERO prior to initiation (CRD42022307071). A total of 1893 articles were retrieved and 14 articles were included in the meta-analysis. The pooled effect of DSC score of clinical target volume (CTV), bladder, rectum, femoral head were 0.86(95%CI 0.84 to 0.87), 0.91(95%CI 0.89 to 0.93), 0.83(95%CI 0.79 to 0.88), and 0.92(95%CI 0.91to 0.94), respectively. For the performance of segmented CTV by two dimensions (2D) and three dimensions (3D) model, the DSC score value for 2D model was 0.87 (95%CI 0.85 to 0.90), while the DSC score for 3D model was 0.85 (95%CI 0.82 to 0.87). As for the effect of the capacity of sample on segmentation performance, no matter whether the sample size is divided into two groups: greater than 100 and less than 100, or greater than 150 and less than 150, the results show no difference (P > 0.05). Four papers reported the time for segmentation from 15 s to 2 min. DLs have good accuracy in automatic segmentation of CT images of cervical cancer with a less time consuming and have good prospects for future radiotherapy applications, but still need public high-quality databases and large-scale research verification.


Investigating duration and intensity of Covid-19 social-distancing strategies.
The exponential character of the recent Covid-19 outbreak requires a change in strategy from containment to mitigation. Meanwhile, most countries apply social distancing with the objective to keep the number of critical cases below the capabilities of the health care system. Due to the novelty and rapid spread of the virus, an a priori assessment of this strategy was not possible. In this study, we present a model-based systems analysis to assess the effectiveness of social distancing measures in terms of intensity and duration of application. Results show a super-linear scaling between intensity (percent contact reduction) and required duration of application to have an added value (a lower number of fatalities). This holds true for an effective reproduction of [Formula: see text] and is reverted for [Formula: see text]. If R is not reduced below 1, secondary effects of required long-term isolation are likely to unravel the added value of disease mitigation. If an extinction is not feasible, we recommend moderate social-distancing that is well balanced against capability limits of national health-care systems.


In vitro and in vivo approaches for identifying the role of aryl hydrocarbon receptor in the development of nonalcoholic fatty liver disease.
Nonalcoholic fatty liver disease (NAFLD) is a chronic hepatic disease associated with the excessive accumulation of lipids in the liver. Premenopausal women are protected from the liver metabolic complications of obesity compared with body mass index (BMI)-matched men. This protection may be related to estrogen's ability to limit liver fat accumulation. Aryl hydrocarbon receptor (AhR), a novel regulator of NAFLD, may be an important target for regulating estrogen homeostasis. In present study, we used benzo[a]pyrene (BaP), a classic and potent ligand of AhR, to activate AhR pathway causes overexpression of the estrogen-metabolizing enzyme cytochrome P450 1A1 (CYP1A1) and affects the expression of important genes involved in hepatic lipid regulation. BaP induces CYP1A1 expression through AhR signaling and inhibits the protective effect of 17β-estradiol (E2) on hepatic steatosis, characterized by triglyceride accumulation, and markers of liver damage are significantly elevated. The expression of adipogenic genes involved in the hepatic lipid metabolism of sterol regulatory element-binding protein-1c (SREBP-1c) was increased compared with that in the control group. Furthermore, the mRNA and protein levels of peroxisome proliferator-activated receptor alpha (PPARα), which is involved in fatty acid oxidation, were significantly reduced. Taken together, our results revealed that the steatotic effect of AhR is likely due to overexpression of the E2 metabolic enzyme CYP1A1, which affects the estrogen signaling pathway, leading to the suppression of fatty acid oxidation, inhibition of the hepatic export of triglycerides, and an increase in peripheral fat mobilization. The results from this study may help establish AhR as a novel therapeutic and preventive target for fatty liver disease.


Synergistic optimization of bio-oil quality and heavy metal solidification during microwave co-pyrolysis of cow dung and red mud.
To decrease the environmental risks caused by heavy metals (HMs) in red mud (RM) and improve the quality of pyrolysis oil from biomass, high-temperature pretreated RM and cow dung (CD) were microwave co-pyrolyzed. Then, the optimization potential of energy consumption was evaluated and the interaction mechanism between RM and CD was explored. The results showed that the increase in transition metal oxides and specific surface area improved the microwave-absorption and catalytic capacity of the pretreated RM. By optimizing the parameters, a pretreatment temperature of 650 °C resulted in a 21.65% reduction in acid content of bio-oil, higher HMs immobilization rates (>91%) and a 7.44% reduction in energy consumption. The synergistic optimization of bio-oil quality, HMs immobilization and energy consumption was achieved. After microwave co-pyrolysis with cow dung, the larger specific surface area (92.90 m2 g-1) and higher carbon crystallinity (ID/IG = 1.02) of pyrolysis residues enhanced the physical adsorption to HMs. The complexation of HMs with -OH could further enhance the solidification of HMs. This work will provide support to efficient resource utilization of solid waste, and demonstrate the great potential of microwave co-pyrolysis in HMs immobilization.


Acute and chronic toxicity of lead in water and diet to the amphipod Hyalella azteca.
We evaluated the influence of waterborne and dietary lead (Pb) exposure on the acute and chronic toxicity of Pb to the amphipod Hyalella azteca. Test solutions were generated by a modified diluter with an extended (24-h) equilibration period. Acute (96-h) toxicity of Pb varied with water hardness in the range of 71 to 275 mg/L as CaCO3, despite similar dissolved Pb concentrations. Acute toxicity was greatest in soft test water, with less than 50% survival at the lowest dissolved Pb concentration (151 microg/L). Survival also was significantly reduced in medium-hardness water but not in hard test water. In chronic (42-d) studies, amphipods were exposed to waterborne Pb and fed either a control diet or a diet equilibrated with waterborne Pb levels. For animals fed the control diet, the median lethal concentration (LC50) for Pb was 24 degrees g/L (as dissolved Pb), and significant reductions in survival occurred at 16 microg/L. Exposure to Pb-treated diets significantly increased toxicity across a wide range of dissolved Pb concentrations, with a LC50 of 16 microg/L and significant reductions in growth and reproduction at 3.5 microg/L. Significant effects on growth and reproduction occurred at dissolved Pb concentrations close to the current U.S. chronic water-quality criterion. Our results suggest that both aqueous- and dietary-exposure pathways contribute significantly to chronic Pb exposure and toxic effects in aquatic biota.


Accuracy of controlled attenuation parameter compared with ultrasound for detecting hepatic steatosis in children with severe obesity.
To determine the diagnostic accuracy of controlled attenuation parameter (CAP) on FibroScan® in detecting and grading steatosis in a screening setting and perform a head-to-head comparison with conventional B-mode ultrasound. Sixty children with severe obesity (median BMI z-score 3.37; median age 13.7 years) were evaluated. All underwent CAP and US using a standardized scoring system. Magnetic resonance spectroscopy proton density fat fraction (MRS-PDFF) was used as a reference standard. Steatosis was present in 36/60 (60%) children. The areas under the ROC (AUROC) of CAP for the detection of grade ≥ S1, ≥ S2, and ≥ S3 steatosis were 0.80 (95% CI: 0.67-0.89), 0.77 (95% CI: 0.65-0.87), and 0.79 (95% CI: 0.66-0.88), respectively. The AUROC of US for the detection of grade ≥ S1 steatosis was 0.68 (95% CI: 0.55-0.80) and not significantly different from that of CAP (p = 0.09). For detecting ≥ S1 steatosis, using the optimal cutoffs, CAP (277 dB/m) and US (US steatosis score ≥ 2) had a sensitivity of 75% and 61% and a specificity of 75% and 71%, respectively. When using echogenicity of liver parenchyma as only the scoring item, US had a sensitivity of 70% and specificity of 46% to detect ≥ S1 steatosis. The difference in specificity of CAP and US when using only echogenicity of liver parenchyma of 29% was significant (p = 0.04). The overall performance of CAP is not significantly better than that of US in detecting steatosis in children with obesity, provided that the standardized scoring of US features is applied. When US is based on liver echogenicity only, CAP outperforms US in screening for any steatosis (≥ S1). • The areas under the ROC curves of CAP and ultrasound (US) for detecting grade ≥ S1 steatosis were 0.80 and 0.68, respectively, and were not significantly different (p = 0.09). • For detecting grade ≥ S1 steatosis in severely obese children, CAP had a sensitivity of 75% and a specificity of 75% at its optimal cutoff value of 277 dB/m. • For detecting grade ≥ S1 steatosis in clinical practice, both CAP and US can be used, provided that the standardized scoring of US images is used.


The Friberg spermagglutination test--a modification.
In our laboratory we encountered problems interpreting the standard Friberg test. After an incubation period of four hours we could not interpret the test in 52 per cent of cases due to a high number of immobile spermatozoa and debris in the supernatant used as antigen in this test. By shortening the incubation period to two hours we could objectively interpret 76 per cent of cases. The applicability of the test was further improved by modifying the preparation of the antigen. Instead of using the supernatant of diluted semen, we "filtered" the motile sperm by means of the sperm penetration meter of Kremer. The capillary tube of the penetration meter was filled with virgin serum and incubated for one hour. After a four hour incubation this test could be applied in 80 per cent of cases, and after a two hour incubation period in all the cases. The reliability of this test was compared with the standard Friberg, the Kibrick and the Franklin-Dukes tests. The modifications did not alter the reliability of the test.


The role of zinc sulfate in enhancing cellular and humoral immune responses to foot-and-mouth disease vaccine.
Foot-and-mouth disease (FMD) is a rapidly propagating infectious disease of cloven-hoofed animals, especially cattle and pigs, affecting the productivity and profitability of the livestock industry. Presently, FMD is controlled and prevented using vaccines; however, conventional FMD vaccines have several disadvantages, including short vaccine efficacy, low antibody titers, and safety issues in pigs, indicating the need for further studies. Here, we evaluated the efficacy of a novel bivalent vaccine containing zinc sulfate as an immunostimulant and FMD type O and A antigens (O PA2 and A YC, respectively) against FMD virus in mice and pigs. Zinc sulfate induced cellular immunity in murine peritoneal exudate cells (PECs) and porcine peripheral blood mononuclear cells (PBMCs) by increasing IFNγ secretion. Additionally, FMD vaccine containing O PA2 and A YC antigens and zinc sulfate induced early, mid-, and long-term immune responses in mice and pigs, and enhanced cellular and humoral immunity by regulating the expression of pathogen recognition receptors (PRRs), transcription factors, co-stimulatory molecules, and cytokines in porcine PBMCs from vaccinated pigs. Overall, these results indicated that the novel immunostimulant zinc sulfate induced potent cellular and humoral immune responses by stimulating antigen-presenting cells (APCs) and T and B cells, and enhanced long-term immunity by promoting the expression of co-stimulatory molecules. These outcomes suggest that zinc sulfate could be used as a novel vaccine immunostimulant for difficult-to-control viral diseases, such as African swine fever (ASF) or COVID-19.


Laryngeal Edema, Metabolic Acidosis, and Acute Kidney Injury Associated with Large-Volume Kohrsolin TH® Ingestion.
Glutaraldehyde is a commonly used disinfectant in most hospitals. It is known to be an irritating agent to the airway. With the exception of one small-quantity (75 mL) ingestion, no large-volume ingestion has been previously reported. A 59-year-old man presented with history of large-volume (500 mL) consumption of a solution containing 10% glutaraldehyde and developed respiratory distress, as well as gastrointestinal and kidney injury. His ingestion necessitated a feeding jejunostomy tube placement and tracheostomy. His condition improved with supportive care and he was discharged after 1 month with no long-term sequelae. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Ingestion of this easily accessible agent, which may initially seem clinically benign, warrants close observation. Emergent airway stabilization and supportive care is crucial to the survival of the patient.


Objective and subjective measures of vergence step responses.
Dichoptic nonius lines are used for subjectively (psychophysically) measuring vergence states, but they have been questioned as valid indicators of vergence eye position. In a mirror-stereoscope, we presented convergent and divergent step-stimuli and estimated the vergence response with nonius lines flashed at fixed delays after the disparity step stimulus. For each delay, an adaptive psychophysical procedure was run to determine the physical nonius offset required for subjective alignment; these vergence states were compared with objective eye movement recordings. Between both measures of initial vergence, we calculated the maximal cross-correlation coefficient: the median in our sample was about 0.9 for convergence and divergence, suggesting a good agreement. Relative to the objective measures, the subjective method revealed a smaller vergence velocity and a larger vergence response in the final phase of the response, but both measures were well correlated. The dynamic nonius test is therefore considered to be useful to relatively evaluate a subject's ability in disparity vergence.


6-Phosphogluconate dehydrogenase polymorphism in some inbred lines of laboratory rats.
We examined 6-PGD isozyme patterns in laboratory rats (Rattus norvegicus) and found the phenotype S in the lines CAP/Cub, WAG/RijCub, BDV/Cub, BDVII/Cub, BDX/Cub, and the phenotype F in the lines LEP/Cub, DA/Cub, AVNj/Cub.


Oral administration of cyanobacterial bloom extract induced the altered expression of the PP2A, Bax, and Bcl-2 in mice.
The frequent occurrences of the toxic cyanobacterial (specifically Microcystis aeruginosa) bloom are becoming a global environmental issue. Lots of researches have been focused on the pure cyanobacterial toxins, but little on the natural cyanobacterial bloom. This study was undertaken to investigate the effect of the natural cyanobacterial bloom extract on the expression of proteins, which have been shown to be affected by pure microcystins. In current study, the cyanobacterial bloom extract has been administered orally to ICR mice for 7 days with different dosages. The expression level of PP2A, Bcl-2, and Bax was measured via western blotting. The results showed that after 7 days of exposure to cyanobacteria extract, in mice liver tissue, the expression level of PP2A and Bax was increased significantly between the control and treatment groups, but there is no significant change on the Bcl-2 expression. This is the first report to describe the altered expression of PP2A in vivo when mice exposure to natural water blooms extract that means many cellular pathways would be interfered via the change of PP2A activity.


Intra-abdominal cryptococcosis by Cryptococcus gattii: case report and review.
Although abdominal cryptococcomas and visceral cryptococcal lymphadenitis as part of disseminated fungal infection have been reported mostly in HIV-infected patients, localized intra-abdominal involvement due to Cryptococcus gattii has not been previously described in non-HIV-infected patients. In general, a smaller proportion of cryptococcosis is caused by C. gattii. We report here on a type II diabetic HIV-negative patient who presented with a localized intra-abdominal cryptococcal mass due to C. gattii. In addition, we review the general aspects of intra-abdominal and gastrointestinal involvement by Cryptococcus neoformans in the literature and discuss the importance of identifying the C. neoformans varieties and C. gattii in routine laboratories.


Efficacy of tumbling in soy sauce marination of pork loins: effects of tumbling time and temperature.
The objectives of this study were to determine the effects of tumbling time on the processing characteristics of soy sauce marinated pork loins, and to compare its efficacy at two different tumbling temperatures. In experiment I, pork loins (M. longissimus thoracis et lumborum) were pumped to 115% (w/w) of original sample weight with soy sauce solution (75%, w/w) and tumbled for 0, 1, 3, and 5 h. In experiment II, the soy sauce pumped pork loins were tumbled at two different temperatures (- 1 and 4 °C) for 4 h. The pH, color characteristics, water-holding capacity, protein solubility, and shear force of pork loins tumbled with soy sauce marinade were determined. An increase in tumbling time increased the cooked pH and yellowness of soy sauce marinated pork loins (p < 0.05). Protein solubility, particularly that of total and salt-soluble proteins, increased with increasing tumbling time (p < 0.05), and a tumbling time of at least 3 h may guarantee excellent water-holding capacity and shear force. In addition, low tumbling temperature of - 1 °C could positively contribute to the improvement of water-holding capacity and shear force of soy sauce marinated pork loins. In conclusion, this current study indicates that the efficacy of tumbling in soy sauce marination of pork loins is affected by tumbling time and temperature, moreover, tumbling at - 1 °C for at least 3 h could be an effective method in the experimental operating condition.


Xanthan-galactomannan interactions as related to xanthan conformations.
The influence of xanthan conformation on the physicochemical behaviour of their mixtures with galactomannan from Schizolobium parahybae mannose:galactose ratio (M/G=3), was studied by viscoelastic measurements, differential scanning calorimetry (DSC) and chiroptical (circular dichroism) methods. The results suggested a more effective interaction of the galactomannan with disordered xanthan segments, which are more abundant in low salt concentrations but are still present in lower proportion at temperatures lower than the temperature of xanthan conformational transition (Tm). The dependence of ellipticity with temperature in a circular dichroism (CD) spectra suggested an ordering of the xanthan chains induced by galactomannan at the temperature of gel formation (Tg approximately 25 degrees C), under conditions where xanthan alone exhibits a disordered conformation. The lower Tg value found (approximately 25 degrees C) compared with that (60 degrees C) usually described in the literature is certainly related to the M/G ratio and the galactosyl unit distribution along the mannan main chain.


An examination of the design for a prefabricated housing unit in Cyprus in terms of energy, daylighting and cost.
Housing prefabrication emerged as an energy and cost-saving solution, which can also be linked to the reduction of environmental impacts, as well as to the development of green construction practices. In the first part of this study, a comprehensive literature review of the prefabricated assembly methods and their inherent potential, in terms of both design and construction are presented. Design strategies that incorporate the integration of environmental systems are also considered. A classification and taxonomy of archetypes is included, based on key design principles pertaining to environmental design. Based on the conclusions drawn from the assessment of these considerations, this paper revisits the realm of design and construction techniques used in energy efficient and environmentally compatible prefabricated housing unit in a Cypriot context. Cost-saving strategies are proposed, as well as architectural design and fabrication recommendations. Consequently, the research aims to contribute to existing literature by drawing results from an actual demonstration project in Cyprus. It goes on to outline considerations affecting the front end of the design and construction processes based on criteria for efficient prefabrication and modular construction. Findings are then related to simulations for energy and daylighting performance supplemented by a techno-economic analysis, aiming to demonstrate the viability of this enterprise. In this way it is hoped that stakeholders considering the adoption of this approach to design and construction may make better informed and more appropriate decisions.


Determining social power: Do Chinese preschoolers integrate verbal and nonverbal cues?
Children aged about 5 years can use verbal and nonverbal cues to determine social power. However, it is not clear what kinds of nonverbal cues preschoolers can use and whether they can integrate each nonverbal cue with verbal content when determining social power. Therefore, this research examined the ability of Chinese preschoolers to use and integrate visual, auditory, and verbal cues when determining social power as well as how this ability develops with age. In Study 1 (N = 478), 4- to 6-year-old Chinese children were recruited to judge the social power in visual, auditory, content, visual-auditory, visual-content, auditory-content, visual-auditory-content, and neutral cues. The results showed that 4-year-olds could not use any cues, 5-year-olds could not use content cues, and 6-year-olds could use all the cues. Children's performance improved with increasing age and the number of channels. Study 2 (N = 240) investigated whether speech tempo influences children's performance when using content cues. The results showed that 5- and 6-year-olds, but not 4-year-olds, could use content cues to determine social power under normal and slow tempos. Study 3 (N = 80) was conducted to clarify which visual cues 5- and 6-year-olds can use and the age difference. The results revealed that 5- and 6-year-olds could use head, eye, posture, and mixed cues to determine social power, whereas their performance was steady for both 5- and 6-year-olds. In sum, the results show that Chinese children aged about 5 years are already able to use and integrate visual, auditory, and content cues when determining social power. Moreover, the ability to determine social power is gradually improved with age during the preschool period.


SCARB1 downregulation in adrenal insufficiency with Allgrove syndrome.
Allgrove disease is a rare genetic syndrome characterized by adrenal insufficiency, alacrimia, achalasia and complex neurological involvement. Allgrove disease is due to recessive mutations in the AAAS gene, which encodes for the nucleoporin Aladin, implicated in the nucleocytoplasmic transport. The adrenal insufficiency has been suggested to rely on adrenal gland-ACTH resistance. However, the link between the molecular pathology affecting the nucleoporin Aladin and the glucocorticoid deficiency is still unknown. By analyzing postmortem patient's adrenal gland, we identified a downregulation of Aladin transcript and protein. We found a downregulation of Scavenger receptor class B-1 (SCARB1), a key component of the steroidogenic pathway, and SCARB1 regulatory miRNAs (mir125a, mir455) in patient's tissues. With the hypothesis of an impairment in the nucleocytoplasmic transport of the SCARB1 transcription enhancer cyclic AMP-dependent protein kinase (PKA), we detected a reduction of nuclear Phospho-PKA and a cytoplasmic mislocalization in patient's samples. These results shed a light on the possible mechanisms linking ACTH resistance, SCARB1 impairment, and defective nucleocytoplasmic transport.


Microneedle arrays integrated with microfluidic systems: Emerging applications and fluid flow modeling.
Microneedle arrays are patches of needles at micro- and nano-scale, which are competent and versatile technologies that have been merged with microfluidic systems to construct more capable devices for biomedical applications, such as drug delivery, wound healing, biosensing, and sampling body fluids. In this paper, several designs and applications are reviewed. In addition, modeling approaches used in microneedle designs for fluid flow and mass transfer are discussed, and the challenges are highlighted.


Comparison of Helicobacter mustelae and Helicobacter pylori adhesion to eukaryotic cells in vitro.
Bacterial adhesion to mucosal surfaces is an important pathogenic mechanism for Helicobacter-induced gastritis. The aims of this study were to compare binding of selected Helicobacter mustelae and Helicobacter pylori strains to lipids extracted from HEp-2, Chinese hamster ovary, human embryonic lung cells, and ferret gastrointestinal tissues as well as to intact tissue culture cells and to analyze the fatty acids of the receptor. Thin-layer chromatography overlay binding and a receptor-based immunoassay detected adhesion of bacteria to commercial lipids and to individual species within the lipid extracts. H. mustelae binding to tissue culture cells was performed by whole cell bacterial adhesion assay. H. mustelae and H. pylori both bound to phosphatidylethanolamine and lysophosphatidylethanolamine. Adhesion of H. mustelae to intact eukaryotic cells correlated with the amount of phosphatidylethanolamine. Binding of helicobacters was greater to lipids derived from ferret antrum compared with colon (P < 0.05). Biochemical analysis suggested that heterogeneity in fatty acid composition of phosphatidylethanolamine could influence the degree of Helicobacter binding. Adhesion of Helicobacter strains correlates with the quantity of phosphatidylethanolamine present in the epithelial cell and with the differences in the fatty acid profile of the lipid.


Methemoglobinemia: an unusual cause of postoperative cyanosis.
Methemoglobinemia, although rare, must be considered in surgical patients presenting with acute respiratory distress and cyanosis. We report two cases of methemoglobinemia in patients undergoing aortic reconstruction. The first patient developed methemoglobinemia while on a nitroglycerin infusion, and the second after receiving benzocaine spray before intubation. Both patients were treated with methylene blue and ascorbic acid, with resolution of their hypoxia and cyanosis. The pathophysiology, etiology, diagnosis, and treatment of methemoglobinemia are reviewed.


Analysis of Ki-67 expression in women with breast cancer: Comparative evaluation of two different methodologies by immunophenotyping.
The Ki-67 antigen is a nuclear protein with proven prognostic value in different neoplasms and recognizes the predictive value in breast cancer (BC). No consensus exists on the ideal cutoff point. In this study, Ki-67 expression was evaluated in samples of BC by flow cytometry (FC) and compared with immunohistochemical (IHC) examination. For this, the BC tissue samples were sectioned, macerated, filtered, and marked with anti-Ki-67 FITC and anti-CD45 V500 antibodies. We selected the neoplastic cells according to CD45 expression and size and internal complexity (FSC × SSC) using the Infinicity 1.7 software. Lymphocytes were negative control. We compared the results with IHC analyses carried out in parallel and independently. The expression of Ki-67 was evaluated in both methodologies through Bland-Altman analysis. Among the 44 samples analyzed, only three showed bias higher than the established confidence interval (mean bias 2.1%, p = 0.62), with no significant difference for the perfect mean bias (0%). Therefore, one can state that FC provides results equivalent to IHC analysis and possibly analyzes more cells simultaneously. The results obtained in this study show the absence of observational bias through software analysis in a larger number of tumor cell populations. We can conclude that FC may be a promising alternative method for investigating Ki-67 in solid tumours.


Predictive factors for response and survival in elderly acute myeloid leukemia patients treated with hypomethylating agents: a real-life experience.
Predictive factors of response to hypomethylating agents (HMA) in elderly acute myeloid leukemia (AML) patients remain unclear in the real-life setting and no direct comparison between azacitidine (AZA) and decitabine (DEC) has been carried out. We retrospectively evaluated 110 AML patients treated with HMA (78 AZA, 32 DEC) as first-line therapy outside of clinical trials. Median age was 75 years (range 58-87). The median overall survival (OS) of the entire cohort was 8.0 months (95% CI 6.1-10), without significant differences among the subgroups: AZA 8.8 months vs DEC 6.3 months (p = 0.291). HMA treatment yielded an overall response rate (ORR) of 40% (AZA 37% vs DEC 47%, p = 0.237). A stable disease (SD) after 4 HMA cycles was not associated with a worse survival outcome compared with an early optimal response. Factors independently associated with a better OS were transfusion independence during treatment (p = 0.049), achievement of an optimal response to treatment (p < 0.001), and a baseline hemoglobin level ≥ 9.25 (p = 0.018). A bone marrow (BM) blast count ≥ 30% (p < 0.001) and a therapy-related AML (p = 0.008) remain poor survival predictors. Of the available biologic features, an adverse risk category according to the ELN classification was significantly associated with a shorter survival over the intermediate risk category (p = 0.034). Disease progression remains the primary cause of death. Infectious complications were more severe (p = 0.036) and occurred earlier (p = 0.006) in the DEC group compared with that of the AZA group. In conclusion, clinical prognostic factors associated to response and survival have been identified without significant associations concerning overall outcomes between the two HMAs.


Functional network properties derived from wide-field calcium imaging differ with wakefulness and across cell type.
To improve 'bench-to-bedside' translation, it is integral that knowledge flows bidirectionally-from animal models to humans, and vice versa. This requires common analytical frameworks, as well as open software and data sharing practices. We share a new pipeline (and test dataset) for the preprocessing of wide-field optical fluorescence imaging data-an emerging mode applicable in animal models-as well as results from a functional connectivity and graph theory analysis inspired by recent work in the human neuroimaging field. The approach is demonstrated using a dataset comprised of two test-cases: (1) data from animals imaged during awake and anesthetized conditions with excitatory neurons labeled, and (2) data from awake animals with different genetically encoded fluorescent labels that target either excitatory neurons or inhibitory interneuron subtypes. Both seed-based connectivity and graph theory measures (global efficiency, transitivity, modularity, and characteristic path-length) are shown to be useful in quantifying differences between wakefulness states and cell populations. Wakefulness state and cell type show widespread effects on canonical network connectivity with variable frequency band dependence. Differences between excitatory neurons and inhibitory interneurons are observed, with somatostatin expressing inhibitory interneurons emerging as notably dissimilar from parvalbumin and vasoactive polypeptide expressing cells. In sum, we demonstrate that our pipeline can be used to examine brain state and cell-type differences in mesoscale imaging data, aiding translational neuroscience efforts. In line with open science practices, we freely release the pipeline and data to encourage other efforts in the community.


Can statins reduce the inflammatory response to cardiopulmonary bypass? A clinical study.
In addition to lowering lipid levels, statins might reduce leukocyte-endothelial cell interactions. Therefore, we assessed whether this effect could limit the inflammatory response to cardiopulmonary bypass (CPB) in cardiac surgical patients. Twenty patients undergoing valve or coronary operations with tepid (34 degrees C) CPB were randomized to receive an oral dose of atorvastatin (40 mg the evening before and 40 mg the morning of surgery) or to serve as controls. Pre- and post-CPB blood samples were assayed for neutrophil CD11b surface adhesion molecule and oxidative burst. Plasma levels of interleukins 6 and 8, P-selectin, soluble intercellular adhesion molecule-1, and lactoferrin were measured by enzyme-linked immunosorbent assay (ELISA). In addition, right atrial biopsies were taken before and at the end of CPB, and processed for the expression of the transcription nuclear factor-kappa B (NF-kappaB). The two groups did not differ with regard to pre- and intraoperative data. Except for P-selectin, postbypass values of all markers significantly increased over baseline values, but atorvastatin therapy failed to attenuate the magnitude of this increase. In the two groups, the expression of NF-kappaB significantly (p = 0.004) increased over baseline without group effect. Postoperative clinical outcomes did not differ either between the two groups. These data show that acute preoperative statin therapy fails to limit the inflammatory response to CPB; however, the data also document a major upregulation of NF-kappaB during cardiac operations, thereby providing a sound rationale for interventions targeted at inactivating this key component of the inflammatory cascade.


Hypnogenic center theory of sleep: no support from metabolic mapping in monkeys.
By comparing rates of glucose utilization in brains of monkeys in non-REM sleep and two types of awake controls, we attempted to reveal cerebral hypnogenic centers that drive organisms to sleep through increases in their neural activity. Instead we found that metabolic activity is reduced in all the putative hypnogenic centers during sleep as compared to wakefulness. The results thus offer no support for the notion of an active center that either maintains or triggers sleep.


Activating alternative chloride channels to treat CF: Friends or Foes?: Report on the Meeting of the Basic Science Working Group in Dubrovnik, Croatia.
The European Cystic Fibrosis Society (ECFS) Basic Science Working Group (BSWG) organized a session on the topic "Activating Alternative Chloride Channels to Treat CF: Friends or Foes?", within the 16th ECFS Basic Science Conference gathering ∼200 researchers from CF Basic Science. The session was organized into two round tables, each chaired by Margarida Amaral (BioISI, University of Lisboa, Portugal) and Jeffrey Beekman (University Medical Centre Utrecht, Netherlands) as Chair and Vice-Chair of the BSWG, respectively. The purpose of this session was to bring attention of participants of the ECFS Basic Science Conference to alternative chloride channels as important therapeutic targets for CF which may treat all individuals with CF, independently of their CFTR genotype. The session had various speakers who had presented abstracts to the conference on this topic and discussants with different views. Here we try to convey the presentations as well as ideas that emerged during the discussion.


Development of an accurate molecular mechanics model for buckling behavior of multi-walled carbon nanotubes under axial compression.
In the present paper, an analytical solution based on a molecular mechanics model is developed to evaluate the elastic critical axial buckling strain of chiral multi-walled carbon nanotubes (MWCNTs). To this end, the total potential energy of the system is calculated with the consideration of the both bond stretching and bond angular variations. Density functional theory (DFT) in the form of generalized gradient approximation (GGA) is implemented to evaluate force constants used in the molecular mechanics model. After that, based on the principle of molecular mechanics, explicit expressions are proposed to obtain elastic surface Young's modulus and Poisson's ratio of the single-walled carbon nanotubes corresponding to different types of chirality. Selected numerical results are presented to indicate the influence of the type of chirality, tube diameter, and number of tube walls in detailed. An excellent agreement is found between the present numerical results and those found in the literature which confirms the validity as well as the accuracy of the present closed-form solution. It is found that the value of critical axial buckling strain exhibit significant dependency on the type of chirality and number of tube walls.


Dynamic coordination of two-phase reactions in heterogeneous Fenton for selective removal of water pollutants.
The •OH-mediated heterogeneous Fenton reaction has been widely applied despite the limitations of low pollutant selectivity and unclear oxidation mechanism. Here we reported an adsorption-assisted heterogeneous Fenton process for the selective degradation of pollutants and systematically illustrated its dynamic coordination in two phases. The results showed that the selective removal was improved by (i) surface enrichment of target pollutants via electrostatic interactions including real adsorption and adsorption-assisted degradation and (ii) inducing the diffusion of H2O2 and pollutants from the bulk solution to the catalyst surface to trigger the homogeneous and surface heterogeneous Fenton reactions. Furthermore, surface adsorption was confirmed as a crucial but not necessary step for degradation. Mechanism studies demonstrated that •O2- and Fe3+/Fe2+ cycle increased •OH generation, which remained active in two phases within ⁓244 nm. These findings are critical for understanding the removal behavior of complex targets and expanding heterogeneous Fenton applications.


Association Between Sociodemographic Factors and Vision Difficulty in the National Health Interview Survey: A Population-Based Analysis.
To investigate the relationship between social determinants of health with self-reported vision difficulty. Cross-sectional, population-based analysis. The National Health Interview Survey (NHIS) is an annual survey based on the U.S. population ≥18 years of age. It provides self-reported data on demographic characteristics, socioeconomic factors, health status, and health care access. The 2021 NHIS database was used in this study. Adult participants of the NHIS who responded to the vision difficulty question "Do you have difficulty seeing, even when wearing glasses or contact lenses?" were included in this analysis. The outcome of interest was self-reported vision difficulty by participants. Analysis was done through univariable and multivariable logistic regression. Overall, there were 29,464 participants included in the analysis. Univariable logistic regression showed an increased odds of self-reported vision difficulty among female (odds ratio [OR] 1.28 [95% confidence interval {CI} 1.20-1.38]; P < .001), gay, lesbian, or bisexual participants (OR 1.24 [95% CI 1.04-1.49]; P = .02), those who possessed public compared with private insurance (OR 1.83 [95% CI 1.69-1.99]; P < .001), those with less than a high school education (OR 1.88 [95% CI 1.67-2.13]; P < .001), and those with an income below the poverty threshold (OR 2.22 [95% CI 1.96-2.51]; P < .001). Multivariable analysis revealed an increased risk of vision difficulty reported amongst non-Hispanic Black participants (OR 1.65 [95% CI 1.21-2.25]; P = .002). A multitude of sociodemographic factors are associated with self-reported vision difficulty in the U.S. Our findings emphasize the importance of considering factors of social determinants of health in clinical practice and policymaking for patients with vision loss.


A network-centric approach to drugging TNF-induced NF-κB signaling.
Target-centric drug development strategies prioritize single-target potency in vitro and do not account for connectivity and multi-target effects within a signal transduction network. Here, we present a systems biology approach that combines transcriptomic and structural analyses with live-cell imaging to predict small molecule inhibitors of TNF-induced NF-κB signaling and elucidate the network response. We identify two first-in-class small molecules that inhibit the NF-κB signaling pathway by preventing the maturation of a rate-limiting multiprotein complex necessary for IKK activation. Our findings suggest that a network-centric drug discovery approach is a promising strategy to evaluate the impact of pharmacologic intervention in signaling.


Toxic equivalency factors study of polycyclic aromatic hydrocarbons (PAHs) in Taichung City, Taiwan.
Airborne particles and polycyclic aromatic hydrocarbons (PAHs) in industrial, background and urban atmosphere environments were investigated using toxic equivalent factors (TEFs) in central Taiwan during the period of August-December 2002. Concentrations of airborne particles were 93.4, 81.3 and 102.4 microg/m3 for industrial, background and urban sites, respectively. Concentrations of 21 gaseous PAHs were 1530, 759 and 1030 ng/m3 for industrial, background and urban sites, respectively; for carcinogenic activity of gaseous PAHs, the benzo[a]pyrene (BaP) equivalent concentrations were 17.0, 7.29 and 12.6 ng/m3 for industrial, background and urban sites, respectively. Twenty-one particle-bound PAHs were only 10% of the 21 gaseous PAHs. Dibenzo(a,h)anthracene (DBA) serves as a surrogate to explain the carcinogenic activity of PAH mixtures in central Taiwan because its carcinogenicity is a high percentage of the total carcinogenic activity. During the sampling period, temperature inversion from a cold front from China occurred, leading to average daily temperatures of 16 degrees C. These cold fronts caused atmospheric particles and pollutants to accumulate in the troposphere, leading to extremely high concentrations of airborne particles and both gaseous and particle-bound PAHs in central Taiwan.


Values, institutions and shifting policy paradigms: expansion of the Israeli National Health Insurance Basket of Services.
To examine the roles of policy paradigms, in particular new public management and regulated competition in different areas of health policy. Quantitative and qualitative methods are used to assess the degree of success of regulated competition in the Israeli context in terms of public understanding, trust, and the basic viability of the system and in somatic as opposed to mental health policy. As Israel's explicit priority setting processes in the area of somatic health services have proceeded, the public indicates increased relative preference for treatments adding quality of life, shifting from prioritizing extending life. The public and physicians gave high scores to preventative screening. Between 1998 and 2001 levels of awareness of the decision-making process rose and then retreated, perhaps due to varying levels of decision-making activity. High levels of trust are evinced in health policy agencies and in the priority setting process. The Israeli case demonstrates that New Public Management (NPM) paradigms, such as regulated competition, can successfully be deployed in attempting to manage health care policy. However, as health policy moves beyond somatic health care into areas requiring more inter-sector orientation, such as mental health, the appropriateness of NPM models is called into question. However, the very success of models such as regulated competition causes policy makers to resort to them instead of developing new paradigms.


Feeding supplemental dried distiller's grains increases faecal shedding of Escherichia coli O157 in experimentally inoculated calves.
Escherichia coli O157 is an important foodborne pathogen and asymptomatic cattle serve as major reservoirs for human infection. We have shown a positive association between feeding distiller's grains and E. coli O157 prevalence in feedlot cattle. The objective of this study was to determine the effect of feeding dried distiller's grain (DDG) on faecal shedding of E. coli O157 in calves experimentally inoculated with E. coli O157. Holstein calves (five per treatment group), fed steam-flaked corn-based high-grain diets supplemented with 0% (control) or 25% DDG, were orally inoculated with a five-strain mixture (6 x 10(9) CFU/calf) of nalidixic acid-resistant (NalR) E. coli O157. Faecal samples were taken three times per week for 6 weeks to determine the prevalence and concentration of Nal E. coli O157. At the end of the study (day 43), calves were euthanized and necropsied. Ruminal, caecum, colon, and rectal contents, and rectoanal mucosal swab (RAMS) samples were collected at necropsy to determine NalR E. coli O157 concentration. There was a trend for an interaction between treatment and faecal sampling day. The concentration of NalR E. coli O157 in the faeces was significantly higher in faecal samples from calves fed DDG compared with control calves on days 35, 37, 39 and 42. At necropsy, the concentration of NalR E. coli O157 was higher in the caecum (P = 0.01), colon (P = 0.03) and rectum (P = 0.01) from calves fed DDG compared with control animals. The number of sites at necropsy positive for NalR E. coli O157 was higher in calves fed DDG compared with calves in the control treatment (P < 0.001). Our results indicate that E. coli O157 gut persistence and faecal prevalence increased in calves fed DDG, which potentially have important implications for food safety.


Refractive index matching to develop transparent polyaphrons: Characterization of immobilized proteins.
Refractive index matching was used to create optically transparent polyaphrons to enable proteins adsorbed to the aphron surface to be characterized. Due to the significant light scattering created by polyaphrons, refractive index matching allowed for representative circular dichroism (CD) spectra and acceptable structural characterization. The method utilized n-hexane as the solvent phase, a mixture of glycerol and phosphate buffer (30% [w/v]) as the aqueous phase, and the non-ionic surfactants, Laureth-4 and Kolliphor P-188. Deconvolution of CD spectra revealed that the immobilized protein adapted its native conformation, showing that the adsorbed protein interacted only with the bound water layer ("soapy shell") of the aphron. Isothermal calorimetry further demonstrated that non-ionic surfactant interactions were virtually non-existent, even at the high concentrations used (5% [w/v]), proving that non-ionic surfactants can preserve protein conformation.


Complete disruption of axillary artery caused by severe atherosclerosis and trivial nonpenetrating trauma.
Complete disruption of the axillary artery related to relatively trivial nonpenetrating trauma in a 67-year-old male is reported. The injury occurred in relation to severe circumferential atherosclerosis of the vessel. Successful revascularization was accomplished with salvage of the extremity and normal function.


Neuroimaging Advances for Depression.
Depression is one of the world's most prevalent mental health problems, with as many as 350 million sufferers worldwide and close to 20 million sufferers in the US. While neuroimaging applications for identifying various types of depression have made enormous strides in recent years, no findings have been sufficiently replicated or considered significant enough to warrant application in clinical settings. Our authors are well equipped to tell us what the future may bring.


Influence of several biodegradable components added to pure and nanosilver-doped PMMA bone cements on its biological and mechanical properties.
Acrylic bone cements (BC) are wildly used in medicine. Despite favorable mechanical properties, processability and inject capability, BC lack bioactivity. To overcome this, we investigated the effects of selected biodegradable additives to create a partially-degradable BC and also we evaluated its combination with nanosilver (AgNp). We hypothesized that using above strategies it would be possible to obtain bioactive BC. The Cemex was used as the base material, modified at 2.5, 5 or 10 wt% with either cellulose, chitosan, magnesium, polydioxanone or tricalcium-phosphate. The resulted modified BC was examined for surface morphology, wettability, porosity, mechanical and nanomechanical properties and cytocompatibility. The composite BC doped with AgNp was also examined for its release and antibacterial properties. The results showed that it is possible to create modified cement and all studied modifiers increased its porosity. Applying the additives slightly decreased BC wettability and mechanical properties, but the positive effect of the additives was observed in nanomechanical research. The relatively poor cytocompatibility of modified BC was attributed to the unreacted monomer release, except for polydioxanone modification which increased cells viability. Furthermore, all additives facilitated AgNp release and increased BC antibacterial effectiveness. Our present studies suggest the optimal content of biodegradable component for BC is 5 wt%. At this content, an improvement in BC porosity is achieved without significant deterioration of BC physical and mechanical properties. Polydioxanone and cellulose seem to be the most promising additives that improve porosity and antibacterial properties of antibiotic or nanosilver-loaded BC. Partially-degradable BC may be a good strategy to improve their antibacterial effectiveness, but some caution is still required regarding their cytocompatibility. STATEMENT OF SIGNIFICANCE: The lack of bone cement bioactivity is the main limitation of its effectiveness in medicine. To overcome this, we have created composite cements with partially-degradable properties. We also modified these cements with nanosilver to provide antibacterial properties. We examined five various additives at three different contents to modify a selected bone cement. Our results broaden the knowledge about potential modifiers and properties of composite cements. We selected the optimal content and the most promising additives, and showed that the combination of these additives with nanosilver would increase cements` antibacterial effectiveness. Such modified cements may be a new solution for medical applications.


Comparative demography of sympatric populations of Lacerta vivipara and Lacerta agilis.
A mark-recapture study was carried out in sympatric populations of Lacerta agilis and Lacerta vivipara in the Netherlands from 1976 to 1982. In most years the age structure of both populations was pyramidal. For both species life expectation of females was higher and on average they did live longer. Hence the sex ratio for adults deviated significantly from 1.0 in favour of females. Maximum age for Lacerta vivipara was 8 years (female) and for Lacerta agilis 12 years (male). The density of both species fluctuated around 100/ha. The biomass of Lacerta agilis was twice that of Lacerta vivipara. In Lacerta vivipara the 3rd and 4th calendar year class supplied 78% of total net reproduction; in Lacerta agilis the 4th, 5th, and 6th calendar year classes supplied 68%. In both populations the population replacement rate was 2. Population turnover time was 4.83 years for Lacerta agilis and 2.81 for Lacerta vivipara. The life history strategy of the Lacerta vivipara population is compared with six other European Lacertavivipara populations.


The effect of group-based Otago exercise program on fear of falling and physical function among older adults living in nursing homes: A pilot trial.
This pilot trial explored the feasibility of group-based Otago exercise program (OEP) and its impact on fear of falling (FOF) and physical function among Chinese older adults living in nursing homes. The intervention group received group-based OEP for 12 weeks, while the control group received routine care. The modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE), timed Up and Go test (TUG), four-stage Balance test (FSBT), and 30 seconds sit-to-stand test (30s-SST) were used. After twelve weeks, we found that the intervention group had better outcomes than the control group in mSAFFE, TUG, FSBT and 30s-SST (p<0.05). Also, we compared the pretest-posttest results within the two groups, respectively. We found that, within the intervention group, the outcomes of mSAFFE, TUG, FSBT, and 30s-SST become significantly better after twelve weeks, but within the control group, the outcomes of TUG, FSBT, and 30s-SST become significantly worse. Our findings demonstrated that a group-based OEP was feasible and acceptability among Chinese older adults living in nursing homes and the group-based OEP could improve FOF and physical function among those older adults.


Comparison of safety and effectiveness between the right and left radial artery approach in percutaneous coronary intervention.
There is a paucity of data comparing the left radial approach (LRA) and right radial approach (RRA) for percutaneous coronary intervention (PCI) in all-comers populations and performed by operators with different experience levels. Thus, we sought to compare the safety and clinical outcomes of the RRA and LRA during PCI in "real-world" patients with either stable angina or acute coronary syndrome (ACS). To overcome the possible impact of the nonrandomized design, a propensity score was calculated to compare the 2 radial approaches. The study group comprised 18 716 matched pairs with stable angina and 46 241 with ACS treated with PCI and stent implantation between 2014 and 2017 in 151 tertiary invasive cardiology centers in Poland (the ORPKI Polish National Registry). The rates of death and periprocedural complications were similar for the RRA and LRA in stable angina patients. A higher radiation dose was observed with PCI via the LRA in both clinical presentations (stable angina: 1067.0±947.1 mGy vs 1007.4±983.5 mGy, P=.001; ACS: 1212.7±1005.5 mGy vs 1053.5±1029.7 mGy, P=.001). More contrast was used in LRA procedures but only in ACS patients (174.2±75.4mL vs 167.2±72.1mL, P=.001). Furthermore, periprocedural complications such as coronary artery dissection (0.16% vs 0.09%, P=.008), no-reflow phenomenon (0.65% vs 0.49%, P=.005), and puncture site bleeding (0.09% vs 0.05%, P=.04) were more frequently observed with the LRA in ACS patients. There was no difference in mortality between the 2 groups (P=.90). Our finding of poorer outcomes with the LRA may be related to lower operator experience with this approach. While both the LRA and RRA are safe in the setting of stable angina, the LRA was associated with a higher rate of periprocedural complications during PCI in ACS patients.


Differential expression of estrogen receptor alpha (ERalpha) protein in MCF-7 breast cancer cells chronically exposed to TCDD.
Estrogens play a key role in the development and evolution of breast cancer tumors. Estrogen receptor alpha (ERalpha) mediates many of the biological activities of estrogens, and its expression is associated with low invasiveness and good prognosis. Recent epidemiological reports suggest that long-term exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is implicated in the increased incidence of breast cancer in exposed women. TCDD interferes with the expression of some ERalpha-dependent genes and inhibits estradiol (E2)- dependent growth of breast cancer cells in vitro. However, E2-dependent xenographs of MCF-7 human breast cancer cells resumed growth after a 2-week exposure to TCDD. The mechanisms involved in the resumption of cell growth are not completely understood. In this study, we show that short term-exposure (16 days) to 1 nM TCDD results in the suppression of ERalpha protein expression, while chronic exposure for more than 1 year (LTDX cells) results in the partial re-expression of the receptor. Immunocytochemistry studies showed that re-expression of ERalpha in LTDX cells occurred in some of the cells. Analysis by Western immunoblots indicated that four out of five LTDX clones expressed ERalpha at levels comparable to those in unexposed MCF-7 cells. Removal of TCDD treatment for 16 days restored the expression of ERalpha in the ERalpha-negative clonal cells. These results suggest that MCF-7 cells chronically exposed to TCDD contain at least two cell subpopulations that may respond differently to the ERalpha-mediated effects of TCDD.


Inference of the distribution of fitness effects of mutations is affected by single nucleotide polymorphism filtering methods, sample size and population structure.
The distribution of fitness effects (DFE) of new mutations has been of interest to evolutionary biologists since the concept of mutations arose. Modern population genomic data enable us to quantify the DFE empirically, but few studies have examined how data processing, sample size and cryptic population structure might affect the accuracy of DFE inference. We used simulated and empirical data (from Arabidopsis lyrata) to show the effects of missing data filtering, sample size, number of single nucleotide polymorphisms (SNPs) and population structure on the accuracy and variance of DFE estimates. Our analyses focus on three filtering methods-downsampling, imputation and subsampling-with sample sizes of 4-100 individuals. We show that (1) the choice of missing-data treatment directly affects the estimated DFE, with downsampling performing better than imputation and subsampling; (2) the estimated DFE is less reliable in small samples (<8 individuals), and becomes unpredictable with too few SNPs (<5000, the sum of 0- and 4-fold SNPs); and (3) population structure may skew the inferred DFE towards more strongly deleterious mutations. We suggest that future studies should consider downsampling for small data sets, and use samples larger than 4 (ideally larger than 8) individuals, with more than 5000 SNPs in order to improve the robustness of DFE inference and enable comparative analyses.


Relationship between adipic acid concentration and the core symptoms of autism spectrum disorders.
Dicarboxylic acids are an important source of information about metabolism and potential physiopathological alterations in children with autism spectrum disorders (ASDs). We measured the concentration between dicarboxylic adipic and suberic acids in children with an ASD and typically-developing (TD) children and analyzed any relationships between the severity of the core symptoms of ASDs and other clinical features (drugs, supplements, drugs, or diet). The core symptoms of autism were evaluated using the DSM-IV criteria, and adipic acid and suberic acid were measured in urine samples. Overall, no increase in the concentration of adipic acid in children with ASDs compared to TD children, however when considering vitamin B supplementation in ASD there were significantly increased level of urinary adipic acid in children with an ASD not taking vitamin B supplementation compared to supplemented children or to TD children. No significant difference were observed in suberic acid. Interestingly, the increase in adipic acid concentration was significantly and indirectly correlated with the severity of the deficit in socialization and communication skills in children with an ASD. Therefore, therapeutic treatments aimed at decreasing adipic acid concentration might not be beneficial for treating the core symptoms of ASDs.


Thread based devices for low-cost diagnostics.
The need for low-cost diagnostic devices, both for developing and industrial countries, has led to the search for inexpensive matrixes that will allow the performance of analytical assays. One approach uses paper to create multiple microfluidic channels which allow analytes in urine or blood to flow to different detection zones the device. The choice of paper arises from its low-cost and its ability to wick biological fluids by capillary forces (i.e., an external power is not required to move fluid in a device). This chapter describes the use of a common material-cotton thread-as an alternative matrix for low-cost diagnostics. Thread-based devices can be fabricated using established techniques that rely on common house-hold tools for manipulating threads (e.g., sewing machines and looms). The fabrication schemes described here could potentially be adapted for large-scale manufacturing of diagnostic devices.


Synthetic EMG Based on Adversarial Style Transfer Can Effectively Attack Biometric-Based Personal Identification Models.
Biometric-based personal identification models are generally considered to be accurate and secure because biological signals are too complex and person-specific to be fabricated, and EMG signals, in particular, have been used as biological identification tokens due to their high dimension and non-linearity. We investigate the possibility of effectively attacking EMG-based identification models with adversarial biological input via a novel EMG signal individual-style transformer based on a generative adversarial network and tiny leaked data segments. Since two same EMG segments do not exist in nature; the leaked data can't be used to attack the model directly or it will be easily detected. Therefore, it is necessary to extract the style with the leaked personal signals and generate the attack signals with different contents. With our proposed method and tiny leaked personal EMG fragments, numerous EMG signals with different content can be generated in that person's style. EMG hand gesture data from eighteen subjects and three well-recognized deep EMG classifiers were used to demonstrate the effectiveness of the proposed attack methods. The proposed methods achieved an average of 99.41% success rate on confusing identification models and an average of 91.51% success rate on manipulating identification models. These results demonstrate that EMG classifiers based on deep neural networks can be vulnerable to synthetic data attacks. The proof-of-concept results reveal that synthetic EMG biological signals must be considered in biological identification system design across a vast array of relevant biometric systems to ensure personal identification security for individuals and institutions.


Promoter sequence variants of LIGHT are associated with female vascular dementia.
LIGHT (homologous to L ymphotoxins, exhibits I nducible expression, and competes with herpes simplex virus G lycoprotein D for H erpes virus entry mediator, a receptor expressed by T lymphocytes) is implicated in the inflammation by disrupted T cell homeostasis, primarily at a transcriptional level. We investigated the association of LIGHT promoter with ischemic stroke and vascular dementia induced by such inflammation. We determined transcription factor binding sites altered by promoter SNPs using transcription factor prediction programs. Six common haplotypes composed of the selected SNPs (C-770T, G-607T, G-543A, and A-399G) were used for the assay of reporter activity. The most frequent haplotype construct, CGGA, induced the highest luciferase activity. The haplotype TTGA showed the lowest expression with 0.39-fold activity (P < 0.001) of CGGA. The substitution from C to T at the locus of C-770T (TGGA) decreased the reporter activity by 47% (P < 0.001). The SNPs and haplotypes were further investigated to see their association with ischemic stroke and vascular dementia in 455 controls and 478 patients. Significant association with vascular dementia was shown in the allele T of C-770T (odds ratio [OR] = 1.54; P < 0.05) and the haplotype TTGA (OR = 10.59; P < 0.05) in females. We concluded that the allele T of C-770T and the haplotype TTGA of the promoter SNPs in LIGHT gene might decrease the expression of LIGHT and subsequently increase the susceptibility to vascular dementia in females.


Time course for urethral neuromuscular reestablishment and its facilitated recovery by transcutaneous neuromodulation after simulated birth trauma in rats.
The aims of the study were to determine the time-course of urinary incontinence recovery after vaginal distension (VD), elucidate the mechanisms of injury from VD leading to external urethral sphincter (EUS) dysfunction, and assess if transcutaneous electrical stimulation (TENS) of the dorsal nerve of the clitoris facilitates recovery of urinary continence after VD. Rats underwent 4-h VD, 4-h sham VD (SH-VD), VD plus 1-h DNC TENS, and VD plus 1-h sham TENS (SH-TENS). TENS or SH-TENS were applied immediately and at days 2 and 4 post-VD. Micturition behavior, urethral histochemistry and histology, EUS and nerve electrophysiology, and cystometrograms were evaluated. VD induced urine leakage and significantly disrupted EUS fibers and nerve-conduction (VD vs SH-VD group; p < 0.01). Urine leakage disappeared 13 days post-VD (p < 0.001). Structural and functional recovery of EUS neuromuscular circuitry started by day 6 post-VD, but did not fully recover by day 11 post-VD (p > 0.05). TENS significantly decreased the frequency of urine leakage post-VD (days 5-7; p < 0.01). We conclude that rat urinary continence after VD requires 2 weeks to recover, although urethra structure is not fully recovered. TENS facilitated urinary continence recovery after VD. Additional studies are necessary to assess if TENS could be used in postpartum women.


Tensions in antibiotic prescribing: pitting social concerns against the interests of individual patients.
To reduce the prevalence of antibiotic-resistant bacteria in the community, physicians must optimize their use of antibiotics. However, optimal use from the perspective of the community (reserving newer agents for future use) is not always consistent with optimal use from the perspective of the individual patient (prescribing newer, broader agents). To identify preferred patterns of antibiotic prescribing for patients with community-acquired pneumonia (CAP), measure explicit attitudes toward antibiotics and antibiotic resistance, and determine the relationship between these prescribing patterns and attitudes. Cross-sectional anonymous mail survey. National random sample of 400 generalist physicians (general internal medicine and family practice) and 429 infectious diseases specialists. Rank ordering of antibiotic preferences for a hypothetical outpatient with CAP and reasons for antibiotic selection. Endorsement of attitudes regarding antibiotic prescribing decisions and resistance. Both generalists and infectious diseases specialists were more likely to prefer newer, broader drugs for the treatment of CAP compared to older agents still recommended by national guidelines. Physicians rated the issue of contributing to antibiotic resistance lowest among 7 determinants of their choices. Despite national guidelines and increasing public awareness, the public health concern of contributing to the problem of antibiotic resistance does not exert a strong impact on physician prescribing decisions for CAP. Future efforts to optimize antibiotic prescribing decisions will need to consider options for increasing the impact of public health issues on the patient-oriented decisions of individual physicians.


Epidemiology and determinants of Clonorchis sinensis infection: A community-based study in southeastern China.
Clonorchiasis is caused by the ingestion of raw freshwater fish and causes high burden in East Asia. The epidemiological profiles and determinants of C. sinensis infection, knowledge, practice and attitude related to clonorchiasis were demonstrated in Hengxian county, Guangxi, China. The overall prevalence of C. sinensis was 60.3%, which was higher in male than in female and in elder population compared to children. The percentage knowing local transmission, transmission route and harm of C. sinensis was 20.9%, 31.4% and 32.5%. A percentage of 60.4% reported ingestion of raw freshwater fish, while 70.1% persons would like to accept treatment if infected with C. sinensis. Of the individuals ingesting raw freshwater fish, 82.0% did at home and 81.3% drunk alcohol when ingesting raw freshwater fish. Sixty-two percent showed the persistence on ingestion of raw freshwater fish in future. The ingestion of raw freshwater fish varied by seasons, with a proportion of 57.8% in spring, 48.3% in summer, 60.2% in autumn and 92.2% in winter. In multivariable regression models, age groups, history with C. sinensis treatment, and frequency on ingesting raw freshwater fish were related to C. sinensis infection, while gender, educational level, history with C. sinensis infection, and knowing local transmission were related to the practice of ingesting raw freshwater fish. Gender, history with C. sinensis treatment, frequency on ingesting raw freshwater fish, duration of ingesting raw freshwater fish and drinking alcohol when ingesting raw freshwater fish were associated to the attitude to the ingestion of raw freshwater fish in future. Great efforts are needed to combat clonorchiasis, in which the heterogeneity of population in knowledge, practice, attitude and infection needs to be considered. Men are of crucial importance in term of the morbidity control through chemotherapy. Meanwhile, massive education is expected to implement, which needs to promote the change of ingesting raw freshwater fish for sustainable control of clonorchiasis.


Weight status in US youth: the role of activity, diet, and sedentary behaviors.
To assess associations of physical activity, diet, and sedentary behaviors with overweight and obesity. Analyses of the NHANES 2003-06 were conducted among 2368 US adolescents, ages 12-19. Self-reported diet and sedentary behavior measures were used; physical activity was assessed using accelerometers. Television/video viewing (OR=1.84; CI=1.24, 2.69), physical activity (OR=0.75; CI=0.59, 0.95), and fiber intake (OR=0.96; CI=0.92, 0.99) were associated with obesity whereas television/video viewing was a risk factor for overweight (OR=1.57; CI=1.1, 2.63). Findings using accelerometer-measured physical activity are consistent with results from other studies using self-reported measurements. No interactions with ethnicity and gender were found.


Assay of caffeine metabolism in vitro by human liver microsomes using radio-high-performance liquid chromatography.
The low turnover of caffeine in vitro by human liver microsomes makes the study of the metabolic pathways of this compound difficult. Analytical methods with high sensitivity and specificity are needed for the detection of its metabolic products. A method based on the on-line radiometric determination of [8C-3H]caffeine and its principal metabolite (paraxanthine) in man has been developed using reversed-phase high-performance liquid chromatography. The method has been successfully employed in preliminary studies of the kinetics of this reaction.


Theoretical design of metal-phthalocyanine dye-sensitized solar cells with improved efficiency.
The present work carried out a theoretical study of the electronic structures, absorption spectra, and photovoltaic performance of two series of transition metal-phthalocyanine derived from nonperipheral electron-donating substituents, either (2-phenyl) phenoxy(M-PC1) or quinoleinoxy(M-PC2). The DFT and TD-DFT were employed for this study. The effect of modifying the central metal atoms and the substitution on cell performance were investigated in terms of polarizability (α), hyper-polarizability (β), chemical potential (μ), chemical hardness (η), electrophilicity power (ω), FMOs, energy gaps, UV/vis absorption spectra and injected driving force (ΔGinject), light harvesting efficiencies (LHE), total reorganization energy (λtot), open circuit photovoltage (Voc), and life time of the excited state (τ). The results obtained by using these parameters showed that the replacement of (2-phenyl) phenoxy by a proposed substituent such as quinoleinoxy would increase the hyper-polarizability, light harvesting efficiency, and open circuit photovoltage, while on the other hand the reorganization energy and the injection driving force are decreased. Modifying central metal atoms, such as Zn, Cd, Pd, and Pt, exhibited good performance in terms of the driving force of electron injection, charge transfer characteristics, and dye reorganization as compared with the Cu reference dye. The findings provided a useful prediction and perspective for the promising future for high-efficiency dye-sensitized solar cells (DSSCs) with dyes based on phthalocyanine. Graphical abstract Photovoltaic performance of Metallo-phthalocyanine contening (2-phenyl) phenoxy and quinoleinoxy.


Early diagnosis of oral squamous cell carcinoma may ensure better prognosis: A case series.
Oral squamous cell carcinoma is an extremely malignant tumour: in order to reduce mortality and morbidity, early diagnosis and treatment is the clinician's best weapon.


Reliability and validity of the National Institutes of Health Chronic Prostatitis Symptom Index questionnaire in the Turkish Population
To develop the first Turkish version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH- CPSI) questionnaire and to investigate its validity and reliability in men with chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) and healthy controls. A total of 204 patients, 116 CP/CPPS and a control group which consisted of 88 healthy individuals were included in this prospective study. The NIH-CPSI form was first translated into Turkish and later on back into English. Using the Turkish version of the NIH CPSI, 40 patients completed the same questionnaires twice at 2-week intervals for test-retest concordance. To evaluate internal consistency and test-retest reliability, Cronbach's alpha value, and the Spearman correlation test were utilized respectively. Our findings demonstrated statistically significant differences in NIH-CPSI scores between the patients and control groups (P <0.001). Cronbach's alpha coefficient value of NIH-CPSI was 0.864. Reliability of test-retest was 0.909 (P <0.001). Additionally, the Spearman correlation test showed that the results obtained using the Turkish NIH-CPSI were significantly correlated. The first Turkish version of the NIH-CPSI was found to be a reliable and valid instrument for Turkish patients with chronic prostatitis in both clinical and research settings.


Elevations of neuropeptide Y-like immunoreactivity and catecholamines in plasma on increased intracranial pressure in the pig.
Graded increases of intracranial pressure (ICP) in anaesthetized pigs induced elevations of plasma levels of neuropeptide Y (NPY)-like immunoreactivity (LI) and catecholamines, simultaneously with hypertension and tachycardia. Plasma adrenaline (ADR) increased at a lower ICP-level than did the plasma levels of noradrenaline (NA) and NPY-LI. At the maximal ICP elevation, 22.9 kPa (172 mmHg), plasma NPY-LI was increased about 10-fold, from 48 +/- 8 pmol/l in the basal state, while NA and ADR concentrations increased more than 100-fold. At this maximal ICP-level the plasma levels of NPY-LI were correlated to the concentrations of both NA (r = 0.87, P less than 0.01) and ADR (r = 0.92, P less than 0.001). Plasma NPY-LI continued to increase to about 1000 pmol/l, 10 min after the maximal elevation of ICP was discontinued, while the catecholamines then had declined considerably. A slight cardiac release of NPY-LI was observed at the maximal elevation of ICP. The half-life of NPY-LI in plasma was about 6 min upon systemic infusion. At plasma levels similar to those obtained upon maximal ICP elevation, exogenous NPY caused slight vasoconstriction in the spleen and skeletal muscle, but had no effects on coronary blood flow or systemic blood pressure. This suggests that NPY mainly exerts local actions after release from nerve endings, while levels of circulating NPY in plasma must be very high to influence blood flow in some organs. It is concluded that elevation of ICP results in hypertension and tachycardia related to elevated plasma levels of NPY-LI and catecholamines.(ABSTRACT TRUNCATED AT 250 WORDS)


High serum LDH and liver metastases are the dominant predictors of primary cancer resistance to anti-PD(L)1 immunotherapy.
Anti-PD-(L)1 immunotherapies improve survival in multiple cancers but remain ineffective for most patients. We applied machine-learning algorithms and multivariate analyses on baseline medical data to estimate their relative impact on overall survival (OS) upon anti-PD-(L)1 monotherapies. This prognostic/predictive study retrospectively analysed 33 baseline routine medical variables derived from computed tomography (CT) images, clinical and biological meta-data. 695 patients with a diagnosis of advanced cancer were treated in prospective clinical trials in a single tertiary cancer centre in 3 cohorts including systemic anti-PD-(L)1 (251, 235 patients) versus other systemic therapies (209 patients). A random forest model combined variables to identify the combination (signature) which best estimated OS in patients treated with immunotherapy. The performance for estimating OS [95%CI] was measured using Kaplan-Meier Analysis and Log-Rank test. Elevated serum lactate dehydrogenase (LDHhi) and presence of liver metastases (LM+) were dominant and independent predictors of short OS in independent cohorts of melanoma and non-melanoma solid tumours. Overall, LDHhiLM+ patients treated with anti-PD-(L)1 monotherapy had a poorer outcome (median OS: 3.1[2.4-7.8] months]) compared to LDHlowLM-patients (median OS: 15.3[8.9-NA] months; P < 0.0001). The OS of LDHlowLM-patients treated with immunotherapy was 28.8[17.9-NA] months (vs 13.1[10.8-18.5], P = 0.02) in the overall population and 30.3[19.93-NA] months (vs 14.1[8.69-NA], P = 0.0013) in patients with melanoma. LDHhiLM+ status identifies patients who shall not benefit from anti-PD-(L)1 monotherapy. It could be used in clinical trials to stratify patients and eventually address this specific medical need.


Investigation of a multimedia, computer-based approach to improve knowledge, attitudes, self-efficacy, and receptivity to cancer clinical trials among newly diagnosed patients with diverse health literacy skills.
Enrollment in therapeutic cancer trials remains low, and is especially challenging for patients with low health literacy. The authors tested an interactive technology designed for patients with diverse health literacy skills with the aim of improving patient receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials. Patients presenting for their first oncology appointment were eligible. Patients viewed an interactive teaching video concerning clinical trials that was adapted from the National Institutes of Health. Validated surveys assessing receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials were administered before and after the test. A total of 120 patients with cancer were enrolled. Approximately 80% were non-Hispanic white, 33% were female, 69% had >high school education, and 8% reported an income <$20,000. Approximately 33% scored within the low health literacy range. Changes between pretest and posttest demonstrated increases in knowledge (P < .001), self-efficacy (P < .001), and positive beliefs (P = .004); a slight decrease in willingness (P = .009); and no difference in patient receptivity (P = .31). Higher health literacy was associated with improved willingness (P = .049) and non-Hispanic white race was associated with improved receptivity (P = .034). Interactive technology that was designed for patients with diverse health literacy skills demonstrated the ability to improve knowledge, self-efficacy, and positive beliefs regarding cancer clinical trials. Contrary to the hypothesis of the current study, patients with lower health literacy did not appear to derive a greater advantage from this technology. There was no improvement noted with regard to patient willingness or receptivity, and clinical trial enrollment remained at historical institutional levels. Talking touchscreen technology has a potential role as an important element in informed decision making for patients, but likely needs to be coupled with more robust and multitargeted interventions.


[Lymphatic metastasis of the neck. Pluridisciplinary approach--surgery].
The main features of tumoral pathology in the neck are metastatic lymph nodes of carcinomas having their origin in the upper respiratory and digestive tracts. Their prognosis will depend directly on the diagnostic approach and correct treatment. The place and modalities of surgery in the treatment of head and neck metastatic lymph nodes are discussed.


Therapeutic effectiveness of tuberculous aneurysm and risk factors for mortality: a systematic review.
This study aimed to determine the therapeutic effectiveness of tuberculous aortic aneurysms (TBAAs) and the risk factors for mortality. We reviewed all case reports of TBAAs treated with open surgery or endovascular aneurysm repair (EVAR) from online database in 1996-2021. Only thoracic and abdominal aortic aneurysms were included. Eighty cases of open surgery and 42 cases of EVAR were included. The 2-year mortality and perioperative mortality rates of open surgery were 11.3% and 10.0%, respectively. Emergent open surgery had a significantly higher mortality (25.0%) than non-emergent open surgery (6.7%). In the EVAR group, 2-year mortality, perioperative mortality, and TBAA-related mortality were 16.7%, 4.8%, and 10.0%, respectively. Patients with typical tuberculosis (TB) symptoms before EVAR had a significantly higher TBAA-related mortality (35.0%) than patients with no typical TB symptoms before EVAR (0%). In the open surgery group, the rate of TB recurrence (2.7% vs 2.4%) and aneurysm recurrence (8.1% vs 7.3%) were quite close between preoperative anti-TB-treated and postoperative anti-TB-treated cases. However, in the EVAR group, TB recurrence (8.7% vs 0%) and aneurysm recurrence (12.5% vs 6.25%) were more common in postoperative anti-TB-treated cases. Open surgery was accompanied by higher perioperative mortality, whereas EVAR was followed with higher TBAA-related mortality. Emergent surgical choices of open surgery may be associated with high perioperative mortality. Typical TB symptoms before EVAR are a significant risk factor for mortality after EVAR. Early anti-TB treatment should be administered if EVAR is the surgical option.


Burning mouth syndrome: a diagnostic challenge.
The aim of this study was to characterize the diagnostic process that patients with burning mouth syndrome (BMS) undergo and to identify the potential pitfalls encountered in the workup and management of BMS. A retrospective chart review of patients with BMS seen at the Oral Medicine clinic at Brigham and Women's Hospital (Boston, MA) was conducted from January 2014 to April 2017. Abstracted data focused on the period from onset of symptoms to referral to the Oral Medicine clinic for definitive diagnosis and included providers consulted, symptom characteristics, diagnostic tests performed, and provisional diagnoses and treatments offered. One hundred and two patients (86.3% females) were included (median age 60 years). Median time from onset of symptoms to referral to the Oral Medicine clinic was 12 months (range 4-370 months). Patients saw a median of 3 providers (range 1-7); 30.4% had undergone a diagnostic test; 63.7% had been given a provisional diagnosis; and 78.4% had received treatment. Candidiasis was the most common misdiagnosis (25.5%), and antifungal medication was the most frequently prescribed therapy (27.5%). Patients with BMS experience delay in diagnosis and management despite seeking and receiving professional care. Many undergo unnecessary tests and tend to be misdiagnosed or receive no diagnosis at all. Even those correctly diagnosed with BMS often receive inappropriate or ineffective treatment.


Correction to: Evidence of asymptomatic submicroscopic malaria in low transmission areas in Belaga district, Kapit division, Sarawak, Malaysia.
Please note that an author has been erroneously omitted from the author list of the published article [1].


[A case of the ascending aorta and aortic arch replacement with thrombo-occlusion of distal arch and descending aorta surround the modified elephant trunk graft].
We report a 65-year-old female who had a extensive thoracic aneurysm from ascending aorta to descending thoracic aorta. The patient underwent a graft replacement of ascending aorta and aortic arch using modified elephant trunk method. The surgery was carried out through median sternotomy with profound hypothermia and selective cerebral perfusion. Postoperatively, the patient was recovered without any complications except bronchial asthma. Postoperative chest computed tomography showed that the surrounding space of the elephant trunk vascular graft inserted into distal arch and descending aneurysm was mostly occupied with thrombus. Therefore, we considered that the second operation on the descending aorta is not necessary at this point and careful attention to the size and shape of the descending aneurysm should be paid.


Contemporary portable oxygen concentrators and diverse breathing behaviours -- a bench comparison.
Decades of clinical research into pulsed oxygen delivery has shown variable efficacy between users, and across a user's behaviours (sleep, rest, activity). Modern portable oxygen concentrators (POCs) have been shown as effective as other oxygen delivery devices in many circumstances. However, there are concerns that they are not effective during sleep when the breathing is shallow, and at very high respiratory rates as during physical exertion. It can be challenging to examine the determinants of POC efficacy clinically due to the heterogeneity of lung function within oxygen users, the diversity of user behaviour, and measurement issues. Representative bench testing may help identify key determinants of pulsed-oxygen device efficacy. Three contemporary devices were bench-evaluated across three simulated breathing behaviours: activity, rest, & oronasal breathing during sleep. Emphasis was placed on breathing patterns representative of oxygen users. All three POCs performed well during simulated breathing during exertion and at rest. Differences in triggering ability were noted for the scenario of oronasal breathing during sleep. The results are supportive of contemporary POC triggering abilities. The differences shown in ultimate trigger sensitivity may have relevance to oronasal breathing during sleep or other challenging scenarios for pulsed oxygen delivery, such as dominant mouth breathing during exertion or unfavourable nasal geometry.


Adolescent images of adolescence.
This study examines the extent to which a group of Scottish adolescents are influenced by negative images of adolescence present in our culture, and investigates their self-image by means of a Q sort. Forty 15- and 16-year-old school students took part in the study, half of whom were female. Half of the sample were staying on at school to take higher examinations, the other half being school leavers. Eleven factors emerged from the analysis, the first six of which met the criterion that distinguishes common factors. Participants defining common factors were re-interviewed, and their responses to factor interpretations noted. Little evidence was found to suggest that adolescents are influenced by newspaper images. Some descriptions hint at conflict, while others do not. If the results of the present study were to be replicated, a more pluralistic view of adolescence may be required.


scLM: Automatic Detection of Consensus Gene Clusters Across Multiple Single-cell Datasets.
In gene expression profiling studies, including single-cell RNAsequencing (scRNA-seq) analyses, the identification and characterization of co-expressed genes provides critical information on cell identity and function. Gene co-expression clustering in scRNA-seq data presents certain challenges. We show that commonly used methods for single-cell data are not capable of identifying co-expressed genes accurately, and produce results that substantially limit biological expectations of co-expressed genes. Herein, we present single-cell Latent-variable Model (scLM), a gene co-clustering algorithm tailored to single-cell data that performs well at detecting gene clusters with significant biologic context. Importantly, scLM can simultaneously cluster multiple single-cell datasets, i.e., consensus clustering, enabling users to leverage single-cell data from multiple sources for novel comparative analysis. scLM takes raw count data as input and preserves biological variation without being influenced by batch effects from multiple datasets. Results from both simulation data and experimental data demonstrate that scLM outperforms the existing methods with considerably improved accuracy. To illustrate the biological insights of scLM, we apply it to our in-house and public experimental scRNA-seq datasets. scLM identifies novel functional gene modules and refines cell states, which facilitates mechanism discovery and understanding of complex biosystems such as cancers. A user-friendly R package with all the key features of the scLM method is available at https://github.com/QSong-github/scLM.