Predictors of 30- and 90-day readmission following craniotomy for malignant brain tumors: analysis of nationwide data.
Hospital readmissions are a major contributor to increased health care costs and are associated with worse patient outcomes after neurosurgery. We used the newly released Nationwide Readmissions Database (NRD) to describe the association between patient, hospital and payer factors with 30- and 90-day readmission following craniotomy for malignant brain tumor. All adult inpatients undergoing craniotomy for primary and secondary malignant brain tumors in the NRD from 2013 to 2014 were included. We identified all cause readmissions within 30- and 90-days following craniotomy for tumor, excluding scheduled chemotherapeutic procedures. We used univariate and multivariate models to identify patient, hospital and administrative factors associated with readmission. We identified 27,717 admissions for brain tumor craniotomy in 2013-2014, with 3343 (13.2%) 30-day and 5271 (25.7%) 90-day readmissions. In multivariate analysis, patients with Medicaid and Medicare were more likely to be readmitted at 30- and 90-days compared to privately insured patients. Patients with two or more comorbidities were more likely to be readmitted at 30- and 90-days, and patients discharged to skilled nursing facilities or home health care were associated with increased 90-day readmission rates. Finally, hospital procedural volume above the 75th percentile was associated with decreased 90-day readmission rates. Patients treated at high volume hospitals are less likely to be readmitted at 90-days. Insurance type, non-routine discharge and patient comorbidities are predictors of postoperative non-scheduled readmission. Further studies may elucidate potentially modifiable risk factors when attempting to improve outcomes and reduce cost associated with brain tumor surgery.


The rationale for shifting from a voluntary clinical approach to a public health approach in addressing refractive errors.
Millions of people need eyeglasses and do not have them. Assuming that the average pair of eyeglasses has an effective life span of two to five years, an additional 60 to 150 million spectacles would be needed each year for the estimated 303 million individuals who currently need correction. Optometrists are engaged in a variety of capacities in an attempt to address the significant public health problem of uncorrected refractive error. One popular method used by many voluntary optometry-led organisations is to provide direct clinical services to individual patients in developing countries. Considerable manpower, materials, money and logistical resources are used in conducting these short-term missions, yet scarce evidence exists regarding their cost effectiveness or the efficacy and long-term impact of these interventions. The provision of direct clinical services by most foreign volunteers does not directly build local capacity and may hinder development of sustainable local services. Adopting public health approaches will enable volunteer provider organisations to dramatically increase their program effectiveness and output, while developing local capacities in a sustainable way. These approaches should include: 1. Following the national strategy for blindness prevention as determined by the Ministry of Health and forming partnerships with relevant local, national and international organisations. 2. Using need-based criteria to target programs more efficiently. 3. Developing sustainable services via local capacity building. 4. Monitoring, evaluating and using evidence to guide programs. By using these approaches, a larger contribution will be made by the volunteer organisations in addressing the unmet need for refractive correction.


The immunosuppressive activities of different cyclosporins are correlated to inhibition of the early membrane phospholipid metabolism in activated lymphocytes.
Recently, it could be shown that Cyclosporin A (CsA) inhibited the activation of T and B lymphocytes by interfering with an early step of the activation, namely the stimulation of the plasma membrane-bound lysophosphatide acyltransferase. In this report, we compared three CsA-derivatives, Dihydro-Cyclosporin C (Dihydro-CsC), "C9-O-Acetyl"-CsA (CsAAC), Cyclosporin H (CsH), regarding the inhibition of proliferation and the interference with the activation of the phospholipid metabolism. At concentrations below 1 microgram/ml, CsAAC and CsH had no effect on any parameter measured. Dihydro-CsC, however, closely resembled CsA: it inhibited the induction of DNA- and RNA-synthesis in T and B lymphocytes from mesenteric lymph nodes of rabbits. Similar to CsA, Dihydro-CsC also interfered with the enhanced incorporation of arachidonic acid into plasma membrane phospholipids by inhibiting the activation of the lysophosphatide acyltransferase. The close correlation between inhibition of proliferation and interferences with the phospholipid metabolism of the plasma membrane suggested that Dihydro-CsC as well as CsA interfered with an early step of lymphocyte activation at the level of the plasma membrane.


Psychotropic Medication Prescribing in Primary Care: Pediatric Chief Resident Perspectives.
Evidence-based treatments for mental health concerns include psychopharmacological and psychosocial approaches. Pediatrics organizations indicate psychopharmacology needs to be a component of training. This study investigated the status of training in psychotropic medication prescribing through a national survey of pediatric chief residents. Pediatric chief residents (one per residency program) completed a survey (response rate = 60.2%, 127/211) about their attitudes, knowledge, comfort, practice, and training around prescribing psychotropic medication in primary care. Quantitative data included descriptive statistics and correlational analyses to explore relationships between variables; qualitative data were examined through classical content analysis. Almost half of respondents reported prescribing sometimes or often. Frequency of prescribing varied by mental health condition, with highest frequency for attention-deficit/hyperactivity disorder. About two-thirds of respondents reported having at least some/average knowledge. About half of respondents reported being uncomfortable with prescribing; respondents were most uncomfortable with prescribing antianxiety, mood stabilizing, and antipsychotic medications, and with discontinuing medication; about half indicated their competence in progress-monitoring needed improvement. Concurrent psychosocial treatment was perceived as very useful, although often inaccessible to patients. Prescribing frequency was related to knowledge, comfort, progress-monitoring competence, and training quality; training quality was related to knowledge and comfort. Over 60% rated their training as not at all or only somewhat adequate. Pediatric chief residents reported having knowledge of psychotropic medication issues, but experience a general discomfort, especially with discontinuing medication, and with medications other than stimulants. Most thought their training needed improvement in terms of comprehensiveness and clinical practice experiences.


How memory effects, check dams, and channel geometry control erosion and deposition by debris flows.
Debris flows can grow greatly in size and hazardous potential by eroding bed and bank material, but effective hazard assessment and mitigation is currently hampered by limited understanding of erosion and deposition dynamics. We have collected high-resolution pre- and post-flow topography for 6 debris flows over a 3 km long unconsolidated reach of the Illgraben channel in the Swiss Alps with drone-based photogrammetry. We show that the spatio-temporal patterns of erosion and deposition in debris-flow torrents are highly variable and dynamic. Check dams strongly control the spatial patterns of erosion and deposition. We identify a memory effect where erosion is strong at locations of strong deposition during previous flows and vice versa. Large sediment inputs from subcatchments initially result in new channel erosion through the subcatchment deposits and simultaneous upstream deposition, likely as a result of backwater effects. It is generally believed that erosion increases with debris-flow magnitude, but we show that there is a limit to debris-flow bulking set by channel geometry. These findings provide key guidelines for flow volume forecasting, emphasizing the importance of memory effects and the need to resolve both erosion and deposition in predictive models.


3D mapping of cerebrospinal fluid local volume changes in patients with hydrocephalus treated by surgery: preliminary study.
To develop automated deformation modelling for the assessment of cerebrospinal fluid (CSF) local volume changes in patients with hydrocephalus treated by surgery. Ventricular and subarachnoid CSF volume changes were mapped by calculating the Jacobian determinant of the deformation fields obtained after non-linear registration of pre- and postoperative images. A total of 31 consecutive patients, 15 with communicating hydrocephalus (CH) and 16 with non-communicating hydrocephalus (NCH), were investigated before and after surgery using a 3D SPACE (sampling perfection with application optimised contrast using different flip-angle evolution) sequence. Two readers assessed CSF volume changes using 3D colour-encoded maps. The Evans index and postoperative volume changes of the lateral ventricles and sylvian fissures were quantified and statistically compared. Before surgery, sylvian fissure and brain ventricle volume differed significantly between CH and NCH (P = 0.001 and P = 0.025, respectively). After surgery, 3D colour-encoded maps allowed for the visual recognition of the CSF volume changes in all patients. The amounts of ventricle volume loss of CH and NCH patients were not significantly different (P = 0.30), whereas readjustment of the sylvian fissure volume was conflicting in CH and NCH patients (P < 0.001). The Evans index correlated with ventricle volume in NCH patients. 3D mapping of CSF volume changes is feasible providing a quantitative follow-up of patients with hydrocephalus. • MRI can provide helpful information about cerebrospinal fluid volumes. • 3D CSF mapping allows quantitative follow-up in communicating and non-communicating hydrocephalus. • Following intervention, fissures and cisterns readjust in both forms of hydrocephalus. • These findings support the hypothesis of suprasylvian block in communicating hydrocephalus. • 3D mapping may improve shunt dysfunction detection and guide valve pressure settings.


A block of transcription elongation by RNA polymerase II at synthetic sites in vitro.
We have previously suggested that transcription elongation by RNA polymerase II can be blocked when the nascent RNA is folded into a stem-and-loop structure followed by polyuridines. As an approach to test this suggestion in vitro, several GC-rich deoxyoligonucleotides with dyad symmetries were chemically synthesized and inserted following the adenovirus 2 major late promoter. These constructs were transcribed in vitro using HeLa whole cell extract. The transcripts of the synthetic inserts can potentially form stem-and-loop structures with destabilization energy from 0 to -48 kcal followed by 3, 5, and 8 U residues. The results obtained show that transcription elongation is blocked by these synthetic inserts and that the extent of the elongation block is directly correlated to the stabilities of the potential stem-and-loop structure and the proceeding number of U residues. Three levels of elongation blocks were observed: a brief pause of the polymerase occurs when the RNA could be folded into a secondary structure or when there were 5-6 T residues on the sense DNA strand. An extended pause occurred when the number of T residues on the sense DNA strand was increased to 8. Transcription termination, with a partial release of the attenuated transcript occurred when a stable RNA secondary structure (delta G = -48 kcal) was followed by 8 U residues. The relevancy of these in vitro results to the in vivo mechanism of a transcription elongation block is discussed.


Leveraging type 1 diabetes human genetic and genomic data in the T1D knowledge portal.
To address the challenge of translating genetic discoveries for type 1 diabetes (T1D) into mechanistic insight, we have developed the T1D Knowledge Portal (T1DKP), an open-access resource for hypothesis development and target discovery in T1D.


Accuracy of Body Size Estimation in Youth with Cystic Fibrosis and Association with Health-Related Quality of Life.
Accuracy of body size estimation may impact motivation to adhere to treatment recommendations and health-related quality of life (HRQOL) in youth with cystic fibrosis (CF), but this has not yet been investigated. Thus, the goal of the current study was to examine accuracy of body size estimation in youth with CF, and associations with HRQOL, lung functioning, and dietary intake. Fifty-four youth diagnosed with CF (M = 13.61 years) completed the Figure Rating Scale, the Cystic Fibrosis Questionnaire-Revised, and a 24-h diet recall interview. Cohen's Weighted Kappa Coefficient evaluated agreement between body size estimation and BMI percentile. Binary logistic regression analyses examined associations between body size accuracy and HRQOL, lung functioning, and dietary intake. A less than adequate agreement was found between youth body size estimation and BMI percentile. Most participants overestimated body size (69.8%). Body Image HRQOL, but neither lung functioning nor dietary intake, was significantly associated with body size estimation accuracy. Working with patients to improve perceptions of body size may also improve HRQOL scores and allow for discussion about treatment goals related to body size.


The WNT signaling pathway from ligand secretion to gene transcription: molecular mechanisms and pharmacological targets.
Wingless/integrase-1 (WNT) signaling is a key pathway regulating various aspects of embryonic development; however it also underlies several pathological conditions in man, including various cancers and fibroproliferative diseases in several organs. Investigating the molecular processes involved in (canonical) WNT signaling will open new avenues for generating new therapeutics to specifically target diseases in which WNT signaling is aberrantly regulated. Here we describe the complexity of WNT signal transduction starting from the processes involved in WNT ligand biogenesis and secretion by WNT producing cells followed by a comprehensive overview of the molecular signaling events ultimately resulting in enhanced transcription of specific genes in WNT receiving cells. Finally, the possible targets for therapeutic intervention and the available pharmacological inhibitors for this complex signaling pathway are discussed.


Status, masculinity, and femininity at the intersection of age and gender.
Although men are generally awarded greater status than women, little is known about how gendered ageism may affect the gender gap in status. Using an online survey experiment (N = 2473), this study examines how cultural beliefs about status, masculinity, and femininity are differentially affected by men's and women's age. Findings show that aging has little effect on men's perceived status, but aging drives both upswings and downswings in women's perceived status, giving men status advantages during early and late adulthood. Similarly, whereas aging does not affect men's perceived masculinity, aging drives upswings and downswings in women's perceived femininity, depending on current age. Perceived masculinity is more strongly linked to men's status than perceived femininity is to women's. Findings contribute to research on status and gendered ageism, and shed light on how age and gender combine to influence ubiquitous social judgments that are integral to the reproduction of social inequality.


Nucleated red blood cells impact DNA methylation and expression analyses of cord blood hematopoietic cells.
Genome-wide DNA methylation (DNAm) studies have proven extremely useful to understand human hematopoiesis. Due to their active DNA content, nucleated red blood cells (nRBCs) contribute to epigenetic and transcriptomic studies derived from whole cord blood. Genomic studies of cord blood hematopoietic cells isolated by fluorescence-activated cell sorting (FACS) may be significantly altered by heterotopic interactions with nRBCs during conventional cell sorting. We report that cord blood T cells, and to a lesser extent monocytes and B cells, physically engage with nRBCs during FACS. These heterotopic interactions resulted in significant cross-contamination of genome-wide epigenetic and transcriptomic data. Formal exclusion of erythroid lineage-specific markers yielded DNAm profiles (measured by the Illumina 450K array) of cord blood CD4 and CD8 T lymphocytes, B lymphocytes, natural killer (NK) cells, granulocytes, monocytes, and nRBCs that were more consistent with expected hematopoietic lineage relationships. Additionally, we identified eight highly differentially methylated CpG sites in nRBCs (false detection rate <5 %, |Δβ| >0.50) that can be used to detect nRBC contamination of purified hematopoietic cells or to assess the impact of nRBCs on whole cord blood DNAm profiles. Several of these erythroid markers are located in or near genes involved in erythropoiesis (ZFPM1, HDAC4) or immune function (MAP3K14, IFIT1B), reinforcing a possible immune regulatory role for nRBCs in early life. Heterotopic interactions between erythroid cells and white blood cells can result in contaminated cell populations if not properly excluded during cell sorting. Cord blood nRBCs have a distinct DNAm profile that can significantly skew epigenetic studies. Our findings have major implications for the design and interpretation of genome-wide epigenetic and transcriptomic studies using human cord blood.


Structure and activity of insulin, XV[1-5]. Further evidence for the importance of arginine residue B22 in the activity of insulin. Semisyntheses of despentapeptide-(B23 - 30)-insulins varied in B22 using desnonapeptide-(B22 - 30)-insulin and tetrapeptides.
Insulin hexamethyl ester was digested by trypsin. The resulting desoctapeptide-(B23 - 30)-insulin pentamethyl ester was purified. This compound was digested by carboxypeptidase B to remove the arginine residue B22 at the end of the B chain. Then the N-terminal amino groups of the remaining desnonapeptide-(B22 - 30)-insulin pentamethyl ester were protected with the Boc residue. The free carboxyl group of the glutamic acid residue B21 of this product was coupled to the following synthetic tetrapeptide esters: Arg-Gly-Phe-Phe-OMe, Lys(Boc)-Gly-Phe-Phe-OMe, Orn(Boc)-Gly-Phe-Phe-OMe, Cit-Gly-Phe-Phe-OMe, Ala-Gly-Phe-Phe-OMe and Gly-Gly-Phe-Phe-OMe. The syntheses of these peptide esters are described. After removal of all protecting groups, despentapeptide-insulin (B22-Arg) and analogues of this product with variation in position B22 could be obtained. They were purified by column chromatography. The biological activities of these components were determined by the mouse fall test. In the case of despentapeptide insulin (C-terminus Arg-Gly-Phe-Phe), the activity rose to the expected value of 34%. The insulin variants with amino acid residues other than arginine in position B22 had much lower activities: with lysine 13%, with ornithine 12%, with citrulline 9%, with alanine 8% and with glycine 6%. Desnonapeptide-insulin by itself posses an activity of 3%. These results demonstrate once more the essential nature of arginine residue B22 for insulin activity.


Regulatory Role for NK Cells in a Mouse Model of Systemic Juvenile Idiopathic Arthritis.
Mice deficient in IFN-γ (IFN-γ knockout [KO] mice) develop a systemic inflammatory syndrome in response to CFA, in contrast to CFA-challenged wild-type (WT) mice who only develop a mild inflammation. Symptoms in CFA-challenged IFN-γ KO resemble systemic juvenile idiopathic arthritis (sJIA), a childhood immune disorder of unknown cause. Dysregulation of innate immune cells is considered to be important in the disease pathogenesis. In this study, we used this murine model to investigate the role of NK cells in the pathogenesis of sJIA. NK cells of CFA-challenged IFN-γ KO mice displayed an aberrant balance of activating and inhibitory NK cell receptors, lower expression of cytotoxic proteins, and a defective NK cell cytotoxicity. Depletion of NK cells (via anti-IL-2Rβ and anti-Asialo-GM1 Abs) or blockade of the NK cell activating receptor NKG2D in CFA-challenged WT mice resulted in increased severity of systemic inflammation and appearance of sJIA-like symptoms. NK cells of CFA-challenged IFN-γ KO mice and from anti-NKG2D-treated mice showed defective degranulation capacities toward autologous activated immune cells, predominantly monocytes. This is in line with the increased numbers of activated inflammatory monocytes in these mice which was particularly reflected in the expression of CCR2, a chemokine receptor, and in the expression of Rae-1, a ligand for NKG2D. In conclusion, NK cells are defective in a mouse model of sJIA and impede disease development in CFA-challenged WT mice. Our findings point toward a regulatory role for NK cells in CFA-induced systemic inflammation via a NKG2D-dependent control of activated immune cells.


A case report of a patient with retinoblastoma and chromosome 13q deletion: assignment of a new gene (gene for LCP1) on human chromosome 13.
Retinoblastoma (Rb) occurs in hereditary, non-hereditary, and chromosomal deletion forms and the locus for the Rb gene (Rb-1) is closely linked to the locus for esterase D (ESD) assigned to the chromosome 13q14.11. We describe a patient who was predicted to have Rb from the genetic analysis of the chromosome and ESD phenotype. Furthermore, the gene for lymphocyte cytosol polypeptide with molecular weight of 64,000 (LCP1: McKusick catalogue No. 15343, 1983) was assigned to chromosome 13 by deletion mapping. A 3-month-old female had many characteristics of chromosome 13q-syndrome, including dolichocephaly, epicanthus, ptosis, depressed nasal bridge, micrognathia, short webbed neck, and short fifth fingers with clinodactyly and single crease. The karyotype of the patient was 46,XX,del(13) (q14.1-q32), though both the parents had normal karyotypes. As expected, the phenotype of ESD derived from one of the parents, the father in this case, was not detected in peripheral blood lymphocytes by two-dimensional gel electrophoresis (two-DE), indicating that ESD from the father was deleted in the abnormal chromosome 13. The possibility of paternity was calculated to be 0.996 based on the data using 22 genetic markers. Bilateral retinoblastomas could be diagnosed by ophthalmologic examinations before the manifestation of any clinical signs of the tumor and immediately intensive care was taken. In addition, the phenotype of LCP1 derived from the father was not expressed in the lymphocyte proteins from the patient. These data indicate that the gene for LCP1 (LCP1) is located in the region q14.1-q32 of chromosome 13 and may be a useful genetic marker for preclinical diagnosis of Rb.


Targeted editing of multiple homologues of GTR1 and GTR2 genes provides the ideal low-seed, high-leaf glucosinolate oilseed mustard with uncompromised defence and yield.
Glucosinolate content in the two major oilseed Brassica crops-rapeseed and mustard has been reduced to the globally accepted Canola quality level (<30 μmoles/g of seed dry weight, DW), making the protein-rich seed meal useful as animal feed. However, the overall lower glucosinolate content in seeds as well as in the other parts of such plants renders them vulnerable to biotic challenges. We report CRISPR/Cas9-based editing of glucosinolate transporter (GTR) family genes in mustard (Brassica juncea) to develop ideal lines with the desired low seed glucosinolate content (SGC) while maintaining high glucosinolate levels in the other plant parts for uncompromised plant defence. Use of three gRNAs provided highly efficient and precise editing of four BjuGTR1 and six BjuGTR2 homologues leading to a reduction of SGC from 146.09 μmoles/g DW to as low as 6.21 μmoles/g DW. Detailed analysis of the GTR-edited lines showed higher accumulation and distributional changes of glucosinolates in the foliar parts. However, the changes did not affect the plant defence and yield parameters. When tested against the pathogen Sclerotinia sclerotiorum and generalist pest Spodoptera litura, the GTR-edited lines displayed a defence response at par or better than that of the wild-type line. The GTR-edited lines were equivalent to the wild-type line for various seed yield and seed quality traits. Our results demonstrate that simultaneous editing of multiple GTR1 and GTR2 homologues in mustard can provide the desired low-seed, high-leaf glucosinolate lines with an uncompromised defence and yield.


Beyond the Health Deficit Count: Examining Deficit Patterns in a Deficit-Accumulation Frailty Index.
Exploring deficit patterns among frail people may reveal subgroups of different prognostic importance. Analysis of National Health and Aging Trends Study. Community. Community dwelling older adults with mild to moderate frailty (deficit-accumulation frailty index (FI) of 0.25-0.40) (n = 1821). Latent class analysis identified distinct clinical subgroups based on comorbidity (range: 0-10), National Health and Aging Trends Study dementia classification, and short physical performance battery (SPPB) (range: 0-12). Survival analyses compared 5-year mortality by subgroups. Three latent classes existed: Class 1 (n = 831, mean FI = 0.30) had 2.7% probable dementia, high comorbidities (mean = 3.6), and low physical impairment (SPPB mean = 9.9); Class 2 (n = 734, mean FI = 0.32) had 6.9% probable dementia, low comorbidities (mean = 2.8), and moderate physical impairment (SPPB mean = 6.2); Class 3 (n = 256, mean FI = 0.34) had 20.7% probable dementia, low comorbidities (mean = 2.4), and high physical impairment (SPPB mean = 2.0). Compared to Class 1, Classes 2 and 3 experienced higher 5-year mortality (C2: 1.28 (95% confidence intervals (CI) = 1.00-1.62); C3: 1.87 (95% CI = 1.29-2.73)). Deficit patterns among the mild-to-moderately frail provide additional prognostic information and highlight opportunities for preventive interventions.


Attainment of continence with J-pouch and artificial bowel sphincter for concomitant imperforate anus and familial adenomatous polyposis: report of a case.
Numerous proven surgical therapies now exist to compensate for loss of anal sphincter function or loss of rectal reservoir capacity. Fecal incontinence that results from the combined loss of rectal reservoir and anal sphincter tone remains a surgical challenge. This case describes what may be the first successful treatment of a patient with imperforate anus and familial adenomatous polyposis using an ileal J-pouch and artificial bowel sphincter.


Insulin resistance in type 1 diabetes: what is 'double diabetes' and what are the risks?
In this review, we explore the concept of 'double diabetes', a combination of type 1 diabetes with features of insulin resistance and type 2 diabetes. After considering whether double diabetes is a useful concept, we discuss potential mechanisms of increased insulin resistance in type 1 diabetes before examining the extent to which double diabetes might increase the risk of cardiovascular disease (CVD). We then go on to consider the proposal that weight gain from intensive insulin regimens may be associated with increased CV risk factors in some patients with type 1 diabetes, and explore the complex relationships between weight gain, insulin resistance, glycaemic control and CV outcome. Important comparisons and contrasts between type 1 diabetes and type 2 diabetes are highlighted in terms of hepatic fat, fat partitioning and lipid profile, and how these may differ between type 1 diabetic patients with and without double diabetes. In so doing, we hope this work will stimulate much-needed research in this area and an improvement in clinical practice.


Energy Storage Characteristics of BiFeO₃/BaTiO₃ Bi-Layers Integrated on Si.
BiFeO₃/BaTiO₃ bi-layer thick films (~1 μm) were deposited on Pt/Ti/SiO₂/(100) Si substrates with LaNiO₃ buffer layers at 500 °C via a rf magnetron sputtering process. X-ray diffraction (XRD) analysis revealed that both BiFeO₃ and BaTiO₃ layers have a (00l) preferred orientation. The films showed a small remnant polarization (Pr ~ 7.8 μC/cm²) and a large saturated polarization (Ps ~ 65 μC/cm²), resulting in a slim polarization-electric field (P-E) hysteresis loop with improved energy storage characteristics (Wc = 71 J/cm³, η = 61%). The successful "slim-down" of the P-E loop from that of the pure BiFeO₃ film can be attributed to the competing effects of space charges and the interlayer charge coupling on charge transport of the bi-layer film. The accompanying electrical properties of the bi-layer films were measured and the results confirmed their good quality.


Photo-induced adhesive carboxymethyl chitosan-based hydrogels with antibacterial and antioxidant properties for accelerating wound healing.
Designing adhesive hydrogel wound dressings with inherent antibacterial and antioxidant properties is desirable to treat cutaneous full-thickness injuries in clinical care. Herein, a series of photo-induced Schiff base crosslinking-based adhesive hydrogels with promising traits are designed and prepared through Diels-Alder (DA) reactions between functional groups-grafted carboxymethyl chitosan (CMCS) and a photo-responsive polyethylene glycol (PEG) crosslinker. The quaternary ammonium and phenol groups in modified CMCS endows hydrogels excellent antibacterial and antioxidant properties. Upon UV (365 nm) irradiation, the generated o-nitrosobenzaldehyde from the photo-isomerization of o-nitrobenzyl in PEG derivative can subsequently crosslink with amino groups on tissue interfaces via Schiff base, endowing the hydrogel with well adhesiveness. Additionally, the hydrogel exhibits good BSA adsorption capacity, cytocompatibility and hemostatic property. The in vivo full-thickness skin defect study on mice indicates that the multi-functional hydrogel with considerable collagen deposition and vascularization capacities can be an effective and promising adhesive dressing for improving wound healing.


No vasodilator response to low-dose heparin in the forearm skeletal-muscle vascular bed.
Recent reports show that heparin induces vasodilation. This heparin-induced vasodilation might interfere with the results of vascular studies using the perfused-forearm technique because the arterial catheter is often flushed with a heparin solution in those experiments. Therefore, we investigated the vascular effects of flushing an arterial catheter with a heparin solution compared with a placebo solution (NaCl 0.9%) in six healthy volunteers. During the first half of each experiment, the arterial catheter was flushed several times with the placebo solution. In the second half, identical flushes were performed with a solution of heparin diluted in NaCl 0.9% (4U x ml(-1)). Forearm blood flow (venous occlusion plethysmography) response was similar with heparin and placebo after all flushes. We conclude that low-dose heparin in the solution to flush an arterial catheter has no short-term vasodilator effect in the human forearm vascular bed. Therefore, the results of studies using the perfused-forearm technique are not confounded by flushes with a low-dose heparin solution.


Two years' investigation of epidemic hepatitis E virus transmission in West Kalimantan (Borneo), Indonesia.
Two years' follow-up investigation of a hepatitis E virus (HEV) outbreak in West Kalimantan, Indonesia in 1991 was carried out to investigate the epidemiology of epidemic HEV transmission and the persistence of the immunoglobulin G (IgG) antibody response. Sixty cases identified as anti-HEV IgG positive during the outbreak in 1991 were matched with 67 controls and examined, together with 318 members of their families. Overall, the prevalence of anti-HEV IgG among the 445 subjects (representing 127 households) was 59%. There was no significant difference in anti-HEV prevalence between cases (72%) and controls (61%). Loss of detectable anti-HEV IgG after 2 years was demonstrated in 17 of 60 subjects (28%) who were originally positive for anti-HEV in 1991. The mean number of anti-HEV positive subjects per household was 2.04. Cross-sectional prevalence of anti-HEV IgG increased significantly with age (P = 0.01). When communities were grouped into areas of low (< 40%), medium (40-59%) and high (> or = 60%) anti-HEV prevalence, use of river water for drinking and cooking (P < 0.001), personal washing (P < 0.0001), and human excreta disposal (P < 0.001) were associated with high prevalence communities. Conversely, boiling drinking water was negatively associated with increased prevalence (P = 0.02). Subnormal rainfall during the month (August) leading up to the 1991 outbreak (19 cm compared to the monthly mean of 209 cm in 1985-1993) may have contributed to favourable epidemic conditions.


Febrile seizures: traffic slows in the heat.
Febrile seizures, which occur in young children, have long been known to have a major inherited component. Mutations in some genes that encode sodium channel and GABA(A) receptor subunits have been found in a few families affected by febrile seizures. These mutations account only for a minority of cases, and much remains to be learnt about the molecular architecture of febrile seizures. A rare inherited cause--a mutation in the GABA(A) receptor subunit GABRG2 gene--has been recently shown to cause a temperature-dependent intracellular trafficking defect. This is an important step in unravelling the molecular pathogenesis of this common childhood disorder.


Novel malonamidases in Bradyrhizobium japonicum. Purification, characterization, and immunological comparison.
Three novel malonamidases (E1a, E1b, and E2) occurring constitutively in Bradyrhizobium japonicum were purified to electrophoretic homogeneity. They were found to catalyze one or more of the following three types of reactions: malonyl transfer to hydroxylamine (reaction 1), hydroxaminolysis of malonamate (reaction 2), and hydrolysis of malonamate (reaction 3). The molecular sizes of E1a, E1b, and E2 were 126, 107, and 103 kDa, respectively, and they were each composed of two identical subunits. The pIs of E1a and E1b, 5.5 and 5.0 respectively, were similar, but that of E2 was 7.2. Optimum pH values varied with the type of reactions catalyzed, but among the enzymes they were found to be similar. The affinity of E2 for malonamate was about 30- and 70-fold higher than that of E1a and E1b, respectively. Acetate and propionate inhibited E1a activity competitively, whereas malonate inhibited E2 activity noncompetitively. The amino acid composition and N-terminal amino acid sequence of the three enzymes were found to be different. These enzymes were also immunologically different. E1a was found to form a malonyl-enzyme intermediate during the catalysis through the isolation of [14C]malonyl-enzyme with gel filtration and through isotope exchange experiments with [18O]malonate. These malonamidases may play a role for the self-protection against malonate toxicity in nodule bacteroids and may also be involved in the transport of fixed nitrogen to the plant cell.


Pharmacokinetic studies of a novel tubulin inhibitor SK1326 in rat plasma by UPLC-MS/MS.
A sensitive method for quantitation of SK1326 in rat plasma has been established using ultra-performance liquid chromatography-electrospray ionization tandem mass spectrometry (UPLC-ESI/MS/MS). SK1326 and the internal standard (tramadol) in plasma sample were extracted using acetonitrile. A centrifuged upper layer was then evaporated and reconstituted with a mobile phase of 0.5% formic acid-acetonitrile (35:65, v/v). The reconstituted samples were injected into a C18 reversed-phase column. Using MS/MS in the multiple reaction monitoring mode, SK1326 and tramadol were detected without severe interference from the rat plasma matrix. SK1326 produced a protonated precursor ion ([M + H]+ ) at m/z 432.3 and a corresponding product ion at m/z 114.4. The internal standard produced a protonated precursor ion ([M + H]+ ) at m/z 264.4 and a corresponding product ion at m/z 58.1. Detection of SK1326 in rat plasma by the UPLC-ESI/MS/MS method was accurate and precise with a quantitation limit of 1.0 ng/mL. The validation, reproducibility, stability and recovery of the method were evaluated. The method has been successfully applied to pharmacokinetic studies of SK1326 in rat plasma. The pharmacokinetic parameters of SK1326 were evaluated after intravenous (at a dose of 10 mg/kg) and oral (at a dose of 20 mg/kg) administration of SK1326 in rats. After oral administration (20 mg/kg) of SK1326, the F (fraction absorbed) value was ~77.1%.


[Prevention of acute stress ulcer and gastrointestinal bleeding in patients with acute necrotizing pancreatitis].
We aimed to compare the efficiency of drugs for prevention a gastrointestinal bleeding. The results of prospective and retrospective clinical study of 51 patients with acute necrotizing pancreatitis ANP. They were distributed assigned depending on the drug for the prevention of gastrointestinal bleeding in the first group (n = 39) used omeprazole (80 mg/day); in second (n = 12) pantoprazole (80 mg/day). The mean age (47,9 +/- 10,6 +/- 9,2) years, the severity of disease (average rating of APACHE II classification system 16,7 +/- 4,5 vs. 14,8 +/- 3,4) were similar. Our data discover that there no statistical difference between groups in bleeding rate. pantoprazole can be used for prevention of hemorrhagic complication of stress ulcer in patients with necrotizing pancreatitis. A high percentage of hidden blood loss confirms the need for drugs with high therapeutic potential


Low bone mineral density in the early menopausal transition: role for ovulatory function.
OBJECTIVE AND CONTEXT: The objective of the study was to determine whether luteal abnormalities or measures of sex steroid hormones collected across a menstrual cycle were associated with bone mineral density (BMD) at the total hip or lumbar spine. The Study of Women's Health Across the Nation is a longitudinal, community-based study conducted at seven clinical sites. Study of Women's Health Across the Nation includes a daily hormone study substudy in which daily urine samples are collected for one menstrual cycle (up to a maximum of 50 d) each year. Participants included 643 pre- and perimenopausal women, aged 43-53 yr. BMD of the lumbar spine and total hip was measured by dual-energy x-ray densitometry. Daily urine samples were assayed for estrone conjugates, pregnanediol glucuronide, LH, and FSH, and the information from across the menstrual cycle was expressed as area under the curve (AUC). BMD levels were evaluated in relation to three menstrual cycle attributes: 1) absence or presence of ovulation; 2) luteal phase length to menstrual cycle length ratio; and 3) ovulatory disturbances, defined as anovulatory cycles or cycles with short luteal phases (<10 d). Lower urine estrone conjugate AUC and higher urine FSH AUC were significantly associated with lower BMD. However, luteal abnormalities based on menstrual cycle attributes were not significantly associated with BMD at the total hip or lumbar spine after adjustment for age, body mass index, urinary hormone concentrations, menopausal status, and race/ethnicity. Direct measures of urinary hormones, not menstrual cycle luteal abnormalities, were associated with lower levels of BMD.


Discovering Public Health Nurse-Specific Family Home Visiting Intervention Patterns Using Visualization Techniques.
Visualization is a Big Data method for detecting and validating previously unknown and hidden patterns within large data sets. This study used visualization techniques to discover and test novel patterns in public health nurse (PHN)-client-risk-intervention-outcome relationships. To understand the mechanism underlying risk reduction among high risk mothers, data representing complex social interventions were visualized in a series of three steps, and analyzed with other important contextual factors using standard descriptive and inferential statistics. Overall, client risk decreased after clients received personally tailored PHN services. Clinically important and unique PHN-client-risk-intervention-outcome patterns were discovered through pattern detection using streamgraphs, heat maps, and parallel coordinates techniques. Statistical evaluation validated that PHN intervention tailoring leads to improved client outcomes. The study demonstrates the importance of exploring data to discover ways to improve care quality and client outcomes. Further research is needed to examine additional factors that may influence PHN-client-risk-intervention-outcome patterns, and to test these methods with other data sets.


Quality of life in Hidradenitis Suppurativa (Acne Inversa): A scoping review.
Hidradenitis Suppurativa (HS) is a chronic, relapsing, inflammatory skin condition which is physically, psychologically and socially disabling and often affects a patient's quality of life (QOL). There are numerous QOL tools used in dermatology. However, assessment of QOL in patients with HS is difficult due to the inability of generic QOL tools to specifically capture QOL in patients with HS. Numerous HS-specific QOL tools have been developed in recent years. It is important to identify evidence on full psychometric evaluation of these tools. There has been a gradual increase in the use of generic and disease-specific QOL tools in the last few decades. The aim of this scoping review (SR) is to evaluate the most widely used generic QOL tools and HS-specific QOL tools to identify the psychometric evaluation of such tools. Design: An SR guided by Joanna Briggs Institute manual and Arskey O'Malley framework guidelines. Data extraction included the studies available on full psychometric evaluation of the most widely used dermatology generic QOL tools in HS and HS-specific QOL tools. Ten papers were included in the review, eight papers demonstrated HS-specific QOL assessment tools. The psychometric properties of these tools were underpinned by reliability, validity and sensitivity measurement. Six disease-specific tools were identified in this SR. However, they all lack full psychometric evaluation. This review indicates that an extensive research in the field of QOL tools for HS is much needed. It is crucial to develop user-friendly and validate disease-specific tools to measure the real impact of disease on patients QOL. QOL instruments can evaluate the impact on life of an HS patient, thus helping improve intervention and management of disease. There is a necessity for more research into existing HS-specific QOL tools and they should be widely tested and fully validated.


Variation in Electronic Health Record Documentation of Social Determinants of Health Across a National Network of Community Health Centers.
This paper describes the adoption of an electronic health record-based social determinants of health screening tool in a national network of more than 100 community health centers. In 2016, a screening tool with questions on 7 social determinants of health domains was developed and deployed in the electronic health record, with technical instructions on how to use the tool and suggested clinical workflows. To understand adoption patterns, the study team extracted electronic health record data for any patient with a community health center visit between June 2016 and May 2018. Patients were considered "screened" if a response to at least 1 social determinants of health domain was documented in the electronic health record tool. A total of 31,549 patients (2% of those with a visit in the study period) had a documented social determinants of health screening. The number of screenings increased over time, time; 71 community health centers (67%) conducted at least one screening, but almost 50% took place in only 4 community health centers. Over half (55%) of screenings only included responses for only 1 domain. Screening was most likely to occur during an office visit with an established patient and documented in the electronic health record by a medical assistant. Screening documentation patterns varied widely across the network of community health centers. Despite the growing national emphasis on the importance of screening for social determinants of health, these findings suggest that simply activating electronic health record tools for social determinants of health screening does not lead to widespread adoption. Potential barriers to screening adoption and implementation should be explored further. This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.


Activation of membrane Na+/K+-ATPase of mouse skeletal muscle by acetylcholine and its inhibition by alpha-bungarotoxin, curare and atropine.
The effect of acetylcholine and of three cholinolytic compounds (alpha-bungarotoxin, curare and atropine) on electrogenic Na+/K+ pump and activity of the membrane Na+/K+-ATPase of mouse skeletal muscles was studied. It was found that acetylcholine potentiated both the muscle electrogenic ionic pump and the Na+/K+-ATPase activity of crude membrane fractions. The cholinolytic drugs had inhibitory effects on both parameters, with the exception of curare which was ineffective in blocking the electrogenic ionic pump.


Disruption of the hexokinase-VDAC complex for tumor therapy.
Unlike mitochondria from most normal tissues, cancer cell mitochondria demonstrate an association between the glycolytic enzyme hexokinase (HK) and the voltage-dependent anion channel (VDAC). This provides a therapeutic opportunity, as the association appears to protect tumor cells from mitochondrial outer membrane permeabilization (MOMP), an event that marks the point of no return in multiple pathways leading to cell death. In this issue of Oncogene, the plant hormone methyl jasmonate (MJ) is shown to disrupt the interaction between human HK and VDAC, causing the inhibition of glycolysis and the induction of MOMP. MJ has already been shown to have selective anticancer activity in preclinical studies, and this finding may stimulate the development of a novel class of small anticancer compounds that inhibit the HK-VDAC interaction.


Blood pressure variability as an indicator of sepsis severity in adult emergency department patients.
Quantify the correlation between blood pressure variability (BPV) and markers of illness severity: serum lactate (LAC) or Sequential Organ Failure Assessment (SOFA) scores. We performed a secondary analysis of data from a prospective, observational study evaluating fluid resuscitation on adult, septic, ED patients. Vital signs and fluid infusion volumes were recorded every 15min during the 3h following ED arrival. BPV was assessed via average real variability (ARV): the average of the absolute differences between consecutive BP measurements. ARV was calculated for the time periods before and after 3 fluid infusion milestones: 10-, 20-, and 30-mL/kg total body weight (TBW). Spearman's rho correlation coefficient analysis was utilized. A p-value<0.05 was considered statistically significant. Forty patients were included. Mean fluid infusion was 33.7mL/kg TBW (SD 22.1). All patients received fluid infusion≥10mL/kg TBW, 25 patients received fluid infusion>20mL/kg TBW, and 16 patients received fluid infusion>30mL/kg TBW. Mean initial LAC was 4.0mmol/L (SD 3.2). Mean repeat LAC was 3.1mmol/L (SD 3.2), obtained an average of 6.6h (SD 5.3) later. Mean SOFA score was 7.0 (SD 4.4). BPV correlated with both follow-up LAC (r=0.564; p=0.023) and SOFA score (r=0.544; p=0.024) among the cohort that received a fluid infusion>20-mL/kg TBW. With the finding of a positive correlation between BPV and markers of illness severity (LAC and SOFA scores), this pilot study introduces BPV analysis as a real-time, non-invasive tool for continuous sepsis monitoring in the ED.


Differential Diagnosis of Post Auricular Swelling with Mastoid Bone Involvement.
Post auricular swelling with mastoid bone involvement most commonly occurs as a cranial complication of chronic or acute suppurative otitis media. Aim of this study, to detect etiology of postauricular swelling with mastoid bone involvement. This is a retrospective study which was done on all patients whom underwent mastoidectomy for post auricular swelling with mastoid bone involved in El Minia University Hospital from January 2014 to June 2017. A total of 49 patients were identified in this study, 23 males and 26 females, their ages ranged 5-28 years old with a mean of 25.8 years old. Group A: these were 45 patients with a history of otorrhea (chronic suppurative otitis media), of 3 months to 4 years duration. Group B: these were four patients without any history of otorrhea. Two patients diagnosed as acute otitis media, one patient diagnosed as Langerhans cell histiocytosis and one patient diagnosed as fungal mastoiditis. Chronic suppurative otitis media is the most common causes of postauricular swelling. Langerhans cell histiocytosis of the temporal bone and fungal mastoiditis are considered a rare presentation of postauricular swelling.


Benefits of surgical reconstruction in pressure ulcers with a non-advancing edge and scar formation.
To highlight the difficulty in treating pressure ulcers associated with scar formation and the benefits of surgical treatment in these cases by presenting a series of clinical cases. Nine sacral ulcers surrounded by significant scar formation and 14 sacral ulcers without significant scars were treated using the same conservative management protocol. Healing status was quantitatively estimated using an assessment tool called DESIGN, which classifies pressure ulcer severity and allows healing to be monitored; a decreasing score indicates progressive improvement. Ulcers with scar formation showed little response to the treatment, while those without remarkable scars exhibited a significant decrease of the DESIGN scores. Surgical reconstruction was conducted in five ulcers surrounded by scar formation, and all showed complete healing within extremely short periods. Conservative treatment of pressure ulcers with a non-advancing edge surrounded by scar formation presents considerable difficulties. Surgical reconstruction offers many benefits for non-healing ulcers.


Dealing with the cold: Shedding light on phototrophic life in the polar regions.
Photoautotrophic organisms face extreme conditions in the Polar Regions including permanently low temperatures, freezing, salinity and low nutrient. Certain microalgae and cyanobacteria are able to withstand these conditions and adaptation mechanisms associated with photophysiology play an important part in overcoming challenges created by variation in irradiance under low temperatures.


Effects of Reductions in Body Mass Index on the Future Osteoarthritis Burden in Canada: A Population-Based Microsimulation Study.
Osteoarthritis (OA) is the most common joint disease and a major cause of disability. Incidence and prevalence of OA are expected to increase due to population aging and increased levels of obesity. The purpose of this study was to project the effect of hypothetical interventions that change the distribution of body mass index (BMI) on OA burden in Canada. We used a microsimulation computer model of OA based on the Population Health Model platform. The model used demographic predictions for Canada and population data from an administrative database in British Columbia and national Canadian surveys. Under the base-case scenario, between 2010 and 2030, OA prevalence is expected to increase from 11.5% to 15.6% in men and 16.3% to 21.1% in women. In scenarios assuming, on average, a 0.3-, 0.5-, or 1-unit drop in BMI per year, OA prevalence in 2030 would reach 14.9%, 14.6%, and 14.2% in men and 20.3%, 19.7%, and 18.5%, in women, respectively. Under these scenarios, the proportion of new cases prevented would be 9.5%, 13.2%, and 16.7%, respectively, in men, and 9.1%, 15.2%, and 25.0% in women. Targeting only those people ages ≥50 years for weight reduction would achieve approximately 70% of the impact of a full population strategy. Targeting only the obese (BMI ≥30) would likely result in a larger benefit for men than women. Due to the aging of the population, OA will remain a major and growing health issue in Canada over the next 2 decades, regardless of the course of the obesity epidemic.


A phase I dose-escalation study of fractionated stereotactic radiosurgery in combination with gefitinib in patients with recurrent malignant gliomas.
To determine the maximum tolerated dose (MTD) of fractionated stereotactic radiosurgery (SRS) with gefitinib in patients with recurrent malignant gliomas. A Phase I clinical trial was performed. Eligible patients had pathologically proved recurrent anaplastic astrocytoma or glioblastoma. Patients started gefitinib (250 mg/day) 7 days before SRS and continued for 1 year or until disease progression. SRS was delivered in three fractions over 3 days. The planning target volume (PTV) was the T1-weighted MRI postcontrast enhancing lesion+2 mm. The first cohort received an SRS dose of 18 Gy, and subsequent cohorts received higher doses up to the maximum dose of 36 Gy. Dose-limiting toxicity (DLT) was any Grade 3 toxicity. The MTD was exceeded if 2 of 6 patients in a cohort experienced DLT. Characteristics of the 15 patients enrolled were: 9 men, 6 women; median age, 47 years (range, 23-65 years); 11 glioblastoma, 4 AA; median prior RT dose, 60 Gy (range, 54-61.2 Gy); median interval since RT, 12 months (range, 3-57 months); median PTV, 41 cc (range, 12-151 cc). Median follow-up time was 7 months (range, 2-28 months). Median time on gefitinib was 5 months (range, 2-12 months). No patient experienced a DLT, and the SRS dose was escalated from 18 to 36 Gy. Grade 1-2 gefitinib-related dermatitis and diarrhea were common (10 and 7 patients, respectively). Fractionated SRS to a dose of 36 Gy in three fractions is well tolerated with gefitinib at daily dose of 250 mg. Further studies of SRS and novel molecular targeted agents are warranted in this challenging clinical setting.


Axial compression generated by cortical and cancellous lag screws in the equine distal phalanx.
Lag screw fixation using single 4.5 mm cortical bone screws is a recommended technique for repair of mid-sagittal plane fractures of the distal phalanx in adult horses. However, implant infection and technical difficulties in obtaining adequate interfragmentary compression have made this surgical procedure somewhat controversial. We hypothesized that use of larger diameter screws would result in increased axial compression and improved stability of this fracture. Paired distal phalanges from the forelimbs of 10 adult horses were collected at necropsy and divided in half in the midsagittal plane. Using a randomized block study design, four types of bone screws (4.5 mm cortical, 5.5 mm cortical, 6.5 mm cancellous pre-tapped, and 6.5 mm cancellous non-tapped) were inserted to a depth of 15 mm. During screw insertion, the axial force generated under the screw head was measured with a load washer containing a piezoelectric force transducer, while torque of insertion was recorded with a torsional testing machine. The 6.5mm screw inserted after pre-tapping generated significantly greater axial force (2781 N) than the 4.5 mm (1522 N), 5.5 mm (2073 N) or 6.5 mm non-tapped (2295 N) screws. The relationship between maximal applied torque and axial force generated was linear for each screw type. Each unit of torque applied during insertion of cortical screws resulted in a greater increase in axial compression, as compared to cancellous screws. These data suggest that use of larger diameter screws would result in improved interfragmentary compression of distal phalangeal fractures.


Epidemiology of cercarial stage of trematodes in freshwater snails from Chiang Mai province, Thailand.
To investigate the epidemiological situation of cercarial trematodes infection in freshwater snails from different water resources in Chiang Mai province, Thailand. The snail specimens were collected from 13 districts of Chiang Mai province during April 2008 to February 2012. The prevalence of cercarial infection in snails was investigated using the crushing method. The drawing was done with the help of a camera lucida for the morphological study. A total of 2 479 snail individuals were collected and classified into 7 families, 11 genera, and 14 species, Among them, 8 snails species were found to be infected with an overall prevalence of 17.27% (428/2 479), which infected with nine groups of cercariae; gymnocephalous cercaria, strigea cercaria, megalurous cercaria, monostome cercaria, parapleurolophocercous cercaria (Haplorchis cercaria), pleurolophocercous cercaria, furcocercous cercaria (Transversotrema cercaria), xiphidiocercaria, and virgulate cercaria. The parapleurolophocercous cercaria was found to be the dominant type among the cercarial infection in the snails (64.25%). The various species of snails found in the research location act as the intermediate hosts for the high prevalence of parasitic infection of many species of mammals. This work will provide new information on both the distribution and first intermediate host of trematodes.


BDMediLeaves: A leaf images dataset for Bangladeshi medicinal plants identification.
This paper introduces a newly curated dataset named "BDMediLeaves" that includes a diverse collection of leaf images of ten distinct medicinal plants from various regions in Dhaka, Bangladesh. The ten distinct categories are Phyllanthus emblica, Terminalia arjuna, Kalanchoe pinnata, Centella asiatica, Justicia adhatoda, Mikania micrantha, Azadirachta indica, Hibiscus rosa-sinensis, Ocimum tenuiflorum, and Calotropis gigantea. The dataset contains a total of 2,029 original leaf images, along with an additional 38,606 augmented images. Each original image was meticulously captured under natural lighting conditions with an appropriate background. Experts provided accurate labeling for each image, ensuring its seamless integration into various machine learning (ML) and deep learning (DL) models. This comprehensive dataset holds immense potential for researchers in utilizing various ML and DL methods to make significant advancements in the healthcare and pharmaceutical sectors. It serves as a valuable resource for future investigations, laying the foundation for crucial developments in these domains.


Association of triglyceride-glucose index with ischemic stroke recurrence in nondiabetic patients with small vessel occlusion: a multicenter hospital-based prospective cohort study.
Triglyceride-glucose (TyG) index is a simple and reliable surrogate marker of insulin resistance. Elevated TyG index was related to stroke recurrence. This study aimed to explore the associations between TyG index with ischemic stroke recurrence in nondiabetic patients with small vessel occlusion. From November 1, 2016 to February 28, 2021, consecutive acute ischemic stroke patients admitted within 1 week after onset were screened. The stroke mechanism was determined based on medical history, laboratory examinations, cardiac examinations, vascular examinations and neuroimaging. Nondiabetic patients with small vessel occlusion were enrolled and followed up for 1 year. The primary outcome was ischemic stroke recurrence. Logistic regression and Kaplan-Meier survival curve were used to analyze the association of the TyG index and stroke recurrence. A total of 6100 acute ischemic stroke patients were screened, with 1970 nondiabetic patients with small vessel occlusion included and divided into 4 groups according to the TyG index quartiles (Q1: < 8.20; Q2: 8.20-8.53; Q3: 8.54-8.92; Q4: > 8.92). There were significant differences in age, body mass index, systolic blood pression, diastolic blood pressure, lipid-lowering agents, infarct location, fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid, and stroke recurrence among the 4 groups. In the multi-adjusted models, compared to Q1 of the TyG index, the odds ratio for Q4 of the TyG index for stroke recurrence was 3.100 (1.366-8.019). The Kaplan-Meier survival (ischemic stroke-free) curves by quartiles of the TyG index also showed statistically significant differences (log-rank test, P = 0.004). Our findings suggested that the TyG index was associated with ischemic stroke recurrence in nondiabetic patients with small vessel occlusion, and it could be a valuable biomarker for assessing the risk of ischemic stroke recurrence in these patients.


Prognostic impact of non-adherence to follow-up cystoscopy in non-muscle-invasive bladder cancer (NMIBC).
To evaluate the underexplored context of cystoscopy adherent versus non-adherent patients in the follow-up of urothelial high-risk non-muscle-invasive bladder cancer (NMIBC). We performed a retrospective study (2005-2016) that evaluated patients´ demographical characteristics, histopathological data, recurrence, progression and cancer-specific mortality between adherent and non-adherents patients in the first 3 years of a proposed cystoscopy protocol. Among the 198 included patients, comparing cystoscopy non-adherent (n = 36, 18%) and adherent patients (n = 162, 82%), there was no demographic or histopathological differences; the rates of disease recurrence, progression and cancer-specific mortality were 15 (41.7%) versus 68 (42.2%), p = 0.58; 12 (33.3%) versus 28 (17.9%), p = 0.014 and 4 (11.1%) versus 19 (11.7%), p = 0.98, respectively. Cystoscopy non-adherence was associated with an inferior number of urinary cytology (p < 0.001) and 2.33 HR for cancer progression, p = 0.014, (95% CI 1.18-4.59). Non-adherence to follow-up cystoscopy in NMIBC is associated with more than twice progression risk. Future studies are needed to confirm our results and correlate cystoscopy non-adherence to other covariates.


Cladosporiosis (cerebral phaeohyphomycosis) of brain--a case report.
A case of cerebral cladosporiosis caused by Cladosporium trichoides (bantianum) now known as Xylohypha bantiana is described and illustrated. Predisposing debilitating diseases were not detectable. The Cladosporiosis diagnosis was based on visualisation of hyphal element in direct Gram's stain, direct KOH preparate of pus from brain abscess and on repeated successful cultivation of Cladosporium trichoides from specimen and by histopathology. Following surgery and anti-fungal chemotherapy the patient was cured.


How we approach the treatment of patients with high-risk neuroblastoma with naxitamab: experience from the Hospital Sant Joan de Déu in Barcelona, Spain.
Naxitamab [humanized 3f8 (hu3F8)] is a humanized monoclonal antibody (mAb) targeting the disialoganglioside GD2. It was approved in 2020 by the United States Food and Drug Administration (FDA) in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF) for treatment of pediatric and adult patients with relapsed/refractory high-risk neuroblastoma, limited to the bone or bone marrow (BM). The team at Sant Joan de Déu Children's Hospital in Barcelona, Spain, have been using naxitamab to treat neuroblastoma under clinical trial protocols [e.g. Trial 201, and hu3F8, irinotecan, temozolomide, and sargramostim (GM-CSF) (HITS) study] and compassionate use since 2017. The team has experience with two primary regimens: naxitamab with GM-CSF only, or naxitamab in combination with irinotecan, temozolomide, and GM-CSF (chemoimmunotherapy). This article aims to provide a practical overview of the team's experience with naxitamab to date, including preparing the treatment room and selecting the team. Adverse event management, including the use of ketamine to manage pain during anti-GD2 mAb infusions, is also discussed. We hope this will provide practical information for other health care providers considering offering this treatment.


Physical and psychological effects of aerobic exercise in boys with learning disabilities.
Aerobic exercise has been associated with improvements in psychological status and physical fitness in adults, but its effects on children are less clear. The purpose of this study was to evaluate the effects of an aerobic exercise program on the self-concept, academic achievement, motor proficiency, and cardiovascular fitness of boys with learning disabilities. Fifty-four boys were randomly assigned to one of two exercise programs lasting 20 weeks. One program emphasized aerobic exercise and the other consisted of similar but less vigorous activities. The self-concept, academic achievement, motor proficiency, and physical fitness of each subject was assessed before and after the exercise programs. The results from group comparisons demonstrated an association between the aerobic exercise program and improvement of self-concept and physical fitness. No effect on academic achievement or motor proficiency could be attributed to the aerobic exercise program.


[Use of the excimer laser in experimental laser angioplasty].
XeCl-excimer laser produce pulsed far uv-light (wave length lambda = 308 nm). Biophysical effects were studied on arteriosclerotic human cadaver aortic and coronary vessels. Ablative photodecomposition results in cleanliness of the incisions with minimal thermal side effects.


Use of a glass bead-containing liquid medium for efficient production of a soil-free culture with polychlorinated biphenyl-dechlorination activity.
We established a soil-free culture capable of dechlorinating polychlorinated biphenyls (PCBs) in Kanechlor-300 and Kanechlor-400 by establishing a PCB-dechlorinating soil culture in liquid medium containing 0.5 mm glass beads. PCB-dechlorination activity in liquid cultures with glass beads appeared to depend on the size of the glass beads, and soil-free cultures with 0.05-, 1.0- or 2.0 mm glass beads did not dechlorinate PCBs. Soil-free culture without glass beads also failed to dechlorinate PCBs. The soil-free culture containing 0.5 mm glass beads dechlorinated 42.6 ± 12.0 mol% in total PCBs. This soil-free culture was more effective than soil culture for dechlorinating PCBs ranging from dichlorinated PCBs to tetrachlorinated PCBs. Clone analysis of the 16S rRNA gene sequences showed that one of the predominant groups of microorganisms in the soil-free culture comprised heat-tolerant and spore-forming bacteria from the phylum Firmicutes. Heat treatment (100 °C, 10 min) did not destroy the PCB-dechlorination activity of the soil-free culture with glass beads. These results suggest that unknown species of the phylum Firmicutes were involved in PCB dechlorination in the soil-free culture. In this study, we succeeded in using a liquid medium containing glass beads as an inorganic soil substitute and showed that such a medium enhances PCB-dechlorination activity. Our study provides valuable information for developing PCB-bioremediation techniques using dechlorinating bacteria in anoxic contaminated soils and sediments.


Synthesis and biological properties of 4-norleucine-neuropeptide Y; secondary structure of neuropeptide Y.
Neuropeptide Y (NPY) is a 36 amino acid peptide amide isolated from porcine brain. The NPY analog, 4-norleucine-NPY was synthesized by a solid-phase method and purified to homogeneity in 20% yield by reverse-phase chromatography. Investigation of the biological properties indicated that the analog is an agonist of NPY. Secondary structural analyses revealed that NPY and the analog exhibited predominantly alpha-helical and beta-sheet structures, respectively; however, experiments in trifluoroethanol indicated that the analog has the potential of assuming an alpha-helical structure. Based on circular dichroism (CD), Raman spectroscopy and Chou-Fasman analyses, a model has been proposed for the secondary structure of NPY.


Incorporation of F-MWCNTs into electrospun nanofibers regulates osteogenesis through stiffness and nanotopography.
Nanotopography and stiffness are major physical cues affecting cell fate. However, the current nanofiber modifications techniques are limited by their ability to control these two physical cues irrespective of each other without changing the materials' surface chemistry. For this reason, the isolated effects of topography and stiffness on osteogenic regulation in electrospun nanofibers have been studied incompletely. Here, we investigated 1. how functionalized multiwall carbon nanotubes (F-MWCNTs) loaded in Polycaprolactone (PCL) nanofibers control their physical properties and 2. whether the resulting unique structures lead to distinctive phenotypes in bone progenitor cells. Changes in material properties were measured by high-resolution electron microscopes, protein adsorption and tensile tests. The effect of the developed structures on human mesenchymal stem cell (MSC) osteogenic differentiation was determined by extensive quantification of early and late osteogenic marker genes. It was found that F-MWCNT loading was an effective method to independently control the PCL nanofiber surface nanoroughness or stiffness, depending on the applied F-MWCNT concentration. Collectively, this suggests that stiffness and topography activate distinct osteogenic signaling pathway. The current strategy can help our further understanding of the mechano-biological responses in osteoprogenitor cells, which could ultimately lead to improved design of bone substitute biomaterials.


Guiding spatial attention by multimodal reward cues.
Our attention is constantly captured and guided by visual and/or auditory inputs. One key contributor to selecting relevant information from the environment is reward prospect. Intriguingly, while both multimodal signal processing and reward effects on attention have been widely studied, research on multimodal reward signals is lacking. Here, we investigated this using a Posner task featuring peripheral cues of different modalities (audiovisual/visual/auditory), reward prospect (reward/no-reward), and cue-target stimulus-onset asynchronies (SOAs 100-1,300 ms). We found that audiovisual and visual reward cues (but not auditory ones) enhanced cue-validity effects, albeit with different time courses (Experiment 1). While the reward-modulated validity effect of visual cues was pronounced at short SOAs, the effect of audiovisual reward cues emerged at longer SOAs. Follow-up experiments exploring the effects of visual (Experiment 2) and auditory (Experiment 3) reward cues in isolation showed that reward modulated performance only in the visual condition. This suggests that the differential effect of visual and auditory reward cues in Experiment 1 is not merely a result of the mixed cue context, but confirms that visual reward cues have a stronger impact on attentional guidance in this paradigm. Taken together, it seems that adding an auditory reward cue to the inherently dominant visual one led to a shift/extension of the validity effect in time - instead of increasing its amplitude. While generally being in line with a multimodal cuing benefit, this specific pattern highlights that different reward signals are not simply combined in a linear fashion but lead to a qualitatively different process.


Laparoscopic ovarian transposition prior to pelvic irradiation in a young female patient with advanced rectal cancer.
In the report, we describe the first case of laparoscopic ovarian transposition prior to pelvic radio-chemo therapy in a young female patient with advanced rectal cancer in Japan. A 14-year-old female visited a hospital because of consistent diarrhea and melena. Colonoscopy examination showed a bulky tumor of the rectum, which was diagnosed as moderately to poorly differentiated adenocarcinoma. The diagnosis was cT3N2aM1a (due to lymph node in pelvic side wall), cStage IVA. In an attempt to improve local control and sphincter preservation, neoadjuvant concurrent radio-chemo therapy was planned. Considering that pelvic irradiation particularly in young female might cause ovarian failure, laparoscopic ovarian transposition was carried out prior to pelvic irradiation. Sequentially the patient underwent low anterior resection of the rectum and lymphadenectomy including pelvic side wall. The menstruation was maintained with delay for 6 months after adjuvant chemotherapy. There is no evidence of cancer recurrence at 3 years after the surgery.In premenopausal patients with rectal cancer undergoing pelvic irradiation, laparoscopic ovarian transposition is one of the choices to prevent ovarian failure.


[Intragastric bile acids and lysolecithin in clinical stress ulcer risk (author's transl)].
In 10 intensive care patients with a risk of stress ulcer intragastric concentrations of lecithin, lysolecithin and bile acids were determined and compared to values in seven normal persons. All results were increased to multiple normal values. In particular lysolecithin and bile acids showed highly abnormal concentrations. These substances have a pathogenic importance for the occurrence of stress ulcers.


Synthesis of N'-(1-pyridin-2-ylmethylene)-2-furohydrazide and its application in construction of a highly selective PVC-based membrane sensor for La(III) ions.
A highly La(III) ion-selective PVC membrane sensor based on N'-(1-pyridin-2-ylmethylene)-2-furohydrazide (NPYFH) as an excellent sensing material was successfully developed. The electrode shows a good selectivity for La(III) ion with respect to most common cations including alkali, alkaline earth, transition and heavy metal ions. The proposed sensor exhibits a wide linear response with slope of 19.2 +/- 0.6 mV per decade over the concentration range of 1.0 x 10(-6) - 1.0 x 10(-1) M, and a detection limit of 7.0 x 10(-7) M of La(III) ions. The sensor response is independent of pH in the range of 3.5-10.0. The proposed electrode was applied as an indicator electrode in potentiometric titration of La(III) ion with EDTA.


Extracellular Ca(2+)-dependent enhancement of cytocidal potency of zoledronic acid in human oral cancer cells.
Direct antitumor effects of bisphosphonates (BPs) have been demonstrated in various cancer cells in vitro. However, the effective concentrations of BPs are typically much higher than their clinically relevant concentrations. Oral cancers frequently invade jawbone and may lead to the release of Ca(2+) in primary lesions. We investigated the effects of the combined application of zoledronic acid (ZA) and Ca(2+) on proliferation and apoptosis of oral cancer cells. Human oral cancer cells, breast cancer cells, and colon cancer cells were treated with ZA at a wide range of concentrations in different Ca(2+) concentration environments. Under a standard Ca(2+) concentration (0.6mM), micromolar concentrations of ZA were required to inhibit oral cancer cell proliferation. Increasing extracellular Ca(2+) concentrations greatly enhanced the potency of the ZA cytocidal effect. The ability of Ca(2+) to enhance the cytocidal effects of ZA was negated by the Ca(2+)-selective chelator EGTA. In contrast, the cytocidal effect of ZA was less pronounced in breast and colon cancer cells regardless of whether extracellular Ca(2+) was elevated. In oral cancer cells incubated with 1.6mM Ca(2+), ZA up-regulated mitochondrial Bax expression and increased mitochondrial Ca(2+) uptake. This was associated with decreased mitochondrial membrane potential and increased release of cytochrome c. We suggest that ZA can specifically produce potent cytocidal activity in oral cancer cells in an extracellular Ca(2+)-dependent manner, implying that BPs may be useful for treatment of oral squamous cell carcinoma with jawbone invasion leading to the hypercalcemic state.


How people with dementia perceive a therapeutic robot called PARO in relation to their pain and mood: A qualitative study.
Interacting with social robots, such as the robotic seal PARO, has been shown to improve mood and acute pain for people with dementia. Little attention has been paid to the effect of PARO on people with dementia and chronic pain. To explore how people with mild to moderate dementia and chronic pain perceive PARO as an alternative intervention to manage their pain and mood. A descriptive qualitative approach nested within a pilot randomised controlled trial. Participants with dementia and chronic pain were recruited from three residential aged care facilities. They interacted with PARO for 30 min, 5 days a week over a 6-week period. A sample of 11 participants completed individual semi-structured interviews at the end of the intervention. Data were collected from January 2018-January 2019. Inductive thematic analysis was undertaken. Reporting of findings followed the COREQ checklist. Four themes emerged from the data: (a) perceptions of PARO; (b) therapeutic effects of PARO; (c) limitations of PARO; and (d) programme improvement. Residents with dementia expressed positive attitudes towards the use of PARO and acknowledged the therapeutic benefits of PARO on mood improvement and relaxation for pain relief but also mentioned the limitations of its weight, voice and characteristics. Residents' responses could also fluctuate during the intervention process, and individual preferences need to be considered. The PARO intervention is a promising intervention to improve positive emotion, and there is some anecdotal evidence that pain may be decreased from the perspectives of people living with chronic pain and dementia. Long-term care staff may incorporate PARO therapy into daily dementia care. Understanding of individual's preferences may enhance the implementation of PARO for pain management in this group.


Hypoxia augments conversion of big-endothelin-1 and endothelin ET(B) receptor-mediated actions in rat lungs.
We have examined the effect of endothelin-1, sarafotoxin-6C, big-endothelin-1 and other agents on perfused lungs from chronically hypoxic rats. Increases in pulmonary perfusion pressure induced by big-endothelin-1, endothelin-1, phenylephrine and potassium chloride were enhanced in hypoxic lungs, while the constrictor action of sarafotoxin-6C was not increased. When basal pulmonary perfusion pressure was raised, low doses of endothelin-1 and sarafotoxin-6C produced decreases in pulmonary perfusion pressure which were significantly greater in chronically hypoxic lungs, whereas responses to sodium nitroprusside were unchanged. Endothelin ET(B) receptor-mediated bronchoconstrictor responses were also potentiated in hypoxic lungs, whereas responses to carbachol were not. In hypoxic lungs, conversion of big-endothelin-1 to endothelin-1 was significantly increased. These data provide evidence for a generalised increase in vasomotor activity in chronically hypoxic lungs, and a more selective increase in endothelin ET(B) receptor-mediated vasodilator and bronchoconstrictor responses. Hypoxia also augments the conversion of big-endothelin-1 to endothelin-1.


Quantitative characterization of single cells by use of immunocytochemistry combined with multiplex LA-ICP-MS.
Actual research demonstrates that LA-ICP-MS is capable of being used as an imaging tool with cellular resolution. The aim of this investigation was the method development for LA-ICP-MS to extend the versatility to quantitative and multiplexing imaging of single eukaryotic cells. For visualization of individual cells selected, lanthanide-labeled antibodies were optimized for immuno-imaging of single cells with LA-ICP-MS. The molar content of the artificial introduced labels per cell was quantified using self-made nitrocellulose-coated slides for matrix-matched calibration and calculated amounts were in the range of 3.1 to 17.8 atmol per cell. Furthermore, the quantification strategy allows a conversion of 2D intensity profiles based on counts per second (cps) to quantitative 2D profiles representing the molar amount of the artificial introduced elemental probes per pixel for each individual cell. Graphical abstract .


1H-NMR investigation of the influence of the heme orientation on functional properties of myoglobin.
There are two interconverting forms of myoglobin, which differ in the orientation of the heme by a 180 degrees rotation around the alpha,gamma-meso axis; the proteins possessing the same heme orientation, as found in the single crystal, and the reversed heme orientation are called the major and minor forms, respectively. Structures and functional properties of these two forms have been investigated by NMR. Heme peripheral side-chain and non-coordinated amino acid proton resonances of the minor form in its met-cyano form have been assigned and the comparison of the shift between the corresponding resonances of the two forms revealed that the heme electronic structure is not largely influenced by the heme rotation. On the other hand, the exchange rate of His E7 NepsilonH proton of the minor form is larger by a factor of 3-5 than that of the major one, indicating that the stability of the hydrogen bond between Fe-bound ligand and His E7 is slightly weaker in the minor form that in the major one. The rate of autoxidation of oxy-myoglobin and azide affinity of met-aquo myoglobin were also found to depend on the orientation of the heme.


A case of disappearing amyloid on technetium pyrophosphate scan.
Technetium-99mm pyrophosphate (Tc-PYP) scintigraphy is a highly accurate non-invasive method for the diagnosis of transthyretin (ATTR) cardiac amyloidosis. Prognosis for this disease is improved following treatment with the transthyretin (TTR) stabilizer tafamidis. Although tafamidis slows disease progression, its effects on myocardial amyloid and Tc-PYP uptake remain unclear. We present a patient with ATTR cardiac amyloidosis who had a strongly positive initial Tc-PYP scan, with a dramatic decrease in Tc-PYP uptake on repeat scan after 3 years of tafamidis treatment. However, myocardial biopsy showed persistent diffuse amyloid deposits. This case highlights the need for further studies regarding the utility of serial Tc-PYP scans in monitoring the progress of ATTR cardiomyopathy.


Serological evidence of infection of dogs and man in Nigeria by lyssaviruses (family Rhabdoviridae).
A survey was conducted for serum neutralizing antibodies against 3 members of the Lyssavirus group (rabies, Lagos bat and Mokola viruses) in Nigerian dogs and humans. Of 463 unvaccinated dogs sampled, 142 (30.7%) had antibodies against rabies; 39.2% of the stray dogs were positive. Of 241 dogs tested, 17.4% had antibodies against Mokola virus and 5.8% against Lagos bat virus. 28.6% of human samples tested had antibodies against rabies and, of 158 human samples tested, 12 (7.5%) had antibodies against Mokola virus and 4 (2.5%) had antibodies against Lagos bat virus.


Does the pediatricians' work setting or years of experience influence febrile seizure education?
A febrile seizure is a benign condition. However, for parents, witnessing their child's FS can cause excessive anxiety. It is therefore important for pediatricians to provide appropriate information in order to reduce anxiety. In this study, we analyze whether work setting and years of experience influence the explanations given to caregivers. Questionnaires were mailed to members of the Japan Pediatric Society, Tokyo Chapter (n=1 870). The Mantel-Haenszel test was used for dichotomous variables. Differences for continuous variables were evaluated at 95% confidence intervals. A total of 482 pediatricians participated. There were no significant differences in responses to any questions according to work setting. Responders with less than 20 years of experience reported a higher prevalence of febrile seizures than those in the more experienced group. Compared to the experienced group, more responders with less than 20 years of experience stated that they would administer antiepileptic prophylaxis and advise parents not to use antipyretics, and indicated that they did not know the FS treatment guidelines. The findings suggest the importance of promoting a better understanding of FS among less-experienced pediatricians and encouraging adherence to the guidelines to maintain a consistent level of support for parents and caregivers.


Relation of atrial natriuretic peptides to left ventricular systolic and diastolic function in heart failure.
Plasma concentrations of atrial natriuretic peptides are correlated with atrial pressures, as are left ventricular ejection fraction and left ventricular filling abnormalities. This study investigated the relation of atrial natriuretic peptides to both left ventricular systolic and diastolic function in heart failure. Plasma concentrations of atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide were measured in 63 patients with chronic heart failure and left ventricular systolic dysfunction. According to Doppler transmitral flow measurements, 19 patients had a restrictive and 44 patients had a non-restrictive left ventricular filling pattern. Plasma concentrations of atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide were higher in patients with a restrictive filling pattern than in patients with a non-restrictive filling pattern (197 vs. 75 pmol/l, P<0.0001 and 1.14 vs. 0.45 nmol/l, P<0.0001). In univariate analysis, atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide correlated with deceleration time, E/A ratio and left ventricular ejection fraction. In multivariate analysis, both peptides appeared independently related to left ventricular ejection fraction and left ventricular filling pattern. In patients with chronic heart failure, atrial natriuretic peptides provide information on left ventricular systolic as well as diastolic function.


Hypoxia modulates mediator responses and neurotransmission in guinea-pig trachea in vitro.
To discover whether hypoxia affects mediator responses and neurotransmission in tracheal smooth muscle, we studied in vitro tracheal segments from guinea-pigs under isometric conditions. Hypoxia itself did not alter the basal tone. The maximum response to acetylcholine and histamine under hypoxia was less than that under oxygenated conditions. The logarithm of 50% effective concentration (log EC50) of the response to acetylcholine under hypoxia was not altered, but the log EC50 of the response to histamine decreased significantly. In contrast to the response to exogenous acetylcholine, the maximum contractile response to electrical field stimulation (EFS) under hypoxia was not different from that under oxygenated conditions, but the logarithm of 50% effective frequency of contractions caused by EFS under hypoxia decreased significantly. On the other hand, non-adrenergic-non-cholinergic relaxation caused by EFS was unaffected by hypoxia. These observations suggest that hypoxia can modulate the responses of tracheal smooth muscle to acetylcholine, histamine and nerve stimulation.


New CT scan classification of leak after sleeve gastrectomy.
Laparoscopic sleeve gastrectomy (LSG) has become one of the most common bariatric procedures. Even so, the gastric leak remains the most feared complication with a difficult, non-standardized treatment. The purpose of this study was to assess the feasibility of a new classification of leakage after LSG used in Montpellier University Hospital. We have studied the correlations between radiological findings and therapeutic outcome for the 20 gastric leaks. The presence of a leak was evaluated according to the day of appearance, the symptomatology, the location, severity on the CT scan, and the management. From May 2010 to September 2012, we prospectively collected data from 20 patients diagnosed with gastric leak after LSG. There were 16 women and 4 men with a mean age of 34 years old (range 21-52 years old). The fistula was diagnosed at postoperative day 28.1 days (range 3-77 days). Patients were grouped by the new classification in: 11-type I, 6-type II, 3-type III fistula, and 0-type IV. The visualization of leakage was observed for five cases (25 %). The initial surgical drainage was performed for 11 cases and the conservative treatment was preferred in 9 cases. Three cases necessitated a delayed surgical drainage after 1 week of conservative treatment. The surgical drainage was performed by laparoscopy in 12 cases and by laparotomy in 2 cases. The new CT scan classification of gastric leak could serve as a working basis for a consensus on the therapeutic management of this dreaded complication.


Recent analytical methodologies on equilibrium, kinetics, and dynamics at liquid/liquid interface.
The form of liquid/liquid interface is flexible and it cannot be fixed at a spatial position. Also the interface is prevented from any physical contact by the organic phase and aqueous phase. In addition, analytical methods operated in vacuo cannot be applied. These restrictions depressed the development of liquid/liquid interfacial chemistry. However, the modification of liquid/liquid interfacial form and original analytical methods have been invented interdependently. The present review classifies the forms of liquid/liquid interface first, and it arrays the related analytical methods with brief explanations. It dominantly deals with recent reports of analytical methodologies, which were published in 2001-2004, on equilibrium, kinetics, and dynamics of substances at liquid/liquid interface, but it also includes historically important studies.


Adsorption of ionic liquids onto an activated carbon: kinetic modeling studies.
In this study, the uptake of hydrophobic bromide-based ionic liquids (ILs) (imidazolium, pyrrolidinium, and pyridinium) from aqueous solutions onto granulated and fabric-based microporous activated carbons (ACs). Surface characterization study shows that both ACs have basic pHpzc, like 8.7 for granulated AC and 8.0 for fabric AC. Granulated AC have ten times higher phenolic groups 0.2 meq g-1 compared to fabric AC which is 0.03 meq g-1. The kinetics of adsorption was remarkably slower for ILs on granulated/fabric AC than milled one. We also studied the effect of AC size on the rate of adsorption in the operating conditions. In order to improve the adsorption kinetics of ILs with ACs, different phenomenological and empirical kinetic models like as pseudo-first order, Boyd model, pseudo-second-order diffusion model and Elovich were applied on the kinetic experimental data. The analysis of kinetic specified that the adsorption mechanism of ILs onto ACs is controlled mainly by the mass transfer through the pores of ACs. So, the selection of appropriate adsorbent particle size of AC plays a main role for the development of viable IL adsorption. Graphical abstract .


Nevoid Basal Cell Carcinoma Syndrome and the Keratocystic Odontogenic Tumor.
To analyze the clinical and radiographic manifestations of nevoid basal cell carcinoma syndrome (NBCCS) with a particular emphasis on the presence, treatment, and outcomes of keratocystic odontogenic tumors (KOTs) in these patients. The authors implemented a prospective case series and enrolled a sample of patients with KOTs and NBCCS. The primary study variables were the demographics, treatment, and outcomes of managing KOTs in this sample. Descriptive statistics were computed. The sample was composed of 16 patients (10 male and 6 female; mean age, 24 yr). These patients presented with 32 previously untreated KOTs. Fifteen patients with 31 KOTs consented to surgery that consisted of a total of 61 procedures during the study period. These procedures included 19 primary enucleation and curettage surgeries and 12 marsupialization procedures followed by secondary enucleation and curettage surgeries. During the course of clinical and radiographic follow-up examinations, 14 new primary and 5 persistent KOTs (refractory to enucleation and curettage surgeries) were diagnosed, of which 13 new primary KOTs and 5 persistent KOTs were treated. A total of 51 KOTs (32 primary, 14 new lesions that developed during follow-up, and 5 persistent lesions) were diagnosed, and 15 patients consented to operative treatment of 49 KOTs. Forty-eight enucleation and curettage surgeries were performed for 49 KOTs that showed effective treatment without persistence in 43 cases (90%) during a follow-up period from 2 to 20 years (mean, 7 yr). One resection was performed for a persistent KOT. The 5-year disease-free estimate after primary enucleation and curettage was 86% (95% confidence interval, 74.8-97.4). Other clinical and radiographic stigmata of the syndrome were diagnosed, including calcified falx cerebri, frontal bossing, hypertelorism, multiple basal cell carcinomas, and others. The results of this study identify the variable expressivity of this syndrome and the favorable outcomes of marsupialization and enucleation and curettage of syndromic KOTs.


Residues of hexachlorobenzene and chlorinated cyclodiene pesticides in the soils of the Campanian Plain, southern Italy.
A systematic grid sampling method and geostatistics were employed to investigate the spatial distribution, inventory, and potential ecological and human health risks of the residues of hexachlorobenzene (HCB) and chlorinated cyclodiene pesticides in soils of the Campanian Plain, Italy, and explore their relationship with the soils properties. The geometric mean (Gmean) concentrations of HCB and cyclodiene compounds followed the order CHLs (heptachlor, heptachlor epoxide, trans-chlordane, and cis-chlordane) > DRINs (aldrin, dieldrin, and endrin) > SULPHs (α-endosulfan, β-endosulfan, and endosulfan sulfate) > HCB. The residual levels of most cyclodienes in agricultural soils were generally higher than those of corresponding counterparts in the other land uses. Significant differences in the concentration of HCB and cyclodienes in the soils across the region are observed, and the Acerra-Marigliano conurbation (AMC) and Sarno River Basin (SRB) areas exhibit particularly high residual concentrations. Some legacy cyclodienes in the Campanian Plain may be attributed to a secondary distribution. The Gmean inventory of HCB, SULPHs, CHLs, and DRINs in the soil is estimated to be 0.081, 0.41, 0.36, and 0.41 metric tons, respectively. The non-cancer and cancer risks of HCB and cyclodienes for exposed populations are deemed essentially negligible, however, endosulfan poses significant ecological risks to some terrestrial species.


In vitro fecal fermentation properties of polysaccharides from Tremella fuciformis and related modulation effects on gut microbiota.
Tremella fuciformis is an edible and medicinal mushroom. Polysaccharides from T. fuciformis have received increasing attention due to their diversely pharmacological activities. In this study, the digestive behavior and fermentation characteristics of T. fuciformis polysaccharides (TFP) were studied. The results revealed that the reducing sugar content, chemical composition, molecular weight, rheological property, constituent monosaccharide, and FT-IR spectrum of TFP were not altered after the in vitro simulated digestion, indicating that it was indigestible under different simulated digestion conditions. However, the physicochemical characteristics of TFP, including reducing sugar content, molecular weight, constituent monosaccharide, and free monosaccharide released, were obviously altered after the in vitro fermentation for 48 h, indicating that it was remarkably utilized by intestinal microbiota in human feces. Notably, TFP could obviously modulate the microbial composition via promoting the relative abundances of Phascolarctobacterium, Bacteroides, and Lachnoclostridium. Moreover, TFP could also increase the production of short-chain fatty acids, including acetic, propionic, n-butyric, and n-valeric acids, after the in vitro fermentation for 48 h. These results showed that TFP was stable under the simulated digestion conditions, but could be utilized by intestinal microbiota in human feces, and might possess the potential to improve intestinal health.


Revascularization for acute regional infarct: superior protection with warm blood cardioplegia.
Continuous retrograde warm blood cardioplegia was compared with two widely used hypothermic myocardial protection techniques in a canine model of acute regional myocardial ischemia with subsequent revascularization. Animals (n = 30) underwent 45 minutes of left anterior descending coronary artery occlusion then cardioplegic arrest (60 minutes), followed by separation from cardiopulmonary bypass and data collection. The cold oxygenated crystalloid cardioplegia group (CC; n = 8) and the cold blood cardioplegia group (CC; n = 10) had cardiopulmonary bypass at 28 degrees C, antegrade arrest, and intermittent retrograde delivery. The warm blood cardioplegia group (WB; n = 12) had normothermic cardiopulmonary bypass, antegrade arrest, and continuous retrograde delivery. Overall ventricular function (preload recruitable stroke work relationship; ergs x 10(3)/mL) was significantly (p < 0.001) better for WB (WB, 80 +/- 11; CB, 67 +/- 13; CC, 57 +/- 12). Systolic function (maximum elastance relationship; mm Hg/mL) was also significantly (p < 0.001) better for WB (WB, 11.6 +/- 3.6; CB, 8.6 +/- 2.7; CC, 6.2 +/- 1.3). Diastolic function (stress-strain relationship; dynes x 10(3)/cm2) revealed significantly (p < 0.001) decreased compliance for CC (WB, 20 +/- 6; CB, 19 +/- 7; CC, 27 +/- 11). Left anterior descending coronary artery regional adenosine triphosphate/adenosine diphosphate ratios were significantly (p = 0.02) worse for CC (WB, 10.2 +/- 2.3; CB, 9.4 +/- 2.6; CC, 5.6 +/- 1.5). Myocardial edema significantly (p = 0.03) increased over time only in the CC animals (WB, 0.4% +/- 2.3%; CB, -0.3% +/- 3.6%; CC, 5.5% +/- 2.3%). In this model of acute regional myocardial ischemia and revascularization, continuous retrograde warm aerobic blood cardioplegia provided superior myocardial protection compared with cold oxygenated crystalloid cardioplegia with intermediate results for cold blood cardioplegia.


Contribution of h-bonding to the preference of platinum anti-tumour drugs for particular bases and particular cross-links.
The stereochemical factors that influence the tendencies for sequence specific binding of platinum antitumour drugs to DNA are examined. The NHs of the platinum-amine moiety can form hydrogen bonds to the O6 of guanine or to a phosphate oxygen of DNA. Modelling the stereochemistry of the NH atoms can lead to compounds with a strong preference for forming one type of adduct with DNA.