Determination of benzalkonium chloride in aqueous ophthalmic preparations by high-performance liquid chromatography.
A high-performance liquid chromatographic method is described for the determination of homologues of benzalkonium chloride in aqueous ophthalmic preparations. The technique involves direct injection of the sample on a 5-microns Spherisorb-CN column. The mobile phase is acetonitrile-triethylamine (0.1%, v/v) in water (pH 2.5; 40:60, v/v). Detection is carried out at 215 nm. The method is rapid, specific, reproducible and simple, and is especially useful for the assay of this preservative in stability studies and quality control procedures.


Interferon gamma-1b in the treatment of idiopathic pulmonary fibrosis.
To examine the clinical aspects of idiopathic pulmonary fibrosis (IPF) and the efficacy and safety of interferon gamma-1b (IFNgamma-1b) in its treatment. Epidemiologic, preclinical, and clinical studies published in the English language were identified by a MEDLINE search (1966-January 2005) using the search terms idiopathic pulmonary fibrosis, cryptogenic fibrosing alveolitis, and interferon. Additional citations were identified from the reference lists of related publications. Selected preclinical studies describing the pathophysiologic basis for IFNgamma-1b therapy and all clinical studies were included. Additional trials describing other treatment modalities and the determinants of response to therapy in patients with IPF were also reviewed. IFNgamma-1b targets the fibrotic rather than inflammatory processes of IPF. The efficacy of IFNgamma-1b in patients with IPF is inconsistent with regard to changes in pulmonary function and mortality, although a modest survival benefit was observed in the largest clinical trial. Adverse events related to IFNgamma-1b are frequent although transient. Several cases of respiratory failure occurring subsequent to the administration of IFNgamma-1b are documented. To date, although trials suggest that earlier-stage IPF may be responsive to IFNgamma-1b, study results overall are inconsistent; further investigation is needed.


Factors associated with the improvement of body image dissatisfaction of female patients with overweight and obesity during cognitive behavioral therapy.
Cognitive behavioral therapy (CBT) has become one of the most commonly used psychotherapeutic treatments for obesity. It stems from CBT for bulimia nervosa and binge eating disorder, which focuses on amelioration of the eating behavior and body image dissatisfaction (BID), but usually does not focus on weight loss. In contrast, CBT for obesity focuses on weight loss, as well as eating behavior and BID. It is at present unclear whether the improvement of BID during CBT for obesity is associated with improvement of factors other than weight loss. The purpose of this study was to determine whether improvement of BID during CBT for obesity was associated with improvement of factors other than weight loss. One hundred and sixty-five women (BMI 31.8 ± 5.2 kg/m2, age 49.3 ± 10.5 years) with overweight or obesity completed a 7-month CBT-based weight loss intervention. BID, depression, anxiety, binge eating, and perfectionism were assessed at both baseline and the end of the intervention through the use of psychological questionnaires. Percent total weight loss, baseline BID, baseline binge eating disorder (BED), change in depression (Δdepression), Δstate anxiety, Δtrait anxiety, Δbinge eating, and Δperfectionism were significantly correlated with ΔBID. Multiple regression analysis showed that baseline BID, baseline BED, percent total weight loss, Δbinge eating, and Δdepression were independently associated with ΔBID. Improvement of binge eating, and improvement of depression, as well as weight loss, were independently associated with amelioration of BID. [https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000008052], identifier [UMIN000006803] and [https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R0000 55850], identifier [UMIN000049041].


Zinc deficiency predicts overt hepatic encephalopathy and mortality in liver cirrhosis patients with minimal hepatic encephalopathy.
Minimal hepatic encephalopathy (MHE) is associated with poor outcomes and the development of overt hepatic encephalopathy (OHE) in patients with liver cirrhosis (LC). Zinc plays a key role in the detoxification of ammonia, a risk factor of hepatic encephalopathy. This study aimed to investigate whether zinc deficiency predicts OHE occurrence and mortality in LC patients with MHE. This retrospective study included 100 LC patients with MHE. MHE was diagnosed using a computer-aided neuropsychiatric test. Predictors associated with the development of OHE were analyzed using the Fine-Gray competing risk regression model. Cox proportional hazards regression analysis was carried out to evaluate the risk factors of mortality. Survival rates were analyzed using the Kaplan-Meier method and log-rank test. Of the 100 LC patients with MHE, 41% had zinc deficiency (<60 μg/dl). Zinc deficiency was observed more frequently in the patients with reduced liver function reserve. During the median follow-up period of 9.9 months, 16% of the patients with MHE developed OHE. The patients with zinc deficiency had a higher risk of OHE than those without zinc deficiency (p = 0.03). Zinc deficiency was also associated with poor survival (p = 0.004). Multivariate analyses showed that zinc predicts the development of OHE (subdistribution hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.92-0.99; p = 0.008) and mortality (HR, 0.96; 95% CI, 0.93-0.99; p = 0.02), independently of liver function reserves. Zinc deficiency is likely to be a predictor of both OHE development and mortality in LC patients with MHE.


SENP1-modulated sumoylation regulates retinoblastoma protein (RB) and Lamin A/C interaction and stabilization.
The retinoblastoma tumor suppressor protein (RB) plays a critical role in cell proliferation and differentiation and its inactivation is a frequent underlying factor in tumorigenesis. While the regulation of RB function by phosphorylation is well studied, proteasome-mediated RB protein degradation is emerging as an important regulatory mechanism. Although our understanding of RB turnover is currently limited, there is evidence that the nuclear lamina filament protein Lamin A/C protects RB from proteasomal degradation. Here we show that SUMO1 conjugation of RB and Lamin A/C is modulated by the SUMO protease SENP1 and that sumoylation of both proteins is required for their interaction. Importantly, this SUMO1-dependent complex protects both RB and Lamin A/C from proteasomal turnover.


Effects of the cyanine dye 3,3'-dipropylthiocarbocyanine on mitochondrial energy conservation.
Mitochondrial respiration and oxidative phosphorylation were inhibited by the membrane potential probe 3,3'-dipropylthiocarbocyanine [diS-C3-(5)]. Evidence is presented that suggests that the dye acts as both an inhibitor of electron transport and an uncoupler of oxidative phosphorylation.


Association of Biosecurity and Hygiene Practices with Environmental Contamination with Influenza A Viruses in Live Bird Markets, Bangladesh.
In Bangladesh, live bird market environments are frequently contaminated with avian influenza viruses. Shop-level biosecurity practices might increase risk for environmental contamination. We sought to determine which shop-level biosecurity practices were associated with environmental contamination. We surveyed 800 poultry shops to describe biosecurity practices and collect environmental samples. Samples from 205 (26%) shops were positive for influenza A viral RNA, 108 (14%) for H9, and 60 (8%) for H5. Shops that slaughtered poultry, kept poultry overnight, remained open without rest days, had uneven muddy floors, held poultry on the floor, and housed sick and healthy poultry together were more frequently positive for influenza A viruses. Reported monthly cleaning seemed protective, but disinfection practices were not otherwise associated with influenza A virus detection. Slaughtering, keeping poultry overnight, weekly rest days, infrastructure, and disinfection practices could be targets for interventions to reduce environmental contamination.


LINC00511 as a ceRNA promotes cell malignant behaviors and correlates with prognosis of hepatocellular carcinoma patients by modulating miR-195/EYA1 axis.
Recently, a growing number of reports indicated that long non-coding RNAs (lncRNAs) were involved in the development of various cancers. However, the performance of LINC00511 is still limited in hepatocellular carcinoma (HCC). Thus, we attempted to assess the effect of LINC00511 and underlying mechanism in HCC progression. TCGA and GEO database acted as supporters to provide us clinical samples data. Overall survival (OS) analyses were plotted using Kaplan-Meier method. Five cell lines were utilized to detect LINC00511 expression level and Cell Counting Kit-8 (CCK-8), colony formation and transwell assays were conducted to examine the effects on cell behaviors. The correlations between LINC00511 and miR-195 or eyes absent homolog 1 (EYA1) were confirmed by luciferase reporter assay. Quantitative real-time PCR and western blotting were fulfilled to ascertain the mRNA and protein expression levels. In this study, we found that LINC00511 was high-regulated in HCC tissue samples and cell lines, which might be linked with unfavorable prognosis of HCC patients and clinical parameters. Loss-of-function experiments determined that LINC00511 deficiency inhibited cell proliferation, colony formation and invasive activity in HepG2 cells, while gain-of-function experiments showed the counter impacts in Huh7 cells. Bioinformatics tools and luciferase reporter assays revealed that LINC00511 may act as a competing endogenous RNA (ceRNA) for miR-195 and positively correlate with EYA1, which was reinforced by rescue experiments. Taken together, these findings indicated that LINC00511 interacted with EYA1 promoted HCC development via mediating miR-195, proposing a promising therapeutic biomarker for HCC diagnosis and prognosis.


A VIKOR-based approach to evaluate river contamination risks caused by wastewater treatment plant discharges.
Wastewater treatment plants (WWTPs) rarely eliminate emerging contaminants from effluents they discharged into waterways, and therefore, represent significant contaminations sources with deleterious environmental risks. This paper presents a VIKOR-based model to assess the contamination risk posed by a cluster of WWTPs. A risk index was defined via building a membership function embodying the performance degrees of WWTPs and risks levels within the framework of fuzzy set theory. The proposed approach was tested using a case study of WWTPs cluster along the Pearl River. Sensitivity analyses were carried out to investigate the robustness of the model. The results confirmed the ability of the proposed approach to reveal the risk level of a given treatment point. Further, the comparison with a TOPSIS scheme as well as sensitivity analysis results substantiate the consistency, accuracy, and reliability of the proposed approach. It is therefore bounds to improve the decentralized management of WWTPs-induced river contamination.


Characterization of a neuraminidase-deficient influenza a virus as a potential gene delivery vector and a live vaccine.
We recently identified a packaging signal in the neuraminidase (NA) viral RNA (vRNA) segment of an influenza A virus, allowing us to produce a mutant virus [GFP(NA)-Flu] that lacks most of the NA open reading frame but contains instead the gene encoding green fluorescent protein (GFP). To exploit the expanding knowledge of vRNA packaging signals to establish influenza virus vectors for the expression of foreign genes, we studied the replicative properties of this virus in cell culture and mice. Compared to wild-type virus, GFP(NA)-Flu was highly attenuated in normal cultured cells but was able to grow to a titer of >10(6) PFU/ml in a mutant cell line expressing reduced levels of sialic acid on the cell surface. GFP expression from this virus was stable even after five passages in the latter cells. In intranasally infected mice, GFP was detected in the epithelial cells of nasal mucosa, bronchioles, and alveoli for up to 4 days postinfection. We attribute the attenuated growth of GFP(NA)-Flu to virion aggregation at the surface of bronchiolar epithelia. In studies to test the potential of this mutant as a live attenuated influenza vaccine, all mice vaccinated with >/==" BORDER="0">10(5) PFU of GFP(NA)-Flu survived when challenged with lethal doses of the parent virus. These results suggest that influenza virus could be a useful vector for expressing foreign genes and that a sialidase-deficient virus may offer an alternative to the live influenza vaccines recently approved for human use.


PCE dechlorination by non-Dehalococcoides in a microbial electrochemical system.
The bioremediation of tetrachloroethene (perchloroethene; PCE) contaminated sites generally requires a supply of some fermentable organic substrates as an electron donor. On the other hand, organic substrates can induce the massive growth of microorganisms around the injection wells, which can foul the contaminated subsurface environment. In this study, PCE dechlorination to ethene was performed in a microbial electrochemical system (MES) using the electrode (a cathode polarized at -500 mV vs. standard hydrogen electrode) as the electron donor. Denaturing gel gradient electrophoresis and pyrosequencing revealed a variety of non-Dehalococcoides bacteria dominant in MES, such as Acinetobacter sp. (25.7 % for AS1 in suspension of M3), Rhodopseudomonas sp. (10.5 % for AE1 and 10.1 % for AE2 in anodic biofilm of M3), Pseudomonas aeruginosa (22.4 % for BS1 in suspension of M4), and Enterobacter sp. (21.7 % for BE1 in anodic biofilm of M4) which are capable of electron transfer, hydrogen production and dechlorination. The Dehalococcoides group, however, was not detected in this system. Therefore, these results suggest that a range of bacterial species outside the Dehalococcoides can play an important role in the microbial electrochemical dechlorination process, which may lead to innovative bioremediation technology.


MEK and MCL-1 sequential inhibition synergize to enhance rhabdomyosarcoma treatment.
Targeted agents have emerged as promising molecules for cancer treatment, but most of them fail to achieve complete tumor regression or attain durable remissions due to tumor adaptations. We used dynamic BH3 profiling to identify targeted agents effectiveness and anti-apoptotic adaptations upon targeted treatment in rhabdomyosarcoma. We focused on studying the use of BH3 mimetics to specifically inhibit pro-survival BCL-2 family proteins, overwhelm resistance to therapy and prevent relapse. We observed that the MEK1/2 inhibitor trametinib rapidly depleted the pro-apoptotic protein NOXA, thus increasing MCL-1 availability. Indeed, we found that the MCL-1 inhibitor S63845 synergistically enhanced trametinib cytotoxicity in rhabdomyosarcoma cells in vitro and in vivo. In conclusion, our findings indicate that the combination of a BH3 mimetic targeting MCL-1 with trametinib improves efficiency on rhabdomyosarcoma by blocking tumor adaptation to treatment.


The nuclear-encoded human NADH:ubiquinone oxidoreductase NDUFA8 subunit: cDNA cloning, chromosomal localization, tissue distribution, and mutation detection in complex-I-deficient patients.
We report the cloning of the cDNA sequence of the nuclear-encoded NDUFA8 subunit of NADH: ubiquinone oxidoreductase, the first mitochondrial respiratory chain complex. The NDUFA8 open reading frame (ORF) includes 519 bp and encodes 172 amino acids (Mr=20.1 kDa). The human cDNA sequence shows 86.2% identity with the bovine sequence, whereas the human NDUFA8 amino acid sequence is 87.8% similar to its bovine PGIV protein counterpart. Both human and bovine NDUFA8 contain a conserved cysteine motif. Polymerase chain reaction analysis of rodent/human somatic cell hybrids maps the human NDUFA8 gene to chromosome 9. A multiple tissue blot has revealed the highest NDUFA8 mRNA expression in human heart, skeletal muscle, and fetal heart. Mutation analysis of the NDUFA8 fibroblast cDNA in 20 patients with an isolated enzymatic complex I deficiency in cultured skin fibroblasts has revealed two polymorphisms, one within the ORF and the other in the 3' untranslated region of the NDUFA8 cDNA sequence. The allelic frequency of both polymorphisms was similar in controls and complex-I-deficient patients.


C-reactive protein and its ratio are useful indicators to exclude anastomotic leakage requiring intervention after laparoscopic rectal surgery.
The goal of this study was to determine whether C-reactive protein (CRP) levels and its ratios can be used as indicators to exclude postoperative anastomotic leak (AL) requiring intervention in patients undergoing elective laparoscopic total mesorectal excision (TME) without a diverting ileostomy for middle or low rectal cancer. We measured CRP values on postoperative days (POD) 1, 2, and 4 and CRP ratios between two PODs in 1278 consecutive patients undergoing rectal surgery. The incidence of AL requiring intervention was 5.9%, and 92% of AL occurred by POD 4. The CRP levels on POD 4 had a maximal area under the curve (AUC) of 0.956 with a negative predictive value (NPV) of 99.7% when the cutoff was established as 80 mg/l. Also, the ratio between CRP levels on POD 4 and CRP levels on POD 2 (CRP POD 4/2) was the most accurate indicator among the CRP ratios, with an AUC of 0.959 and an NPV of 99.5% when the cutoff was set at one. CRP on POD 4 < 80 mg/l and the ratio of CRP POD 4/2 < 1 can be used to rule out AL requiring intervention in patients undergoing elective laparoscopic TME without a diverting ileostomy for middle or low rectal cancer.


X-ray source arrays for volumetric imaging during radiotherapy treatment.
This work presents a novel hardware configuration for radiotherapy systems to enable fast 3D X-ray imaging before and during treatment delivery. Standard external beam radiotherapy linear accelerators (linacs) have a single X-ray source and detector located at ± 90° from the treatment beam respectively. The entire system can be rotated around the patient acquiring multiple 2D X-ray images to create a 3D cone-beam Computed Tomography (CBCT) image before treatment delivery to ensure the tumour and surrounding organs align with the treatment plan. Scanning with a single source is slow relative to patient respiration or breath holds and cannot be performed during treatment delivery, limiting treatment delivery accuracy in the presence of patient motion and excluding some patients from concentrated treatment plans that would be otherwise expected to have improved outcomes. This simulation study investigated whether recent advances in carbon nanotube (CNT) field emission source arrays, high frame rate (60 Hz) flat panel detectors and compressed sensing reconstruction algorithms could circumvent imaging limitations of current linacs. We investigated a novel hardware configuration incorporating source arrays and high frame rate detectors into an otherwise standard linac. We investigated four potential pre-treatment scan protocols that could be achieved in a 17 s breath hold or 2-10 1 s breath holds. Finally, we demonstrated for the first time volumetric X-ray imaging during treatment delivery by using source arrays, high frame rate detectors and compressed sensing. Image quality was assessed quantitatively over the CBCT geometric field of view as well as across each axis through the tumour centroid. Our results demonstrate that source array imaging enables larger volumes to be imaged with acquisitions as short as 1 s albeit with reduced image quality arising from lower photon flux and shorter imaging arcs.


Determination of cetirizine in human urine by high-performance liquid chromatography.
A high-performance liquid chromatographic method for the determination of the histamine H1-receptor antagonist cetirizine in human urine was developed. Cetirizine and the internal standard are extracted from acidified (pH 5) urine (0.5 ml) into chloroform and the organic layer is evaporated to dryness. The residue is chromatographed on a Spherisorb 5ODS-2 column using Pic A (5 mM aqueous tetrabutylammonium phosphate)-methanol-tetrahydrofuran (33:65:2, v/v) as the mobile phase with ultraviolet detection (230 nm). The calibration graph is linear from 0.1 to 10 micrograms/ml and using 0.5 ml of urine the detection limit is 20 ng/ml. The within-run relative standard deviation is less than 6% and the accuracy is within 10% of the theoretical value at concentrations between 0.1 and 10 micrograms/ml in urine. There is a good correlation (r = 0.99606) with a previously described capillary gas chromatographic assay.


Unusual presentation of sigmoid diverticulitis as an acute scrotum.
We report a case of inflammation of the spermatic cord and testicle resulting from a perforated diverticulum of the sigmoid colon. Management included sigmoid resection with diversion, right orchiectomy and débridement of the right groin. To our knowledge this is the first reported case of retroperitoneal necrotizing fasciitis presenting initially as an acute scrotum.


Lumbosacral fracture-dislocation: a case managed conservatively, with return to heavy work.
A 41-year-old agricultural sustained a lumbosacral fracture-dislocation when a tree fell across his back. The initial anterior displacement of half the depth of the body of L5 progressed to three-quarters of the body over a 2-year period. Neurological deficit was minimal and the management was conservative. Spontaneous arrest of the displacement occurred by anterior sacral buttressing and the patient has returned to his previous heavy work.


Alginate coated loofa sponge discs for the removal of cadmium from aqueous solutions.
A biosorbent was prepared by coating the fibrous network of loofa sponge (Luffa cylindrica) with a thin film of calcium alginate. Alginate-coated loofa sponge removed Cd(II) rapidly, reaching equilibrium loading of 124 mg g(-1) in 30 min. Seventy % of equilibrium uptake was achieved in 10 min. In contrast, it took 240 min for alginate beads to reach a loading equilibrium of 88 mg g(-1) under identical conditions. The biosorption behaviour followed the Langmuir adsorption isotherm and the ACLS biosorbent was shown to be highly effective in removing Cd(II) from a 10 mg l(-1) solution in a continuous flow fixed-bed column bioreactor.


Spontaneous Retroperitoneal Hematoma in Vitamin C Deficiency.
Retroperitoneal hematoma is rare but potentially life-threatening. It is commonly caused by traumatic or iatrogenic vascular injury, retroperitoneal neoplasm, coagulopathy, chronic anticoagulation, or fibrinolytic therapy. However, retroperitoneal hematoma due to vitamin C deficiency is rare. Here, we report a case of 40 years old man who developed retroperitoneal hematoma in context of very low vitamin C. To our knowledge, this is the second described case of retroperitoneal hematoma from vitamin C deficiency.


Effect of Shuanghu Qinggan Granule () and Yigan Yiqi Jieyu Granule () plus lamivudine on chronic hepatitis B patients: A randomized double-blind placebo-controlled trial.
To observe the clinical efficacy and safety of Shuanghu Qinggan Granule ( , SQG) plus Yigan Yiqi Jieyu Granule (, YYJG) combined with lamivudine (LAM) on chronic hepatitis B (CHB) patients. The study was a multicenter, randomized, double-blinded and parallel controlled trial. A total of 320 patients were randomly allocated into 2 groups equally: 160 patients (treatment group) were given SQG and YYJG combined with LAM; and 160 patients (control group) were given LAM plus Chinese herb placebo, respectively. Liver functions, hepatitis B envelop antigen (HBeAg) titer levels, and hepatitis B virus DNA (HBV-DNA) load were monitored. (1) In the 48th week, the treatment group showed superior HBeAg seroconversion rate than that in the control group (38.0% vs. 24.0%, P<0.05). (2) In the 48th week, the treatment group demonstrated lower HBeAg titer than that in the control group (P<0.05). (3) In the 12th, 24th, 48th week, there was no statistical significance in HBV-DNA response rate between the two groups. (4) In the 12th week, the level of glutamyl transpeptidase (GGT) was significantly decreased in the treatment group compared with the control group (P<0.05); in the 36th week, the levels of alanine aminotransferase and aspartate transaminase were significantly lower in the treatment group than those in the control group (P<0.05). The protocol of SQG and YYJG combined with LAM to treat CHB showed superior efficacy than LAM monotherapy.


Vismia cauliflora extracts: bioactive compounds and the in vitro scavenging capacity against reactive oxygen and nitrogen species.
Vismia cauliflora, a scientific unexploited plant from Amazonian forest, used by Amerindians to treat dermatosis and inflammatory processes in the skin may be considered an interesting source of bioactive compounds. Thus, we evaluated for the first time in literature, the scavenging capacity of five extracts of V. cauliflora (leaf, branch, stem bark, flower and whole fruit) against reactive oxygen and nitrogen species. In addition, the phenolic compounds and carotenoids were also identified and quantified (dry basis). In general, (-)-epicatechin and proanthocyanidin dimers and trimer were the major phenolic compounds identified in leaf, branch, stem bark and flower extracts, while dihydroxybenzoic in whole fruit extracts. The highest phenolic contents were found in stem bark extract (106mg/g extract), followed by leaf (103mg/g) and flower (85mg/g). Regarding carotenoids composition, leaf extract presented the highest contents (0.6mg/g extract) and the major compound tentatively identified was all-trans-zeinoxanthin, followed by all-trans--carotene. All V. cauliflora extracts showed high efficiency against superoxide anion radical, hypochlorous acid, singlet oxygen, nitric oxide and peroxynitrite; however, flower and stem bark exhibited the most remarkable scavenging capacity (IC50 from 0.9 to 11.5g/mL). Therefore, V. cauliflora has a great potential to be used in the development of phytopharmaceutical products due to its characteristic to be a promising source of bioactive compounds with antioxidant properties.


Optic Nerve and Perioptic Sheath Diameter (ONSD), Eyeball Transverse Diameter (ETD) and ONSD/ETD Ratio on MRI in Large Middle Cerebral Artery Infarcts: A Case-Control Study.
Despite recent progress in the multidisciplinary management of large middle cerebral artery infarcts, the neurological prognosis remains worrying in a non-negligible number of cases. The objective of this study is to analyze the contribution of optic nerve and perioptic sheath measurement on MRI to the acute phase of large middle cerebral artery infarcts. A retrospective case-control study between January 2008 and December 2019 in a single academic medical center was performed. Cases and controls were selected by interrogation of International Classification of Diseases (ICD), 10th edition, with ischemic stroke as criterion (code I64). Decompressive hemicraniectomy was a criterion for large middle cerebral artery infarcts (cases). Cases were matched with controls (1:3) based on age (± 5 years), sex, and year of hospitalization (± 2 years) The examinations were performed on 3T MRI (Siemens IRM 3T Magnetom).Optic nerve and perioptic sheath diameter was calculated using electronic calipers, 3 mm behind retina and in a perpendicular vector with reference to the orbit in axial 3D TOF sequence. Of 2612 patients, 22 patients met all the criteria of large middle cerebral artery infarcts and they were paired with 44 controls. Patients were mainly women, mean age of 53.6 years. There is a significant difference in the size of the optic nerve and perioptic sheath diameter measured on MRI at patient's admission (right: 5.13 ± 0.2 mm vs. 4.80 mm ± 0.18, p <0. 0001, left: 5.16 ± 0.17 vs 4.78 ± 0.20, p<0.0001). The AUC of optic nerve and perioptic sheath diameter was 0.93 (95%IC [0.85-1.00]), for a threshold at 5.03 mm, the sensitivity was 0.82 (95%IC [0.6-0.93]), specificity 0.94 (95%IC [0.85-0.98]). The Odds Ratio of large middle cerebral artery infarcts was 46.4 for optic nerve and perioptic sheath diameter the (95%IC [6.15-350.1] p=0.0002). Optic nerve and perioptic sheath diameter in the first MRI can predict the risk of developing large middle cerebral artery infarcts requiring a decompressive hemicraniectomy.


Association between intracranial vessel calcifications, structural brain damage, and cognitive impairment after minor strokes: a prospective study.
Vascular calcifications are a hallmark of atherosclerosis, and in the coronary arteries are routinely used as a prognostic marker. Calcifications of intracranial vessels (ICC) are frequently observed on non-contrast CT (NCCT) and their effect on post-stroke cognitive impairment (PSCI) remains unclear. Our aim was to explore the association of ICC with prospective long-term cognitive function and advanced MRI-measures in a large prospective cohort of cognitively intact mild stroke survivors. Data from the Tel-Aviv brain acute stroke cohort (TABASCO) study [ClinicalTrials.gov #NCT01926691] were analyzed. This prospective cohort study (n = 575) aimed to identify predictors of PSCI, in cognitively intact mild stroke survivors. A quantitative assessment of the intracranial calcium content - The ICC score (ICCS) was calculated semi-automatically on NCCT using a validated calcium quantification application. Participants underwent a 3 T-MRI and prospective comprehensive cognitive clinical and laboratory assessments at enrollment, 6, 12, and 24-months. Data were available for 531 participants (67.4 years, 59.5% males). The incidence of PSCI at two-years doubled in the high ICCS group (26% vs. 13.7%, p < 0.001). The high ICCS group had significantly greater small-vessel-disease (SVD) tissue changes and reduced microstructural-integrity assessed by Diffusion-Tensor-Imaging (DTI) maps (p < 0.05 for all). In multivariate analysis, a higher ICCS was independently associated with brain atrophy manifested by lower normalized white and gray matter, hippocampal and thalamic volumes (β = -0.178, β = -0.2, β = -0.137, β = -0.157; p < 0.05) and independently predicted PSCI (OR 1.83, 95%CI 1.01-3.35). Our findings suggest that the ICCS, which is a simple and readily available imaging marker on NCCT, is associated with brain atrophy, microstructural damage, the extent of SVD, and may predict PSCI. This finding has implications for identifying individuals at risk for PSCI and implementing targeted interventions to mitigate this risk.


Ultrafast energy transfer between the 3MLCT state of [Ru(II)(dmb)2(bpy-an)]2+ and the covalently appended anthracene.
The time scale for triplet-triplet energy transfer (EnT) between a Ru(II) chromophore and a ligand bound anthracene acceptor in [Ru(II)(dmb)2(bpy-an)]2+ (dmb = 4,4'-dimethyl-2,2-bipyridine; bpy-an = 4-(9-anthrylethylene), 4-methyl-2,2-bipyridine) has been measured using femtosecond transient absorption spectroscopy. The appearance of the anthracene excited state is monitored following photoexcitation to a metal-to-ligand charge transfer (MLCT) state via the pi pi* absorption of the triplet excited state of anthracene. Our time-resolved experiments show the presence of fast, sub-100 ps energy transfer to the anthracene occurring on two characteristic time scales of 23 and 72 ps.


Leaching assessment of cemented bauxite tailings through wetting and drying cycles of durability test.
Disposal of mine tailings can cause negative environmental effects by releasing contaminants to surface and underground water. Alkali activation is a promising technique for immobilizing metals in stabilization/solidification of these wastes. This study evaluates the leaching behavior of cemented bauxite tailings (BT) submitted to weathering conditions. The alkali-activated binder was composed of sugar cane bagasse ash, carbide lime, and sodium hydroxide solution. Comparisons of the durability and leaching behavior of BT stabilized with alkali-activated binder and high initial strength Portland cement were performed. The durability results for alkali-activated were similar to the Portland cement, showing an average difference of 16%. Portland cement showed favorable results in the encapsulation of heavy metals like Cd and Hg, while the alkali-activated cement on Al, Cr, and Se. For Ba, Fe, Mn, and Zn immobilization, both types of cement presented an equal performance. The durability and leaching behavior of stabilized bauxite tailings is governed by the cement content and porosity of the blends, as well as their pH.


Relationship between hemoglobin A1c level and flow-mediated vasodilation in patients with type 2 diabetes mellitus receiving antidiabetic drugs.
Diabetes mellitus is associated with endothelial dysfunction. However, it is still controversial as to whether antidiabetic drug treatment affects endothelial function. The purpose of this study was to evaluate the relationships of the hemoglobin A1c (HbA1c) level with flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) in patients with type 2 diabetes mellitus who are receiving antidiabetic drugs. The FMD was measured in 866 patients with type 2 diabetes mellitus who were receiving antidiabetic drugs (625 men and 241 women; mean age: 62 ± 10 years). The patients were divided into four groups according to HbA1c levels: <6.5, 6.5-6.9, 7.0-7.9, and ≥8.0%. There was an inverted U-shaped pattern of association of the HbA1c level with the FMD at an HbA1c level of about 7% of the peak of FMD in patients with type 2 diabetes mellitus who were receiving antidiabetic drugs. The FMD was significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5-6.9% group and the HbA1c 7.0-7.9% group (P < 0.001 and P < 0.001, respectively). The FMD values were similar in the HbA1c <6.5% group and HbA1c ≥8.0% group (P = 0.10). There were no significant differences in NID among the four groups (P = 0.98). These findings suggest that a low HbA1c <6.5% as well as a high HbA1c ≥8.0% is associated with endothelial dysfunction in patients with type 2 diabetes mellitus who are receiving antidiabetic drugs and that vascular smooth muscle function is similar in such patients regardless of the HbA1c level.


Lateral medullary infarct/Wallenberg syndrome--Jamaica.
We describe two cases of lateral medullary syndrome at the University Hospital of the West Indies, Mona, Jamaica. This diagnosis is often missed and not well understood, so we will discuss the underlying pathophysiology.


Phospholipid-stabilized mesoporous carbon nanospheres as versatile carriers for systemic delivery of amphiphobic SNX-2112 (a Hsp90 inhibitor) with enhanced antitumor effect.
Systemic delivery of amphiphobic drugs (insoluble in both water and oil) represents a formidable challenge in drug delivery. This work aimed to engineer a functional mesoporous carbon material to efficiently load SNX-2112, an amphiphobic anticancer agent, and to evaluate its performance in tumor-targeting delivery. Hydrothermal reaction combined with high-temperature activation was used to fabricate glucose-based mesoporous carbon nanospheres (MCNs). SNX-2112-loaded MCNs stabilized by phospholipid (SN-PMCNs) were prepared by the absorption/solvent diffusion/high-pressure homogenization method. The obtained SN-PMCNs were 180nm around in particle size, showing a high drug load (42.7%) and acceptable physical stability. SN-PMCNs demonstrated an enhanced in vitro antitumor effect and increased uptake into cancer cells in comparison with the formulation of SNX-2112 solution (SN-Sol). The in vivo antitumor effect and biodistribution in 4T1 xenograft tumor mice, a breast cancer model, were also significantly improved through SN-PMCNs. It was shown that specific clathrin-dependent and nonspecific caveolae-dependent endocytosis were involved in the cellular trafficking of SN-PMCNs. Glucose transporter-mediated transport, prolonged body residence time and improved biodistribution via EPR effect were the main mechanisms of enhanced antitumor effect. SN-PMCNs have presented excellent tumor targeting properties and should be a promising carrier to address the systemic delivery of SNX-2112.


Application of a high-throughput, parallel HPLC system for quantitative chiral analysis of pantoprazole.
Chromatographic separation of enantiomers is considered a task in analytical chemistry particularly for high sample throughput. This paper describes a high-throughput parallel HPLC-MS/MS method for the determination of pantoprazole enantiomers. Baseline separation of pantoprazole enantiomers was achieved on a Chiralcel OZ-RH column in a run time of 4.5 min. Assays for enantiomers were linear with satisfactory intra- and inter-day precision and accuracy. The assay was suitable for high-throughput analysis as shown by its successful application to a chiral PK study in beagle dog. A high-throughput parallel HPLC-MS/MS assay for pantoprazole has been developed and validated. This method provides nearly twofold increased sample throughput, and was shown to be suitable for application in PK studies.


Humanoid robot-assisted interventions among children with diabetes: A systematic scoping review.
Although the humanoid robot is highly engaging for children, whether humanoid robot-assisted interventions could help in diabetes management is still unclear. This review aimed to elucidate the roles of humanoid robot in managing diabetes and observe the effects of humanoid robot-assisted interventions among children with type I diabetes mellitus. Arksey and O'Malley's methodological framework was used to conduct this scoping review. We conducted a comprehensive search in 10 databases, including IEEE Xplore Digital Library, CINAHL, Cochrane Library, EMBASE, PubMed, Scopus, Web of Science, ProQuest, WanFang, and CNKI, from May 1, 1989 to February 1, 2020. The reference lists of key texts were examined and citation chaining was conducted. In addition, our team searched gray literature and relevant journals to maximise the searching. Two independent reviewers examined all full articles for fitness with the eligibility criteria. Items of data extraction included the characteristics of articles, description of intervention, and mechanism of humanoid robot in improving the management of children with diabetes. A total of 2,755 articles were retrieved, 22 of which were included from five countries across different ethnicities. Five roles of humanoid robots in managing diabetes among children with type I diabetes mellitus were identified: disease manager, educator, advocator, emotional supporter, and communicator. To some extent, effects seem to be related to the positive improvement of affective, experiential, relational, cognitive, and behavioral perspectives from humanoid robot-assisted intervention. The roles of humanoids have been designed to perform their multidomain functionality. Although many positive effects were observed, the majority of selected articles have methodological issues. Future studies need an improved methodology for large-scale controlled trials.


Eosinophilic cystitis and coexistent eosinophilic gastroenteritis in an infant.
This report describes the first documented case of eosinophilic cystitis and eosinophilic gastroenteritis occurring in a child.


Phase I trial of 5-fluorouracil by 24-hour infusion weekly.
A novel schedule of 5-fluorouracil administration has been developed for biochemical modulation studies. In combination with the pyrimidine synthesis inhibitor PALA, 5-fluorouracil has been given as a 24-hour infusion, repeated weekly: a dose of 2600 mg/m2 is well tolerated. To identify a suitable dose of 5-fluorouracil as a single agent on this schedule, we treated 26 patients at doses ranging from 2800 to 3400 mg/m2 per week. Two-thirds of the patients had failed previous therapy, and most were symptomatic from their disease. Over half of the patients had metastatic colorectal cancer. The dose-limiting toxicity was diarrhea: Grade 3 or 4 toxicity occurred at every level tested. Twenty-two of the 26 patients required therapy interruption because of toxicity. The severity of this toxicity indicated that escalation of 5-fluorouracil on this schedule beyond the 2600 mg/m2 known to be tolerated in the PALA-containing regimen, would be impractical. Two patients, both with previously untreated colorectal cancer, had partial remissions lasting three and five months respectively. This dose-intense schedule of 5-fluorouracil administration will be explored further in large-scale randomized trials.


Metal insertion in a microporous metal-organic framework lined with 2,2'-bipyridine.
Reaction of AlCl(3)·6H(2)O with 2,2'-bipyridine-5,5'-dicarboxylic acid (H(2)bpydc) affords Al(OH)(bpydc) (1, MOF-253), the first metal-organic framework with open 2,2'-bipyridine (bpy) coordination sites. The material displays a BET surface area of 2160 m(2)/g and readily complexes metals to afford, for example, 1·xPdCl(2) (x = 0.08, 0.83) and 1·0.97Cu(BF(4))(2). EXAFS spectroscopy performed on 1·0.83PdCl(2) reveals the expected square planar coordination geometry, matching the structure of the model complex (bpy)PdCl(2). Significantly, the selectivity factor for binding CO(2) over N(2) under typical flue gas conditions is observed to increase from 2.8 in 1 to 12 in 1·0.97Cu(BF(4))(2).


Immunomagnetic beads assay for the detection of botulinum neurotoxin types C and D.
An immunomagnetic beads assay for the simultaneous quantification of botulinum neurotoxin types C and D was developed. Specific monoclonal antibodies against the heavy chain of the toxin and affinity-purified biotinylated polyclonal antibodies (pAbs) were used. The antibodies were preincubated with the sample. The complex being formed was then captured by magnetic beads coated with antimouse IgG. Streptavidin-poly-horseradish peroxidase, a signal amplifier, bound to the biotinylated pAb. A maximum sensitivity of approximately 0.3 minimal lethal doses for mice per milliliter was achieved with culture supernatants of both toxin types.


The role of magnetic resonance imaging in oncology.
Conventional diagnostic magnetic resonance imaging (MRI) techniques have focused on improving the spatial resolution and image acquisition speed (whole-body MRI) or on new contrast agents. Most advances in MRI go beyond morphologic study to obtain functional and structural information in vivo about different physiological processes of tumor microenvironment, such as oxygenation levels, cellular proliferation, or tumor vascularization through MRI analysis of some characteristics: angiogenesis (perfusion MRI), metabolism (MRI spectroscopy), cellularity (diffusion-weighted MRI), lymph node function, or hypoxia [blood-oxygen-level-dependent (BOLD) MRI]. We discuss the contributions of different MRI techniques than must be integrated in oncologic patients to substantially advance tumor detection and characterization risk stratification, prognosis, predicting and monitoring response to treatment, and development of new drugs.


Study on serviceability and efficiency of seven pilot carbon trading exchanges in China.
Carbon trading has become a major innovation for many countries to cope with climate change, where in China the 7 pilot markets have been running for over 6 years with different performances shown. Being the actual venue where buyers and sellers trade carbon permits, how well and efficient a carbon trading exchange is designed directly affects whether the market can fulfill its environmental purpose. This paper selects 13 sub-indicators from three dimensions of main settings, risk prevention & control, and regional cooperation to evaluate the serviceability of the 7 exchanges in pilot carbon markets in China. Using which as input indicator and market operational effect as output indicator that represented by 5 sub-indicators including percentage of valid trading days, dispersion of trading volume etc., the study attempts to analyze how the serviceability of exchanges affect market operation. By applying the SUP-CCR-DEA (Super-efficiency CCR Data Envelope Analyze) model on 7 exchanges' trading data from 2013 to 2017, the study finds that the serviceability of the exchanges varies significantly, with Shanghai being the best and Shenzhen ranks the second. Obvious stratification is detected but with small changes during the four years observed, differences in main settings and transaction management system being the primary cause. It is found that the serviceability has a direct and significant impact on the market performance for all 6 exchanges except for Tianjin, and for those top-ranked exchanges, strong enforcement system and legally binding agreements contribute to their high service efficiency.


A personalized decision aid for prostate cancer shared decision making.
A shared decision-making model is preferred for engaging prostate cancer patients in treatment decisions. However, the process of assessing an individual's preferences and values is challenging and not formalized. The purpose of this study is to develop an automated decision aid for patient-centric treatment decision-making using decision analysis, preference thresholds and value elicitations to maximize the compatibility between a patient's treatment expectations and outcome. A template for patient-centric medical decision-making was constructed. The inputs included prostate cancer risk group, pre-treatment health state, treatment alternatives (primarily focused on radiation in this model), side effects (erectile dysfunction, urinary incontinence, nocturia and bowel incontinence), and treatment success (5-year freedom from biochemical failure). A linear additive value function was used to combine the values for each attribute (side effects, success and the alternatives) into a value for all prospects. The patient-reported toxicity probabilities were derived from phase II and III trials. The probabilities are conditioned on the starting state for each of the side effects. Toxicity matrices for erectile dysfunction, urinary incontinence, nocturia and bowel incontinence were created for the treatment alternatives. Toxicity probability thresholds were obtained by identifying the patient's maximum acceptable threshold for each of the side effects. Results are represented as a visual. R and Rstudio were used to perform analyses, and R Shiny for application creation. We developed a web-based decision aid. Based on preliminary use of the application, every treatment alternative could be the best choice for a decision maker with a particular set of preferences. This result implies that no treatment has determinist dominance over the remaining treatments and that a preference-based approach can help patients through their decision-making process, potentially affecting compliance with treatment, tolerance of side effects and satisfaction with the decision. We present a unique patient-centric prostate cancer treatment decision aid that systematically assesses and incorporates a patient's preferences and values to rank treatment options by likelihood of achieving the preferred outcome. This application enables the practice and study of personalized medicine. This model can be expanded to include additional inputs, such as genomics, as well as competing, concurrent or sequential therapies.


The gluconate high affinity transport of GntI in Escherichia coli involves a multicomponent complex system.
Within the main system for gluconate utilization in E. coli, the gntT gene (located at the minute 76.4) that encodes a permease, is currently the only element involved in the high affinity transport. In this paper, the nucleotide sequence of the upstream region of this locus was determined. Two open reading frames of 729 bp (gntX) and 573 bp (gntY) were identified as additional gnt genes by complementation studies. Our observations suggest that these loci might conform an operon distinct of gntT under the control of the gntR gene product. Such operon encodes a gluconate periplasmic binding protein (GntX) and a putative membrane-bound protein (GntY). These products and the permease encoded by the gntT gene seem to conform a high-affinity complex transport system for gluconate. We suggest that this novel system could belong to the TRAP transporters.


Assessment of Differences in Academic Rank and Compensation by Gender and Race/Ethnicity Among Academic Radiation Oncologists in the United States.
Advancing equity, diversity, and inclusion in the physician workforce is essential to providing high-quality and culturally responsive patient care and has been shown to improve patient outcomes. To better characterize equity in the field of radiation oncology, we sought to describe the current academic radiation oncology workforce, including any contemporary differences in compensation and rank by gender and race/ethnicity. We conducted a retrospective cohort study using data from the Society of Chairs of Academic Radiation Oncology Programs (SCAROP) 2018 Financial Survey. Multivariable logistic regression models were used to identify factors associated with associate or full professor rank. Compensation was compared by gender and race/ethnicity overall and stratified by rank and was further analyzed using multivariable linear regression models. Of the 858 academic radiation oncologists from 63 departments in the United States in the sample, 33.2% were female, 65.2% were White, 27.2% were Asian, and 7.6% were underrepresented in medicine (URiM). There were 44.0% assistant professors, 32.0% associate professors, and 22.8% full professors. Multivariable logistic regression analysis for factors associated with associate or full professor rank did not reveal statistically significant associations between gender or race/ethnicity with academic rank (odds ratio [OR], 0.86; 95% confidence interval [CI], 0.56-1.32; P = .48 for gender; OR, 0.81; 95% CI, 0.5-1.30; P = .37 for Asian vs White; and OR, 0.69; 95% CI, 0.31-1.55; P = .37 for URiM vs White), but CIs were wide due to sample size, and point estimates were <1. Similarly, multivariable linear regression analysis modeling the log relative total compensation did not detect statistically significant differences between radiation oncologists by gender (-1.7%; 95% CI, -6.8% to 3.4%; P = .51 for female vs male) or race/ethnicity (-1.6%; 95% CI, -7.3% to 4.0%; P = .57 for Asian vs White and -3.0%; 95% CI, -12.1% to 6.0%; P = .51 for URiM vs White). The low numbers of women and faculty with URiM race/ethnicity in this radiation oncology faculty sample limits the ability to compare career trajectory and compensation by those characteristics. Given that point estimates were <1, our findings do not contradict larger multispecialty studies that suggest an ongoing need to monitor equity.


What's in a name? Expiratory tracheal narrowing in adults explained.
Tracheomalacia, tracheobronchomalacia, and excessive dynamic airway collapse are all terms used to describe tracheal narrowing in expiration. The first two describe luminal reduction from cartilage softening and the latter refers to luminal reduction from exaggerated posterior membrane movement. Expiratory tracheal narrowing is a frequent occurrence that can cause symptoms of airway obstruction, such as dyspnoea, wheeze, and exercise intolerance. The accurate diagnosis and quantification of expiratory tracheal narrowing has important aetiological, therapeutic, and prognostic implications. The reference standard for diagnosis has traditionally been bronchoscopy; however, this method has significant limitations. Expiratory tracheal disorders are readily detected by four-dimensional dynamic volume multidetector computed tomography (4D-CT), an emerging, non-invasive method that will potentially enable detection and quantification of these conditions. This review discusses the morphological forms of expiratory tracheal narrowing and demonstrates the utility of 4D-CT in the diagnosis, quantification, and treatment of these important conditions.


Oral contraceptive pretreatment in women undergoing controlled ovarian stimulation in ganirelix acetate cycles may, for a subset of patients, be associated with low serum luteinizing hormone levels, reduced ovarian response to gonadotropins, and early pregnancy loss.
Oral contraceptive pretreatment facilitated scheduling of pure FSH/GnRH antagonist cycles but in a small subset of patients was associated with low serum LH levels, reduced ovarian response, and early pregnancy loss. Supplementation with LH could be examined as a possible way to improve cycle outcome.


Thyroid function in patients with myotonic dystrophy.
In order to investigate endocrine disturbances in patients with myotonic dystrophy (MD), 12 patients and 20 normal controls were studied. All patients were clinically euthyroid and there were no significant differences between circulating levels (mean +/- SD) of T4 (114.7 +/- 26.8 vs 129.9 +/- 28.3 nmol/l), FT4 (16.6 +/- 4.5 vs 18.4 +/- 3.8 pmol/l), T3 (1.61 +/- 0.29 vs 1.86 +/- 0.33 pmol/l), TSH (2.7 +/- 1.3 vs 2.4 +/- 1.4 mU/l), TBG (26.7 +/- 5.5 vs 27.6 +/- 4.9 mg/l), T4/T3 (84.3 +/- 18.4 vs 82.1 +/- 15.3), and FT4/FT3 (0.28 +/- 0.05 vs 0.33 +/- 0.08). Serum FT3 (4.3 +/- 1.4 pmol/l) in patients were significantly lower than those (5.3 +/- 0.9 pmol/l) in normal controls (P less than 0.02). Thyroidal 131I-uptakes (8.7 +/- 4.3%) in patients were significantly lower than those (25.8 +/- 7.4%) in controls (P less than 0.01). The mean maximal TSH responses following TRH stimulation were significantly less in patients with MD (11.4 +/- 4.5 vs 17.0 +/- 6.2 mU/l; P less than 0.02). Neither circulating thyroid microsomal nor thyroglobulin antibodies were detectable in the 11 patients tested. Serum thyroglobulin concentrations were within the normal range in all patients but one. In conclusion, it is suggested that normal levels of serum T4, T3, FT4, TSH, TBG, T4/T3 and FT4/FT3, slight but significant decrease of serum FT3, reduced TSH response to TRH and a decrease of thyroidal radioiodine uptake might be due to a slight functional failure of TSH secretion in patients with myotonic dystrophy.


Association of volumetric bone mineral density with abdominal aortic calcification in African ancestry men.
We tested for association between cortical and trabecular volumetric bone mineral density (vBMD) with abdominal aortic calcification (AAC) prevalence in 278 Afro-Caribbean men. AAC was present in 68.3 % of the men. Greater cortical, but not trabecular, vBMD was associated with significantly decreased odds of AAC independent of traditional risk factors. The aim of this study is to assess the prevalence and correlates of AAC in a sample of 278 Afro-Caribbean men (mean age 56) and to test for a largely unexplored association between cortical and trabecular vBMD with AAC prevalence. Men were recruited consecutively as part of an ongoing prospective cohort study of body composition in men aged 40+. For this analysis, AAC was assessed by computed tomography of the abdomen from L3 to S1. Aortic calcium was scored using the Agatston method, and prevalence was defined as a score ≥10 to rule out false positives. Men also had BMD assessed using peripheral quantitative computed tomography at 4 % (trabecular vBMD) and 33 % (cortical vBMD) of the radius and tibia. Abdominal aortic calcification was present in 68.3 % of the men. Significant independent predictors of AAC prevalence were increased age, increased BMI, hypertension, and current smoking. Age was the strongest predictor, with each SD (7.8 year) increase in age conferring 2.7 times increased odds of having AAC (P < 0.0001). A one SD greater cortical, but not trabecular, vBMD was associated with a significant decreased odds of AAC prevalence independent of other traditional risk factors (OR 0.65; 95 % CI 0.45-0.92). Cortical vBMD is inversely associated with AAC presence. This finding suggests that there may be shared physiology between cortical bone compartment remodeling and vascular calcification.


Application of artificial intelligence centric workflows for evaluation of neuroradiology emergencies.
The goal of this study was to perform a pilot study to assess user-interface of radiologists with an artificial-intelligence (AI) centric workflow for detection of intracranial hemorrhage (ICH) and cervical spine fractures (CSFX). Over 12-month period, interaction and usage of AI software implemented in our institution, Aidoc, on head and cervical spine CT scans were obtained. Several interaction variables were defined, assessing different types of interaction between readers of different training level and AI software. The median usage of AI-centric workflow for detection of ICH and CSFX were 28.8% and 21.8%, respectively, demonstrating a significant additional engagement beyond Native workflow (worklist and PACS). Further studies are warranted to expand interaction assessments to further understand the value unlocked by the AI-centric workflows.


Production of lentiviruses displaying ''early-acting'' cytokines for selective gene transfer into hematopoietic stem cells.
A major limitation of current lentiviral vectors (LVs) is their inability to govern efficient gene transfer into quiescent cells, such as human CD34+ cells that reside in the G0 phase of the cell cycle and that are highly enriched in hematopoietic stem cells. This hampers their application for gene therapy of hematopoietic cells. We describe here novel LVs that overcome this restriction by displaying early-acting cytokines on their surface. Display of thrombopoietin, stem cell factor or both cytokines on LV surface allows high transfer into quiescent cord blood CD34+ cells. Moreover, these surface-engineered LVs preferentially transduce and promote survival of resting CD34+ cells rather than cycling cells. These novel LVs allow superior gene transfer in the most immature CD34+ cells compared to conventional LVs, even in the presence of recombinant cytokines. This is demonstrated by their capacity to promote selective transduction in long-term culture initiating cell colonies (LTC-ICs) and of long-term non-obese diabetic/severe combined immunodeficient (NOD/SCID) repopulating cells (SRCs). Here we describe the production of these "early acting cytokine" displaying vectors and the methodology to confirm the capacity of these vectors to promote selective transduction of HSCs.


A dual-process model for cognitive training.
A key goal in cognitive training research is understanding whether cognitive training enhances general cognitive capacity or provides only task-specific improvements. Here, we developed a quantitative model for describing the temporal dynamics of these two processes. We analyzed data from 1300 children enrolled in an 8 week working memory training program that included 5 transfer test sessions. Factor analyses suggested two separate processes: an early task-specific improvement, accounting for 44% of the total increase, and a slower capacity improvement. A hidden Markov model was then applied to individual training data, revealing that the task-specific improvement plateaued on the third day of training on average. Thus, training is not only task specific or transferable but a combination of the two. The models provide methods for quantifying and separating these processes, which is crucial for studying the effects of cognitive training and relating these effects to neural correlates.


Pulmonary hypertension in lymphangioleiomyomatosis: characteristics in 20 patients.
This retrospective, multicentre study evaluated patients with lymphangioleiomyomatosis (LAM) and pre-capillary pulmonary hypertension (PH) by right heart catheterisation. It was conducted in 20 females with a mean ± SD age of 49 ± 12 yrs and a mean ± SD time interval between LAM and PH diagnoses of 9.2 ± 9.8 yrs. All, except for one patient, were receiving supplemental oxygen. 6-min walking distance was mean ± SD 340 ± 84 m. Haemodynamic characteristics were: mean pulmonary artery pressure (PAP) 32 ± 6 mmHg, cardiac index 3.5 ± 1.1 L · min(-1) · m(-2) and pulmonary vascular resistance (PVR) 376 ± 184 dyn · s · cm(-5). Mean PAP was >35 mmHg in only 20% of cases. The forced expiratory volume in 1 s was 42 ± 25%, carbon monoxide transfer factor was 29 ± 13%, and arterial oxygen tension (P(a,O(2))) was 7.4 ± 1.3 kPa in room air. Mean PAP and PVR did not correlate with P(a,O(2)). In six patients who received oral pulmonary arterial hypertension (PAH) therapy, the PAP decreased from 33 ± 9 mmHg to 24 ± 10 mmHg and the PVR decreased from 481 ± 188 dyn · s · cm(-5) to 280 ± 79 dyn · s · cm(-5). The overall probability of survival was 94% at 2 yrs. Pre-capillary PH of mild haemodynamic severity may occur in patients with LAM, even with mild pulmonary function impairment. PAH therapy might improve the haemodynamics in PH associated with LAM.


Bradycardia in neurosurgery.
Cushing reflex' is characterized by the occurrence of hypertension, bradycardia and apnoea secondary to raised increased intracranial pressure (ICP), leading to pressure on and or stretch, or both, of the brainstem. With the wide availability of monitoring facilities and advancements in investigation techniques, observation of increased intracranial pressure resulting in haemodynamic instability and bradycardia has been increasingly recognized in relation to many neurosurgical conditions and procedures. The causes of bradycardia include space occupying lesion involving or compressing the brain parenchyma (subdural haematoma, tumours, hydrocephalus), neurosurgical procedures (neuroendoscopy, placement of extradural drains), epileptic and non-epileptic seizures, trigemino-cardiac reflex, cerebellar lesions, spinal lesions (neurogenic shock, autonomic dysreflexia) and many other rare causes (Ventricular catheter obstruction in cases of hydrocephalus, colloid cysts related acute neurogenic cardiac dysfunction, Ondine's curse syndrome, etc.). This highlights that bradycardia can be a warning sign in many neurosurgical conditions and Cushing's reflex is a protective and effective action of the brain for preserving an adequate cerebral perfusion pressure despite an increased intracranial pressure. Management of these patients include identification and treatment of the underlying cause of bradycardia, anti-cholinergics and if necessary cardiac pacing, nevertheless, other causes of haemodynamic changes (i.e. anesthetic drugs, tumor manipulation) should also be considered and managed accordingly. We believe that this knowledge and understanding will help to identify the patients' at risk and will also help in the management of neurosurgical patients with bradycardia.


Myelination: Both Mindful and Mindless?
The amount of myelin that forms on individual axons can vary considerably. Recent work, including a new study, indicates that myelin profiles on distinct subclasses of axons might be determined by diverse mechanisms.


Social Skills in Youth With Spina Bifida: A Longitudinal Multimethod Investigation Comparing Biopsychosocial Predictors.
To examine the relative contributions of neuropsychological (attention and executive function), family (cohesion and conflict), and health (body mass index, lesion level, gross motor function) domains on social skills over time in youth with spina bifida (SB). In all, 140 youth with SB (T1 mean age = 11.43 years) and their families participated in the study at baseline with an additional visit 2 years later. Study variables were assessed with multiple methods (questionnaire, medical chart review, observation, neuropsychological tests) and reporters (parents, teachers). Multivariate hierarchical linear regressions determined the predictive power of the three domains for T2 social skills. Neuropsychological variables accounted for significant variance in mother- and father-reported T2 social skills. Neither family nor health variables contributed significantly to later social skills when other domains were included in the model. Neuropsychological factors are particularly important for social skill development in youth with SB. Findings can inform screening and intervention practices.


Gene cloning and functional study of PmKSPI from Pinctada fucata martensii.
Kunitz-type serine protease inhibitors (KSPI) are a family of serine protease inhibitors (SPIs) and are extensively found in animals, plants, and microbes. SPI can inhibit proteases that may be harmful or unwanted to its cells. Here, a four-domain Kunitz-type SPI, PmKSPI, was cloned by RACE in the pearl oyster Pinctada fucata martensii. The full-length cDNA sequence of PmKSPI was 1318 bp, including the 5' UTR (25 bp), the 3' UTR (96 bp) and ORF (1197 bp). Homology analysis indicated that PmKSPI had the highest resemblance (30.14%) with its homolog in Crassostrea gigas. Phylogenetic analysis revealed that PmKSPI clustered with homologs in other molluscs. We found that PmKSPI mRNA expression in P. f. martensii was distributed in all six tissues, with the highest level in the mantle, and almost no expression in other tissues. After PAMPs challenge, expression of PmKSPI mRNA in the mantle was significantly up-regulated. The recombinant protein rPmKSPI significantly inhibited the growth of 5 kinds of Gram-negative bacteria but had little effect on Gram-positive bacterial activity. Transmission electron microscopy showed that plasmolysis occurred in two Gram-negative bacteria species when treated with rPmKSPI. rPmKSPI may thus have a bactericidal effect by destroying the bacterial cell membrane or cell walls and releasing its contents. Therefore, our results suggest that PmKSPI is tightly associated with the immunological defence of P. f. martensii.


Dominant immune cells in pregnancy and pregnancy complications: T helper cells (TH1/TH2, TH17/Treg cells), NK cells, MDSCs, and the immune checkpoints.
Pregnancy problems including recurrent pregnancy loss, repeated implantation failure and pre-eclampsia are common problems in the reproductive ages. Different reasons such as genetic, immunological, and environmental agents and also infections could develop these complications. In those cases in which the cause of the abortion is diagnosed, the chance of a successful pregnancy is increased by eliminating defective factors. However, in patients with unknown causes, there may be an imbalance in immune cells pattern. As a matter of fact, an inappropriate immune response is often associated with a failed pregnancy. Hence, the focus of treatment is to increase tolerance, not to suppress maternal immune system. These findings are linked to an elevated number of Treg cells and immune checkpoints through normal pregnancy. The present review discusses the balance of myeloid-derived suppressor cells, natural killer cells, T cells, and immune checkpoints, and also targeting them to maintain pregnancy and prevent associated complications.


Women with pregnancy-related polymyositis and high serum CK levels in the newborn.
Two previously healthy women developed an inflammatory myopathy before the term of their first pregnancy. Skeletal muscle biopsy led to a diagnosis of T cell-mediated polymyositis. Both babies were healthy, but their serum creatine kinase levels remained elevated for a few months after birth. Their mothers did well after corticosteroid treatment.


Cerebral Whipple's disease: clinical and cerebrospinal fluid findings.
The case of a patient who had a relapse of cerebral Whipple's disease (WD) one year after discontinuation of a two-years' antibiotic treatment is reported. Neither the clinical course nor the results of magnetic resonance imaging (MRI) and routine examination of the cerebrospinal fluid (CSF) allowed the caring physician to predict the relapse. Retrospective analysis of serial specimens of CSF showed that slight CSF leucocytosis and intrathecal synthesis of IgA might have suggested persistence of infection. The decision to stop antibiotic therapy in cerebral WD is difficult, but evaluation of cell counts and of intrathecal synthesis of IgA may help in the decision. Some patients may need to take treatment indefinitely.


A novel coping metal material CoCrCu alloy fabricated by selective laser melting with antimicrobial and antibiofilm properties.
The aim of this study was to fabricate a novel coping metal CoCrCu alloy using a selective laser melting (SLM) technique with antimicrobial and antibiofilm activities and to investigate its microstructure, mechanical properties, corrosion resistance and biocompatibility. Novel CoCrCu alloy was fabricated using SLM from a mixture of commercial CoCr based alloy and elemental Cu powders. SLM CoCr without Cu served as control. Antibacterial activity was analyzed using standard antimicrobial tests, and antibiofilm properties were investigated using confocal laser scanning microscope. Cu distribution and microstructure were determined using scanning electron microscope, optical microscopy and X-ray diffraction. Corrosion resistance was evaluated by potential dynamic polarization and biocompatibility measured using an MTT assay. SLM CoCrCu alloys were found to be bactericidal and able to inhibit biofilm formation. Other factors such as microstructure, mechanical properties, corrosion resistance and biocompatibility were similar to those of SLM CoCr alloys. The addition of appropriate amounts of Cu not only maintains normal beneficial properties of CoCr based alloys, but also provides SLM CoCrCu alloys with excellent antibacterial and antibiofilm capabilities. This material has the potential to be used as a coping metal for dental applications.


[Overexpression of COX-2 and its clinical significance in non-small cell lung cancer].
To study the relations among COX-2 expression in non-small cell lung cancer (NSCLC), its clinical characteristics and brognosis. Immunostaining was performed with COX-2 antibody to the surgically resected tissue samples from 79 patients with NSCLC. Vessel epithelium cell COX-2 expression was taken as positive control. The positive rate of adenocarcinoma and squamous cell carcinoma was 85% and 57%, respectively (P = 0.013). COX-2 expression was associated with the extent of adenocarcinoma differentiation, tumor size, and TNM period, but not with the extent of squamous cell carcinoma differentiation. In the COX-2 positive group, the 5-year survival rate and a median survival time were 27.1% and 53 months; however in the negative group they were 52.0% and 61 months (P = 0.029). Invasive development of NSCLC is related to inceased expression of COX-2. COX-2 overexpression may be one of the risky factors for the prognosis of NSCLC.


Patient-reported outcomes in adequately treated hypothyroidism - insights from the German versions of ThyDQoL, ThySRQ and ThyTSQ.
Disease-specific patient-reported outcome measures (PROMs) have been developed as important research tools in the study of various diseases. For hypothyroidism there exist three validated disease-specific questionnaires in English: the Thyroid-Dependent Quality of Life Questionnaire (ThyDQoL), the Underactive Thyroid Symptom Rating Questionnaire (ThySRQ) and the Thyroid Treatment Satisfaction Questionnaire (ThyTSQ). We report psychometric properties of new German versions of the questionnaires including construct validity from two independent samples. 230 envelopes with ThyDQoL, ThySRQ and ThyTSQ were given out to patients receiving levothyroxine for diagnosed hypothyroidism. Reliability and factor analyses were performed, correlations and hypothesised subgroup differences calculated to assess psychometric properties. Independently, 18 patients with treated hypothyroidism for autoimmune thyroiditis (Hashimoto's disease) and 18 healthy control subjects were enrolled in a clinical study. Participants filled in the above questionnaires alongside well-known generic PROMs, e.g. the Beck Depression Inventory, the 12-item Well-Being Questionnaire and the Short-Form-36. Two blood samples were taken. Groups were compared and correlations between disease-specific and generic instruments analysed. Relationships between PROMs and biochemically determined thyroid hormone status were investigated. 102 patients returned completed questionnaires (response rate 44%). The newly translated questionnaires had satisfactory psychometric properties. Cronbach's alpha was 0.92 for ThyDQoL, 0.81 for ThySRQ and 0.86 for ThyTSQ. For each of the questionnaires, a single factor structure explained the data best. Adequately treated patients with thyroid stimulating hormone levels in the upper normal range reported more symptoms in the ThySRQ. Those with autoimmune hypothyroidism reported being more bothered by depressive symptoms. Within the clinical sample, correlation with well-known generic instruments revealed good construct validity. In the clinical sample patients reported more symptoms in the ThySRQ, being more bothered by tiredness, higher depression and reduced well-being despite biochemically adequate treatment. Correlations between PROMs and biochemical thyroid hormone status revealed moderate though consistent associations. Psychometric properties including construct validity of German versions of the ThyDQoL, ThySRQ and ThyTSQ are satisfactory. Feasibility and sensitivity in a clinical sample could be shown. We encourage the use of disease-specific PROMs in future studies as important additions to generic instruments in clinical research on hypothyroidism.


Melatonin prevents kidney injury in a high salt diet-induced hypertension model by decreasing oxidative stress.
Melatonin, a potent antioxidant molecule, plays a role in blood pressure regulation. We hypothesized that melatonin may generate a protective effect in a high salt diet (HSD) rodent model mediated by decreasing renal oxidative stress. Dahl salt-sensitive rats were divided into three groups according to diet: normal chow (control); HSD; HSD with melatonin [30/mg/kg/day]) placed in their water (HSD + Mel) over an 8-wk period. Blood pressure was measured by the tail cuff method. Kidney injury was evaluated by 24 H urine protein excretion. Glomerular injury index (GII) (fibrotic glomeruli/100 glomeruli) was evaluated from a Masson's trichrome-stained section. Kidney oxidative stress was determined by superoxide production via dihydroethidium staining. Expression of oxidative stress-related genes was measured by reverse transcriptase-qPCR. Melatonin had no effect on blood pressure increase induced by HSD and attenuated proteinuria induced by HSD (HSD--50.7 ± 12, HSD + Mel--22.3 ± 4.3, controls--6.5 ± 1.0 gram protein/gram creatinine, P < 0.001). HSD-induced glomerular damage was significantly diminished by melatonin (GII in HSD--24 ± 6, HSD + Mel--3.6 ± 0.8, controls--0.8 ± 0.5, P < 0.05). Superoxide production was significantly higher in kidneys of HSD fed rats than the controls (99 ± 9 versus 60 ± 7 relative fluorescent units (RFU)/μm(2), respectively, P < 0.05). Melatonin also decreased superoxide production (74 ± 5 RFU/μm(2), P < 0.05). The expression of kidney inducible nitric oxide synthase and p67(phox) mRNA was significantly higher in HSD than in the controls and HSD + Mel rats. Treatment with melatonin eliminated the deleterious effect of HSD in the kidneys of Dahl salt-sensitive rats. The beneficial effect of melatonin is not mediated by lowering blood pressure but by a direct antioxidative effect.


The pink elephant in the room: Declining public interest in breast cancer and the impact of marketing efforts.
Public interest in breast cancer is associated with breast cancer awareness month. However, no study has analyzed the temporal trends in breast cancer interest or assessed how funding for breast cancer research is influenced by public interest. We performed a cross-sectional analysis of Google Trends using the search query "Breast Cancer" between January 2004 - July 2020. We then computed bivariate correlations to assess the association between relative search interest (RSI) and the financial records of the Susan G. Komen Foundation. Average search interest has declined since 2004. We identified increasing breast cancer RSI beginning in October 2009, corresponding with breast cancer awareness month, with an overall peak in 2012 followed by a downtrend through 2017. These fluctuations in peak RSI corresponded with the U.S. National Football League's initiation of "Pink October" during which the players wore pink jerseys which started in 2009 and ceased in 2017. We also found a strong correlation between peak RSI and Susan G. Komen Foundation net assets as well as funding of public health screening services and public health education. Average interest in breast cancer has been declining since 2004 and peak interest, as well as breast cancer funding, has been declining since 2012. This suggests new marketing efforts are needed to improve breast cancer awareness and to increase fundraising. Considering the decline in breast cancer interest and funding, we recommend implementing local, regional, and national policies that improve marketing campaigns and improve breast cancer awareness.


Oxytocin-like peptide: a novel epitope colocalized with the FMRFamide-like peptide in the supernumerary neurons of the sex segmental ganglia of leeches--morphological and biochemical characterization; putative anti-diuretic function.
A large number of oxytocin (OT)-like neurons were detected in the sex segmental ganglia (SG5, SG6) of three species of leeches belonging to different orders: Theromyzon tessulatum, Hirudo medicinalis and Erpobdella octoculata. In this latter species, an epitope close to the vertebrate OT by its C-terminal part (MSH release inhibiting factor: MIF), localized in granules of a size diameter of ca 120 nm and colocalized with FMRFamide(FMRFa)-like material was demonstrated. With reverse phase-high performance liquid chromatography, evidence was given that the two epitopes (OT and FMRFa) colocalized in the same neurons were biochemically different. A titration of OT per SG indicated that the OT-like amount was considerably higher in sex SG than in non-sex SG (ca. 5 pmol vs. ca. 0.5 pmol). Moreover, at the level of sex SG, this amount was ca. 3-fold higher in immature leeches than in mature specimens. Injections of extracts of SG of E. octoculata and of fragments of OT (Tocinoic acid or MIF) to T. tessulatum, indicated that MIF (the epitope found in the sex SG) and sex SG have the same anti-diuretic effect on the leeches injected. These results pointed to an anti-diuretic role of the leech OT-like substance.


Randomized trial of yoga as a complementary therapy for pulmonary tuberculosis.
The present prospective, randomized trial compared the efficacy of anti-tuberculosis treatment (ATT) with two separate programs (yoga and breath awareness), on lung capacities and bacteriological status in pulmonary tuberculosis patients. A total of 1009 pulmonary tuberculosis patients were screened and 73 were alternately allocated, to yoga (n = 36) or breath awareness (n = 37) groups, with 48 patients completing the 2-month trial. Patients aged between 20 and 55 years, who were sputum-positive on three consecutive examinations, had no prior ATT, and no comorbidities or extrapulmonary tuberculosis were included. In addition to ATT, one group practised yoga (n = 25) and the other practised breath awareness (n = 23) for 6 h per week, each session being 60 min. The main outcome measures were: symptom scores, bodyweight, FVC, FEV(1), FEV(1)/FVC%, sputum microscopy, sputum culture, and postero-anterior view of the CXR. At the end of 2 months, the yoga group showed a significant reduction in symptom scores (88.1%), and an increase in weight (10.9%), FVC (64.7%) and FEV(1) (83.6%) (P = 0.001, in all comparisons, paired t-test). The breath awareness group also showed a significant (paired t-test) reduction in symptom scores (16.3%, P= 0.02), and an increase in weight (2.1%, P= 0.003) and FEV(1) (63.8%, P= 0.04). Significantly more patients in the yoga group showed sputum conversion based on microscopy on days 30 and 45 compared to the breath awareness group (P = 0.045 and P= 0.002, respectively, chi(2) test). Ten of 13 in the yoga group had negative sputum culture after 60 days compared with four of 19 in the breath awareness group (P = 0.005, chi(2) test). Improvement in the radiographic picture occurred in 16/25 in the yoga group compared to 3/22 in the breath awareness group on day 60 (P = 0.001, chi(2) test). The improved level of infection, radiographic picture, FVC, weight gain and reduced symptoms in the yoga group suggest a complementary role for yoga in the management of pulmonary tuberculosis.


Children, young people and parent engagement in health intervention design and implementation: A scoping review.
Engaging children and young people (CYP) with and without their parents in health research has the potential to improve the development and implementation of health interventions. However, to our knowledge, the scope of engagement activities used with this population and barriers to their engagement is unknown. The objective of this review was to identify and describe CYP engagement with and without their parents in the development and/or implementation of health interventions. This scoping review included any primary research studies reporting on engaging CYP, with or without parents, in the design and/or implementation of health interventions. Healthcare professionals had to be involved over the course of the study and the study had to take place in either community, primary or tertiary care settings. The following databases were searched in May 2017, May 2020 and June 2021: Medline (OVID), CINAHL (EBSCO) and Embase (Elsevier). Two independent reviewers screened titles, abstracts and full-text articles and used a previously piloted extraction form to extract and summarize information from the included articles. Twenty-eight articles discussing twenty-four studies were included. CYP engagement throughout the research cycle was limited. There were no observed differences in the reported presence of engagement, types of interventions or outcomes of engagement between studies engaging CYP or CYP and parents. Studies engaging CYP and parents contained limited information on how these relationships affected outcomes of engagement. Engagement was enabled primarily by the maintenance of resources and relationships among stakeholders. Although CYP engagement often influenced health intervention and implementation design, they are inconsistently engaged across the research cycle. It is unclear whether parental involvement enhances CYP engagement. Future research should consider reporting guidelines to clarify the level of CYP and/or parent engagement, and enhance CYP engagement by fostering synergistic and sustainable partnerships with key stakeholders. A parent partner with codesign experience contributed to the creation of the research questions, screened titles, abstracts and full texts, helped with data extraction and provided feedback on the manuscript.


Cloning and relative expression analysis of rat stromal cell derived factor-1 (SDF-1)1: SDF-1 alpha mRNA is selectively induced in rat model of myocardial infarction.
Stromal cell derived factor-1 (SDF-1) is a member of the non-ELR subfamily of CXC chemokines. SDF-1 and its receptor, CXCR4, are essential for cardiogenesis, hematopoiesis, and vasculogenesis during embryonic development, in addition to involvement in chemotaxis of leukocyte subsets and endothelial cells. In order to study SDF-1 expression in a rat model of myocardial infarction, we cloned and functionally expressed the rat SDF-1alpha orthologue. Rat SDF-1alpha is highly conserved, with >95% identity to its known human, feline, and murine counterparts. Constitutive expression of SDF-1 mRNA was observed in heart, brain, liver, and kidney. Significantly, apart from the SDF-1alpha and beta splice variants, expression of the recently identified SDF-1gamma was uniquely abundant in the heart. SDF-1alpha mRNA was selectively induced in permanent coronary artery occlusion model of myocardial infarction in rat, while SDF-1gamma remained unchanged. Such modulation of SDF-1alpha mRNA expression may be indicative of its role in the inflammatory events in cardiovascular disease.


Automatic detection of head and neck squamous cell carcinoma on pathologic slides using polarized hyperspectral imaging and machine learning.
The aim of this study is to incorporate polarized hyperspectral imaging (PHSI) with machine learning for automatic detection of head and neck squamous cell carcinoma (SCC) on hematoxylin and eosin (H&E) stained tissue slides. A polarized hyperspectral imaging microscope had been developed in our group. In this paper, we imaged 20 H&E stained tissue slides from 10 patients with SCC of the larynx by the PHSI microscope. Several machine learning algorithms, including support vector machine (SVM), random forest, Gaussian naive Bayes, and logistic regression, were applied to the collected image data for the automatic detection of SCC on the H&E stained tissue slides. The performance of these methods was compared among the collected PHSI data, the pseudo-RGB images generated from the PHSI data, and the PHSI data after applying the principal component analysis (PCA) transformation. The results suggest that SVM is a superior classifier for the classification task based on the PHSI data cubes compared to the other three classifiers. The incorporate of four Stokes vector parameters improved the classification accuracy. Finally, the PCA transformed image data did not improve the accuracy as it might lose some important information from the original PHSI data. The preliminary results show that polarized hyperspectral imaging can have many potential applications in digital pathology.


Achieving Effective Remote Working During the COVID-19 Pandemic: A Work Design Perspective.
Existing knowledge on remote working can be questioned in an extraordinary pandemic context. We conducted a mixed-methods investigation to explore the challenges experienced by remote workers at this time, as well as what virtual work characteristics and individual differences affect these challenges. In Study 1, from semi-structured interviews with Chinese employees working from home in the early days of the pandemic, we identified four key remote work challenges (work-home interference, ineffective communication, procrastination, and loneliness), as well as four virtual work characteristics that affected the experience of these challenges (social support, job autonomy, monitoring, and workload) and one key individual difference factor (workers' self-discipline). In Study 2, using survey data from 522 employees working at home during the pandemic, we found that virtual work characteristics linked to worker's performance and well-being via the experienced challenges. Specifically, social support was positively correlated with lower levels of all remote working challenges; job autonomy negatively related to loneliness; workload and monitoring both linked to higher work-home interference; and workload additionally linked to lower procrastination. Self-discipline was a significant moderator of several of these relationships. We discuss the implications of our research for the pandemic and beyond.


Combined spinal-epidural anesthesia for outpatient surgery. Dose-response characteristics of intrathecal isobaric lidocaine using a 27-gauge Whitacre spinal needle.
Combined spinal-epidural anesthesia (CSE) may offer theoretic advantages for outpatient surgery, because it produces the rapid onset of spinal anesthesia, with the option to extend the blockade with an epidural catheter. In this study, the authors attempted to determine an appropriate initial dose of a short-acting local anesthetic, 2% lidocaine, to administer for outpatient knee arthroscopy using CSE. Data were collected from 90 patients undergoing outpatient knee arthroscopy. Using a double-blinded, prospective study design, patients were randomly assigned to receive CSE with an initial dose of intrathecal 2% lidocaine of 40, 60, or 80 mg. A 27-G 4 11/16-inch Whitacre needle was placed through a 17-G Weiss needle. Onset and regression of sensory anesthesia and motor blockade were measured by a blinded observer at frequent intervals. All 90 patients had adequate anesthesia. Durations of thoracic and lumbar sensory and lower limb motor blockade were significantly shorter in the 40-mg group compared with the 60- or 80-mg groups (P < 0.0002 Mantel-Cox, Survivorship Analysis). Indices of neural blockade resolved 30-40 min more rapidly in the 40-mg group than in either the 60- or 80-mg group. Times to urinate, site upright in a chair, take oral fluids, and be discharged were all significantly shorter (between 30 and 60 min) in the 40-mg group compared with the 60- and 80-mg groups (P < 0.01). Seven patients required intraoperative epidural supplementation: three in the 40-mg group, three in the 60-mg group, and one in the 80-mg group. Combined spinal-epidural anesthesia with a 40-mg initial intrathecal dose of lidocaine provided reliable anesthesia for knee arthroscopy. Duration of spinal anesthesia with lidocaine was dose related.


Associates and their working environment: a comparison of corporate and non-corporate associates.
Introduction The share of the dental market held by corporate bodies continues to increase. With the profession currently facing many challenges it is important to understand their place in the profession and their effect.Aim This exploratory study aims to provide an insight into dental associates in relation to their working environment. Specifically, the differences between working in corporate and non-corporate environments in England.Materials and methods Secondary analysis of a self-report questionnaire examining demographics, pay, working conditions, job satisfaction and morale using a combination of closed and open-ended responses sent to randomly selected associate dentists who are BDA members. Responses from associates working in England solely in either the corporate or non-corporate sector were analysed.Results Significant differences were seen between associates working in corporate practice when compared to those in non-corporates practice, for example, significantly less corporate associates were female and corporate associates reported relatively lower levels of autonomy and control.Discussion The differences seen between sectors could be related to rationalisation and should this be the reality it could have far reaching effects on the profession and its ability to manage itself.Conclusion This study highlights some differences between the corporate and non-corporate dental sectors. Further work is needed to build a deeper understanding of the sector.


Symptoms in the cancer patient: of importance for their caregivers' quality of life and mental health?
To examine the level of symptom burden in a sample of cancer patients in a curative and palliative phase. In addition to determine a) whether the patients' symptom burden and patients' demographic variables, and b) the caregivers' demographic variables' impact on the caregivers' quality of life and mental health. This descriptive, cross-sectional study combines data from two samples. The first group consists of caregivers of hospitalized patients with cancer in the late palliative phase and the second group is caregivers of outpatients with cancer who have pain and/or use of analgesics. The main result showed that the symptom burden was close to equal when we compared the cancer patients in the palliative and the curative phase respectively. The whole sample of patients seemed extremely tired because they scored high on items capturing fatigue or weakness. They also had problems with pain and constipation. For patients having trouble sleeping, the caregivers' reported higher level of depression, whilst caregivers' gender had impact on the caregivers' anxiety. The younger the patients the more the impact on caregivers' QOL mental health. In this study no significant differences were revealed when comparing symptom burden among cancer patients in different stages of the disease. Caregivers reported more depression when patients had trouble sleeping and more declined mental quality of life when patients were younger. Female caregivers reported more anxiety than male caregivers.


Testosterone metabolism by homogenates of human prostates with benign hyperplasia: effect of tissular concentrations of zinc, magnesium and copper.
Zinc, magnesium and copper concentrations were measured in homogenates of 20 human prostates with benign hyperplasia and a significant direct relationship between zinc and magnesium contents was found. Activities of the testosterone-5 alpha-reductase in the same homogenates were not significantly changed according to the concentrations of the three metals but activities of the 3 alpha- and 3 beta-hydroxysteroid dehydrogenases were inversely related with the zinc concentrations of the tissue preparations. This inverse relationship may explain the known increased 5 alpha-dihydrotestosterone content in prostatic tissues with high zinc concentrations.


Immunoblotting conditions for small peptides from streptococci.
Streptococci secrete small peptides with important biological functions. These peptides are not amenable to standard immunoblotting, and are often detected indirectly using activity assays, or by alternative approaches that may be expensive and laborious. Here we describe an immunoblotting method that enables reproducible detection of these small streptococcal peptides.


Influence of smoking on interleukin-1beta level, oxidant status and antioxidant status in gingival crevicular fluid from chronic periodontitis patients before and after periodontal treatment.
The aim of this study was to evaluate the impact of smoking on the relationship between interleukin-1 (IL-1β) and oxidation in patients with periodontitis and response to nonsurgical periodontal therapy. Data were obtained from 30 patients with generalized chronic periodontitis (15 smokers and 15 nonsmokers) and from 10 periodontally healthy controls. IL-1β level, total oxidant status (TOS) and total antioxidant status (TAS) were recorded in gingival crevicular fluid. Probing depth, clinical attachment level, gingival and plaque indices and bleeding on probing were also measured. The gingival crevicular fluid and clinical parameters were recorded at baseline and 6 wk after periodontal treatment. The study showed statistically significant improvement of clinical parameters in both smokers and nonsmokers after periodontal treatment. Moreover, the baseline IL-1β levels were significantly higher in smokers compared with nonsmokers (p < 0.05). After periodontal treatment, the IL-1β levels were significantly reduced in both smokers and nonsmokers (p < 0.05). There were no significant differences in TOS and TAS between periodontitis patients and healthy controls at baseline and 6 wk after periodontal treatment. The level of IL-1β in gingival crevicular fluid was positively correlated with TOS in both smokers and nonsmokers. Periodontal treatment improved the clinical parameters in both smokers and nonsmokers. The results confirm that periodontal therapy has an effect on IL-1β levels in gingival crevicular fluid, but not on TOS and TAS.


Effective communication during an influenza pandemic: the value of using a crisis and emergency risk communication framework.
During a crisis, an open and empathetic style of communication that engenders the public's trust is the most effective when officials are attempting to galvanize the population to take a positive action or refrain from a harmful act. Although trust is imperative in a crisis, public suspicions of scientific experts and government are increasing for a variety of reasons, including access to more sources of conflicting information, a reduction in the use of scientific reasoning in decision making, and political infighting. Trust and credibility--which are demonstrated through empathy and caring, competence and expertise, honesty and openness, and dedication and commitment--are essential elements of persuasive communication.


The contribution and potential of older blood donors in Asia Pacific regions.
To investigate the blood supply contribution of older donors in five Asia Pacific regions. Older people are often the largest blood user group. Thus, as the population ages blood supply needs increase. Minimum and maximum donation age criteria potentially constrain the size of the donor pool. Haemoglobin values and demographic frequency analytics (sex, age and blood type) were analysed on blood donors aged 60 years or more, from Hong Kong, Indonesia, Japan, Singapore and South Korea over 12 months. Data on 434357 donations was analysed. ABO Rh(D) frequencies of older donors matched that of national frequencies. Older donors were a disproportionately smaller proportion of the total donor pool for each country. Indonesia was the only region with no maximum age limit. Median haemoglobin for older males ranged from 14.2 to 14.8 g/dl and for females 13.1 to 13.9 g/dl. The frequency of female donors was between 15% and 33% of older donors. Older donors had higher donation frequency and lower deferral rates. Older donors are loyal and regular donors but under-represented in all regions studied. They could help meet future blood supply needs, especially post-menopausal female donors. Studies including ferritin levels are needed to determine if upper age limits can be safely modified.