Two-dimensional acoustic pattern derived strain parameters closely correlate with one-dimensional tissue Doppler derived strain measurements.
Two-dimensional strain echocardiography (2D-SE) calculates tissue velocities via frame-to-frame tracking of unique acoustic markers within the image and provides strain parameters in two dimensions. Novel 2D-SE software allows semi-automated strain measurements and increased averaging capabilities optimizing signal-noise ratio. We tested whether 2D-SE and the currently used and well-validated tissue Doppler derived strain echocardiography (TD-SE) yield similar information in the clinical setting. We performed 2D-SE and TD-SE on 17 patients with amyloid cardiomyopathy and 10 age-matched healthy volunteers. Single walls from standard apical views (2- and 4-chamber) were acquired at high frame rates ( approximately 200fps). Offline analysis was performed by observers blinded to clinical data using the EchoPAC program with custom 2D-SE software. Longitudinal strain rate and strain from the basal, mid and apical segments of the septal and lateral walls were determined by each method (TD-SE and 2D-SE). Ejection fraction was >0.55 in healthy volunteers and ranged from 0.30 to 0.80 in cardiomyopathy group. A total of 54 walls (162 segments) were examined. Acceptable quality strain data was available in 92% and 85% segments by 2D-SE and TD-SE, respectively. Two-dimensional strain echocardiography values correlated closely with TD-SE values (r=0.94 and 0.96 for strain rate and strain, respectively). Deformation analysis by 2D-SE is feasible in a clinical setting and 2D-SE values correlate closely with TD-SE measurements over a wide range of global systolic function. Two-dimensional strain echocardiography may help to facilitate the routine clinical implementation of deformation analysis.


A long-acting prostacyclin agonist with thromboxane inhibitory activity for pulmonary hypertension.
The balance between prostacyclin and thromboxane plays an important role in the regulation of pulmonary vascular tone. Recently, we developed ONO-1301, a novel, long-acting prostacyclin agonist with thromboxane synthase inhibitory activity. We investigated whether modulation of prostacyclin/thromboxane balance by ONO-1301 ameliorates monocrotaline-induced pulmonary hypertension in rats. After subcutaneous injection of monocrotaline or vehicle, rats were randomized to receive repeated subcutaneous administration of ONO-1301 or vehicle twice per day for 3 wk. There was significant development of pulmonary hypertension 3 wk after monocrotaline injection. Treatment with ONO-1301 significantly attenuated the increases in right ventricular systolic pressure and ratio of right ventricular weight to body weight in monocrotaline rats. Furthermore, ONO-1301 significantly attenuated the increase in medial wall thickness of peripheral pulmonary arteries in monocrotaline rats. The half-life of plasma ONO-1301 concentration after a single subcutaneous administration was approximately 5.6 h. A single administration of ONO-1301 increased plasma cyclic adenosine 3', 5'-monophosphate level, which lasted at least up to 8 h. Treatment with ONO-1301 significantly decreased plasma 11-dehydro-thromboxane B2, a metabolite of thromboxane, in monocrotaline rats. Finally, Kaplan-Meier survival curves demonstrated that repeated administration of ONO-1301 improved survival rate in monocrotaline rats compared with vehicle administration (80 vs. 30% in 6-wk survival). Subcutaneous administration of a novel prostacyclin agonist (ONO-1301) markedly attenuated monocrotaline-induced pulmonary hypertension and improved survival in rats. The beneficial effects of ONO-1301 may occur through its long-lasting stimulation of cyclic adenosine 3', 5'-monophosphate and inhibition of thromboxane synthase.


Assessing intervention fidelity in a multi-level, multi-component, multi-site program: the Children's Healthy Living (CHL) program.
Addressing complex chronic disease prevention, like childhood obesity, requires a multi-level, multi-component culturally relevant approach with broad reach. Models are lacking to guide fidelity monitoring across multiple levels, components, and sites engaged in such interventions. The aim of this study is to describe the fidelity-monitoring approach of The Children's Healthy Living (CHL) Program, a multi-level multi-component intervention in five Pacific jurisdictions. A fidelity-monitoring rubric was developed. About halfway during the intervention, community partners were randomly selected and interviewed independently by local CHL staff and by Coordinating Center representatives to assess treatment fidelity. Ratings were compared and discussed by local and Coordinating Center staff. There was good agreement between the teams (Kappa = 0.50, p < 0.001), and intervention improvement opportunities were identified through data review and group discussion. Fidelity for the multi-level, multi-component, multi-site CHL intervention was successfully assessed, identifying adaptations as well as ways to improve intervention delivery prior to the end of the intervention.


Radiographic evaluation of the forelimbs and hind limbs of marmosets (Callithrix spp.).
The maintenance of marmosets in captivity may trigger various disorders. The objective of this study was to provide a radiographic evaluation of the forelimbs and hind limbs of marmosets rescued from illegal wildlife trade and maintained in captivity. Fourteen marmosets were studied. Three marmosets were apparently normal. Of the eleven marmosets with radiographic changes in the hind limbs, five had pelvic narrowing and bilateral varus deviation of the femur, with one suggestive of rickets and another of osteomalacia. The other marmosets showed changes such as malunion of acetabular fracture, transtibial amputation, tibial antecurvatum, and knee osteoarthritis. Six marmosets showed alterations in the forelimbs such as radius fracture, scapulohumeral subluxation, and elbow joint incongruence. In conclusion, 78.57% of the marmosets had bone and/or joint changes detected by plain radiography, which were found predominantly in the hind limbs and without impediment to locomotion in captivity.


Identifying the origins of countertransference using the core conflictual relationship theme method: A multiple case study approach.
Measurement of countertransference (CT) has proven challenging throughout the history of studying this construct. We sought to determine the potential value of using a common measure of transference, the Core Conflictual Relationship Theme (CCRT) method, as a means of studying CT. The Relationship Anecdote Paradigm and the CCRT method were used to examine CT in two studies. In Study 1, we examined the correspondence between a therapist's wishes with significant people in her life (i.e., her parents and husband) and three long-term patients. In Study 2, we identified the interpersonal wishes of a different therapist and examined 14 of her sessions with 3 patients for evidence of how these wishes and needs were displayed in her clinical work. Analyses revealed that specific wishes in therapists' personal lives could be detected from projective interviews and these wishes were similar, but not necessarily identical, to wishes in therapists' descriptions of, and actual work with, their patients. Evidence of both chronic wishes and patient-specific wishes was revealed. These findings support the idea that the origins of CT reside in therapists' interpersonal wishes and that the CCRT may be a promising means of identifying CT in research, practice, and supervision.


Cross-linking of fibronectin to sulfated proteoglycans at the cell surface.
Fibronectin is a major surface protein of normal animal cells but is absent from many transformed cells. Addition of fibronectin to transformed cells causes increased cell substrate adhesion and changes in the morphology and cytoskeleton of the cells. We have coupled fibronectin to photoactivable chemical cross-linkers and have added it to cells to identify those molecules to which it binds. In this way, fibronectin can be cross-linked to sulfated proteoglycans at the cell surface. The cross-linking is specific for fibronectin. The fibronectin-proteoglycan complex is sensitive to chondroitinase ABC and AC and to trypsin. Addition of fibronectin also affects binding of hyaluronic acid to the cells. These results suggest that fibronectin interacts with proteoglycans at the cell surface. The existence of such interactions may have implications for the role of fibronectin and proteoglycans in cell adhesion.


Machine learning-based identification of endogenous cellular microRNA sponges against viral microRNAs.
A "miRNA sponge" is an artificial oligonucleotide-based miRNA inhibitor containing multiple binding sites for a specific miRNA. Each miRNA sponge can bind and sequester several miRNA copies, thereby decreasing the cellular levels of the target miRNA. In addition to developing artificial miRNA sponges, scientists have sought endogenous RNA transcripts and found that long non-coding RNAs, competing endogenous RNAs, pseudogenes, circular RNAs, and coding RNAs could act as miRNA sponges under precise conditions. Here we present a computational approach for the prediction of endogenous human miRNA sponge candidates targeting viral miRNAs derived from pathogenic human viruses. Viral miRNA binding sites were predicted using a newly-developed machine learning-based method, and candidate interactions between miRNAs and sponge RNAs were experimentally validated using luciferase reporter assay, western blot analysis, and flow cytometry. We found that BX649188.1 functions as a potential natural miRNA sponge against kshv-miR-K12-7-3p.


Long-term assessment of natural attenuation: statistical approach on soils with aged PAH contamination.
Natural attenuation processes valorization for PAH-contaminated soil remediation has gained increasing interest from site owners. A misunderstanding of this method and a small amount of data available does not encourage its development. However, monitored natural attenuation (MNA) offers a valuable, cheaper and environmentally friendly alternative to more classical options such as physico-chemical treatments (e.g., chemical oxidation, thermal desorption). The present work proposes the results obtained during a long-term natural attenuation assessment of historically contaminated industrial soils under real climatic conditions. This study was performed after a 10 year natural attenuation period on 60 off-ground lysimeters filled with contaminated soils from different former industrial sites (coking industry, manufactured gas plants) whose initial concentration of PAH varied between 380 and 2,077 mg kg(-1). The analysed parameters included leached water characterization, soil PAH concentrations, evaluation of vegetation cover quality and quantity. Results showed a good efficiency of the PAH dissipation and limited transfer of contaminants to the environment. It also highlighted the importance of the fine soil fractions in controlling PAH reactivity. PAH dissipation through water leaching was limited and did not present a significant risk for the environment. This PAH water concentration appeared however as a good indicator of overall dissipation rate, thereby illustrating the importance of pollutant availability in predicting its degradation potential.


Large pulmonary arteriovenous fistula.
A 55-year-old woman with Rendu-Osler-Weber disease underwent surgical resection of a pulmonary arteriovenous fistula deriving from right middle lobe vessels. The fistula was 10 x 6 x 5 cm, to our knowledge, the largest ever reported. Although the major part of the fistula was well exposed through median sternotomy, extensive bleeding during dissection of feeding and drainage vessels precluded safe dissection. Total cardiopulmonary bypass was therefore used to divert the pulmonary blood flow. Anatomy was clearly delineated and connecting vessels were safely suture-closed from within the fistula without sacrificing the right middle lobe vein, which might have been damaged without cardiopulmonary bypass. The postoperative course was uneventful, and no complications associated with cardiopulmonary bypass occurred.


Laryngitis: types, causes, and treatments.
Inflammatory processes that affect the unified airway can concurrently exert significant influence on the larynx and surrounding mucosal surfaces. Laryngeal inflammation can be present secondary to direct effects of irritants, toxins, and antigens, but can also involve mechanical and infectious effects as well as secondary inflammation from behavioral mechanisms. This review examines laryngeal inflammation in the context of the unified airway and discusses pathophysiologic mechanisms that are central to the development of acute and chronic laryngitis.


Affinity and class probability-based fuzzy support vector machine for imbalanced data sets.
The learning problem from imbalanced data sets poses a major challenge in data mining community. Although conventional support vector machine can generally show relatively robust performance in dealing with the classification problems of imbalanced data sets, it treats all training samples with the same contribution for learning, which results in the final decision boundary biasing toward the majority class especially in the presence of outliers or noises. In this paper, we propose a new affinity and class probability-based fuzzy support vector machine technique (ACFSVM). The affinity of a majority class sample is calculated according to support vector description domain (SVDD) model trained only by the given majority class training samples in kernel space similar to that used for FSVM learning. The obtained affinity can be used for identifying possible outliers and some border samples existing in the majority class training samples. In order to eliminate the effect of noises, we employ the kernel k-nearest neighbor method to determine the class probability of the majority class samples in the same kernel space as before. The samples with lower class probabilities are more likely to be noises and their contribution for learning seems to be reduced by their low memberships constructed by combining the affinities and the class probabilities. Thus, ACFSVM can pay more attention to the majority class samples with higher affinities and class probabilities while reducing their effects of the ones with lower affinities and class probabilities, eventually skewing the final classification boundary toward the majority class. In addition, the minority class samples are assigned relative high memberships to guarantee their importance for the model learning. The extensive experimental results on the different imbalanced datasets from UCI repository demonstrate that the proposed approach can achieve better generalization performance in terms of G-Mean, F-Measure, and AUC as compared to the other existing imbalanced dataset classification techniques.


The clinical characteristics of patients with an isolate epiglottic collapse.
We analyzed the clinical characteristics of patients with isolated epiglottic collapse (IEC) who had an epiglottic anteroposterior (AP) collapse as the only cause of snoring during drug-induced sleep endoscopy (DISE). A retrospective analysis of 334 consecutive DISE examinations was performed. Patients who had only epiglottic AP collapse were designated as the IEC group. There were four age- and sex-matched controls for each case, and these patients were designated as the control group. Demographic factors, polysomnography findings, cephalometry, and awake nasopharyngoscopic findings were analyzed. A total of 11 IEC cases and 44 controls were included. The IEC group had a significantly lower apnea-hypopnea index, higher minimum oxygen saturation level, lower body mass index, and shorter mandible plane to hyoid distance than the controls. However, there were no differences in epiglottic shape or curvature between the two groups. In addition, no IEC was noted during awake endoscopy. Nine (81.8%) epiglottic collapses were resolved with the mouth open and jaw thrust maneuver, which simulated the use of an oral appliance. Six (54.4%) were resolved with head turning, mimicking the lateral sleep position. The clinical characteristics of IEC patients differed from the control group, and IEC could not be identified during awake endoscopy. Therefore, patients with severe snoring but AHI < 5 or mild sleep apnea on polysomnographic findings and DISE, should be considered likely to have IEC. In addition, use of an oral appliance is recommended as an effective treatment for IEC.


Women's motivators for seeking treatment for alcohol use disorders.
This study examined types of internal and external motivations for seeking treatment and the predictive utility of different types of motivation among 180 women with an alcohol use disorder (AUD) participating in a two-armed trial testing different individual and couple therapies for AUDs. Reasons for seeking treatment were coded for type of internal or external motivation. Most women (97%) cited internal reasons for seeking help, including: concern about progression of AUD (61.1%), health (43.3%), mental health (38.9%), and family (38.3%). Occupational concerns, an internal motivator cited by 6% of women, were associated with better drinking outcomes; interpersonal-family concerns were associated with poorer outcomes. Some motivators for seeking treatment may not be related to sustained changes in drinking, suggesting that understanding motivators for treatment may be inadequate to maintain change. Reasons for help-seeking may need to be addressed in treatment to produce long-lasting change.


Interrelationship between affinity for DNA, cytotoxicity and induction of DNA-breaks in cultured L1210 cells for two series of tricyclic intercalators. Simplified analogues of ellipticine derivatives.
The interrelationship between affinity for DNA, cytotoxicity and induction of single-strand DNA breaks in cultured L1210 cells was studied for 21 compounds belonging to two series of tricyclic intercalators: 1-amino-substituted 4-methyl-5H-pyrido[4,3-b]indoles (gamma CARB) and 1-amino-substituted 4-methyl-5H-pyrido[3',4':4,5]pyrrolo[2,3-c]pyridines (PPP), which are simplified analogues of Ellipticine derivatives obtained by deletion of one cycle. Adriamycin, m-AMSA (4'-(9-acridinylamino) methanesulfon-m-anisidide), PZE (10-[diethylaminopropyl amino]-6-methyl-5H-pyrido[3',4':4,5]-pyrrolo[2,3-g] isoquinoline and RTE [( 1-(3-diethylaminopropylamino)-9-methoxy ellipticine, bimaleate) are used as reference compounds. The intercalation of these compounds into DNA was strongly suggested by three experimental observations: (i) the competitive inhibition of ethidium bromide intercalation, (ii) bathochromic and hypochromic effects on absorption spectra induced by DNA, and (iii) drug-induced increase of the DNA length, measured by viscosimetry. PPP derivatives are generally less cytotoxic and induce DNA breaks less efficiently than the gamma CARB ones, both in terms of maximum breakage frequencies and required drug concentrations. The most active compounds induced SSB in the DNA of L1210 cells, in a bell-shaped manner: the SSB frequency increased, rose to a maximum and then decreased as the drug concentrations increased. The maximum SSB frequencies induced by the most active compounds are of the same order as those of reference compounds Adriamycin and PZE. The structurally important requirements are essentially the same for both DNA breakage activity and cytotoxicity: (i) a N-CH3 in the 5-position, (ii) a CH3 in the 4-position, (iii) a hydroxy in the 8-position and (iv) the presence of an (aminoalkyl)amino side chain with preferentially a 3 carbon unit. There is no direct relationship between DNA affinity in vitro and induction of DNA breaks in cells, although a relatively high affinity seemed to be a necessary condition, since the most active compounds have the highest affinities and compounds having a very low affinity are totally inactive. The close correlation between cytotoxicity and extent of induction of DNA breaks suggests that these breaks may be in fact the lethal lesions responsible for cell death and thereby for the antitumor properties of these tricyclic intercalators.


Ability of different adiposity indicators to identify children with elevated blood pressure.
Body composition measured by dual-energy X-ray absorptiometry (DXA) is believed to be superior to crude measures such as BMI or waist circumference (WC) to assess health risks associated with adiposity in adults. We compared the ability of BMI, WC, waist-to-height ratio (WHtR), percentage body fat from skinfold thickness, and measures of total and central fat assessed by DXA to identify children with elevated blood pressure (BP). The QUALITY Study follows 630 Caucasian families (father, mother, and child originally aged 8-10 years). BP, height, weight, WC, and skinfold thickness were measured according to standardized protocols. Elevated BP was defined as systolic or diastolic BP at least 90th age, sex, and height-specific percentile. Total and central fat were determined with DXA. The area under the receiver operating characteristic (ROC) curve (AUC) statistic was computed from logistic models that adjusted for age, sex, height, Tanner stage, and physical activity. All adiposity indicators were highly correlated. WC and WHtR did not show superior ability over BMI to identify children with elevated SBP (P = 0.421 and 0.473). Measures of total and central fat from DXA did not show an improved ability over BMI or WC to identify children with elevated SBP (P = 0.325-0.662). Results support the use of BMI in clinical and public health settings, at least in this age group. As all indicators had a limited ability to identify children with elevated BP, results also support measurement of BP in all children of this age independent of a weight status.


Comparison of the pupil card and pupillometer in measuring pupil size.
To determine the difference in pupil size measured with the Colvard pupillometer in mesopic and scotopic luminance and with the Rosenbaum pupil card in mesopic luminance between 2 examiners. Michel Pop Clinics, Montreal, Quebec, Canada. Two examiners used the Colvard pupillometer and the Rosenbaum card to measure pupil size in 58 eyes. The Colvard pupillometer was used in mesopic and scotopic light conditions. The Rosenbaum card was used in mesopic luminance only. Pupil size was evaluated with a 1.0 mm interval scale at the nearest half millimeter. For the 3 sets of data, the limits of agreement and coefficient of interrater repeatability were calculated and a 2 x 2 factorial analysis of variance was performed. Because of interexaminer bias, measurements done in mesopic luminance with the Rosenbaum card were not statistically different from those with the Colvard pupillometer in scotopic luminance, although interrater repeatability of the Colvard pupillometer (0.8 mm) was superior to that of the Rosenbaum card (1.3 mm). Examiner bias was the greatest statistical bias in all sets of measures. Surgeons may want to opt for a "safe" limit of pupil size (ie, 0.5 to 0.8 mm greater than the measured size) when calculating optical zones in refractive surgery. Future devices for pupil measurement should be based on automatic adjustment sizing.


An Interleukin-1 Signature in Breast Cancer Treated with Interleukin-1 Receptor Blockade: Implications for Treating Cytokine Release Syndrome of Checkpoint Inhibitors.
In this issue of Cancer Research, Wu and colleagues show that IL1b orchestrates tumor-promoting inflammation in breast cancer and can be targeted in patients using an IL1 receptor antagonist. Cancer Res; 78(18); 5200-2. ©2018 AACRSee related article by Wu et al., p. 5243.


Mifepristone versus laminaria: a randomized controlled trial of cervical ripening in midtrimester termination.
Mifepristone was compared with laminaria for cervical ripening in second-trimester induction of labor (IOL). We performed a randomized, controlled, open-label study of women undergoing second-trimester IOL for fetal demise, aneuploidy or anomalies at a single tertiary care center from January 2004 to May 2006. Main outcome measures were induction-to-delivery time and pain with cervical ripening. Of 50 eligible women, 37 were enrolled in the study, of whom 33 completed the study: 16 were randomized to laminaria and 17 to mifepristone. Induction-to-delivery time was significantly shorter in the mifepristone arm (mean=10 h vs. 16 h, p=.01; median=7.5 h vs. 13.4 h, p=.01). Pain with cervical ripening was also significantly less in the mifepristone group than in the laminaria group (median=1 vs. 6 on an 11-point visual analogue scale, p<.001). Maternal age, parity, gestational age, fetal demise prior to induction, need for postpartum curettage, blood loss, pain during induction, delivery and at the time of discharge were not significantly different between the two groups. Mifepristone shortens the induction-to-delivery time and decreases pain with cervical ripening when compared with laminaria for second-trimester induction.


Retrieved highly crosslinked UHMWPE acetabular liners have similar wear damage as conventional UHMWPE.
Highly crosslinked UHMWPE is associated with increased wear resistance in hip simulator and clinical studies. Laboratory and case studies, however, have described rim fracture in crosslinked acetabular liners. Controversy exists, therefore, on the relative merits of crosslinked liners over conventional liners in terms of wear performance versus resistance to fatigue cracking. We asked whether crosslinked liners would show less surface damage than conventional liners but would be more susceptible to fatigue damage. We examined 36 conventional UHMWPE and 39 crosslinked UHMWPE retrieved implants with similar patient demographics and identical design for evidence of wear damage, including articular surface damage, impingement, screw-hole creep, and rim cracks. We observed no difference in wear damage scores for the two liners. Conventional liners more frequently impinged but were more often elevated with smaller head sizes. We observed creep in approximately 70% of both types of liners. Incipient rim cracks were found in five crosslinked liners, and one liner had a rim fracture. Only one conventional liner had an incipient rim crack. Contrary to our expectation, damage was similar between crosslinked and conventional UHMWPE liners. Moreover, the 15% occurrence (six of 39) of incipient or complete fractures in crosslinked liners as compared with a 3% occurrence (one of 36) in conventional liners may have implications for the long-term performance of crosslinked liners. Longer-term studies will be necessary to establish the fate of rim cracks and thus the overall clinical fatigue performance of crosslinked liners.


Lymphangiography and bone scan in the study of lymphangiomatosis.
Lymphangiomatosis is a rare congenital systemic lymphatic malformation involving multiple bones and other sites. A 12-year old boy with lymphangiomatosis was studied with lymphangiography and bone scan. Lymphangiogram demonstrated irregular pooling of contrast medium in both the mediastinal tumor and bones. Bone scan also revealed increased activity in areas which were not demonstrated radiographically.


Comparison of Clinical and Economic Outcomes of an Optimized Lean Versus a Standard Transcatheter Aortic Valve Implantation Program (from SOLAR [Safe Outcomes Lean And Resourceful] Study).
The increasing prevalence of aortic stenosis (AS) and the increasing number of patients indicated for transcatheter aortic valve implantation (TAVI) can lead to increased hospital constraints. This study aimed to compare, from the hospital perspective, the costs, resource use, and 30-day clinical outcomes of patients who underwent TAVI under an optimized or standard clinical pathway. A single-center, retrospective study was conducted among patients with native AS who underwent TAVI between January 2018 and March 2021. Patients who underwent optimized lean TAVI were propensity-score matched 1:1 to those who underwent standard TAVI. In-hospital costs and 30-day clinical outcomes were compared between the 2 groups. A total of 182 patients (91 in each group) were included in the final analysis. Baseline covariates were well balanced after matching. Patients who underwent lean TAVI had shorter length of stay (median [interquartile range] 3.0 days [2.0 to 6.0] vs 6.0 days [5.0 to 9.0], p <0.001). Patients in the lean TAVI group incurred lower total costs than did those in the standard TAVI group (mean ± SD: $41,346 ± 10,062 vs $50,471 ± 15,115, p = 0.002). There was no between-group difference in 30-day all-cause mortality (2.2% vs 1.1%, p = 0.573) and pacemaker implantations (5.5% vs 6.6%, p = 0.788). Rates of procedural complications were comparable between groups. In conclusion, lean TAVI leads to hospital efficiencies without compromising patient safety. Efforts to streamline the TAVI procedure should be encouraged to improve access to TAVI for patients with AS, amid resource constraints.


Early Occurrence of Adverse Events in Hospitalized Patients With COVID-19 and Beneficial Effect of Anticoagulation.
This study analyzed the characteristics of patients with COVID-19 with major events during the first days of hospitalization. This is a retrospective analysis of prospectively collected data from consecutive patients admitted to two hospitals in Athens, Greece. The characteristics of patients with COVID-19 who suffered the primary endpoint (venous thromboembolic events, intubation, and death) during the first days of hospitalization were analyzed. Among 95 patients included in the analysis, 21 presented with major adverse events during a median follow-up of 13 days. More than 50% of these patients presented with a major event during the first 3 days. Anticoagulation treatment was inversely associated with the cumulative incidence of the primary endpoint [hazard ratio=0.16 (95% confidence interval=0.06-0.47)]. Patients with major events were older, with lower baseline SatO2, and higher number of Wells' criteria and Charlson comorbidity index. Among these patients, those with hypertension were at higher risk for early occurrence of events (≤ first three days of hospitalization). Major adverse events may occur early in hospitalized patients with COVID-19 with a high-risk profile. Anticoagulation treatment appears to reduce this risk and thus prompt thromboprophylaxis should be employed in these patients.


Pulse transit time-estimated blood pressure: a comparison of beat-to-beat and intermittent measurement.
Pulse transit time (PTT), which refers to the travel time between two arterial sites within the same cardiac cycle, has been developed as a novel cuffless form of continuous blood pressure (BP) monitoring. The aim of this study was to investigate differences in BP parameters, including BP variability, between those assessed by beat-to-beat PTT-estimated BP (eBPBTB) and those assessed by intermittent PTT-estimated BP at fixed time intervals (eBPINT) in patients suspected of having sleep disordered breathing (SDB). In 330 patients with SDB (average age, 66.8 ± 11.9 years; 3% oxygen desaturation index [ODI], 21.0 ± 15.0/h) from 8 institutes, PTT-estimated BP was continuously recorded during the nighttime. The average systolic eBPBTB, maximum systolic and diastolic eBPBTB, standard deviation (SD) of systolic and diastolic eBPBTB, and coefficient variation (CV) of systolic and diastolic eBPBTB were higher than the respective values of eBPINT (all P < 0.05). Bland-Altman analysis showed a close agreement between eBPBTB and eBPINT in average systolic BP and SD and CV of systolic BP, while there were disagreements in both minimum and maximum values of eBPBTB and eBPINT in patients with high systolic BP (P < 0.05). Although systolic BP variability incrementally increased according to the tertiles of 3%ODI in both eBPBTB and eBPINT (all P < 0.05), there was no difference in this tendency between eBPBTB and eBPINT. In patients with suspected SDB, the difference between eBPBTB and eBPINT was minimal, and there were disagreements regarding both the minimum and maximum BP. However, there were agreements in regard to the index of BP variability between eBPBTB and eBPINT.


Geo-environmental and socioeconomic determinants of poverty in China: an empirical analysis based on stratified poverty theory.
According to the stratified poverty theory, poverty includes individual (people) and regional (place) poverty. Understanding the interaction mechanism between individual poverty and regional poverty is crucial to achieving the UN goal of poverty eradication by 2030. However, at present, the relevant empirical research is still limited by the availability of data. To fill this important gap, based on the multi-source data of poverty census, geo-environmental and socio-economic data of China's 1587 counties in 2013, we used exploratory spatial data analysis (ESDA) and spatial econometric models (spatial-lag and spatial-error model) to identify determinants of individual poverty and regional poverty in this county. Results show that the spatial distribution of the rural poor in China had strong spatial dependence (Global Moran's I = 0.574). There was a high degree of spatial overlap between individual poverty and regional poverty. The poverty-causing factors were complex and varied across regions and individuals. Disease of family members was the leading factor driving rural areas in Northeast, Central, and Southwest China. Northeast China was mainly affected by the illness and lack of labor skills of family members. The complex terrain conditions were the determinants driving rural poverty in most areas of China. Improved transportation can greatly reduce rural poverty. Geographical isolation or lack of geographical capital caused by complex terrain conditions, backward transportation, and regional closure promoted regional poverty. In turn, regional poverty-causing factors further restricted the improvement of rural residents' self-development ability and aggravated individual poverty. Our findings indicate that individual poverty and regional poverty have different poverty-causing mechanisms and poverty reduction priorities. Effective poverty reduction strategies require the coordinated promotion of individual and regional poverty reduction. The reduction of individual poverty should focus on enhancing the livelihood capital of the poor through differentiated policy intervention, while regional poverty alleviation should focus on creating a favorable development environment by increasing infrastructure investment and public service supply.


"Be Kind But Not Too Kind": Black Males' Prosocial Behaviors in the Face of Dehumanization.
This qualitative study examined how adolescent Black males (N = 12) talk about their identities, prosocial behaviors, and connections between them. Of special interest was whether and how the participants included their experiences of dehumanization. Focus group data were analyzed using modified analytic induction. Participants felt good about their racially gendered identities but felt they occupied a precarious position in the United States. Participants' beliefs about how others viewed them motivated restraint from engaging in too many prosocial acts to prevent appearing vulnerable. Participants explicitly referred to their experience of oppression in these discussions and its interaction with identity and prosociality. Results suggest research must consider how macro-level processes like racism influence the identities and prosocial behaviors of adolescent Black males.


On stochastic compartmental models.
The statistical averaging of compartmental models with parameters being random processes is derived for the case of vanishing input and uniformly bounded input. The difference of resulting models is discussed.


Cellulosimicrobium aquatile sp. nov., isolated from Panagal reservoir, Nalgonda, India.
A Gram-stain positive, non-spore forming, non-motile, yellow-pigmented, rod shaped and coccoid aerobic strain designated 3bp(T) was isolated from Panagal reservoir, at Nalgonda, Telangana, India. Based on 16S rRNA gene sequence analysis it was identified that strain 3bp(T) belongs to the class Actinobacteria and is closely related to Cellulosimicrobium funkei VTT E-072700(T), Cellulosimicrobium cellulans LMG16221(T) and Cellulosimicrobium terreum KCTC 19206(T). The DNA-DNA relatedness data demonstrated that strain 3bp(T) is distinguishable from the above three species of the genus. Further, the chemotaxonomic properties of strain 3bp(T) were consistent with those of the genus Cellulosimicrobium: MK-9(H4) was the predominant menaquinone, anteiso-C15 : 0, iso-C15:0, anteiso-C17 : 0 and iso- C16:0 were the predominant cellular fatty acids and the cell-wall peptidoglycan contains L-lysine. The DNA G+C content of strain 3bp(T) was 73.8 mol%. The results of the polyphasic analysis allowed a clear differentiation of strain 3bp(T) from all other members of the genus Cellulosimicrobium. Strain 3bp(T) is thus considered to represent a novel member of the genus Cellulosimicrobium, for which the name Cellulosimicrobium aquatile sp. nov. is proposed. The type strain is 3bp(T) (=KCTC 39527(T) = MCC 2761(T) = LMG 28646(T)).


Interaural sound pressure level differences associated with sound-source locations in the frontal hemifield of the domestic cat.
Interaural sound pressure level differences (ILDs) associated with a range of sound-source azimuths and elevations in the frontal hemifields of four cats were measured for each of seven pure-tone stimuli ranging in frequency from 2-32 kHz. The overall pattern of ILD across location at each frequency was remarkably similar in all cats. At 2, 4 and 8 kHz the relationships of ILD to azimuth and elevation were generally monotonic with ILD increasing with increasing azimuth. At 12 kHz and above, however, non-monotonic relationships developed and circumscribed regions of particularly large, positive and negative ILDs were apparent. That ILDs associated with many sound-source locations on the near side of the head are negative in sign has not been widely noted in the previous literature. The data obtained in this study were compared with those from previous studies and the acoustical mechanisms likely to have contributed to production of the observed ILDs were considered. Some implications of the data for auditory localization in three-dimensional space were discussed.


Anti-estrogenic activity of a human resveratrol metabolite.
Resveratrol, the most investigated dietary compound in studies aimed at linking wine consumption to human health, is an extremely minor component of this beverage and it is generally studied in vitro as the unconjugated aglycone at concentrations largely exceeding those found in the human circulatory system after dietary intake. Moreover, following intestinal absorption, trans-resveratrol and its glucoside, which are naturally present in wine and other food sources, are converted to sulphate and glucuronide metabolites. An estrogenic activity has previously been documented for resveratrol, yet nothing is known about the activity of its blood-circulating metabolic derivatives. Using a yeast two-hybrid detection system relying on the interaction between the ligand-binding domain of the human oestrogen receptors α and β and the human coactivator Tif2, we have systematically examined the oestrogen agonist and antagonist activities of the two main resveratrol forms present in planta (trans-resveratrol and trans-resveratrol-3-O-glucoside) and of the three main metabolites found in human plasma (trans-resveratrol-3-O-sulphate, trans-resveratrol-3-O-glucuronide and trans-resveratrol-4'-O-glucuronide). Only resveratrol-3-O-sulphate was found to display a fairly strong and oestrogen receptor α-preferential antagonistic activity, which was confirmed in a human breast adenocarcinoma cell line containing a luciferase reporter gene under the control of an oestrogen-responsive promoter. We show, for the first time, that resveratrol-3-O-sulphate, but neither of its metabolites, is endowed with anti-estrogenic activity and how human metabolism of phenolic substances plays a pivotal role in modulating their biological effect.


Phenothiazine therapy and plasma immunoreactive beta-MSH in schizophrenia and pruritic dermatoses.
Plasma immunoreactive beta-melanocyte-stimulating hormone (beta-MSH) concentrations were normal in schizophrenic patients on prolonged and high dosage phenothiazine therapy. A group of patients treated with chlorpromazine 25 mg three times daily for pruritic dermatoses also showed no significant change in plasma beta-MSH concentration.


Ultrasound-guided fine needle aspiration in the diagnosis of peripheral nerve sheath tumors in 4 dogs.
Ultrasound-guided fine needle aspiration was used in establishing the diagnosis in 4 cases of malignant peripheral nerve sheath tumor. Sonographic and cytologic characteristics are discussed. Because of its availability and ease of use, axillary ultrasonography with fine needle aspiration can be an initial diagnostic step for suspected brachial plexus tumors.


Some implications of the Linear Quadratic model for tumor control probability.
To define an optimal radiation therapy strategy, the dependence of the probability of cure and of significant complications, on the parameters controlled by the radiotherapist must be determined. The recent success of the Linear Quadratic (LQ) model in constructing isoeffect relations for normal tissue damage and in describing in vitro cell survival curves, indicate that this model could be used to determine this dependence. The problem of tumor control is addressed. Using LQ model parameters obtained from human tumor cell lines, the sigmoid dose-response curves for controlling tumors of fixed size but of several histologies, with a fractionated course of radiotherapy is obtained. Except for squamous cell carcinoma, the calculated average tumor control doses (TCD37 or TCD50) are unrealistically low, but the model can be made more realistic by including inhomogeneities in the spatial dose distribution and heterogeneous tumor cell populations. The slope of the dose response curves are determined and the significance of the "relative slope" parameter rho as a measure of the number of cells in a tumor's most radioresistant clone is noted. The relation of the model's predictions to qualitative features of the experimental animal data for both tumor control and for normal tissue damage is discussed. Experiments to test the validity of this type of model are suggested.


Biliary tract cancers: SEOM clinical guidelines.
Biliary tract cancer (BTC) is an uncommon and highly fatal malignancy. It is composed of three main different entities; Gall bladder carcinoma (GBC), intrahepatic cholangiocarcinoma (iCC) and extrahepatic cholangiocarcinoma (eCC) sharing different genetic, risk factors and clinical presentation. Multidetector-row computed tomography (MDCT) and magnetic resonance cholangio-pancreatography (MRCP) are the more important diagnostic techniques. Surgery is the only potentially curative therapy but disease recurrence is frequent. Treatment with chemotherapy, radiotherapy or both has not demonstrated survival benefit in the adjuvant setting. Cisplatin plus gemcitabine constitutes the gold standard in metastatic disease. New ongoing studies mainly in the adjuvant and neoadjuvant setting along with molecular research will hopefully help to improve survival and quality of life of this disease.


Exceptionally high charge mobility in phthalocyanine-based poly(benzimidazobenzophenanthroline)-ladder-type two-dimensional conjugated polymers.
Two-dimensional conjugated polymers (2DCPs), composed of multiple strands of linear conjugated polymers with extended in-plane π-conjugation, are emerging crystalline semiconducting polymers for organic (opto)electronics. They are represented by two-dimensional π-conjugated covalent organic frameworks, which typically suffer from poor π-conjugation and thus low charge carrier mobilities. Here we overcome this limitation by demonstrating two semiconducting phthalocyanine-based poly(benzimidazobenzophenanthroline)-ladder-type 2DCPs (2DCP-MPc, with M = Cu or Ni), which are constructed from octaaminophthalocyaninato metal(II) and naphthalenetetracarboxylic dianhydride by polycondensation under solvothermal conditions. The 2DCP-MPcs exhibit optical bandgaps of ~1.3 eV with highly delocalized π-electrons. Density functional theory calculations unveil strongly dispersive energy bands with small electron-hole reduced effective masses of ~0.15m0 for the layer-stacked 2DCP-MPcs. Terahertz spectroscopy reveals the band transport of Drude-type free carriers in 2DCP-MPcs with exceptionally high sum mobility of electrons and holes of ~970 cm2 V-1 s-1 at room temperature, surpassing that of the reported linear conjugated polymers and 2DCPs. This work highlights the critical role of effective conjugation in enhancing the charge transport properties of 2DCPs and the great potential of high-mobility 2DCPs for future (opto)electronics.


Superantigens SPEA and SMEZ do not affect secretome expression in Streptococcus pyogenes.
The superantigens, toxic shock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxin B (SEB), were recently reported to repress global exoprotein synthesis in Staphylococcus aureus. To investigate if this phenomenon could be observed in a different Gram-positive pathogen, the effects of two major Streptococcus pyogenes superantigens on streptococcal secretome expression were examined. Using mutagenesis and genetic complementation, we demonstrated that neither streptococcal pyrogenic exotoxin A (SPEA) nor streptococcal mitogenic exotoxin Z (SMEZ) had any consistent effect on global protein expression or on transcription of genes encoding the secreted exoproteins, DNase B, SPEB and SPEG. In S. pyogenes, superantigen production does not appear to have a major regulatory role.


Comparison mitochondrial DNA DAMPs changes in platelet prepared by apheresis and PRP.
Mt DNA (DAMPs) plays a key modulatory role in immune cells and may also mediate a variety of adverse transfusion reactions. The cross-sectional study was performed on 22 (PRP) and 14 (SDP) between February 2019 and 2020. mtDNA DAMPs by quantitative real-time PCR was assessed on days 1, 3, and 5 of platelets storage. The data was entered in REST 2009 software, and the amount of fold change was calculated. Multiple t tests were also used. The mtDNA DAMPs fold change in SDP on days 1-3, 1.3 times, on days 3-5, 1.5 times, and on days 1-5, 2.1 times increased. The fold change on days 1-3, 0.8 times, on days 3-5, 0.6 times, and on days 1-5, 0.49 times decreased in PRP products. The method of preparation and processing can affect mtDNA DAMPs fold changes.


Phonemic imperception in aphasia.
This study investigated characteristics of 14 aphasics with impaired phoneme discrimination identified from a population of 100 patients with left hemisphere lesions. All patients with impaired phoneme discrimination were significantly impaired in aural comprehension, but many showed intact sound recognition and some showed normal reading comprehension. Defects in phoneme discrimination were typically seen in the acute stage of aphasia resulting from stroke; and in most instances, defects in phoneme discrimination were no longer apparent 4 months postonset. All patients who recovered normal phoneme discrimination also made significant improvement in aural comprehension. The findings support the concept that some aural comprehension defects result from a specific disturbance in phoneme discrimination.


Helicobacter pylori and Gastric Malignancy.
Last year there were a few important clinical data on long-term prognosis of mucosa-associated lymphoid tissue (MALT) lymphoma after eradication of Helicobacter pylori. Similarly, there were clinical data to support the role of eradication of H. pylori in the primary prevention of gastric cancer. We understand more about the host susceptibility as well as the pathogenetic mechanisms of the bacteria in the gastric mucosa. This article summarizes the important breakthroughs in H. pylori and gastric malignancies last year.


Differences in structural and pain phenotypes in the sodium monoiodoacetate and meniscal transection models of osteoarthritis.
To characterize differences in joint pathology and pain behavior between two rat models of osteoarthritis (OA) in order to inform selection of animal models for interventional studies. Knee OA was induced in Sprague Dawley rats by either meniscal transection (MNX) or intra-articular injection of monosodium iodoacetate (MIA). Controls were subjected to sham surgery or saline-injection. In a separate experiment, a single intra-articular injection of triamcinolone acetonide was administered 14 days after MNX or MIA arthritis induction. Pain behavior and joint pathology were quantified. Both models displayed synovial inflammation, chondropathy and osteophytosis. Chondropathy scores increased with time similarly in the two models. Inflammation and osteophyte scores were greater in MNX model compared to the MIA model. At day 49, the MNX model exhibited a greater number of channels crossing the osteochondral junction compared to all other groups. The MNX model exhibited greater weight bearing asymmetry compared to the MIA model, whereas the MIA model displayed more consistent hindpaw allodynia. Triamcinolone attenuated weight bearing asymmetry and distal allodynia to control levels in the MNX model, but distal allodynia was unaltered in the MIA model. The comparison of the two models of OA in rats, using identical assessment tools has demonstrated that although both models display features of OA, there are differences between the models which may represent different aspects of human OA. Thus, model selection should be based on the pathological aspects of OA under investigation.


Second non-germ cell malignancies after radiotherapy of testicular cancer with or without chemotherapy.
The incidence of a new primary non-germ cell malignancy was determined in 876 patients with testicular cancer treated at the Norwegian Radium Hospital from 1956 to 1977. Sixty-five patients developed a second cancer leading to a statistically significant increased relative risk (RR = 1.58), especially if extended radiotherapy had been given (RR = 4.13). The excess risks of developing lung cancer and malignant melanoma were 2.03 and 3.89, respectively. Increased RR for these two cancer types were seen both after extended radiotherapy and after radiotherapy combined with chemotherapy. Studies of the time between treatment and secondary lung cancer indicated that the development of the new lung cancer could be partly treatment related, whereas the raised incidence of malignant melanoma may be related to the frequent health checks performed in patients with testicular cancer. Patients who had received extended radiotherapy were also at an increased risk of developing cancer of the stomach and of the colon. Three cases of acute leukaemia were observed more than 5 years after treatment, all of them in patients who had received abdominal radiotherapy only. It is concluded that patients apparently cured of a testicular cancer have an increased risk of developing a new treatment related non-germ cell malignancy, in particular lung cancer. The application of the extended radiotherapy or the combination of radiotherapy and chemotherapy containing alkylating drugs should be avoided in order to reduce this excess risk.


Chromatic properties of the retinal afferents in the thalamus and the tectum of the frog (Rana temporaria).
In order to clarify physiological mechanisms underlying colour-specific visually guided behaviour, we measured spectral sensitivities of On-fibres projecting to the thalamus and class 2 and 3 fibres passing to tectum opticum. In addition we recorded responses of these fibres to moving coloured papers with known spectral reflectancies. The latter method, here called paper colourimetry, allowed us to change the relative stimulations of the blue-, green- and red-sensitive photoreceptors in any direction desired. Under the photopic conditions used the tectal fibres were driven exclusively by red-sensitive receptors, while the thalamic fibres received strong On-inputs from both red- and blue-sensitive receptors. Due to a partly antagonistic interaction between these inputs the On-fibres acted in a dichromatic way, responding with specific extended low-frequency discharges to all relative increases in blue receptor stimulation, e.g. to a great reduction in red stimulation combined with unchanged blue stimulation. Thus they have functional characteristics which could serve a visual system showing colour constancy.


Safety and efficacy of paediatric silicone Ahmed glaucoma valve (AGV) in adult eyes with post-VR surgery glaucoma.
To compare the safety and efficacy of the FP8 AGV (paediatric) with the standard FP7 AGV in adult post-vitreoretinal (VR) surgery glaucoma. We included 45 consecutive eyes with post-VR surgery glaucoma implanted with either FP8 (n = 28) or FP7 (n = 17) AGV between 2008 and 2016. The data analysed included visual acuity (VA), intraocular pressure (IOP), complications, interventions, and outcomes. Mean age (p = 0.24), mean baseline VA (p = 0.77), preoperative IOP (p = 0.41), number of antiglaucoma medications (p = 0.92), and previous surgeries (p = 0.16) were comparable in the two groups. The number of eyes with previous belt buckle was significantly higher (p < 0.001) in the FP8 group (17/28) compared with the FP7 group (2/17), indicating space constraint and scarred conjunctiva. The median follow-up (25th, 75th percentile) was 14.7 (9.1, 25.3) months in the FP7 and 9.8 (6.4, 34.7) months in the FP8 groups (p = 0.62). Postoperatively, the median VA (p = 0.24), the mean IOP at final follow-up (p = 0.15), and median number of AGM (p = 0.99) were comparable in both the groups. The median percentage drop in IOP (95% confidence interval) with the FP7 implant was 55% (43.70%) and with FP8 implant was 53.8% (25, 73), (p = 0.20). None in the FP7 group failed, while three eyes in the FP8 group failed. During the study period, two eyes in the FP8 group had tube exposure that was surgically managed. None of the eyes had implant exposure or loss of light perception. Use of the paediatric FP8 AGV in adult post-VR surgery glaucoma eyes with severe conjunctival scarring and limited subconjunctival space resulted in reasonable IOP control compared with the standard FP7 AGV implant. There were no eyes with implant extrusion.


The Knee injury and Osteoarthritis Outcome Score reflects the severity of knee osteoarthritis better than the revised Knee Society Score in a general Japanese population.
The purposes of this study were to examine population-based reference data for sex- and age-related differences between the 2011 revised Knee Society Score (KSS2011) and the Knee injury and Osteoarthritis Outcome Score (KOOS), to assess the correlation between those scores and radiographic knee osteoarthritis (OA), and to validate the use of the scores in a general Japanese population. This cross-sectional study included 963 volunteers (368 males, 595 females; mean age: 54.7years). Participants were classified into five subgroups by age: under 40, 40s, 50s, 60s, and over 70years old. The KSS2011 and KOOS were determined using self-administered questionnaires. Weight-bearing radiographs of the bilateral knee were taken and graded according to the Kellgren-Lawrence (KL) scale. The mean KSS2011 and KOOS were compared among age groups. Correlations between the severity of knee OA and each score were assessed using multiple regression analysis. The overall KSS2011 tended to gradually decrease with age. Most subscales of the KSS2011 did not show sex-related differences. Similarly, the overall KOOS and all its subscales steadily decreased by approximately 20 points per decade with age. Most subscales of the KOOS were significantly decreased in females over 50. The KL grade was significantly related to both the overall KOOS (β=-0.42, p<0.001) and KSS2011 (β=-0.13, p=0.001), though the correlation to the KOOS was stronger. The overall KSS2011 and KOOS appear to decrease with age. In this population, the KOOS reflects the severity of knee OA better than the KSS2011.


Prognostic value of serum amyloid A protein in patients with acute myocardial infarction.
The relationship between plasma levels of serum amyloid A protein (SAA) concentrations and clinical course (including mortality) was investigated in patients with acute myocardial infarction (AMI). The study enrolled 280 consecutive AMI patients who were admitted within 10 h of onset and were successfully reperfused by primary percutaneous coronary intervention. Plasma SAA concentrations were evaluated at 24 h after onset. The threshold of the upper quintile (325 mug/dl) was used to divide patients into 2 groups: either a high SAA (H group: > or =325 mug/dl; n=56) or low SAA (L group: <325 microg/dl; n=224). (I) Left ventricular (LV) ejection fraction in the chronic phase was significantly less in the H group than in the L group (52+/-14% vs 57+/-13%, p=0.03). (II) There were significantly more major complications in the H group than in the L group (cardiac rupture: p=0.0007, cardiogenic shock: p<0.0001; subacute thrombosis: p=0.0007; cardiac death: p=0.0003). (III) Multivariate analysis identified SAA as an independent predictor of 6-month mortality in AMI patients (risk ratio: 5.8, 95%confidence interval: 1.3-27.7, p=0.03). In the setting of AMI, plasma SAA concentrations may be closely related to LV systolic dysfunction and poor patient outcomes, including mortality.


Design and preliminary techno-economic assessment of a pilot scale pharmaceutical wastewater treatment system for ammonia removal and recovery of fertilizer.
Recovery of nutrients from wastewater has a paramount importance for a sustainable and safe environment. In this study removal of ammonia and recovery of resources in the form of struvite from a complex pharmaceutical acidic wastewater having high concentration of ammoniacal nitrogen (NH4-N > 40 g/L) and other co-existing contaminants (magnesium, phosphorous, phenol etc.) was explored. Response Surface Methodology (RSM) was employed for design of experiments and process optimization. RSM results revealed that removal of ammoniacal nitrogen, i.e., struvite precipitation was found to be maximum in alkaline pH (10.5-11.0) at a N:Mg molar ratio (1:0.030 to 1:0.035) and N:P molar ratio (1:0.025 to 1:0.030). X-Ray diffraction, thermo-gravimetric analysis and Fourier transform-infrared spectroscopy confirmed the presence of struvite crystals in the obtained precipitate. Techno-economic assessment (TEA) based on mass energy balance principle and market equipment specifications revealed that a pilot-scale plant set up would have a break-even period of 1.06 years with a return on investment as 94.28%. This clearly elucidated the economic viability of the developed process for industrial applications for management of high ammonia laden pharmaceutical wastewater. While further specific technological improvements are needed for reduction of cost, this study will guide researchers and industries for careful selection of target markets to reduce the cost for successful implementation.


Trans-species activation of human T cells by rhesus macaque CD1b molecules.
Despite crucial importance of non-human primates as a model of human infectious diseases, group 1 CD1 genes and proteins have been poorly characterized in these species. Here, we isolated CD1A, CD1B, and CD1C cDNAs from rhesus macaque lymph nodes that encoded full-length CD1 proteins recognized specifically by monoclonal antibodies to human CD1a, CD1b, and CD1c molecules, respectively. The monkey group 1 CD1 isoforms contained amino acid residues and motifs known to be critical for intramolecular disulfide bond formation, N-linked glycosylation, and endosomal trafficking as in human group 1 CD1 molecules. Notably, monkey CD1b molecules were capable of presenting a mycobacterial glycolipid to human CD1b-restricted T cells, providing direct evidence for their antigen presentation function. This also detects for the first time a trans-species crossreaction mediated by group 1 CD1 molecules. Taken together, these results underscore substantial conservation of the group 1 CD1 system between humans and rhesus macaque monkeys.


Analysis of Rockwood et Al's Clinical Frailty Scale and Fried et Al's Frailty Phenotype as Predictors of Mortality and Other Clinical Outcomes in Older Patients Who Were Admitted to a Geriatric Ward.
There are few data regarding the accuracy of short frailty tools as predictors of mortality and other clinical outcomes of older patients admitted to a geriatric ward. We therefore analyzed the accuracy of Rockwood et al's Clinical Frailty Scale and an easy and quick to perform operationalization of Fried et al's frailty phenotype, as predictors of mortality and other clinical outcomes in our cohort of patients. Prospective analysis with a follow-up period of 6 months. 307 patients who were 65 years of age or older were included in the study. The patients were assessed in terms of the two frailty measures during their stay in a geriatric ward. The Clinical Frailty Scale and the frailty phenotype were both suitable for differentiating between patients who died due to any cause from those who survived during follow-up (primary outcome) (area under the ROC curves (AUC) values 0.867 (95% CI 0.807-0.926), p<0.001 and 0.754 (95% CI 0.688-0.821), p<0.001, respectively). Regarding the secondary outcomes: 1. unplanned admission to hospital and 2. a fall during follow-up, the Clinical Frailty Scale discriminated or tended to discriminate between patients to whom these criteria applied and those to whom they did not (AUC=0.569 (95% CI 0.502-0.636), p=0.046 and AUC=0.574 (95% CI 0.501-0.647), p=0.071, respectively). The frailty phenotype did not show such a differentiation when applied to secondary outcomes (AUC=0.500 (95% CI 0.432-0.568), p=0.994 and AUC=0.518 (95% CI 0.439-0.598), p=0.658, respectively). Both short frailty instruments are suitable predictors of mortality in older patients who were admitted to a geriatric ward. The Clinical Frailty Scale, but not the frailty phenotype, predicted at least some of the secondary outcomes, i.e., the outcome unplanned admission to hospital during follow-up.


Pulmonary function after extracorporeal shock wave lithotripsy--a comparison of general and regional anaesthesia.
The effect of general anaesthesia on postoperative pulmonary mechanics was studied by comparing pre- and postoperative spirometry in 30 patients undergoing extracorporal shock wave lithotripsy, 15 of whom received a unilateral intercostal nerve block, the remainder a general anaesthetic. Both groups of patients had significant postoperative changes in peak expiratory flow rate, expiratory reserve volume and vital capacity; forced expiratory volume at one second was not significantly changed in either group. There were no significant differences in the pre- or postoperative mechanics between the two groups. We conclude that general anaesthestics do not play a significant role in the generation of abnormalities in postoperative spirometry.


[Subacute butyric acid exposure in cattle. 6. Effects of a butyric acid or a sodium butyrate exposure up to 2.0 g. per kg. body weight per day].
Two cows each received intraruminal applications of 1.0 g/kg B.W. of butyric acid or sodium butyrate, for three weeks running, before daily applications were increased up to 2.0 kg/B.W., within one week. Resulting alterations primarily included increase in acidosis or alkalosis, whereas the typical symptoms of ketosis were lacking. Signs of impaired liver function were to some extent recordable in response to sodium butyrate.


ADAMTS4 and ADAMTS5 may be considered as new molecular therapeutic targets for cartilage damages with Kashin-Beck Disease.
There are a pretty number of research demonstrating that ADAMTS4 and ADAMTS5 playing primary roles in the degradation of cartilage during inflammatory joint diseases like osteoarthritis (OA). Because Kashin-Beck Disease (KBD) has been found to own the common pathological changes and symptoms with OA, and is regarded as the specific type of osteoarthritis, it's reasonable to believe that ADAMTS4 and ADAMTS5 may exert an enormous functions on the injury of cartilage of the KBD and may be potential molecular therapeutic targets for KBD.


A comparative study of adsorption of an anionic and a non-ionic surfactant by soils based on physicochemical and mineralogical properties of soils.
In the present work we performed a comparative study on the adsorption of the surfactants sodium dodecyl sulphate (SDS) (anionic), and octylphenoxypolyethoxyethanol (Triton X-100) (non-ionic) to 18 soils with organic matter (OM) and clay fraction contents varying over a broad range. The objective of the study was to gain further insight into the influence of the physicochemical and mineralogical properties of soils on the adsorption of surfactants by soils. Adsorption isotherms were obtained using concentrations below the critical micellar concentration (cmc) of the surfactants. The adsorption coefficients, Kf, determined from the Freundlich equation were lower for SDS (range 1.77-82.1, mean value 36.3) than for Triton X-100 (range 0.01-913, mean value 257). Simple and multiple correlation coefficients were obtained between Kf values and soil characteristics. The results obtained indicate the influence of the OM content on the adsorption of SDS (r=0.64, p<0.01) and of the clay fraction content on that of Triton X-100 (r=0.83, p<0.001). Additionally, we observed a preferential adsorption of SDS by the 1:1 mineral kaolinite (r=0.54, p<0.05), while Triton X-100 was adsorbed mainly by the 2:1 minerals, montmorillonite (r=0.66, p<0.01) and illite (r=0.87, p<0.001). According to the influence of different soil parameters on adsorption, different mechanisms of adsorption are proposed for each surfactant. Our findings point to the interest of considering the physicochemical properties of soils and also the mineralogy of the soil clay fraction when selecting a surfactant in technologies involving enhanced solubilization and removal of contaminants from soils and sediments.


Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit.
To determinate the incidence, incidence rate and risk factors of pressure ulcers in critical care patients. Pressure ulcers represent one of the most frequent health problems in clinical practice. Specifically, critical patients who are hospitalised in intensive care units have a higher risk of developing a pressure ulcer, with an incidence that fluctuates between 3.3-39.3% according to previous studies. Prospective cohort study. Three hundred and thirty-five adult patients (over 18 years old) who were hospitalised in intensive care units for at least 24 hr were monitored for a maximum of 32 days. They were excluded if they had a pressure ulcers at admission. The survival rate for pressure ulcers, from stages I-IV, was calculated using the Kaplan-Meier method. A multivariate Cox regression model was adjusted to identify the main risk factors for pressure ulcers: demographic, clinical, prognostic and therapeutic variables. The incidence of pressure ulcers in critical patients was 8.1%, and the incidence rate was 11.72 pressure ulcers for 1,000 days of intensive care units stay; 40.6% of pressure ulcers were of stage I and 59.4% of stage II, mainly in the sacrum. According to the Cox model, the main risk factors for pressure ulcers were in-hospital complications, prognostic scoring system (SAPS III) and length of immobilisation. The incidence of pressure ulcers is lower than that shown in recent studies. Complications on the unit and the prognosis score were risk factors associated with pressure ulcers but, surprisingly, length of immobilisation was a protective factor. Survival analysis of pressure ulcer allows for identification of risk factors associated with this health problem in the intensive care units. Identifying these factors can help nurses establish interventions to prevent pressure ulcers in this healthcare scenario, given that pressure ulcers prevention is an indicator of nursing quality.


Cooperative binding of T cell receptor and CD4 to peptide-MHC enhances antigen sensitivity.
Antigen recognition by the T cell receptor (TCR) of CD4+ T cells can be greatly enhanced by the coreceptor CD4. Yet, understanding of the molecular mechanism is hindered by the ultra-low affinity of CD4 binding to class-II peptide-major histocompatibility complexes (pMHC). Here we show, using two-dimensional (2D) mechanical-based assays, that the affinity of CD4-pMHC interaction is 3-4 logs lower than that of cognate TCR-pMHC interactions, and it is more susceptible to increased dissociation by forces (slip bond). In contrast, CD4 binds TCR-pre-bound pMHC at 3-6 logs higher affinity, forming TCR-pMHC-CD4 tri-molecular bonds that are prolonged by force (catch bond), and modulated by protein mobility on the cell membrane, indicating profound TCR-CD4 cooperativity. Consistent with a tri-crystal structure, using DNA origami as a molecular ruler to titrate spacing between TCR and CD4 we show that 7-nm proximity optimizes TCR-pMHC-CD4 tri-molecular bond formation with pMHC. Our results thus provide deep mechanistic insight into CD4 enhancement of TCR antigen recognition.


Risk factors for anterior traumatic dental injury in children and adolescents with autism spectrum disorders: a case-control study.
This was to assess and compare risk factors for traumatic dental injury (TDI) among children/adolescents with and without autism spectrum disorders (ASD). The study consisted of 122 children and adolescents (98 males, 24 females), 61 with ASD (study group) and 61 without ASD (control group, CG). Dental injuries were determined according to Andreaseńss classification. The cause, location and type of activity at the time of trauma were recorded from patient/carer recollection. Subjects with ASD presented higher percentages of TDI in routine activities (P = 0.003), falling while walking and episodes of self-harm (P = 0.007) in the individual's own residence (P = 0.036). TDI prevalence in the ASD group was higher (39.3%) than in the CG (26.2%) though not significant, (P = 0.123). Girls with ASD presented a significantly higher TDI percentage (50.0%) compared with girls from the CG (8.3%) (P = 0.024). Enamel fracture was the most frequent type of TDI for both groups (P = 0.292). The teeth most commonly affected were #11 and #21 for both groups. Children and adolescents with ASD exhibit different risk factors for TDI compared with those without ASD, and girls with ASD are more prone than boys.


Involvement of the domains of histones H1 and H5 in the structural organization of soluble chromatin.
We have studied in reconstitution experiments the conditions under which peptides derived from histones H1 and H5 are bound in chromatin and to what extent they are involved in the organization of chromatin fibers. The fragments of rat liver histone H1 (rH1) and chicken erythrocytes H1 (cH1) and H5 (cH5) used were the globular domains (rG-H1, cG-H1, cG-H5), the globular domain and the N-terminal tail (rCT-N), about half of the globular domain and the C-terminal tail (rNBS-C) and the C-terminal tail (rCT-C). Fragments containing the C-terminal tail (rNBS-C and rCT-C) dissociate from H1-depleted rat liver chromatin at 300 mM-NaCl and above (similar to uncleaved H1) and fragments lacking the C-terminal tail (rG-H1 and rCT-N) dissociate between 100 and 200 mM-NaCl. This suggests that at putative physiological ionic strengths the binding of rH1 is dominated by its C-terminal tail, whereas the globular region and the N-terminal tail might only be loosely bound or not bound at all and by this modulate chromatin structure. The globular domain of cH5 binds more tightly than that of the chicken and rat H1 and is only partially released at 200 mM. Since in the transcriptionally silent erythrocytes of birds H5 replaces H1 to a large extent, we suggest that the globular domain of H1 serves as a temporary seal and that of H5 as a permanent seal of the nucleosome. All the H1 and H5 peptides tested condensed and precipitated chromatin and H1-depleted chromatin: rNBS-C and rCT-C at lower peptide per nucleosome ratios than rG-H1, cG-H1 and rCT-N. At about one peptide per nucleosome none of the H1 fragments induced condensation similar to that of native chromatin. At a peptide per nucleosome ratio close to the point of precipitation, all H1 fragments, but not poly-L-lysine, induced similar compact forms which were fiberlike, although more irregular than the compact fibers of native chromatin. These reconstitution experiments suggest that both halves of H1 as well as the globular domain by itself are involved and capable in forming higher-order chromatin structures. Details of these structures are not known.


The use of felodipine in the treatment of severe hypertension.
To investigate the use of felodipine in severe hypertension 2 separate studies were carried out. In the first study, 101 patients on a fixed combination of atenolol 100mg and chlorthalidone 25mg who required additional or 'third line' therapy for proper control, were randomised to either felodipine or hydralazine and the dosage was increased if the supine diastolic blood pressure was greater than 90mm Hg. Felodipine reduced blood pressure more effectively than hydralazine and the incidence of adverse reactions was similar in both groups. In the second study, 17 patients with severe hypertension (WHO stage III), who had not been controlled by therapy with atenolol, thiazide diuretic and hydralazine, prazosin or nifedipine were studied. Patients were subsequently controlled by a combination of atenolol, frusemide or bumetanide, and minoxidil. Once stabilised, the patients then took part in a double-blind crossover study comparing minoxidil and felodipine. The patients' blood pressure was the same on both treatment regimes but their bodyweight was lower after felodipine administration. Felodipine is probably more effective than hydralazine and as effective as minoxidil in treating severe hypertension. As felodipine is usually well tolerated it should prove a useful drug in treating refractory hypertension.


In vitro interaction of porcine serum and colostrum protease inhibitors with pancreatic trypsin, chymotrypsin and elastase.
The partition of 125I-labelled pancreatic trypsin, chymotrypsin and elastase between the inhibitors, alpha 2-macroglobulin f and s, alpha 1-protease inhibitor, alpha 2-antitrypsin, inter-alpha-trypsin inhibitor and the specific sow colostrum protease inhibitor, was studied in vitro by gradually increasing the concentration of these proteases in blood serum from adult and newborn pigs. As revealed by immunoelectrophoresis in combination with autoradiography, differences were noted in the abilities of the various protease inhibitors to interact with and to form complexes with the three proteases, resulting in changes in location, height and numbers of precipitates. Among the serum inhibitors, alpha 2-macroglobulins showed the highest relative affinity to all three proteases, while alpha 1-protease inhibitor showed a high relative affinity only for chymotrypsin. Serum alpha 2-antitrypsin complexed only with trypsin, with a low relative affinity. alpha 2-Antitrypsin also interacted with chymotrypsin and elastase, but without forming complexes. When complexes of sow colostrum protease inhibitor and trypsin were added to the serum from neonatal pigs, these complexes remained stable. The results obtained from these in vitro studies, indicating differences in the relative affinities of the inhibitors to the various proteases, give some information about the role of the inhibitors in vivo, both in adult and in neonatal pigs.


WORK SCHEDULE OF NURSING OFFICERS - A REVIEW.
A survey was conducted among 345 nursing officers working in hospitals of Army, Navy and Air Force to find out their preferences on type of shift system, working hours in each shift, duration of night duties, entitlement of compensatory 'off days' and distribution of 'off days'. Majority of them has demanded a change from the existing pattern of duty system, split shift to a 'modified shift' system. The 'modified shift' will have 6 hours each in first and second shifts and 12 hours in the third shift (night). Their preference for night duties is for a duration of two weeks with two compensatory 'off days' at the end of the night duties in one instalment. But they opt for the compensatory 'off days' of day shifts in instalments of one per week.


Influence of nutrients on cardiac autonomic function in nondiabetic overweight subjects.
The current study sought to determine whether there is a link between cardiac autonomic dysfunction and food intake in overweight subjects. One hundred five nondiabetic overweight (body mass index >27 kg/m2) subjects were studied. Heart rate variations were analyzed during 3 bedside standard tests investigating mainly vagal control: deep breathing, lying-to-standing, and Valsalva tests. The resting metabolic rate and substrate oxidation rates were measured by indirect calorimetry. Dietary intake was estimated from a 3-day recall of food intake. Cardiac parasympathetic dysfunction (PSD) was found in 39 subjects. The sex ratio, age, anthropometric parameters, biochemical parameters and insulin resistance index, resting metabolic rate, and substrate oxidation rates did not differ in the subjects with or without PSD. The total 24-hour energy intake was similar, but the carbohydrate intake was significantly higher in the subjects with PSD (P = .006), and the fat and protein intakes were significantly lower (P = .026 and .045, respectively). In the logistic regression analyses, PSD correlated with carbohydrate and fat intake, independently of serum insulin levels. Glucose oxidation rate correlated negatively with fasting and postglucose serum insulin levels only in the subjects with PSD (P = .006 and .005, respectively). Cardiac parasympathetic dysfunction is associated with higher carbohydrate intake and lower fat and protein intakes in overweight subjects. A sympathetic override may contribute to reducing the glucose oxidation rate in subjects with PSD.


Genetic diversity among Escherichia coli O157:H7 isolates from Bovines living on farms in England and Wales.
Pulsed-field gel electrophoresis of Escherichia coli O157:H7 isolates (n = 228) from 122 healthy animals on 11 farms discriminated 57 types. Most clones were found only on individual farms. Numerous clones were found within each farm, with a prevalent clone normally found in several animals. A variety of clones were found within the different phage types.


Effective removal of organic pollution by using sonochemical prepared LaFeO3 perovskite under visible light.
In the present work, LaFeO3 perovskite was prepared via ultrasonic probe with power of 60 W and frequency of 18 KHz. LaFeO3 nanorods were formed when sonication time was 20 min. In this research, green materials including corn, starch, and rice were used to control the size, morphology, and purity of final products. As-prepared LaFeO3 nanostructures were used to purify water containing organic contaminants. LaFeO3 nanostructures prepared by using corn, starch, and rice showed higher photocatalytic activity compare to LaFeO3 nanostructures without natural capping agents. Using corn increased degradation efficiency by 65% under visible light. XRD results show that Fe2O3 appeared as an impurity when starch was used to prepare LaFeO3 nanostructures. This impurity significantly boosts the degradation efficiency under UV light. Fe2O3 under UV light act as co-absorbent and boost efficiency by 43%. LaFeO3 nanostructures were characterized by XRD, EDX, SEM, CV, BET, TEM, DRS and FT-IR.


Transumbilical single-site laparoscopic parallel mattress suturing prevents bleeding and chronic pelvic pain in myomectomy: a retrospective cohort study of 124 cases with intramural fibroids.
The most common complications of myomectomy are intraoperative hemorrhage and postoperative adhesion. The key point to overcome this problem is to improve suture quality. However, to date, there is still no consensus on the optimal method of uterine repair. In this study, we explored the effectiveness and feasibility of single-site laparoscopic parallel mattress sutures to reduce intraoperative bleeding and postoperative adhesion. A retrospective cohort analysis was performed, according to the STROBE guidelines, on 124 patients with intramural fibroids admitted between May 2020 and April 2021. The cases were divided into two groups based on the description of the uterine incision suture in the surgical records, including 68 cases in the parallel mattress suture (PMS) group and 56 cases in the simple continuous suture (SCS) group. Operation-related indicators, bleeding indicators, surgical complications, scar reduction index 1 month after surgery, and the incidence of chronic pelvic pain 6 months after the surgery were observed. Independent sample t-tests and Mann-Whitney U tests were performed for the measurement data, and Pearson Chi-square tests were performed for count data. Statistical significance was set at P < 0.05. There was no significant difference in the baseline characteristics between the two groups. All operations were performed under transumbilical single-site laparoscopy without conversion. Compared to the SCS group, the PMS group had earlier postoperative anal exhaust (14.3 ± 6.7 h vs. 19.2 ± 9.6 h, P = 0.002), fewer postoperative hemoglobin drops (7.6 ± 3.7 g/L vs. 11.6 ± 4.3 g/L, P = 0.000), smaller uterine scars (3.7 ± 1.9 cm vs. 5.2 ± 1.8 cm, P = 0.000), and a larger uterine scar reduction index (50.2% vs. 31.0%, P = 0.000) one month after surgery and less chronic pelvic pain 6 months after surgery (2.9% vs. 12.5%, P = 0.016). No difference was found in auxiliary trocar usage, transfusion rate, operation time, hospital stay, or perioperative complications between the two groups. Seromuscular parallel mattress sutures during myomectomy can prevent pinhole errhysis of the uterine incision, achieve complete serosal and aesthetic incisions, and reduce postoperative chronic pelvic pain. It is effective and feasible to complete a parallel mattress suture during myomectomy via single-site laparoscopy. Further prospective studies are required to determine its efficacy as well as pregnancy outcomes.


A test of the reward-contrast hypothesis.
Source memory, a facet of episodic memory, is the memory of the origin of information. Whereas source memory in rats is sustained for at least a week, spatial memory degraded after approximately a day. Different forgetting functions may suggest that two memory systems (source memory and spatial memory) are dissociated. However, in previous work, the two tasks used baiting conditions consisting of chocolate and chow flavors; notably, the source memory task used the relatively better flavor. Thus, according to the reward-contrast hypothesis, when chocolate and chow were presented within the same context (i.e., within a single radial maze trial), the chocolate location was more memorable than the chow location because of contrast. We tested the reward-contrast hypothesis using baiting configurations designed to produce reward-contrast. The reward-contrast hypothesis predicts that under these conditions, spatial memory will survive a 24-h retention interval. We documented elimination of spatial memory performance after a 24-h retention interval using a reward-contrast baiting pattern. These data suggest that reward contrast does not explain our earlier findings that source memory survives unusually long retention intervals.


Analysis of Color and Hardness of a Medical Silicone with Extrinsic Pigmentation after Accelerated Aging.
The aim of this study is to evaluate the color alteration and shore A hardness of a medical silicone with extrinsic pigmentation, before and after accelerated aging. Twenty samples (Silastic Q7-4735) were made with an intrinsic pigmentation. This intrinsic pigmentation was composed of a pink pigment (H-109-P, Factor II) and an opacifier (ZnO). All samples had standardized dimensions (45-mm diameter and 2-mm thickness). Half of the 20 samples manufactured subsequently received an extrinsic pigment (Tan FE-215, Factor II). Therefore, two groups were created (n = 10): Group 1, group with intrinsic pigmentation and without extrinsic pigmentation (control) and Group 2, group with intrinsic and extrinsic pigmentation. Samples were submitted to color and Shore A hardness tests, before and after 1,008 hours of aging. Color alteration data were submitted to Student's t-test (α = 0.05). Shore A hardness data were submitted to two-way analysis of variance and Tukey test (α = 0.05). The incorporation of the extrinsic pigment on the silicone did not affect its color (ΔE) when the two groups were compared (p = 0.232). Regarding the hardness test, the interaction between group and period did not interfere with the hardness results(p=0.599). However, the period factor showed that there was a reduction in the hardness of the silicone after aging (p < 0.05). In this study, all the hardness and color results of the silicone used were clinically acceptable, regardless of the presence of extrinsic pigmentation.


Craniofacial involvement in Langerhans cell histiocytosis: A review of 44 cases at a single medical center.
Craniofacial bones are the most commonly involved site of Langerhans cell histiocytosis (LCH). The main purpose of this study was to clarify the relation between subsites of craniofacial bone and clinical presentation, treatment modalities, outcomes, and permanent consequences (PCs) in patients with LCH. Forty-four patients diagnosed with LCH involving the craniofacial region presenting at a single medical center during 2001-2019 were collected and divided into four groups: single system with unifocal bone lesion (SS-LCH, UFB); single system with multifocal bone lesions (SS-LCH, MFB); multisystem without risk organ involvement (MS-LCH, RO-); and multisystem with risk organ involvement (MS-LCH, RO+). Data including demographics, clinical presentation, treatments, outcomes, and the development of PC were retrospectively reviewed. Temporal bone (66.7% versus 7.7%, p = 0.001), occipital bone (44.4% versus 7.7%, p = 0.022), and sphenoid bone (33.3% versus 3.8%, p = 0.041) involvement were more common in SS-LCH, MFB than they were in SS-LCH, UFB. No difference of reactivation rate was noted among the four groups. The most common PC is diabetes insipidus (DI), reported in 9 of the 16 (56.25%) patients with PC. The single system group was reported with the lowest incidence of DI (7.7%, p = 0.035). The reactivation rate was also higher in patients with PC (33.3% versus 4.0%, p = 0.021) or DI (62.5% versus 3.1%, p < 0.001). An increased risk of multifocal or multisystem lesions was associated with temporal bone, occipital bone, sphenoid bone, maxillary bone, eye, ear, and oral involvement, which may indicate poor outcomes. Longer follow-up may be indicated if there is the presence of PC or DI due to the high risk of reactivation. Therefore, multidisciplinary evaluation and treatment according to risk stratification are vital for patients diagnosed with LCH involving the craniofacial region.


Cooperative interactions in nerve membrane potential and in photosynthesis, evidenced by non-linear Arrhenius plots and critical exponents.
The resting membrane potential of Aplysia nerve and the rate of photosynthesis by intact Chlorella cells have temperature dependences characterized by curved Arrhenius plots, for which the logarithm of the activation energy is a linear function of temperature. Ferromagnetic and ferroelectric systems show similar curves, which suggests that the above two biological systems are governed by cooperative interactions between adjacent molecular sites. Critical exponent analysis suggests the same conclusion.


Anticarcinogenic activity of natural sweeteners, cucurbitane glycosides, from Momordica grosvenori.
To search for cancer chemopreventive agents from natural resources, many phytochemicals and food additives have been screened. Consequently, two natural sweeteners, mogroside V and 11-oxo-mogroside V isolated from the fruits of Momordica grosvenori, exhibited strong inhibitory effect on the primary screening test indicated by the induction of Epstein-Barr virus early antigen (EBV-EA) by a tumor promoter, 12-O-tetradecanoylphorbol-13-acetate (TPA). These sweet glycosides, having cucurbitane triterpenoid aglycon, exhibited the significant inhibitory effects on the two-stage carcinogenesis test of mouse skin tumors induced by peroxynitrite (ONOO-) as an initiator and TPA as a promoter. Further, 11-oxo-mogroside V also exhibited the remarkable inhibitory effect on two-stage carcinogenesis test of mouse skin tumor induced by 7,12-dimethylbenz[a]anthracene (DMBA) as an initiator and TPA as a promoter.


Melatonin enhances spermatogonia activity through promoting KIAA1429-mediated m6A deposition to activate the PI3K/AKT signaling.
Melatonin is a key neuroendocrine hormone that promotes spermatogenesis and sperm motility, but the underlying mechanisms remains poorly understood. In this study, we aimed to investigate the possible roles of m6A (N6--methyl-adenosine) in mediating melatonin-regulated spermatogonia activity alterations. In this study, mouse-derived GC-1 spermatogonia (spg) cell line was used as the in vitro cellular model. The viability, proliferation rates and apoptosis of spermatogonia were detected via CCK-8, Edu staining and flow cytometry respectively. Total m6A level was quantitated by dot blot, while mRNA and proteins contents in spermatogonia were measured by qRT-PCR and western blot respectively. Differentially expressed mRNAs were characterized by deep RNA sequencing method. Results showed that melatonin significantly promoted viability and proliferation rate while inhibited apoptosis in the GC-1 spg cells. The total m6A levels in GC-1 spg cells were also greatly increased by melatonin treatment, accompanied by remarkable expressional elevation of the m6A writer KIAA1429. Moreover, the regulation of GC-1 spg cell viability, proliferation and apoptosis by melatonin were greatly abrogated by KIAA1429 silencing but effectively strengthened by KIAA1429 overexpression. In addition, KIAA1429 overexpression regulates multiple biological process and signaling pathways in spermatogonia such as the PI3K/AKT signaling. The PI3K inhibitor LY294002 effectively mitigated the regulation of spermatogonia activity by KIAA1429 overexpression under melatonin treatment. Taken together, melatonin promotes spermatogonia activity via enhancing KIAA1429 expression and m6A RNA methylation to activate the downstream PI3K/AKT signaling pathway.


Transitional cell papilloma of the bladder in a child: a case report and review of literature.
Transitional cell papillomas of the bladder are tumours of epithelial origin that are extremely rare in children. A large number have been found to be sited adjacent to one of the ureteric orifices. They are benign and endoscopic excision has been considered curative; however, the rate of recurrence reported in the literature is fairly high, with the earliest recurrence being at 3 months. We report the case of a 7-year-old girl who presented with the rare lesion situated just above the right ureteric orifice.


Paradoxical atrial undersensing due to inappropriate atrial noise reversion of atrial fibrillation in dual-chamber pacemakers.
Paradoxical atrial undersensing. Paradoxical atrial undersensing at high atrial sensing levels was described as false atrial noise reversion of dual-chamber pacemakers during atrial fibrillation in a sheep model. It is unknown whether this phenomenon occurs in humans. In total, 71 patients with implanted dual-chamber pacemakers and atrial fibrillation were tested for the occurrence of paradoxical atrial undersensing. After determination of the sensing threshold of atrial fibrillation (30 seconds of continuous mode switch), the atrial sensing level was stepwise increased. If, after correct mode switch behavior at insensitive levels, loss of mode switch occurred at higher sensing levels and if the pacing mode was consistent with atrial noise reversion, paradoxical atrial undersensing was assumed. Paradoxical atrial undersensing could be provoked in 9 of 71 (13%) patients at a median sensing level of 0.4 (range 0.15-2.0) mV. Six different pacemaker models of five different manufacturers were affected. The occurrence of paradoxical atrial undersensing was significantly associated with the sensing threshold of atrial fibrillation (2.7+/-1.5 mV for patients with paradoxical undersensing compared to 1.6+/-1.3 mV for those without, P=0.02). Decreasing the atrial sensing level avoided paradoxical undersensing in 8 of 9 patients while maintaining an adequate safety margin for the detection of atrial fibrillation. Paradoxical atrial undersensing is inherent to all current dual-chamber pacemakers. The incidence is about 13% when using very high atrial sensing levels. Inappropriate atrial noise reversion can be resolved in most of the cases by decreasing atrial sensing levels and knowledge of this phenomenon is important to avoid unwarranted atrial lead revisions.


Lived experiences of Canadian women with metastatic breast cancer in preparation for their death: a qualitative study. Part I--preparations and consequences.
This study aimed to detail the tasks of death preparation and the consequences of such preparation for women with metastatic breast cancer. A phenomenological qualitative approach was used. Five women with metastatic breast cancer were interviewed on two occasions. Themes were analyzed, described, and validated, until saturation was met. Outcomes of thematic analysis related to the impetus, process, and consequences of preparing for one's own death. The women prepared for their death by: acknowledging their grief; preparing mentally; seeking information and support; preparing the family; and preparing for the end of life. They also engaged in creating life projects that enhanced their connections with loved ones, and lived full and joyful lives. These activities helped increased their readiness to die in peace. Preparing for their own death can help women with incurable cancer live full, satisfying lives, and be prepared to face their own death with peace. Helping women express their feelings around their own death and their preparation for death should be a key interdisciplinary psychosocial nursing intervention.


Circadian and circaseptan rhythms in human epilepsy: a retrospective cohort study.
Epilepsy has long been suspected to be governed by cyclic rhythms, with seizure rates rising and falling periodically over weeks, months, or even years. The very long scales of seizure patterns seem to defy natural explanation and have sometimes been attributed to hormonal cycles or environmental factors. This study aimed to quantify the strength and prevalence of seizure cycles at multiple temporal scales across a large cohort of people with epilepsy. This retrospective cohort study used the two most comprehensive databases of human seizures (SeizureTracker [USA] and NeuroVista [Melbourne, VIC, Australia]) and analytic techniques from circular statistics to analyse patients with epilepsy for the presence and frequency of multitemporal cycles of seizure activity. NeuroVista patients were selected on the basis of having intractable focal epilepsy; data from patients with at least 30 clinical seizures were used. SeizureTracker participants are self selected and data do not adhere to any specific criteria; we used patients with a minimum of 100 seizures. The presence of seizure cycles over multiple time scales was measured using the mean resultant length (R value). The Rayleigh test and Hodges-Ajne test were used to test for circular uniformity. Monte-Carlo simulations were used to confirm the results of the Rayleigh test for seizure phase. We used data from 12 people from the NeuroVista study (data recorded from June 10, 2010, to Aug 22, 2012) and 1118 patients from the SeizureTracker database (data recorded from Jan 1, 2007, to Oct 19, 2015). At least 891 (80%) of 1118 patients in the SeizureTracker cohort and 11 (92%) of 12 patients in the NeuroVista cohort showed circadian (24 h) modulation of their seizure rates. In the NeuroVista cohort, patient 8 had a significant cycle at precisely 1 week. Two others (patients 1 and 7) also had approximately 1-week cycles. Patients 1 and 4 had 2-week cycles. In the SeizureTracker cohort, between 77 (7%) and 233 (21%) of the 1118 patients showed strong circaseptan (weekly) rhythms, with a clear 7-day period. Between 151 (14%) and 247 (22%) patients had significant seizure cycles that were longer than 3 weeks. Seizure cycles were equally prevalent in men and women, and peak seizure rates were evenly distributed across all days of the week. Our results suggest that seizure cycles are robust, patient specific, and more widespread than previously understood. They align with the accepted consensus that most epilepsies have some diurnal influence. Variations in seizure rate have important clinical implications. Detection and tracking of seizure cycles on a patient-specific basis should be standard in epilepsy management practices. Australian National Health and Medical Research Council.


Superoxide dismutase and hydrogen peroxide formation in Campylobacter sputorum subspecies bubulus.
Cell-free extracts of Campylobacter sputorum subspecies bubulus contained superoxide dismutase. The enzyme was located in the cytoplasmic fraction and insensitive to cyanide. After centrifuging a cell-free extract at 144000 x g for 1.5 h the total activity in the supernatant fraction was threefold higher than in the crude cell-free extract. The pellet fraction thus obtained was shown to have a lowering effect on superoxide dismutase activities from different sources in the assay method used here. C. sputorum responded to a raised oxygen tension in the culture by an increase in the superoxide dismutase activity. The ability to produce superoxide anion radicals (O2-.) during oxidation of formate and lactate was demonstrated. Furthermore C. sputorum was found to produce H2O2 while oxidizing formate. In experiments in which the reduction of cytochrome c by formate was followed, step-wise kinetics were observed. One of the steady states then obtained was attributed to the oxidizing action of H2O2, because it was abolished by the addition of catalase and lengthened by H2O2 added in addition to H2O2 formed as a product of formate oxidation. An overall reaction for formate oxidation by C. sputorum is discussed.