Effect of laser-assisted uvulopalatoplasty on oral airway resistance during wakefulness in obstructive sleep apnea syndrome.
The aim of the study was to evaluate the effects of successful laser-assisted uvulopalatoplasty (LAUP) on oral airway resistance (R(OA)) during wakefulness in patients with OSAS. Fifteen healthy subjects (group I) and 25 subjects (group II) with moderately severe or severe obstructive sleep apnea syndrome (OSAS) proven by an overnight sleep study and who desired LAUP were enrolled. All underwent an overnight sleep study, pulmonary function testing and measurement of oral airway resistance [R(OA) (including impedance (Zrs), resistance (R) and reactance (X)] measurement by Impulse Oscillometry (IOS) (MasterScreen IOS, VIASYS Healthcare GmbH, Germany) in the upright (seated) position and then in the supine position while awake. Group II subjects had these measurements twice, both before and 3 months after LAUP. Based on the assessment of their sleep study after LAUP, they were divided into two groups: responders (group IIa) and nonresponders (group IIb). Zrs was normal in the sitting position both before and after LAUP in both groups IIa and IIb and comparable to that of group I controls. There was an increase in Zrs in the supine position in both groups IIa and IIb subjects before LAUP. After LAUP, the Zrs in group IIb subjects remained elevated, while that in group IIa subjects returned to levels comparable to those in the normal controls. OSAS patients before LAUP have abnormal R(OA) in the supine position as reflected by a high Zrs. The Zrs is improved after LAUP that successfully ameliorates OSAS.


A Lewis Acid Stabilized Ketenimine in an Unusual Variant of the Electrophilic Aromatic Substitution.
Electrophilic aromatic substitution (EAS) can provide a straightforward approach to the efficient synthesis of functionalized complex aromatic molecules. In general, Lewis acids serve as a beneficial stimulus for the formation of a Wheland complex, the intermediate in the classical SE Ar mechanism of EAS, which is responsible for H/E (E=electrophile) substitution under formal H+ elimination. Herein, we report an unusual variant of EAS, in which a complex molecule such as the tricyanomethane, HC(CN)3 , is activated with a strong Lewis acid (B(C6 F5 )3 ) to the point where it can finally be used in an EAS. However, the Lewis acid here causes the isomerization of the tricyanomethane to the ketenimine, HN=C=C(CN)2 , which in turn directly attacks the aromatic species in the EAS, with simultaneous proton migration of the aromatic proton to the imino group, so that no elimination occurs that is otherwise observed in the SE Ar mechanism. By this method, it is possible to build up amino-malononitrile-substituted aromatic compounds in one step.


Antibody-mediated targeting of liposomes. Binding to lymphocytes does not ensure incorporation of vesicle contents into the cells.
Small sonicated lipid vesicles containing the water-souble fluorescent dye 6-carboxyfluorescein were formed from dioleoyl phosphatidylcholine and the antigenic lipid N-dinitrophenylaminocaproyl phosphatidylethanolamine. When these vesicles were incubated with trinitrophenyl-modified human lymphocytes and divalent anti-trinitrophenyl antibody, the antibody bound 5000 to 15 000 vesicles to each cell. Binding was detected by fluorescence microscopy and quantitated by fluorometry and flow microfluorometry. Binding was three times greater with F(ab')2 fragments than with the whole antibody and, as expected, was almost absent with the monovalent F(ab') fragments. It was also absent or greatly reduced, (i) with control immunoglobulin G, (ii) in the presence of excess soluble trintrophenyl hapten, or (iii) if hapten was omitted from either cells or vesicles. It was unaffected by sodium azide and 2-deoxy-D-glucose but was markedly decreased at 3 degrees C. It was not reversed by incubation at 3 degrees C with excess trinitrophenyl lysine. Self-quenching of the fluorescence of 6-carboxyfluorescein was used to distinguish between release of vesicle contents into the cells and simple binding of intact vesicles (Weinstein, J.N., Yoshikami, S., Henkart, P., Blumenthal, R. and Gagins, W.A. (1977) Science 195, 489--491). Antibody-mediated binding led to little or no increase over spontaneous background levels in the amount of vesicle contents released into the lymphocytes.


Neuronal correlate of pictorial short-term memory in the primate temporal cortex.
It has been proposed that visual-memory traces are located in the temporal lobes of the cerebral cortex, as electric stimulation of this area in humans results in recall of imagery. Lesions in this area also affect recognition of an object after a delay in both humans and monkeys, indicating a role in short-term memory of images. Single-unit recordings from the temporal cortex have shown that some neurons continue to fire when one of two or four colours are to be remembered temporarily. But neuronal responses selective to specific complex objects, including hands and faces, cease soon after the offset of stimulus presentation. These results led to the question of whether any of these neurons could serve the memory of complex objects. We report here a group of shape-selective neurons in an anterior ventral part of the temporal cortex of monkeys that exhibited sustained activity during the delay period of a visual short-term memory task. The activity was highly selective for the pictorial information to be memorized and was independent of the physical attributes such as size, orientation, colour or position of the object. These observations show that the delay activity represents the short-term memory of the categorized percept of a picture.


Acid extraction of molybdenum, nickel and cobalt from mineral sludge generated by rainfall water at a metal recycling plant.
This study investigated the leaching yields of Mo, Ni and Co from a mineral sludge of a metal recycling plant generated by rainfalls. The investigated mineral sludge had a complex heterogeneous composition, consisting of particles of settled soil combined with metal-bearing particles (produced by catalysts, metallic oxides and battery recycling). The leaching potential of different leaching reagents (stand-alone strong acids (HNO3 (68%), H2SO4 (98%) and HCl (36%)) and acid mixtures (aqua regia (nitric + hydrochloric (1:3)), nitric + sulphuric (1:1) and nitric + sulphuric + hydrochloric (2:1:1)) was investigated at changing operational parameters (solid-liquid (S/L) ratio, leaching time and temperature), in order to select the leaching reagent which achieves the highest metal leaching yields. Sulphuric acid (98% H2SO4) was found to be the leachant with the highest metal leaching potential. The optimal leaching conditions were a three-stage successive leaching at 80 °C with a leaching time of 2 h and S/L ratio of 0.25 g L(-1). Under these conditions, the achieved mineral sludge sample leaching yields were 85.5%, 40.5% and 93.8% for Mo, Ni and Co, respectively. The higher metal leaching potential of H2SO4 in comparison with the other strong acids/acid mixtures is attributed to the fact that H2SO4 is a diacidic compound, thus it has more H(+) ions, resulting in its stronger oxidizing power and corrosiveness.


Recommendations on the use of biosimilars by the Brazilian Society of Rheumatology, Brazilian Society of Dermatology, Brazilian Federation of Gastroenterology and Brazilian Study Group on Inflammatory Bowel Disease--Focus on clinical evaluation of monoclonal antibodies and fusion proteins used in the treatment of autoimmune diseases.
The Brazilian Societies of Rheumatology (SBR) and Dermatology (SBD), the Brazilian Federation of Gastroenterology (FBG) and the Brazilian Study Group on Inflammatory Bowel Disease (GEDIIB) gathered a group of their respective specialists on the topic of interest to discuss the most relevant issues regarding the clinical use of biosimilar medicines in Brazil. The main aim of that meeting was to prepare a document with recommendations to guide medical specialists and to help the national regulatory and policy-making agencies as concerns the authorization for marketing biosimilars used in autoimmune diseases, such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn's disease, juvenile idiopathic arthritis and ulcerative colitis. In addition to considerations on the typical differences between innovator medicines and biosimilars, the specialists established a set of seven recommendations on regulatory advances related to clinical studies, indication extrapolation, nomenclature, interchangeability, automatic substitution and pharmacovigilance.


Lipids as a principle for the identification of archaebacteria.
The 'Archaebacteria' consist of several distinct subgroups including methanogens, extreme halophiles and specific thermoacidophiles. These bacteria are distinct from other bacteria with respect to their characteristic RNA compositions, the absence of muramic acid in the cell walls and the predominance of nonsaponifiable [correction of nonsaponifable] lipids. The lipid composition of the archaebacteria consists of isoprenoid and hydroisoprenoid hydrocarbons and isopranyl glycerol ether lipids. The pathways for the biosynthesis of the lipid components are those shared by most microorganisms and demonstrate a close relationship; however, an independent line of descent is indicated by the formation of the isopranyl glycerol ether lipids. This discontinuity formulates a point for delineating the early stages of biological evolution and for dividing bacteria into two subgroups.


Vascular Risk Factor Prevalence and Trends in Native Americans with Ischemic Stroke.
Native Americans have a higher incidence and prevalence of stroke and the highest stroke-related mortality among race-ethnic groups in the United States. We aimed to analyze trends in the ischemic stroke (IS) vascular risk factor prevalence in Native Americans along with a comparison to the other race-ethnic groups. National Inpatient Sample (NIS) database was used to explore the prevalence of risk factors among hospitalized IS patients during 2000 - 2016. Prevalence estimates were calculated for each risk factor within each race-ethnic group in 6 time periods. Linear trends were explored using linear regression models, with differences in trends between the Native American group and the other race-ethnic groups assessed using interaction terms. The analysis accounted for the complex sampling design, including hospital clusters, NIS stratum, and trend weights for analyzing multiple years of NIS data. Native Americans constituted 5472 of the 1,278,784 IS patients. The age-and-sex-standardized prevalence of hypertension (slope = 2.24, p < 0.001), hyperlipidemia (slope = 6.29, p < 0.001), diabetes (slope = 2.04, p = 0.005), atrial fibrillation/flutter (trend slope = 0.80, p = 0.011), heart failure (trend slope = 0.73, p = 0.036) smoking (trend slope= 3.65, p < 0.001), and alcohol (slope = 0.60, p = 0.019) increased among Native Americans. They showed larger increases in hypertension prevalence compared to Blacks, Hispanics, and Asian/Pacific Islanders and in smoking prevalence compared to Hispanics and Asian/Pacific Islanders. By the year 2015-2016, Native Americans had the highest overall prevalence of diabetes, coronary artery disease, smoking, and alcohol among all race-ethnic groups. The prevalence of most vascular risk factors among ischemic stroke patients has increased in Native Americans over the last two decades. Significantly larger increases in hypertension and smoking prevalence were seen in Native Americans compared to other groups along with them having the highest prevalence in multiple risk factors in recent years.


[Clinical update-multiple myeloma].
Multiple myeloma (MM) is a malignancy of hematopoetic system and is associated with destruction of bone, suppressed bone marrow function and renal failure. It is characterized by strong proliferation of malignant plasma cells. Classic therapies contained an alkylating agent and a glucocorticoid. In the 1990s, treatments were supplemented with transplantation of peripheral blood stem cells. During the 2000s, new therapies emerged, combining an immunomodulator (thalidomide, lenalidomide or pomalidomide), a proteasome inhibitor (bortezomib, carfilzomib or ixazomib), and a monoclonal antibody against CD38. Currently, antibodies against BCMA (B-cell maturation antigen), bispecific antibodies, and CAR T‑cell (chimeric antigen receptor T cells) therapies are being investigated in clinical trials. Classic diagnostics were based on end-organ damage, e.g., bone destruction, and estimated tumor load. Since 2014, new criteria for an earlier start of therapy were introduced-concentration of antibody light chains in blood serum, bone marrow lesions and its infiltration by malignant plasma cells. These lesions (clusters of myeloma cells) can be detected by magnetic resonance imaging (MRI) or positron emission tomography/computed tomography (PET/CT). Both methods are also used to monitor therapy response. Traditional X‑ray imaging has been replaced by the more gentle, low-dose CT. The standard diagnostic process is extended by cytogenetic examination of bone marrow samples via imaging fluorescent in situ hybridization (iFiSH) to identify patients at high risk. While most MM patients could be treated only palliatively until the 1990s, the prognosis has continuously improved since then. Nowadays, MM can be classified as a chronic disease.


Primary hyperparathyroidism: iliac crest cortical thickness, structure, and remodeling evaluated by histomorphometric methods.
Iliac crest bone biopsies from 62 patients (42 women, 20 men; median age 59 years; range 17-79 years) with primary hyperparathyroidism (PHP) were examined. Static and structural parameters were compared with 30 age- and sex-matched normal controls. Eighteen sex-matched younger controls were used for evaluation of the dynamic controls. On the endocortical surface increase in extension of eroded (p < 0.01) and formative (p < 0.01) surfaces was found in PHPs compared with normals. Endocortical bone formation rate was increased in PHPs (p < 0.05), but mineral appositional rate and adjusted appositional rate were normal. On the periosteal surface very little remodeling activity was found. Although bone formation rate was found increased in PHPs (p < 0.05), more than half of the labeled biopsies were without periosteal tetracycline in patients, and only 2 of 18 biopsies from normals contained periosteal tetracycline labels. No significant decreases in cortical width or relative cortical width were found in PHPs. In both patients and controls an age-related decrease in relative cortical width cortical width were found in PHPs. In both patients and controls an age-related decrease in relative cortical width was noted for women (PHPs: r = -0.52, p < 0.01; controls: r = -0.59, p < 0.001), but not for men. Cortical porosity was about 30% increased in PHPs (p < 0.02). Only normal women showed a positive age-related increase in porosity (r = 0.61, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)


Synaptic changes in Purkinje cell dentritic spine of mouse cerebellum after neonatal administration of cytosine arabinoside.
This study was undertaken to elucidate morphological changes in the synaptic area of the Purkinje cell dendritic spines when granule cells were decreased in number. The mice were injected s.c. with 30 mg/kg b.w. of cytosine arabinoside on days 2, 3, and 4, and on days 7, 8 and 9, and were designated as group I and group II, respectively. The mice injected with saline on days 2, 3, and 4 served as control. The cerebella of the mice in each group were examined by electron microscopy on days 30, 60, and 90. Using photographs thus obtained, the synaptic length and area of Purkinje cell dendritic spines which participated in synapses with axons of granule cells were measured by computer. In the controls, these spines did not increase significantly either in synaptic length or in spine area in the duration from 30 to 90 days after birth. In the 90-day-old mice belonging to group I and group II, however, they increased by about 20% in the synaptic length and by about 35% in the spine area as compared to those in age-matched control. The elongation and enlargement show that the synaptic surface on the spine spreads to compensate for synapses lost by reduction in number of granule cells in experimental groups.


Two-site exchange revisited: a new method for extracting exchange parameters in biological systems.
A new analysis is presented which links real volume fractions, relaxation rates, and intracompartmental exchange rates directly with apparent volume fractions and relaxation rates obtained from biexponential fits of transverse magnetization decay curves. The analysis differs from previous methods in that measurements from two paramagnetic doping levels are used to close the two-site exchange equations. Both the new method and one previously described by Herbst and Goldstein (HG) have been applied to paramagnetically doped whole-blood data sets. Significant differences in the calculated exchange parameters are found between the two methods. A small dependence of the intracellular relaxation rate on extracellular paramagnetic agent concentration, assumed nonexistent with the HG method, is inferred from the new analysis. The analysis was also applied to published data on perfused rat hearts, and we obtained a limited assessment of two-site exchange in this system.


The value of 6-month interval imaging after benign radiologic-pathologic concordant minimally invasive breast biopsy.
Current National Comprehensive Cancer Network guidelines recommend repeat imaging 6-12 months after a benign radiologic-pathologic concordant image-guided breast biopsy. We hypothesized that interval imaging <12 months after benign concordant biopsy has a low cancer yield and increases health care costs. An institutional review board-approved retrospective chart review identified 689 patients who underwent image-guided breast biopsy at Bryn Mawr Hospital between January and December 2010. Charts were evaluated for documentation of radiologic-pathologic concordance. Of 689 patients, 188 (27 %) had malignant pathology, 3 (0.4 %) had nonbreast pathology, and 498 (72.3 %) had benign pathology. Of 498 patients with benign findings, 44 (8.8 %) underwent surgical excision as a result of discordance, atypia, papillary lesion, or other benign finding. Of the remaining 454 patients who did not undergo excision, 337 (74.2 %) had documented radiologic-pathologic concordance. Interval imaging <12 months after benign biopsy was obtained in 182 (54.0 %) concordant patients. Five (2.7 %) patients had suspicious [American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS) 4] findings on follow-up imaging. Only one breast cancer was identified, representing 0.5 % (95 % confidence interval 0-3.4) of all benign concordant patients undergoing interval imaging. The cost of detecting a missed cancer with interval imaging after benign concordant biopsy was $41,813.77 in this cohort. Interval imaging performed <12 months after benign concordant breast biopsy demonstrated a low yield for the detection of breast cancer and resulted in increased health care costs. Our data support the policy for discontinuation of routine interval imaging after benign concordant biopsy.


Zinc and birth weight in uncomplicated pregnancies.
The relationship between zinc status and birth weight in uncomplicated pregnancies was studied in 59 nulliparous and 27 multiparous Chinese women with singleton pregnancies, delivered at term. Maternal and umbilical cord blood, maternal pubic hair and a segment of the umbilical cord were collected at delivery for analysis. The zinc concentration was significantly higher (p less than 0.0001) in the plasma of newborn infants (13.9 +/- 2.8 mumol/l) than in maternal plasma (9.3 +/- 2.2 mumol/l), while the converse was found in tissue (60.8 +/- 17.0 vs 208.1 +/- 96.2 micrograms/g, p less than 0.0001). There was no significant correlation between birth weight and either maternal or newborn plasma or tissue zinc concentrations. Parity had no significant effect on maternal or newborn zinc concentrations in tissue and plasma.


Protection of Reinforced Concrete Structures of Waste Water Treatment Reservoirs with Stainless Steel Coating Using Arc Thermal Spraying Technique in Acidified Water.
Waste water treatment reservoirs are contaminated with many hazardous chemicals and acids. Reservoirs typically comprise concrete and reinforcement steel bars, and the main elements responsible for their deterioration are hazardous chemicals, acids, and ozone. Currently, a variety of techniques are being used to protect reservoirs from exposure to these elements. The most widely used techniques are stainless steel plating and polymeric coating. In this study, a technique known as arc thermal spraying was used. It is a more convenient and economical method for protecting both concrete and reinforcement steel bar from deterioration in waste water treatment reservoirs. In this study, 316L stainless steel coating was applied to a concrete surface, and different electrochemical experiments were performed to evaluate the performance of coatings in different acidic pH solutions. The coating generated from the arc thermal spraying process significantly protected the concrete surface from corrosion in acidic pH solutions, owing to the formation of a double layer capacitance-a mixture of Cr3+ enriched with Cr₂O₃ and Cr-hydroxide in inner and Fe3+ oxide on the outer layer of the coating. The formation of this passive film is defective owing to the non-homogeneous 316L stainless steel coating surface. In the pH 5 solution, the growth of a passive film is adequate due to the presence of un-dissociated water molecules in the aqueous sulfuric acid solution. The coated surface is sealed with alkyl epoxide, which acts as a barrier against the penetration of acidic solutions. This coating exhibits higher impedance values among the three studied acidic pH solutions.


Plain film of the abdomen remains a low sensitivity test in A&E.
Plain film abdomens (PFA) are frequently used in the emergency department to help guide the management of patients presenting with abdominal symptoms. A plain film abdomen contributes minimally to clinical scenarios due to low sensitivity and specificity. Is a PFA useful in the emergency setting or does it serve to further complicate decision making? We hypothesise that PFAs in the emergency department are over utilised to falsely reassure clinicians and patients alike. A search of the National Integrated Medical Imaging System (NIMIS) database in an Irish tertiary referral hospital was conducted. All plain film abdominal radiographs requested by the emergency department between 01/01/2022 and 31/08/2022 were identified. Requests where there was suspicion of foreign body were excluded. A retrospective search of the NIMIS database identified subjects who underwent subsequent imaging. A total of 619 abdominal films were deemed suitable for inclusion. These comprised of 338 male and 282 female subjects. Subjects had an average age of 64 years. Fifty-seven per cent of PFAs detected no abnormality. Forty-two per cent of subjects had subsequent imaging. The plain film findings correlated with further imaging in only 15% of cases. One case of ruptured aortic aneurysm and 11 perforations were detected on computerised tomography, none of these cases were evident on abdominal X-ray. Plain film abdomen requests are over utilised in the emergency department. PFAs are not sensitive for detecting acute pathology and should not be used to decide if a patient requires further imaging or a full clinical assessment.


Lipoxins inhibit Akt/PKB activation and cell cycle progression in human mesangial cells.
Lipoxins (LX) are endogenously produced eicosanoids with a spectrum of bioactions that suggest anti-inflammatory, pro-resolution roles for these agents. Mesangial cell (MC) proliferation plays a pivotal role in the pathophysiology of glomerular inflammation and is coupled to sclerosis and tubulointerstitial fibrosis. We have previously reported that LXA4 acts through a specific G-protein-coupled-receptor (GPCR) to modulate MC proliferation in response to the proinflammatory mediators LTD4 and platelet-derived growth factor (PDGF). Further investigations revealed that these effects were mediated by modulation of receptor tyrosine kinase activity. Here we have explored the underlying mechanisms and report inhibition of growth factor (PDGF; epithelial growth factor) activation of Akt/PKB by LXA4. LXA4 (10 nmol/L) modulates PDGF-induced (10 ng/ml, 24 hours) decrements in the levels of cyclin kinase inhibitors p21Cip1 and p27Kip1. PDGF-induced increases in CDK2-cyclin E complex formation are also inhibited by LXA4. The potential of LXA4 as an anti-inflammatory therapeutic is compromised by its degradation; this has been circumvented by synthesis of stable analogs. We report that 15-(R/S)-methyl-LXA4 and 16-phenoxy-LXA4 mimic the native compound with respect to modulation of cell proliferation and PDGF-induced changes in cell cycle proteins. In vivo, MC proliferation in response to PDGF is associated with TGFbeta1 production and the subsequent development of renal fibrosis. Here we demonstrate that prolonged (24 to 48 hours) exposure to PDGF is associated with autocrine TGFbeta1 production, which is significantly reduced by LXA4. In aggregate these data demonstrate that LX inhibit PDGF stimulated proliferation via modulation of the PI-3-kinase pathway preventing mitogen-elicited G1-S phase progression and suggest the therapeutic potential of LX as anti-fibrotic agents.


Correction: Wang, C.; et al. Changes in Indoor Insecticide Residue Levels after Adopting an Integrated Pest Management Program to Control German Cockroach Infestations in an Apartment Building.
Following the publication of our article [...].


Psychoendocrine aspects of mother-infant relationships in nonhuman primates.
Studies will be presented which examine the physiological and behavioral responses of squirrel monkeys and rhesus macaques following disruptions of mother-infant relationships. Reliable increases in circulating levels of plasma cortisol occur following separation of the infant from its mother. The presence of familiar conspecifics during the time of separation reduces the pituitary-adrenal response, compared to that elicited by total isolation. Visual access to the mother during separation also ameliorates the plasma cortisol response. However, when infants are separated in the presence of unfamiliar conspecifics, the physiological response is exaggerated compared to animals which are totally isolated. The behavior expressed by the infant during separation, particularly separation-induced vocalizations, is not concordant with this physiological index of affect. The rate of vocalization produced when the infant has visual access to the mother was higher than when the infant was totally isolated. However, when allowed access to familiar conspecifics, the rate of vocalization was lower than during total isolation, with no vocalization produced while the separated infant was in the unfamiliar social group. The curvilinear relationship between vocalization and the physiological index of arousal has led to a revision of the traditional concept that separation-induced infant vocalization is reflective of distress. These data support the hypothesis that vocalizations may serve as a coping response that reduces the physiological indices of arousal. Social interaction with familiar cospecifics may serve as a non-vocal coping response (e.g., proximity contact to other monkeys) which also reduces the behavioral and physiological responses to maternal separation.


Cyclic variation of integrated delta components during nocturnal sleep in mentally retarded children.
The cyclic variation of the integrated delta component in 80 mentally retarded children (from 2 months to 12 years of age) was studied throughout nocturnal sleep, and the following results were obtained. In 62 out of 80 subjects the high integrated delta rhythm power was noted in sleep EEG. In 11 out of the 80, low integrated delta rhythm power was found. In the remaining 7 subjects, no integrated delta rhythm power was found throughout nocturnal sleep. A significant increase in abnormal clinical EEG was found in subjects without delta rhythm power as compared to those with high delta rhythm power. A significant decrease in DQ was found in the subjects without delta rhythm power as compared to those with high and low delta rhythm powers.


Short- and long-term prediction of self-reported cigarette smoking in a cohort of late adolescents: report of an 8-year follow-up of public school students.
The purpose of this study was to assess accuracy in predicting adolescent smoking status using attitude, knowledge, behavioral, and sociodemographic variables. A cohort of 4,641 schoolchildren was tested in 1975 (grades 4-6), in 1978 (grades 6-8), and, finally, in 1983 (grades 10-12). From 1978 to 1983, eight variables were used to account for 25% of the variance in smoking status. Over the 8-year period, six variables accounted for 13% of the variance. In both models, prior experience with cigarettes, peer and parental smoking, sex, and student intention were used. Tests of the Ajzen-Fishbein model and social learning theory indicate that social factors were more important than attitudinal ones in predicting future smoking, but these relationships were relatively weak. However, for both long- and short-term prediction, previous behavior proved to be the best predictor. Implications for the design of prevention programs are discussed.


The utility of exercise testing after cardiac transplantation in older patients.
The criteria for cardiac transplantation recipient selection, including the appropriate recipient upper age limit, continue to expand with an increasing number of recipients greater than 60 years of age. While others have reported their transplant experience in older recipients in terms of quality of life assessment, we have examined the role of exercise cardiopulmonary testing post-transplantation in older cardiac transplant recipients. We reviewed inpatient and outpatient charts of 28 patients 60 years of age or older who underwent orthotopic heart transplantation at Vanderbilt University Medical Center. In this population, perioperative mortality of 7.1% and Kaplan-Meier survival at 1 and 5 years of 89 and 77%, respectively, were similar to the institutional 1-year (89%) and 5-year (75%) survival among younger adult transplant recipients. Exercise cardiopulmonary testing results were available in 22/25 patients surviving greater than 1 year. Both peak oxygen consumption and percentage of maximum VO2 were significantly greater among patients reporting NYHA Class 1 or 2 functional status, in comparison with those NYHA Class 3 or greater. Following cardiac transplantation, survival of patients greater than 60 years of age is equivalent to that of younger patients at our institution. Exercise testing provides an objective measure of performance and correlates with subjective status following heart transplantation. Most patients demonstrate good functional status, with minimal symptoms and good exercise capacity. These results, although retrospective, suggest that cardiac transplantation remains a reasonable therapeutic option for patients greater than 60 years of age with end-stage cardiomyopathy.


Effects of experience on palatability hierarchies of novel plants in the polyphagous grasshopperSchistocerca americana.
We studied the influence of diet composition and breadth on the subsequent acceptability of three novel plants to sixth instarSchistocerca americana. Rearing diets of equal breadth differing in composition, and diets differing in breadth, significantly altered first meal length on some but not all of the test plants. These effects on palatability altered and at times reversed the palatability hierarchy of insects reared on different diets. The effects of rearing insects on broad diets were not produced by exposure to the plant odors alone, but apparently required contact with a diversity of plants while feeding. Switching diets for 24 h prior to testing did not alter preferences induced by rearing diets. The relationship of these patterns to induced preferences in other insects, and some possible mechanisms for generating induced preferences, are discussed.


Facile fabrication of Nishamalaki churna mediated silver nanoparticles with antibacterial application.
Antimicrobial resistance (AMR) is one of the most serious threats to today's healthcare system. The prime factor behind increasing AMR is the formation of complex bacterial biofilms which acts as the protective shield between the bacterial cell and the antimicrobial drugs. Among various nanoformulations, green synthesized metallic silver nanoparticles are currently gaining research focus in safely breaking bacterial biofilms due to the inherent antimicrobial property of silver. In the current work, the aqueous extract of the ayurvedic formulation Nishamalaki churna is used to exhibit one pot green synthesis of silver nanoparticles. The physicochemical characteristics of Nishamalaki churna extract mediated AgNPs were evaluated using various analytical techniques, like UV-Visible spectrophotometer, FT-IR spectroscopy, SEM, XRD, DLS-Zeta potential analyzer etc. The synthesized spherical AgNPs were well formed within the size range of 30 nm to 80 nm. Furthermore, the synthesized AgNPs showed potent antibacterial effects against two primary AMR-causing bacterial species like Staphylococcus aureus and Pseudomonas aeruginosa with the successful destruction of their biofilm formation. Additionally, these AgNPs have shown profound antioxidant and anti-inflammatory activities as desirable add-on effects required by a prospective antibacterial agent.


Antitumor efficacy of nedaplatin, a novel platinum complex, with cyclophosphamide in murine and human tumor model.
The antitumor efficacy of the combination of Nedaplatin (NDP) with cyclophosphamide (CPM) was evaluated using murine and human carcinoma implanted mice. NDP was developed as a second generation platinum complex. Because of its superior antitumor activity and lower nephrotoxicity than Cisplatin (CDDP), we also compared the antitumor activity of NDP plus CPM with that of CDDP plus CPM. Various doses of NDP or CDDP (1/4 to 1 maximum tolerated dose; MTD) and CPM (58 or 78 mg/kg) were injected once via the tail vein into mice implanted with Lewis murine lung carcinoma or Ma44 human lung carcinoma. Simultaneous administration of NDP or CDDP with CPM resulted in synergistically enhanced inhibition of tumor growth and prolonged survival in comparison with therapy using only NDP, CDDP or CPM. The combination therapy of NDP with CPM showed a superior survival effect with frequent long-term tumor-free survivors in comparison to that of CDDP plus CPM without increased hematotoxicity. The augmented antitumor efficacy of the combination of NDP with CPM was also demonstrated against Ma44 human lung carcinoma. The results suggested the effectiveness of using a combination of NDP with CPM for clinical therapy.


A vacuolar serine protease (Rho m 2) is a major allergen of Rhodotorula mucilaginosa and belongs to a class of highly conserved pan-fungal allergens.
Rhodotorula mucilaginosa is one of the most frequently encountered species of yeasts in our environment. We reported here a major allergen of R. mucilaginosa. A major R. mucilaginosa allergen (Rho m 2) was characterized by two-dimensional (2D) immunoblotting, protein sequencing, cDNA cloning and IgE cross-reactivity with fungal serine proteases. Fourty-four sera (28%) from 157 bronchial asthmatic patients showed IgE-immunoblot reactivity against R. mucilaginosa extract. Among these 44 sera, 25 (57%) demonstrated IgE binding against a 31-kDa protein of R. mucilaginosa. Protein sequencing results suggest that it is a vacuolar serine protease. The corresponding cDNA clone encoding a mature protein of 312 residues was isolated. It shares 67-68% sequence identity with vacuolar serine protease allergens from three different Penicillium species (Pen ch 18, Pen o 18 and Pen c 18) and designated as Rho m 2 by the Allergen Nomenclature Committee. The native and recombinant Rho m 2 react with IgE antibodies and monoclonal antibody (MoAb) FUM20 against fungal serine proteases. IgE cross-reactivity between nRho m 2 and nPen ch 18 was observed. It was also detectable between rRho m 2 and rPen o 18. Our results suggest that R. mucilaginosa may also be a significant causative agent of human respiratory allergic disorders. We identified a vacuolar serine protease as a major allergen of R. mucilaginosa (Rho m 2) and a pan allergen of prevalent airborne fungal species. We detected IgE cross-reactivity among these highly conserved serine protease pan-fungal allergens.


FAF1 mediates necrosis through JNK1-mediated mitochondrial dysfunction leading to retinal degeneration in the ganglion cell layer upon ischemic insult.
Aberrant cell death induced by ischemic stress is implicated in the pathogenesis of ischemic diseases. Fas-associated factor 1 (FAF1) has been identified as a death-promoting protein. This study demonstrates that FAF1 functions in death signaling triggered by ischemic insult. The expression changes of FAF1 and phophorylated JNK1 were detected by Western blotting. Immunoprecipitation was employed to investigate protein-protein interaction. We determined the cell death using flow cytometry and lactate dehydrogenase release measurement. To validate the death-promoting role of FAF1 in the retina, we generated conditional retinal FAF1 knockout mice. We used hematoxylin and eosin staining to detect retinal cell death in retinal ganglion cell layer. FAF1 was found to function upstream of c-Jun N-terminal kinase 1 (JNK1), followed by mitochondrial dysregulation and necrotic cell death processes upon ischemic insult. We investigated whether FAF1 is involved in the pathogenesis of ischemic diseases using a retinal ischemia model. Indeed, FAF1 potentiated necrosis through JNK1 activation upon ischemic stress in retinal cells demonstrating retinal ganglion-like character. Conditional FAF1 depletion attenuated JNK1 activation in the retinas of Dkk3-Cre;Faf1flox/flox mice and ameliorated death of retinal cells due to elevated intraocular pressure (IOP). Our results show that FAF1 plays a key role in ischemic retinal damage and may be implicated in the pathogenesis of retinal ischemic disease.


Understanding youths' attitudes and practices regarding listening to music, video recording and terrain park use while skiing and snowboarding.
Skiing and snowboarding are popular activities among Canadian youth and these sports have evolved to include certain risk behaviours such as listening to music, using terrain parks, and video recording yourself or others. The objective of this study was to determine the prevalence of these risk behaviours and identify factors that are associated with the risk behaviours. Using focus group methodology, a questionnaire was developed to capture aspects of the Theory of Planned Behaviour. A cross-sectional study was conducted where the questionnaire was administered to youth aged 13-18 during two winter seasons at two ski hills in Manitoba, Canada. The sample was comprised of 735 youth (mean age 14.9; 82.1% male, 83.6% snowboarding). The most common behavior was using the TP (83.1%), followed by listening to music that day (36.9%), and video recording that day (34.5%). Youth had significantly higher odds of listening to music that day if they planned to next time (OR 19.13; 95% CI: 10.62, 34.44), were skiing or snowboarding alone (OR 2.33; 95% CI: 1.10, 4.95), or thought listening to music makes skiing or snowboarding more exciting or fun or makes them feel more confident (OR 2.30; 95% CI: 1.31, 4.05). They were less likely to if they believed that music made it more difficult to hear or talk to others (OR: 0.35; 95% CI: 0.18, 0.65). Youth had significantly higher odds of using the terrain park if they believed that terrain parks were cool, challenging, or fun (OR: 5.84; 95% CI: 2.85, 11.96) or if their siblings used terrain parks (OR: 4.94; OR: 2.84, 9.85). Those who believed that terrain parks were too busy or crowded (OR: 0.31; 95% CI: 0.16, 0.62) were less likely to use them. Youth had significantly higher odds of video recording that day if they reported that they plan to video record next time (OR: 8.09, 95% CI: 4.67, 14.01) or if they were skiing or snowboarding with friends (OR: 3.65, 95% CI: 1.45, 9.18). Youth had significantly higher odds of video recording that day if they agreed that recording makes them try harder and improved their tricks (OR: 3.34, 95% CI: 1.38, 8.08) compared to those who neither agreed nor disagreed. Youth were less likely to record themselves that day if their friends did not do so (OR: 0.36; 95% CI: 0.16, 0.80). Common predictors of engaging in risk behaviours suggest that injury prevention programs may not have to be specific to each behaviour. Some strategies for injury prevention are suggested.


On the utility of hierarchical self-healing fiber bundle materials under different environments.
Bio-materials use a hierarchical structure to optimize their self-healing mechanical behavior. However, the utility may be restricted by different environments. In this paper, based on the previous work in Ji and Li (J Mater Sci 53:14858-14870, 2018) on the constitutive relation of hierarchical self-healing fiber bundle materials (FBMs), the stability is investigated for the mechanical-environmental interaction system established in Ji and Li (Int J Fract 212:105-112, 2018). With the principle of total potential, the stability criterion is proposed. The critical environment stiffness is derived and the system is therefore classified into the absolutely stable one and the conditionally stable one. For the conditionally stable system, the applied strain of FBMs reduces to be [0,[Formula: see text]], where [Formula: see text] is the cutoff strain. Finally, the toughness of hierarchical self-healing FBMs is studied for different interaction systems. The results show that in the absolutely stable system there exists a critical healing rate across which the toughness benefits from a hierarchical structure. In the conditionally stable system, the toughness is significantly affected by the environment stiffness, i.e., the toughness of a FBM increases with a rising hierarchical level, whereas it decreases with a rising healing rate. Moreover, the critical healing rate for toughness becomes greater compared to that in an absolutely stable system.


Sleep Measurements in Women.
Sleep in women and men have been studied in several studies with higher prevalence of sleep complaints in women compared with men. Several factors can affect sleep and could be argued to contribute to sex and gender differences in general sleep. There are no differences in guidelines when measuring sleep in women but several sleep assessment tools have been validated or compared between sexes. Because there is still a lack of knowledge on sleep measurements in women, the present review aimed to produce an overview of the current knowledge of objective and subjective sleep measurements in women.


Robotic Partial Nephrectomy: Update on Techniques.
Surgical techniques for robot-assisted partial nephrectomy are driven by the aims of simplifying the most challenging surgical steps, maximizing functional and oncologic outcomes, and consistently pushing the envelope on possibilities. Over the past several years, we have seen an emergence in not only innovation in surgical technique, and robotic platforms, but integration of a variety of imaging techniques. We believe with developing robotic expertise, practicing urologists will continue to push the envelope in nephron preservation and complication-free recovery.


Preparing for communities of care for child and family mental health for the twenty-first century.
In a period of unprecedented change in the American health care system, a strong reform movement for child and family mental health services has developed in the last two decades that provides blueprints and models for the development of communities of care to provide individualized, strength-based services tailored to the needs of each child and family. To bring the spirit and substance of this reform into the twenty-first century, a two-pronged strategy is proposed, focusing on the broad implementation of value-based outcome measures and the development of skilled clinician leaders to ensure the effectiveness of the new delivery system.


Identification of cryptotanshinone from Tongmai to inhibit thrombosis in zebrafish via regulating oxidative stress and coagulation cascade.
Thromboembolic events are leading causes of mortality and morbidity all over the world. Tongmai (TM) is a botanical drug with valid clinical efficacy and safety in the management of thrombosis and ischemic cardiovascular diseases, however, its active compounds and underlying mechanism are largely unclear. To investigate the endogenous effects, therapeutic mechanism and active compounds of TM in thrombus formation. Combined with transgenic zebrafish models and high-content imaging system, this study evaluated the endogenous antithrombotic effects of TM and screened for the active compounds. The PHZ-induced thrombotic model in erythrocytes or platelets labeled transgenic zebrafish were established, to dynamically evaluate the antithrombotic effects of TM. The oxidative damage levels were analyzed by specific fluorescent probes, and the expression levels of key factors in coagulation cascades and platelet activation were examined by QPCR. TM were dissected into fractions by reverse phase chromatography and subsequently screened for their antithrombotic effects in the transgenic fish models. The compounds of the active TM fraction were then analyzed by UPLC-Q-TOF analysis and further verified for their antithrombotic effects and mechanisms. In PHZ-induced zebrafish thrombotic model, TM incubation markedly increased cardiac blood flow, decreased peripheral erythrocytes aggregation, and recovered peripheral platelet circulation. Besides, the levels of oxidative stress and lipid peroxidation were increased in the PHZ-induced thrombotic fish, which were greatly decreased by TM treatment. Moreover, TM significantly reduced the expression of coagulation factor II (thrombin) and the downstream fibrinogen. In order to identify the active compounds of TM, four fractions were separated from the extract by reverse phase chromatography, which were subsequently screened for their antithrombotic effects in the fish model. As a result, fraction 4 showed the strongest effect in inhibiting thrombosis. Finally, through UPLC-Q-TOF analysis and endogenous screening, cryptotanshione was identified as the main active compound with antithrombotic effects. Our study demonstrated the endogenous antithrombotic effects of TM, which is possibly mediated by inhibiting oxidative stress and coagulation cascade. Cryptotanshione was identified as a major compound with antithrombotic activity and is a promising candidate for novel antithrombotic therapy.


Body composition in long-standing juvenile dermatomyositis: associations with disease activity, muscle strength and cardiometabolic measures.
To compare body composition parameters in patients with long-standing JDM and controls and to explore associations between body composition and disease activity/inflammation, muscle strength, health-related quality of life (HRQoL) and cardiometabolic measures. We included 59 patients (median disease duration 16.7 y; median age 21.5 y) and 59 age- and sex-matched controls in a cross-sectional study. Active and inactive disease were defined by the PRINTO criteria. Body composition was assessed by total body DXA, inflammation by high-sensitivity CRP (hs-CRP) and cytokines, muscle strength by the eight-muscle manual muscle test, HRQoL by the 36-item Short Form Health Survey physical component score and cardiometabolic function by echocardiography (systolic and diastolic function) and serum lipids. DXA analyses revealed lower appendicular lean mass index (ALMI; reflecting limb skeletal muscle mass), higher body fat percentage (BF%) and a higher android fat:gynoid fat (A:G) ratio (reflecting central fat distribution) in patients than controls, despite similar BMI. Patients with active disease had lower ALMI and higher BF% than those with inactive disease; lower ALMI and higher BF% were associated with inflammation (elevated monocyte attractant protein-1 and hs-CRP). Lower ALMI was associated with reduced muscle strength, while higher BF% was associated with impaired HRQoL. Central fat distribution (higher A:G ratio) was associated with impaired cardiac function and unfavourable serum lipids. Despite normal BMI, patients with JDM, especially those with active disease, had unfavourable body composition, which was associated with impaired HRQoL, muscle strength and cardiometabolic function. The association between central fat distribution and cardiometabolic alterations is a novel finding in JDM.


Enhancement of immune response against Mycobacterium tuberculosis HspX antigen by incorporation of combined molecular adjuvant (CASAC).
Tuberculosis (TB) is one of the deadliest human diseases worldwide caused by mycobacterial infection in the lung. Bacillus Calmette-Guerin (BCG) vaccine protects against disseminated TB in children, but its effectiveness is still questionable due to highly variable protections in adolescence and elderly individuals. Targeting the latency M.tb antigen is a recent therapeutic approach to eradicate dormant pathogen that could possibly lead to disease activation. In this study, we aimed to potentiate immune responses elicited against 16 kDa α-crystalline (HspX) tuberculosis latency antigen by incorporation of Combined Adjuvant for Synergistic Activation of Cellular immunity (CASAC). Histidine-tagged recombinant HspX protein was initially produced in Escherichia coli and purified using Ni-NTA chromatography. To evaluate its adjuvanticity, C57BL/6 mice (n = 5) were initially primed and intradermally immunised in 2-weeks interval for 4 rounds with recombinant HspX, formulated with and without CASAC. Humoral and cell-mediated immune responses elicited against HspX antigen were evaluated using ELISA and Flow Cytometry. Our findings showed that CASAC improved humoral immunity with increased antigen-specific IgG1 and IgG2a antibody response. Stronger CD8+ and Th1-driven immunity was induced by CASAC formulation as supported by elevated level of IFN-γ, TNF-α, IL-12 and IL-17A; and with low IL-10 secretion. Interestingly, adjuvanted HspX vaccine triggered a higher percentage of effector memory T-cell population than those immunised with unadjuvanted vaccine. In conclusion, CASAC adjuvant has great potential to enhance immunogenicity elicited against HspX antigen, which could be an alternative regimen to improve the efficacy of future therapeutic vaccine against Mycobacterium tuberculosis.


Cognitive and emotional conflicts of counter-conformity choice in purchasing books online: an event-related potentials study.
Using event-related potentials (ERPs), this study investigated the neural substrates of the conflicts in counter-conformity choices in purchasing books online. For each trial, a participant decided whether to buy a book according to the title keyword, as well as the numbers of positive and negative reviews on the book. A participant's choice was termed conformity if she/he decided to buy the book under the condition of consistently positive reviews, or not to buy the book under the condition of consistently negative reviews, whereas the case was counter-conformity if a participant did the opposite. In the time window 300-600ms after the stimulus onset, a strong negative deflection of ERP (N500) was recorded when participants made counter-conformity choices. The topographic distribution of the N500 (N400-like) is not typical of the semantic N400. The N500 might be evoked by the cognitive and emotional conflicts faced by participants in counter-conformity choices. The present findings provide evidence that the N400 can be elicited by non-semantic conflicts.


A Banff-based histologic chronicity index is associated with graft loss in patients with a kidney transplant and antibody-mediated rejection.
Antibody-mediated rejection (AMR) is the major cause of graft loss in kidney transplant recipients. The Banff classification defines two classes of AMR, active and chronic active but over time this classification has become increasingly complex. To simplify the approach to AMR, we developed activity and chronicity indices based on kidney transplant biopsy findings and examined their association with graft survival in 147 patients with active or chronic active AMR, all of whom had donor-specific antibodies and were treated for AMR. The activity index was determined as the sum of Banff glomerulitis (g), peritubular capillaritis (ptc), arteritis (v) and C4d scores, with a maximum score of 12. The chronicity index was the sum of interstitial fibrosis (ci), tubular atrophy (ct), chronic vasculopathy (cv), and chronic glomerulopathy (cg) scores, the latter doubled, with a maximum score of 15. While the activity index was generally not associated with graft loss, the chronicity index was significantly associated with graft loss with an optimal threshold value of 4 or greater for predicting graft loss. The association of the chronicity index of 4 or greater with graft loss was independent of other parameters associated with graft loss, including the estimated glomerular filtration rate at the time of biopsy, chronic active (versus active) AMR, AMR with de novo (versus persistent/rebound) donor-specific antibodies, Banff (g+ptc) scores, concurrent T cell-mediated rejection and donor-specific antibody reduction post-biopsy. The association of the chronicity index of 4 or greater with graft loss was confirmed in an independent cohort of 61 patients from Necker Hospital, Paris. Thus, our findings suggest that the chronicity index may be valuable as a simplified approach to decision-making in patients with AMR.


Determinants of brain-derived neurotrophic factor (BDNF) in umbilical cord and maternal serum.
Brain-derived neurotrophic factor (BDNF) plays a fundamental role in brain development; additionally, it is involved in various aspects of cerebral function, including neurodegenerative and psychiatric diseases. Involvement of BDNF in parturition has not been investigated. The aim of our study was to analyze determinants of umbilical cord BDNF (UC-BDNF) concentrations of healthy, term newborns and their respective mothers. This cross-sectional prospective study was performed at a tertiary referral center. Maternal venous blood samples were taken on admission to labor ward; newborn venous blood samples were drawn from the umbilical cord (UC), before delivery of the placenta. Analysis was performed with a commercially available immunoassay. Univariate analyses and stepwise multivariate regression models were applied. 120 patients were recruited. UC-BDNF levels were lower than maternal serum concentrations (median 641 ng/mL, IQR 506 vs. median 780 ng/mL, IQR 602). Correlation between UC- and maternal BDNF was low (R=0.251, p=0.01). In univariate analysis, mode of delivery (MoD), gestational age (GA), body mass index at delivery, and gestational diabetes were determinants of UC-BDNF (MoD and smoking for maternal BDNF, respectively). Stepwise multivariate regression analysis revealed a model with MoD and GA as determinants for UC-BDNF (MoD for maternal BDNF). MoD and GA at delivery are determinants of circulating BDNF in the mother and newborn. We hypothesize that BDNF, like other neuroendocrine factors, is involved in the neuroendocrine cascade of delivery. Timing and mode of delivery may exert BDNF-induced effects on the cerebral function of newborns and their mothers.


Mutational analysis of major, sequential IgE-binding epitopes in alpha s1-casein, a major cow's milk allergen.
Allergy to cow's milk is common in early childhood, and no therapy other than avoidance exists. In murine models of peanut allergy, immunotherapy with mutated, engineered, proteins appears promising. We sought to identify the critical amino acids (AAs) for immunoglobulin E (IgE) binding within the major B-cell epitopes of alpha(s1)-casein, a major cow's milk allergen. This will provide the necessary information to alter the cDNA to encode a protein capable of activating milk-specific T cells, but with reduced IgE-binding capacity. For mutational analysis of the IgE-binding epitopes, peptides of 10-14 AAs in length were synthesized on a derivatized cellulose membrane with single or multiple AA substitutions. Membranes were immunolabeled with pooled sera from 15 cow's-milk-allergic patients and with 8 individual sera. With the pooled sera, substitution of a single AA led to complete abrogation of IgE binding to 2 of 8 peptides and diminished binding in the remainder. Substitution of multiple AAs led to an abrogation of binding in the remaining peptides. In 4 of the 8 peptides, the critical AA identified with pooled sera did not result in significant reduction of IgE binding with 1 or more individual patients. For these patients, other critical AAs were identified, indicating a more heterogeneous pattern in IgE recognition. This study indicates that single or multiple AA substitutions within IgE-binding epitopes result in reduced binding of milk-specific IgE antibodies by patients' sera. However, for future immunotherapeutic interventions with mutated peptides, critical AAs should be evaluated with individual patient sera to determine B-cell-epitope heterogeneity.


Tissue tropism: Is it an intrinsic characteristic of Leishmania species?
The genus Leishmania comprises a wide range of species, some of which are pathogenic to humans and each of which has a different tissue preference, resulting in one of the three clinical forms of human leishmaniasis: visceral, cutaneous, or mucocutaneous. Although, all pathogenic species are deposited intradermally in the mammalian host upon an infectious sand fly bite, only the viscerotropic strains can leave the skin and reach the internal organs. We assume that Leishmania tissue tropism is not only the result of Leishmania genetic determinism but is also governed by the interaction of the parasite with different vectorial and human host elements. To shed light on these elements and key steps determining the course of the infection, we describe throughout this review the disease's progression from the early stages of infection taking place in the skin to the late stages succeeding in the parasite's visceral dissemination. Hence, we address the question of Leishmania tropism, through providing relevant hypotheses and answers gathered from the literature.


Molecular Characterization of Intermediate Susceptible Typhoidal Salmonella to Ciprofloxacin, and its Impact.
Extensive use of ciprofloxacin to treat Salmonella typhi infections has led to the emergence of resistance, resulting in clinical failure and delayed treatment response. Interpretative breakpoints for ciprofloxacin were revised by the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in 2012. Since the majority of S. typhi isolates fall under the category of 'intermediate susceptible' as per CLSI criteria, we undertook molecular characterization to better define the susceptibility of these isolates. Of 113 typhoidal Salmonella isolates collected during 2014, 33 (27 S. typhi and 6 S. paratyphi A) were randomly selected to determine the presence of chromosomal (gyrA, gyrB and parC), plasmid (qnrA, qnrB, qnrS and aac(6')-lb-cr), and efflux-mediated fluoroquinolone resistance. To the best of our knowledge, the parC mutation Glu(84)-Gly was observed for the first time in S. typhi in India. Of 33 isolates, only one harbored the qnrB gene, which is responsible for plasmid-mediated resistance. No significant change in efflux pump activity was observed for ciprofloxacin, except one that showed a fivefold decrease. Ninety-six percent of isolates with intermediate minimum inhibitory concentration to ciprofloxacin (CLSI) had mutations in the gyrA and parC genes, which might translate to possible/probable clinical failure in patients if treated with ciprofloxacin. In contrast, the EUCAST criteria define these isolates as resistant and may result in appropriate therapy with reduced morbidity. It was clear that the molecular mechanism of ciprofloxacin resistance correlates better with the EUCAST criteria than the CLSI criteria, which is also in agreement with the pefloxacin results, suggesting it as a surrogate marker for identifying fluoroquinolone susceptibility.


Effect of antiglaucoma agents on postoperative intraocular pressure after cataract surgery with Viscoat.
To compare the effectiveness of brinzolamide 1%, brimonidine 0.2%, acetazolamide 250 mg, intracameral acetylcholine, and timolol 0.5% in preventing intraocular pressure (IOP) peaks during the early period after phacoemulsification in which sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat) was used as the ophthalmic viscosurgical device (OVD). Department of Ophthalmology, Baskent University Medical Faculty, Ankara, Turkey. This prospective randomized study comprised 185 eyes of 185 patients with uncomplicated cataract scheduled for phacoemulsification using Viscoat as the OVD. Patients were randomly assigned to 1 of 6 groups: postoperative application of topical brinzolamide 1%, brimonidine 0.2%, oral acetazolamide 250 mg, intracameral acetylcholine, timolol 0.5%, or no ocular hypotensive agent (control group). The IOP was measured at baseline (preoperatively) as well as 6 hours, 20 to 24 hours, and 1 week after surgery. The mean preoperative IOP values were not significantly different between the groups. Six hours and 20 to 24 hours postoperatively, the mean IOP was significantly lower in all groups receiving an ocular hypotensive agent than in the control group (P<.01). Six hours after surgery, the mean IOP significantly increased in all groups but was higher in the control group. At 20 to 24 hours, the mean IOP decreased significantly in all ocular hypotensive agent groups but remained significantly high in the control group. One week after surgery, there were no significant differences between the groups. Brinzolamide, brimonidine, acetazolamide, intracameral acetylcholine, and timolol had similar effects in reducing IOP increases after phacoemulsification performed using Viscoat.


A child with a novel ACAN missense variant mimicking a septic arthritis.
Heterozygous mutations of the ACAN gene have been associated with a broad spectrum of non-lethal skeletal dysplasias, called Aggrecanopathies. We report a case of a child with severe inflammatory elbow involvement mimicking septic arthritis who carried the new ACAN missense variant c.6970 T > C, p.Trp2324Arg. The comprehensive clinical evaluation of the patient and his family, focused on the associated clinical features (facial dysmorphisms, short stature, brachydactily), led us to suspect a hereditary condition. Our findings suggest that Aggrecanopathies should be considered in children with familial short stature, poor growth spurt and joint involvement.


Potential-pH diagram for "Leucobacter sp. Ch-1-Cr-H(2)O" system.
Laboratory experiments were used to investigate the effects of initial pH and applied potential on the growth of Leucobacter sp. Ch-1 and Cr (VI) reduction and establish the pH-Eh diagram for Leucobacter sp. Ch-1-Cr-H(2)O system. The results showed that the preferred initial pH for Leucobacter sp. Ch-1 growth was from 7.0 to 11.0. At this pH range, 56.2-99.5% of Cr (VI) was reduced by Ch-1 strain. The applied potentials from -700 to 0 mV, from -800 to +300 mV and from -800 to +400 mV at 7.0, 9.0 and 11.0 of initial pH values were favorable for the bacterial growth. The corresponding ranges of applied potentials for bio-reduction of Cr (VI) were from -200 to 0 mV, from -800 to +200 mV, and from -700 to +100 mV at above initial pH values. In the potential-pH diagram, the region of initial pH and Eh for Cr (VI) bio-reduction was included in the region for Leucobacter sp. Ch-1 growth and the stable region of Cr(OH)(3), which implied that Cr (VI) could be reduced to trivalent chromium existing in the forms of Cr(OH)(3) precipitate under the presence of Leucobacter sp. Ch-1 in alkaline condition. The results suggest that Leucobacter sp. Ch-1 has potential application for remediation of Cr (VI) contamination sites.


The role of earthworm Lampito mauritii (Kinberg) in amending lead and zinc treated soil.
A laboratory experiment was carried out to determine the effect of earthworm (Lampito mauritii) activity on mobility of Pb2+ and Zn2+ in the soil (DTPA-extractable) and its composting potential in presence of these metals. Well clitellate earthworms collected from an uncontaminated site were exposed to different concentrations (75, 150, 300mgkg(-1)) of Pb2+ and Zn2+ separately for 30 days. It was observed that the metal burden in the earthworm tissue increased with the increase in metal treatment. L. mauritii elevated the soil pH of all the metal treated beds and lowered the soil C/N ratio in the cast by reducing the organic carbon and fixing additional nitrogen. Earthworm activity significantly increased the availability of phosphorous, potassium and decreased the amount of DTPA-extractable Pb2+ and Zn2+ in the cast, which implies the immobilization of metals in soils. These findings suggest the use of L. mauritii in amelioration of metal contaminated soil.


Ribosomal RNA in Alzheimer's disease and aging.
Ribosomal RNA genes are involved in cell transcription and translation processes and can modulate gene expression. In an earlier cytogenetic study, (Payão, S.L.M., Smith, M.de A.C., Kormann-Bortolotto, M.H., Toniolo, J., 1994 (Investigation of the nucleolar organizer regions in Alzheimer's disease. Gerontology 40, 13-17), reported a decreased activity of ribosomal genes in Alzheimer's disease (AD). We studied the ratio of mature rRNA 28S and 18S in peripheral blood samples derived from eight patients with AD, eight healthy elderly sisters of these patients (SA), eight healthy elderly (EC) and eight healthy young (YC) controls, all female. Our results showed a statistically significant decrease of mature rRNA 28S and 18S ratio in the elderly groups (AD, SA, EC) in relation to the young one, probably by fragmentation of 28S rRNA. The Alzheimer's patient group had the lowest 28S/18S ratio. Thus, we can suggest that there is a possible change in the transcriptional or maturation process, or a preferential degradation of the 28S subunit with ageing.


How to manage children and young adults with myeloproliferative neoplasms.
On the basis of my personal clinical and research experience and validated by the current literature, my approach to the management of pediatric (age <18 years) and young patients (age <40 years) with classic myeloproliferative neoplasms is presented by focusing on diagnosis, patient communication, risk stratification and therapy. The WHO-2008 diagnostic criteria are recommended, even though in children suspected with essential thrombocythemia (ET), a specific set of diagnostic features may be required. Patient communication includes information on natural history, genetic abnormalities and counseling in all women of child-bearing age. The main challenge in children and young adults with ET and polycythemia vera (PV) is to avoid recurrence of major thrombosis by selecting those patients who ultimately can benefit from cytotoxic and antithrombotic therapy without increasing the incidence of drug-induced side effects. In asymptomatic low-risk patients no therapy is prescribed while in high-risk low-dose aspirin, hydroxyurea and interferon-alpha are my first line drugs. My first decision when considering treatment of a young patient with primary myelofibrosis (PMF) or post-PV or post ET-myelofibrosis, is whether he/she qualifies for bone marrow allotransplantation. In the remaining young PMF patients palliative therapy or experimental drugs are considered.


Correlation between the Tobacco Free Educational Institution (TOFEI) Policy Compliance and Current Tobacco use among 13-15 Years Old School Students in Urban India: An Ecological Study.
The government of India has developed Guidelines for "Tobacco Free Educational Institutions" (TOFEI), which must be followed by schools across the country. This study utilized an ecological design to identify an association between "compliance to TOFEI guidelines" and the "current tobacco use" among 13-15 years school students in urban India. Aggregate data related to "current tobacco users" and "percentage of schools that followed tobacco-free guidelines" were taken from the Global Youth Tobacco Survey (GYTS) India- 4 (2019). We performed a simple linear regression model, and Pearson Correlation was used to see the said association. The results showed that as compliance with TOFEI Guidelines increases in Urban India, Current Tobacco Use decreases among school students in the 13-15 years age group. Thus, it is essential to address enablers and barriers to adherence to the TOFEI guidelines, as it will help reduce the prevalence of tobacco use among adolescents in urban India.


Factors influencing the dimensional accuracy of additively manufactured dental models: A systematic review of in vitro studies.
This study aims to systematically review the literature and evaluate the effect of post-printing factors such as aging, heat, appliance fabrication and storage on the dimensional accuracy of full-arch dental models manufactured by additive manufacturing (AM) technology for the intended use of working model purposes. Three online databases, Medline (Ovid), Scopus and Web of Science were screened and last searched in March 2023. In-vitro studies and publications involving any distortions and shrinkage to the additively manufactured (AMed) model after printing and post-processing were included. However, literature reviews, abstracts, publications in a language different from English, or publications not testing a dental model with an arch or dentition were excluded. The references cited in the studies included were also checked via Google Scholar to identify relevant published studies potentially missed. The systematic search identified and screened 769 different studies after the removal of duplicates. After applying inclusion and exclusion criteria, a total of 30 relevant titles and abstracts were found, yielding six final selections after full-text screening. Four out of the six studies evaluated the effect of both storage and aging on the dimensional accuracy of AMed dental models. The other two studies assessed the dimensional accuracy after the fabrication of thermoformed and vacuum-formed appliances on the AMed dental model. AMed models can be utilised as working models on the condition that specific printing parameters are followed and additional model design features are employed. No definitive conclusions can be drawn on standardised methods to assess the dimensional accuracy of AMed dental models after storage, aging and appliance fabrication. In addition, there is no consensus on specific storage periods for an AMed model. Majority of study designs removed the palatal region to create a horseshoe shaped model, making the results less applicable to a working model scenario requiring the palate for retention purposes. The parameters investigated on AMed models include storage, aging, and appliance fabrication through thermoforming and vacuum-forming. Printing densities of solid models and wall thickness of hollow models were shown to influence the accuracy of AMed models. Dimensional accuracy of AMed models have been shown to be affected during appliance fabrication through thermoforming and vacuum-forming in certain conditions. There is a clear need of standardisation when manufacturing AMed dental models for working model purposes. The current methods investigated in this study lack established protocols to accurately manufacture the AMed models, and effectively store and utilise an AMed dental model for fabrication of orthodontic and prosthodontic appliances.


Reversible phosphorylation of histidine residues in vertebrate proteins.
Knowledge on kinases and phosphatases acting on serine, threonine and tyrosine residues of vertebrate proteins is huge. These enzymes are still under intensive investigation at present. This is in sharp contrast to what is known about kinases and phosphatases acting on histidine, arginine, lysine and aspartate residues in vertebrate proteins. It also is in contrast to extensive studies of histidine/aspartate phosphorylation in prokaryotes. This minireview briefly summarizes what we have learned about the reversible phosphorylation of histidine residues in mammals. It is described how the field developed during 40 years of science. The article especially highlights the discovery of the first protein histidine phosphatase from vertebrates. Having identified and characterized a protein histidine phosphatase provides at least one desperately required tool to handle and study phosphorylation and dephosphorylation of histidine residues in vertebrates in more detail. Recent evidence even suggests an involvement of histidine phosphorylation in signal transduction.


Extracorporeal shock wave lithotripsy in childhood.
Extracorporeal shock wave lithotripsy is the treatment of choice for the majority of upper urinary calculi in adults. Technical limitations, including patient size and concerns over post-treatment stone fragment passage, have made the application of extracorporeal shock wave lithotripsy in children less clearly defined. We report the successful application of the Dornier lithotriptor in the management of 18 children (22 kidneys) with upper urinary calculi.


The implantable defibrillator and the emergency physician.
The automatic implantable cardioverter defibrillator (AICD) is a proven therapy for preventing the potentially lethal consequences of recurrent ventricular arrhythmias. Given the ever-increasing number of patients who have these devices, it can be anticipated that an increasing number of these patients will likely present to emergency departments with problems associated with this therapy. We review normal automatic implantable cardioverter defibrillator function and focus on the evaluation and treatment of problems that may bring a patient to the ED. Included are interaction with the device by magnets, assessment of the propriety of shocks received by the patient, and what to do when patients state they have received a shock from the device. An algorithmic approach is presented to facilitate management of these patients.


Cosmopolitan honey bee, Apis mellifera, as quick and efficient marker of pesticide pollution in environment through RP-HPLC.
Pesticides are extremely hazardous to human health as well as various kinds of non-target organisms. The honey bee (Apis mellifera) is not only a dominant pollinator, but also a good indicator of pesticide residue and pollutants in the environment. At the time of sample collection in each village, the surrounding flora was Triticum aestivum and Brassica species. The area chosen for this study covered only 15% of the land in the state of Punjab, but pesticide consumption was approximately 75% of the state consumption. Pesticides in the collected samples (from six districts) were analyzed using RP-HPLC chromatography. The chemical methoxychlor (MC) was not found in any of the six villages' honey samples; however, spiromesifen (n = 5) and aldicarb (n = 5) were the most prevalent chemicals and were found in every honey sample. The pesticides carbendazim (n = 1) and parathion methyl (n = 1) were found only in Behman (longitude 29.9224° N and latitude 75.1137° E), and Malumazra (longitude 30.2468° N and latitude 75.8500° E). The carbofuran (n = 3) was discovered in Talwandi Sabo (longitude 29.984° N and latitude 75.8500° E), Himmatpura (longitude 30.5289° N and latitude 75.3616° E), and Malumazra, while atrazine (n = 4) was discovered in all except Malumazra. Three identical pesticides were observed in Chukrian (longitude 29.9759° N and latitude 75.4476° E) and Singo (longitude 29.9092° N and latitude 75.1589° E) indicating the same pesticides used in these villages. The given study gives a summary model to use A. mellifera as a quick monitoring bioindicator of the environment. This model helps to maintain a pesticide or pollutant database of selected areas for regular monitoring of the surrounding environment.


The urban spread of visceral leishmaniasis: clues from spatial analysis.
The pattern of spread of visceral leishmaniasis in Brazilian cities is poorly understood. We used geographic information systems and spatial statistics to evaluate the distribution of 1061 cases of visceral leishmaniasis in Teresina, Brazil, in 1993 through 1996. A locally weighted (LOESS) regression model, which was fit as a smoothed function of spatial coordinates, demonstrated large-scale variation, with high incidence rates in peripheral neighborhoods that bordered forest land and pastures. Moran's I indicated small-scale variation and clustering up to 300 m, roughly the flight range of the sand fly vector. Spatial analytical techniques can identify high-risk areas for targeting control interventions.


Trichophyton rubrum DNA Strains in Patients with Onychomycosis with Persistent Mixed Infections Involving a Nondermatophyte Mold.
Onychomycosis is estimated to occur in approximately 10% of the global population, with most cases caused by Trichophyton rubrum. Some persistent onychomycosis is caused by mixed infections of T rubrum and one or more co-infecting nondermatophyte molds (NDMs). In onychomycosis, T rubrum strain types may naturally switch and may also be triggered to switch in response to antifungal therapy. T rubrum strain types in mixed infections of onychomycosis have not been characterized. T rubrum DNA strains in mixed infections of onychomycosis containing co-infecting NDMs were compared with a baseline North American population through polymerase chain reaction amplification of ribosomal DNA tandemly repetitive subelements (TRSs) 1 and 2. The baseline DNA strain types were determined from 102 clinical isolates of T rubrum. The T rubrum DNA strain types from mixed infections were determined from 63 repeated toenail samples from 15 patients. Two unique TRS-2 types among the clinical isolates contributed to four unique TRS-1 and TRS-2 strain types. Six TRS-1 and TRS-2 strain types represented 92% of the clinical isolates of T rubrum. Four TRS-1 and TRS-2 strain types accounted for 100% of the T rubrum within mixed infections. Four unique North American T rubrum strains were identified. In support of a shared ancestry, the T rubrum DNA strain types found in mixed infections with NDMs were among the most abundant types. A population of T rubrum strains in mixed infections of onychomycosis has been characterized, with more than one strain detected in some nails. The presence of a co-infecting NDM in mixed infections may contribute to failed therapy by stabilizing the T rubrum strain type, possibly preventing the antifungal therapy-induced strain type switching observed with infections caused by T rubrum alone.


Transcriptomic analysis of cave, surface, and hybrid samples of the isopod Asellus aquaticus and identification of chromosomal location of candidate genes for cave phenotype evolution.
Transcriptomic methods can be used to elucidate genes and pathways responsible for phenotypic differences between populations. Asellus aquaticus is a freshwater isopod crustacean with surface- and cave-dwelling ecomorphs that differ greatly in multiple phenotypes including pigmentation and eye size. Multiple genetic resources have been generated for this species, but the genes and pathways responsible for cave-specific characteristics have not yet been identified. Our goal was to generate transcriptomic resources in tandem with taking advantage of the species' ability to interbreed and generate hybrid individuals. We generated transcriptomes of the Rakov Škocjan surface population and the Rak Channel of Planina Cave population that combined Illumina short-read assemblies and PacBio Iso-seq long-read sequences. We investigated differential expression at two different embryonic time points as well as allele-specific expression of F1 hybrids between cave and surface individuals. RNAseq of F2 hybrids, as well as genotyping of a backcross, allowed for positional information of multiple candidate genes from the differential expression and allele-specific analyses. As expected, genes involved in phototransduction and ommochrome synthesis were under-expressed in the cave samples as compared to the surface samples. Allele-specific expression analysis of F1 hybrids identified genes with cave-biased (cave allele has higher mRNA levels than the surface allele) and surface-biased expression (surface allele has higher mRNA levels than the cave allele). RNAseq of F2 hybrids allowed for multiple genes to be placed to previously mapped genomic regions responsible for eye and pigmentation phenotypes. In the future, these transcriptomic resources will guide prioritization of candidates for functional analysis.


Pregnancy outcome in fetuses with increased nuchal translucency.
The aim of this study was to examine fetal and neonatal outcomes in the setting of nuchal translucency (NT) > or =3 mm at routine first-trimester screening. A nested case-series study within a retrospective cohort of women screened for Down syndrome at 11-14 weeks of gestation. Crown-rump length, NT values and additional anomalies at first and early second trimesters were recorded. Follow-up information was obtained by a review of medical records and self-report from patients. Adverse outcomes included fetal death and termination of pregnancy due to structural or chromosomal anomalies. A total of 1930 pregnant women were screened between 11 and 14 weeks of gestation. The prevalence of increased fetal NT (> or =3 mm) was 1.4% (n=27). Among these, 12 showed increased fetal NT as an isolated finding. In this group, 2 women experienced fetal demise (16%) and 10 delivered healthy babies. In the group with additional abnormalities (n=15), 9 (60%) were found to have chromosomal abnormalities, all of which were terminated. For all cases with increased fetal NT, total incidence of adverse outcome was 62%. At first-trimester ultrasonography, a fetal NT > or =3 mm was associated with a high incidence of chromosomal abnormalities in the presence of associated abnormalities. For cases with the increased fetal NT at first-trimester fetal assessment and follow-up is necessary to detect possible adverse outcomes.


Co-substitution effects on the Fe valence in the BaFe2As2 superconducting compound: a study of hard x-ray absorption spectroscopy.
The Fe K x-ray absorption near edge structure of BaFe(2-x)Co(x)As(2) superconductors was investigated. No appreciable alteration in shape or energy position of this edge was observed with Co substitution. This result provides experimental support to previous ab initio calculations in which the extra Co electron is concentrated at the substitute site and do not change the electronic occupation of the Fe ions. Superconductivity may emerge due to bonding modifications induced by the substitute atom that weakens the spin-density-wave ground state by reducing the Fe local moments and/or increasing the elastic energy penalty of the accompanying orthorhombic distortion.


Separation of pyrimidine deoxyribooligonucleotides according to length and composition using thin-layer chromatography on deae-cellulose.
A procedure has been developed for the fractionation of pyrimidine deoxyribo-oligonucleotides, PynPn+1, according to length and composition using ascending thin-layer chromatography on DEAE-cellulose. The separation of oligonucleotides according to length (n=1-7) into individual isopliths was carried out using a linear 0-0.35 M sodium chloride gradient in 0.01 M sodium acetate buffer of pH 5.1-5.3 and 5 M urea. Then the oligonucleotides of individual isopliths were separated according to composition using the same gradient of sodium chloride in 0.01 M sodium acetate or sodium citrate buffer of pH 3.2. The procedure can be used for rapid fractionation (2-3 h) and serial determination of the frequencies of pyrimidine sequences differing in length and composition in DNAs of various origin. The procedure can be used for both preparative and analytical applications. It was employed to study the distribution of 5-methylcytosine in pyrimidine isopliths of some DNAs.


Effect of Internal Electric Fields on Charge Carrier Dynamics in a Ferroelectric Material for Solar Energy Conversion.
Spontaneous polarization is shown to enhance the lifetimes of photogenerated species in BaTiO3 . This is attributed to polarization-induced surface band bending acting as a thermal barrier to electron/hole recombination. The study indicates that the efficiencies of solar cells and solar fuels devices can be enhanced by the use of ferroelectric materials.


Medical grand rounds. West Virginia University Health Sciences Center. Bites and stings. Part 1. Spiders.
Most animals can bite or sting. In narrowing the kingdom down to those that harm humans, the field still is vast. It would be interesting to explore the rich variety of pathology produced in us by moray eels, lionfish, sea urchins, jellyfish, sting rays, fire ants, kissing bugs, flies, lice, mosquitoes, ticks, mites, fleas, puss caterpillars, centipedes, snakes, dogs and cats, camels, and myriad other creatures including homo sapiens (not a trivial biter)--but for this grand rounds, the topic will simply be spiders (Part 1), bees and vespid (Part 2). Vespids are the wasps, yellow jackets and hornets.


Gender influence on clinical presentation and high-resolution ultrasound findings in primary carpal tunnel syndrome: do women only differ in incidence?
High-resolution ultrasound is increasingly used in the diagnosis of carpal tunnel syndrome; yet little is known about gender differences in clinical presentation and ultrasound findings. In this high-resolution ultrasound-based retrospective study in 170 cases, we assessed gender influence in CTS in terms of the severity of neural alterations by wrist-to-forearm ratio (WFR), epineural thickening, loss of fascicular anatomy, as well as classical signs and symptoms. The control group consisted of 42 wrists. Women present with a greater WFR at first admission are affected more often bilaterally, and report less subjective pain intensity, while men report fewer nightly pain episodes at higher WFR. Loss of fascicular anatomy is three times more frequent in women. An increase in epineural thickness, loss of fascicular anatomy, and involvement of more than 1.5 fingers correlate significantly with WFR regardless of sex. Women differ significantly from men in terms of clinical presentation and ultrasound findings upon first diagnosis of CTS, which should be included in further diagnostic considerations.


Impact of computerized physician order entry system on parenteral nutrition medication errors in a teaching neonatal intensive care unit.
Parenteral nutrition (PN) offers a quality therapeutic option when enteral feeding is non-tolerated or impossible. However, it can be associated with an increased risk of medical errors, especially in sensitive populations such as newborns. This study aimed at determining the impact of the implementation of a computerized physician order entry (CPOE) system on PN medication errors in the neonatology department in the largest teaching hospital in Tunisia. The frequency of medication errors in PN, in a teaching neonatal intensive care unit, was prospectively reviewed by a pharmacist between December 2018 and March 2019 in a two-phase interventional study (pre and post locally developed CPOE System implementation). Implementation of CPOE system decreased PN order errors from 379 to 147 representing a 61.1% reduction. The decreases on PN order errors per stage, i.e. prescribing and preparation, were form 207 to 22 (89.4%), and from 117 to 66 (43.6%), respectively. Mean nutrients intakes were in conformity to the recommended daily intakes during the CPOE phase of the study. CPOE is a protective tool against prescription and preparation errors. It significantly impacted all items of the ordering process. In addition to the rigorous application of the recommendations, the CPOE system allows to reduce the risk of PN medication errors. This improves the safety and quality of medicines in newborns.


Revision of the genus Thyreocephalus and description of Afrus gen. nov. of Africa south of the Sahara (Coleoptera: Staphylinidae: Staphylininae).
A revision of the genus Thyreocephalus Guérin-Méneville, 1844 of Africa south of the Sahara is presented. A new genus Afrus gen. nov. was described with the type species Thyreocephalus spegazzinii Bernhauer, 1915, which resulted in following new combination: Afrus spegazzinii (Bernhauer, 1915), comb. nov. Eulissus collarti (Cameron, 1932) was transferred to Afrus. Based on a revision of types and of additional material, 32 species of the genus Thyreocephalus and two species of the genus Afrus are recognized in Africa south of the Sahara. All species are described or redescribed and illustrated, seven of them for the first time: Thyreocephalus camerunensis sp. nov., T. manfredi sp. nov., T. marginipennis sp. nov., T. meridioafricanus sp. nov., T. pseudoafricanus sp. nov., T. subcorticalis sp. nov. and T. tsingidianus sp. nov. Neotypes are designated for Eulissus ater Laporte, 1835, Xantholinus coeruleipennis Quedenfeldt, 1881, and X. interocularis Eppelsheim, 1895. Lectotypes are designated for Eulissus atlanticus Bernhauer, 1915, E. burgeoni Bernhauer, 1929, E. mokaensis Bernhauer, 1915, E. secretus Bernhauer, 1935, E. turneri Bernhauer, 1937, Xantholinus alluaudi Fauvel, 1907, X. mocquerysi Fauvel, 1903, X. pilosus Roth, 1851, Thyreocephalus diversiceps Bernhauer, 1936, and T. spegazzinii Bernhauer, 1915. Eulissus africanus Bernhauer, 1913, E. alluaudi (Fauvel, 1907) (originally described in Xantholinus Dejean, 1821), E. atlanticus Bernhauer, 1915, E. brunneiventris Tottenham, 1956, E. burgeoni Bernhauer, 1929, E. guineensis Bernhauer, 1912, E. mokaensis Bernhauer, 1915, E. secretus Bernhauer, 1935, E. strinatii Scheerpeltz, 1958, and Xantholinus nairobiensis Fauvel, 1907 were transferred to Thyreocephalus. Following synonymies are proposed: Thyreocephalus nairobiensis (Fauvel, 1907) = Eulissus turneri Bernhauer, 1937, syn. nov., Thyreocephalus interocularis (Eppelsheim, 1895) = Thyreocephalus diversiceps Bernhauer, 1936, syn. nov., Thyreocephalus mokaensis (Bernhauer, 1915) = Eulissus flaviventris Bernhauer, 1939, syn. nov. = Thyreocephalus semirufus Coiffait, 1968, syn. nov., Thyreocephalus mocquerysi (Fauvel, 1903) = Eulissus milliaui Bernhauer, 1932, syn. nov. The distribution of both genera in Africa south of Sahara is mapped and a key to species is presented.


Correlation Between Air-Bone Gap and Vestibular Aqueduct Size in Enlarged Vestibular Aqueduct Syndrome: A Systematic Review.
The purpose of this review was to evaluate the air-bone gap with vestibular aqueduct size in enlarged vestibular aqueduct syndrome. According to the PRISMA guidelines we conducted a systematic review of the literature. Published international articles in English from 2000 to 2022 were screened, checking for studies that evaluated the air-bone gap of patients affected by enlarged vestibular aqueduct syndrome and the size of vestibular aqueduct. Data related to the hearing assessment and imaging investigation of enrolled participants were extracted. The chosen primary outcome measure was the correlation between air-bone-gap and vestibular aqueduct size. The database search allowed us to screen 485 articles and to select 5 articles discussing this topic for a total of 349 patients. Two studies showed a positive correlation between air-bone gap and vestibular aqueduct size, one only a trend and two no correlation. To date, it is not possible to draw conclusions whether or not there is a positive correlation between air-bone gap and vestibular aqueduct size in enlarged vestibular aqueduct syndrome. Higher quality studies would be conducted with standardized outcome measures to clarify the specific research question.


[A preliminary study on speech therapy for marginal velopharyngeal insufficiency].
To investigate the feature and therapy of patients with marginal velopharyngeal insufficiency(MVPI). Fifteen patients(10 males,5 females, age ranging form 8 to 25 years, mean age of 17.6 years) with MVPI were selected. All the patients received behavior therapy and speech therapy. Chinese speech intelligibility test and blow test were carried out before and after the therapy. All cases achieved satisfactory results through 12 to 20 weeks of speech therapy. The results of speech intelligibility test and blow test after therapy were better than those before therapy. For patients with MVPI, a satisfactory result and pronunciation improvement could be obtained through a series of behavior therapy and a good velopharyngeal closure.


MAO activity and EEG sleep in primary depression.
Platelet monoamine oxidase (MAO) activity and electroencephalographic (EEG) sleep measures were examined in 56 drug-free hospitalized patients with primary depression as defined by the Research Diagnostic Criteria. The group included 35 females and 21 males with a mean age of 42.6 +/- 1.4 years. Platelet MAO and EEG sleep data were compared for the group as a whole and separately for the unipolar, bipolar, male, and female subgroups. No significant relationships could be demonstrated for the entire group or for the unipolar, male, or female subgroups. However, an inverse relationship between MAO activity and REM sleep percent was noted in the bipolar subgroup (p < 0.02). While changes in REM sleep have been relatively firmly established in primary depression, the relationship of MAO to depression and to REM sleep remains unclear.


Delivery success rate of engineered nanoparticles in the presence of the protein corona: a systems-level screening.
Nanoparticles (NPs) for medical applications are often introduced into the body via intravenous injections, leading to the formation of a protein corona on their surface due to the interaction with blood plasma proteins. Depending on its composition and time evolution, the corona will modify the biological behavior of the particle. For successful delivery and targeting, it is therefore important to assess on a quantitative basis how and to what extent the presence of the corona perturbs the specific interaction of a designed NP with its cellular target. We present a theoretical systems-level analysis, in which peptides have been covalently coupled to the surface of nanoparticles, describing the delivery success rate in varying conditions, with regard to protein composition of the surrounding fluid. Dynamic modeling and parameter sensitivity analysis proved to be useful and computationally affordable tools to aid in the design of NPs with increased success rate probability in a biological context. The formation of a protein corona consisting of blood plasma proteins on the surface of intravenously delivered nanoparticles may modify the biological behavior of the particles. This team of investigators present a theoretical systems-level analysis of this important and often neglected phenomenon.


Testicular prosthesis insertion following testicular loss or atrophy during early childhood--technical aspects and evaluation of patient satisfaction.
The absence of a testis may be a major traumatic experience with possible consequent negative behavioral impact. The current study is aimed to assess young adults who had lost their testicles early in childhood and subsequently underwent testicular prosthesis (TP) implantation at the end of their adolescence. Nineteen patients aged 19.4 years on average underwent TP implantation following testicular loss at early childhood. A postal anonymous questionnaire was sent to the patients and 13 (68%) replied. Average follow-up was 50 months. Sixty-two percent of patients believed TP size were equal or close to the size of their native testicle, while 23% claimed it was too small. Similarly, 54% had the impression its weight was appropriate, while 38% claimed it was too heavy and 38% supposed its location was too high in the scrotum. However, 85% considered it "very comfortable" or "comfortable" and 77% got used to its presence within 1-4 weeks following surgery. All patients precluded any obstacle in intimate relationships. In accordance, all of them would recommend the operation to a friend with a similar problem. TP implantation in adolescents with an undeveloped scrotum is a highly successful surgical procedure. The operation positively influences self-confidence, inter-personal interactions and intimate relationships.