A vein entry indicator device for facilitating peripheral intravenous cannulation in children: a prospective, randomized, controlled trial.
Vascular access is often technically difficult in children because of the small caliber and impalpability of the veins. In this study, we sought to determine if use of the Vein Entry Indicator Device (VEIDtrade mark) in children facilitates peripheral venous access. Two-hundred-two healthy (ASA grade I and II) children scheduled for same-day surgery at a major tertiary hospital in Israel were randomly allocated to undergo VEID-assisted or standard peripheral venous cannulation. All cases involved the insertion of a 22-gauge cannula into an upper limb vein. Primary outcome measures were number of attempts to successful cannulation, rate of success at first attempt, and time required for insertion. The data were presented as mean (sd). Analyses of variance and Pearson chi(2) test or Fisher's exact test were used to compare the groups; forward stepwise logistic regression was used to identify the three variables (age, vein assessment category, use of the VEID) significantly associated with a successful first attempt. A P value of < or =0.05 was considered significant. Successful cannulation was achieved at the first attempt in the majority of patients in both groups. Two attempts were needed in 8% of the VEID group and 28% of the control group, and 3 attempts were needed in 1% and 3%, respectively (P < 0.01). Analysis by vein assessment category yielded a similar rate of successful first-attempt cannulations in the two groups for easy veins. However, for the difficult and intermediate categories, the rate was 89.7% in the VEID group compared to 23.3% in the control group (P < 0.001). The fewer number of attempts in the study group was associated with a shorter time from the start of the search for an appropriate vein to successful cannulation (9.1 s versus 22.5 s in the control group). The VEID facilitates the insertion of peripheral venous cannulas in healthy children with intermediate/difficult veins undergoing same-day surgery, reducing the number of attempts and the overall time required.


Large cell lymphoma masquerading as a viral retinitis.
A 37 year old woman presented with a bilateral vitritis. 4 months previously, she had developed in her left eye a necrotizing retinitis compatible with acute retinal necrosis (ARN). A trial of Acyclovir was unsuccessful as were systemic steroids. Over the following 2 months the vitritis worsened. The patient underwent a diagnostic vitrectomy revealing the presence of a large B-cell lymphoma with a predominance of lambda light chains.


Left Subclavian Artery Coverage is Not Associated with Neurological Deficits in Trauma Patients Undergoing Thoracic Endovascular Repair.
Endovascular repair of the thoracic aorta (TEVAR) outcomes have been studied with an interest in complications related to left subclavian artery (LSA) coverage in patients with atherosclerotic pathologies; however, specific data on the management of the LSA in a trauma population are lacking. The objective of this study is to evaluate outcomes following TEVAR for traumatic aortic injury based on LSA coverage. The Vascular Quality Initiative thoracic endovascular aortic repair module (2010-2017) was analyzed. Patients were included if they had a traumatic aortic injury requiring TEVAR. Patients were placed in 2 groups based on coverage of the LSA. Patients were propensity score matched and the primary outcomes were cerebrovascular symptoms and spinal cord ischemia. Additional clinical and resource utilization outcomes were analyzed. Four hundred and fifty one patients were included in the analysis. There were 268 patients in the LSA not-covered group and 183 patients in the LSA covered group. The mean aortic injury grade was 2.88 ± 0.056 vs. 2.88 ± 0.049 in the covered versus not-covered group (P = 0.957). Glasgow coma scale and injury severity score were not different between the groups. There was no difference between groups for cerebrovascular symptoms or spinal cord ischemia, 1.4% vs. 2.8%, P = 0.684 and 0% vs. 2.1%, P = 0.247, after propensity score matching. Significant differences in access site complications and resource utilization were identified between groups. This is the largest series to evaluate complications based on LSA coverage following TEVAR in trauma patients. Our data demonstrate that coverage of the LSA during TEVAR following blunt trauma is associated with no difference in central nervous system outcomes. As such, LSA revascularization strategies, while possible, are not directly supported by these data and should be individualized based on each patient's specific clinical scenario.


Long-term exposure to air-pollution and COVID-19 mortality in England: a hierarchical spatial analysis.
Recent studies suggested a link between long-term exposure to air-pollution and COVID-19 mortality. However, due to their ecological design, based on large spatial units, they neglect the strong localised air-pollution patterns, and potentially lead to inadequate confounding adjustment. We investigated the effect of long-term exposure to NO2 and PM2.5 on COVID-19 deaths up to June 30, 2020 in England using high geographical resolution. We included 38 573 COVID-19 deaths up to June 30, 2020 at the Lower Layer Super Output Area level in England (n=32 844 small areas). We retrieved averaged NO2 and PM2.5 concentration during 2014-2018 from the Pollution Climate Mapping. We used Bayesian hierarchical models to quantify the effect of air-pollution while adjusting for a series of confounding and spatial autocorrelation. We find a 0.5% (95% credible interval: -0.2%-1.2%) and 1.4% (-2.1%-5.1%) increase in COVID-19 mortality rate for every 1μg/m3 increase in NO2 and PM2.5 respectively, after adjusting for confounding and spatial autocorrelation. This corresponds to a posterior probability of a positive effect of 0.93 and 0.78 respectively. The spatial relative risk at LSOA level revealed strong patterns, similar for the different pollutants. This potentially captures the spread of the disease during the first wave of the epidemic. Our study provides some evidence of an effect of long-term NO2 exposure on COVID-19 mortality, while the effect of PM2.5 remains more uncertain. Medical Research Council, Wellcome Trust, Environmental Protection Agency and National Institutes of Health.


Laparoscopic robot-assisted pancreas transplantation: first world experience.
Surgical complications are a major disincentive to pancreas transplantation, despite the undisputed benefits of restored insulin independence. The da Vinci surgical system, a computer-assisted electromechanical device, provides the unique opportunity to test whether laparoscopy can reduce the morbidity of pancreas transplantation. Pancreas transplantation was performed by robot-assisted laparoscopy in three patients. The first patient received a pancreas after kidney transplant, the second a simultaneous pancreas kidney transplantation, and the third a pancreas transplant alone. Operations were carried out through an 11-mm optic port, two 8-mm operative ports, and a 7-cm midline incision. The latter was used to introduce the grafts, enable vascular cross-clamping, and create exocrine drainage into the jejunum. The two solitary pancreas transplants required an operating time of 3 and 5 hr, respectively; the simultaneous pancreas kidney transplantation took 8 hr. Mean warm ischemia time of the pancreas graft was 34 min. All pancreatic transplants functioned immediately, and all recipients became insulin independent. The kidney graft, revascularized after 35 min of warm ischemia, also functioned immediately. No patient had complications during or after surgery. At the longer follow-up of 10, 8, and 6 months, respectively, all recipients are alive with normal graft function. We have shown the feasibility of laparoscopic robot-assisted solitary pancreas and simultaneous pancreas and kidney transplantation. If the safety and feasibility of this procedure can be confirmed by larger series, laparoscopic robot-assisted pancreas transplantation could become a new option for diabetic patients needing beta-cell replacement.


A simple enzymatic assay for the quantification of C1-specific cellulose oxidation by lytic polysaccharide monooxygenases.
The development of an enzymatic assay for the specific quantification of the C1-oxidation product, i.e. gluconic acid of cellulose active lytic polysaccharide monooxygenases (LPMOs). In combination with a β-glucosidase, the spectrophotometrical assay can reliably quantify the specific C1- oxidation product of LPMOs acting on cellulose. It is applicable for a pure cellulose model substrate as well as lignocellulosic biomass. The enzymatic assay compares well with the quantification performed by HPAEC-PAD. In addition, we show that simple boiling is not sufficient to inactivate LPMOs and we suggest to apply a metal chelator in addition to boiling or to drastically increase pH for proper inactivation. We conclude that the versatility of this simple enzymatic assay makes it useful in a wide range of experiments in basic and applied LPMO research and without the need for expensive instrumentation, e.g. HPAEC-PAD.


Cardiovascular and respiratory changes elicited by stimulation of rat superior colliculus.
Stimulation of the rat superior colliculus can produce either orienting or defensive movements, which if elicited by natural stimuli would be accompanied by cardiovascular changes. To assess whether cardiovascular changes might also be mediated by the superior colliculus, blood pressure and heart rate were measured in Saffan-anaesthetised rats while the dorsal midbrain was systematically explored with electrical and chemical stimulation. Electrical stimulation (10 sec trains of 0.3 msec 100 Hz cathodal pulses, 50 microA) within the superficial and intermediate layers of the rostral superior colliculus transiently lowered blood pressure without affecting heart rate. In contrast sites within the deep layers, and in adjacent periaqueductal grey and midbrain tegmentum, gave pressor responses accompanied by a variety of heart-rate changes, that usually included a period of bradycardia. A roughly similar distribution was obtained with the cell-stimulant bicuculline (200 or 500 nl, 490 microM), though sodium L-glutamate (200 nl, 0.05 or 1.0 M) was ineffective. These results suggest that (a) cardiovascular responses can be produced by stimulation of the rat superior colliculus; (b) their nature depends on the location of the stimulation; and (c) they may be mediated in part by cells differentially sensitive to glutamate and to bicuculline. In addition, in some animals respiratory responses were measured stethographically. Short-latency increases in thoracic girth, often accompanied by increases in respiratory rate and depth, were elicited by electrical stimulation from 61% of the collicular sites examined, and by microinjection of glutamate from 56% of collicular sites. These data suggest that (a) cells within the superior colliculus are capable of influencing respiration; (b) given the widespread distribution of responsive sites within the superior colliculus, the respiratory changes may be preparatory for both approach and defensive movements; (c) the collicular cells that affect respiration may be different from those that influence blood pressure, because the latter are relatively insensitive to microinjection of glutamate.


Combining Landsat time series and GEDI data for improved characterization of fuel types and canopy metrics in wildfire simulation.
Wildfires in the Chornobyl Exclusion Zone (CEZ) and other radioactively contaminated areas threaten human health and well-being with the potential to resuspend radionuclides. Wildfire behavior simulation is a necessary tool to examine the efficiency of fuel treatments in the CEZ, but it requires systematically updated maps of fuel types and canopy metrics. The objective of this study was to demonstrate an effective approach for mapping fuel types, canopy height (CH), and canopy cover (CC) in territories contaminated by radionuclides using Landsat time series (LTS) and Global Ecosystem Dynamics Investigation (GEDI) LiDAR observations. We combined LTS and GEDI data to map fuel types and canopy metrics used in wildfire simulations within the CEZ. Our classification model showed an adequate overall accuracy (75%) in mapping land covers and associated fuel types. The phenology metrics extracted from LTS reliably distinguished spectrally similar vegetation types (such as grasslands and croplands) which exhibit different flammability through the year. We also predicted a suite of relative heights metrics and CC at Landsat 30-m pixel level (R2 = 0.23-0.26) using the nearest neighbor technique. The imputed maps adequately captured the dynamics of CH and CC in the CEZ after recent large wildfires occurred in 2015, 2020, and 2022. Thus, we illustrate a LTS processing approach to produce wall-to-wall maps of canopy characteristics that are important for wildfire simulations. We conclude that continuous updating of land cover and canopy fuel data is crucial to ensure relevant fire management of radioactively contaminated landscapes and support local decision-making.


Response of the rabbit diaphragm to tendon vibration.
To evaluate the potential role of diaphragmatic muscle spindles in the act of breathing, we have recorded the electromyograms of the diaphragm and the external intercostal muscle in the third interspace during high-frequency mechanical vibration (50 Hz) of the central tendon in eight anesthetized, spontaneously breathing rabbits. Vibration induced a consistent, clear-cut increase in the inspiratory activity recorded from the external intercostal, thus indicating that the mechanical stimulus applied to the diaphragm was strong enough to trigger muscle spindles at distant sites. However, vibration did not elicit any alteration in costal or crural diaphragmatic activity in any animal. Similarly, when vibration was applied during hyperventilation-induced apnea, activity was recorded in the external intercostal but not in the diaphragm. These observations support the traditional view that the diaphragm is poorly endowed with muscle spindles and that these play little or no significant role in the act of breathing.


Nicotinamide Mononucleotide Attenuates LPS-Induced Acute Lung Injury With Anti-Inflammatory, Anti-Oxidative and Anti-Apoptotic Effects.
Nicotinamide mononucleotide (NMN) is a nucleotide that is commonly recognized for its role as an intermediate of nicotinamide adenine dinucleotide (NAD+) biosynthesis with multiple pharmacological effects. The purpose of this study was to evaluate the protective effect of nicotinamide mononucleotide (NMN) against lipopolysaccharide (LPS)-induced acute lung injury (ALI). We investigated the effect of NMN on ALI-induced inflammatory response, oxidative stress, and cell apoptosis. The ALI mouse model was performed by injecting LPS intratracheally at a dose of 10 mg/kg in 50 μL saline. Flow cytometry was used to detect neutrophil infiltration in bronchoalveolar lavage fluid (BALF), and ELISA was used to detect the contents of inflammatory cytokines TNF-α, IL-1β and IL-6 in BALF. Oxidative stress was evaluated by determining the superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in lung tissue. ROS formation was analyzed by immunofluorescence. Western blotting was performed to detect apoptotic levels and p38MAPK/NF-κB phosphorylation levels in lung tissue. In the ALI mouse model, NMN showed a significant therapeutic effect compared to the LPS group. NMN attenuated the pathological damage and cell apoptosis in lung tissue, decreased the levels of TNF-α, IL-1β, and IL-6 in BALF, and reduced the number of total cells and neutrophils in BALF. In addition, NMN attenuated the LPS-induced elevation of dry-to-wet ratio, MDA content, p38 MAPK and p65 NF-κB phosphorylation levels, and the SOD activity was increased by NMN treatment. In conclusion, the present study showed that NMN exerted a protective effect on LPS-induced ALI with anti-inflammatory, antioxidative, and antiapoptotic effects.


Pediatric hand disease. Diagnosis and treatment.
Proper care of the pediatric hand requires a careful, systematic history, and physical examination, and is facilitated by recognizing common disease patterns, making it easier to determine which conditions require specialty referral, and the timing of those referrals. The article outlines pertinent details of examination and discusses diagnosis and treatment of a number of common diseases entities of the hand.


Benefits of a bolus calculator in pre- and postprandial glycaemic control and meal flexibility of paediatric patients using continuous subcutaneous insulin infusion (CSII).
To assess the efficacy in pre- and postprandial glycaemic control and the impact on treatment satisfaction of a bolus calculator (Bolus Wizard) incorporated into the insulin pump in Type 1 diabetic (T1D) paediatric patients using continuous subcutaneous insulin infusion (CSII) treatment at various stages of pubertal development. Thirty-six T1D patients on CSII treatment (19 males; mean age 13.9 +/- 3.5 years; range 4.9-17.8 years), were prospectively enrolled into this two-period crossover study. Eighteen patients were randomized to begin phase A using the Bolus Wizard, followed by phase B, using their current conventional insulin dosing method to determine pre-meal boluses. The remaining subjects were randomized to begin with phase B followed by phase A. Each study period lasted 2 weeks. A questionnaire assessing treatment satisfaction with the Bolus Wizard was compiled. There was a significant reduction in blood glucose levels before and 2 h after meals and in the number of correction boluses during phase A with respect to phase B of the study. The lower frequency of hypoglycaemic events during phase A did not reach statistical significance. There were no differences between the two phases: insulin requirement, daily bolus rate (%) and meal bolus quantity. When paediatric patients used CSII, the bolus insulin dose calculated using the Bolus Wizard was more effective in improving pre- and postprandial glycaemic control with fewer correction boluses, without differences in the prandial insulin requirements and without restriction in the carbohydrate content of meals. The use of the Bolus Wizard was easy and was associated with a high level of satisfaction in these patients.


Pentagastrin modulation of sensitivity of neurons of the lateral hypothalamus to noradrenaline and dopamine.
The chemical sensitivity of neurons of the lateral hypothalamus of hungry and fed rabbits to pentagastrin (PG) and to the mediators, noradrenaline (NA) and dopamine (DA), was investigated utilizing indices which permit the assessment of the structural-functional organization of the impulse stream of nerve cells. It was demonstrated that the neurons of the lateral hypothalamus possess varied chemical sensitivity in the presence of alimentary motivation and during the satisfaction of the corresponding need. The microiontophoresis of PG changes the sensitivity of cells in hungry animals to a higher degree to DA (60%) than to NA (30%), while in fed animals, to a higher degree to NA (48%) than to DA (23%). The administration of NA against the background of the action of PG to fed rabbits decreased the percent of neurons with spike train complex activity. The number of cells in the deprived animals with impulse activity of a similar character decreased following the microiontophoresis of DA alone and DA against the background of the action of PG. It is concluded that PG exerts a modulating influence on the effects of NA and DA on the impulse activity of the neurons, and that the character of the effect of PG depends on the initial state of the animal.


Structured line illumination Raman microscopy.
In the last couple of decades, the spatial resolution in optical microscopy has increased to unprecedented levels by exploiting the fluorescence properties of the probe. At about the same time, Raman imaging techniques have emerged as a way to image inherent chemical information in a sample without using fluorescent probes. However, in many applications, the achievable resolution is limited to about half the wavelength of excitation light. Here we report the use of structured illumination to increase the spatial resolution of label-free spontaneous Raman microscopy, generating highly detailed spatial contrast from the ensemble of molecular information in the sample. Using structured line illumination in slit-scanning Raman microscopy, we demonstrate a marked improvement in spatial resolution and show the applicability to a range of samples, including both biological and inorganic chemical component mapping. This technique is expected to contribute towards greater understanding of chemical component distributions in organic and inorganic materials.


Nonsense suppression in aminoacyl-t-RNA limited cells.
A number of nonsense alleles of lacZ exhibit phenotypic suppression (as much as a sixteen-fold increase in leakiness) during partial limitation for certain aminoacyl-tRNA species in relA mutant cells. Each responsive allele has its individual pattern of response to limitation for one or more amino acids or aminoacyl-tRNA's. The phenotypic suppression occurs only during limitation, and ceases once limitation is reversed. Suppression is much reduced by the presence of the relA+ allele or an allele of rpsL which restricts ribosomal ambiguity. In one case, the suppressed product has been identified by radioimmune assay and gel electrophoresis, and is a full-length lacZ protomer. Mechanisms are discussed whereby aberrations of translation at codons calling for an aminoacyl-tRNA species in short supply might lead to readthrough of a nearby nonsense codon.


Care workers health in Swiss nursing homes and its association with psychosocial work environment: A cross-sectional study.
Previous studies have demonstrated poor health of care workers in nursing homes. Yet, little is known about the prevalence of physical and mental health outcomes, and their associations with the psychosocial work environment in nursing homes. (1) To explore the prevalence of physical and mental health outcomes of care workers in Swiss nursing homes, (2) their association with psychosocial work environment. This is a secondary data analysis of the cross-sectional Swiss Nursing Home Human Resources Project (SHURP). We used survey data on socio-demographic characteristics and work environment factors from care workers (N=3471) working in Swiss nursing homes (N=155), collected between May 2012 and April 2013. GEE logistic regression models were used to estimate the relationship between psychosocial work environment and physical and mental health outcomes, taking into account care workers' age. Back pain (19.0%) and emotional exhaustion (24.2%) were the most frequent self-reported physical and mental health. Back pain was associated with increased workload (odds ratios (OR) 1.52, confidence interval (CI) 1.29-1.79), conflict with other health professionals and lack of recognition (OR 1.72, CI 1.40-2.11), and frequent verbal aggression by residents (OR 1.36, CI 1.06-1.74), and inversely associated with staffing adequacy (OR 0.69, CI 0.56-0.84); emotional exhaustion was associated with increased workload (OR 1.96, CI 1.65-2.34), lack of job preparation (OR 1.41, CI 1.14-1.73), and conflict with other health professionals and lack of recognition (OR 1.68, CI 1.37-2.06), and inversely associated with leadership (OR 0.70, CI 0.56-0.87). Physical and mental health among care workers in Swiss nursing homes is of concern. Modifying psychosocial work environment factors offer promising strategies to improve health. Longitudinal studies are needed to conduct targeted assessments of care workers health status, taking into account their age, along with the exposure to all four domains of the proposed WHO model.


Factors affecting flexion gap tightness in cruciate-retaining total knee arthroplasty.
With the exception of flexion gap tightness, which is common in cruciate-retaining (CR) total knee arthroplasty (TKA), the risk factors of flexion gap tightness have not been described. This retrospective study characterized factors that are associated with flexion gap tightness in CR TKA. Data on 203 consecutive knees that underwent CR TKA were reviewed. The prevalence rate of flexion gap tightness was 21.1%. By logistic regression analysis after adjusting for age, preoperative flexion contracture, and referencing method used for femoral sizing, insufficient tibial slope remained a significant independent risk factor of flexion gap tightness. Although excessive tibial slope should be avoided, the findings of the present study demonstrate that the risk of flexion gap tightness can be reduced by increasing the tibial slope in CR TKA.


Inhibitory effect of frusemide on sympathetic vasoconstrictor responses: dependence on a renal hormone and the vascular endothelium.
1. Mesenteric perfusion pressure was measured in the in situ mesentery perfused at a constant rate with blood drawn from the carotid artery of the same anaesthetized rat. Increases in perfusion pressure were produced by mesenteric periarterial electrical stimulation. These responses were measured before and 30 min after the administration of frusemide (5 mg/kg i.v.) to the rat. Loss of volume due to the frusemide-induced diuresis was prevented by a urinary bladder-venous extracorporeal circuit. 2. Responses to stimulation were reduced after frusemide and were not increased by the subsequent administration of indomethacin (2 mg/kg i.v.). This indomethacin treatment rapidly and completely prevented the fall in blood pressure produced by i.v. arachidonic acid. 3. In rats where the renal papilla had been ablated by treatment with bromoethylamine (200 mg/kg i.p.) 5 weeks previously, frusemide administration did not reduce sympathetic responses in the in situ blood-perfused mesentery. 4. A segment of rat tail artery, cannulated at both ends was mounted in an organ bath and perfused with blood withdrawn from, and returned to, an anaesthetized rat. Increases in perfusion pressure produced by periarterial electrical stimulation of this ex vivo blood perfused tail artery segment were reduced by frusemide administration to the anaesthetized rat. 5. When the endothelium was removed from the tail artery segment, frusemide administration did not lead to any reduction of vasoconstrictor responses. 6. Frusemide may lead to the release of a non-prostanoid hormone from the renal medulla which results in inhibition of peripheral sympathetic vasoconstrictor responses. The release of the hormone may involve intra-renal prostaglandins. The final antivasoconstrictor effect requires an intact vascular endothelium.


Donor-acceptor molecular architecture involving carbazole/pyrazine/anthraquinone units for efficient supercapacitor applications.
A donor-acceptor composed of two 3,6-di-tert-butyl-9H-carbazoles (DTCs) and fused pyrazine (Pyz; 1)-anthraquinone (AQ; 1) was successfully synthesized. The as-fabricated DTCz-Pyz-AQ/graphite foil (GF) electrode in supercapacitor (SC) applications exhibited excellent specific capacitance (Csp) of about 304. 37 F g-1 and 106.0 F g-1 at 0.5 A g-1 current density in three electrode and symmetric two electrode configurations of SC cells, respectively, accompanied by good cycling stability. The highest energy density of the SSC cell was found to be 15.94 W h kg-1 at 899.71 W kg-1 power density. As a proof of concept DTCz-Pyz-AQ/GF (D-A/GF) has great potential in energy storage (ES) applications.


The effects of infusions of ring-A-reduced derivatives of aldosterone on the antinatriuretic and kaliuretic actions of aldosterone.
Infusion of Ring-A-reduced metabolites of aldosterone in adrenalectomized male rats for 4 days revealed that 5 alpha-Ring-A-reduced derivatives, 5 alpha-dihydroaldosterone (5 alpha-DHAldo; 2.5-5.0 micrograms/day), 3 alpha,5 alpha-tetrahydroaldosterone (3 alpha,5 alpha-THAldo; 5-25 micrograms/day), and 3 beta,5 alpha-THAldo (50-175 micrograms/day) possessed intrinsic Na+-retaining activity. The same infusions of 5 alpha-DHAldo, 3 alpha,5 alpha-THAldo, and 3 beta,5 alpha-THAldo, also lowered the urinary excretion of potassium. The 5 beta-Ring-A-reduced derivative 3 alpha,5 beta-THAldo did not demonstrate either of these biological properties. In another set of experiments, on the fourth day of infusion, aldosterone (0.1 microgram/rat) was administered acutely subcutaneously; none of the Ring-A-reduced derivatives altered the Na+-retaining activity of aldosterone. However, in a dose-dependent manner, both 3 alpha,5 alpha-THAldo and 3 beta,5 alpha-THAldo blunted the urinary K+-secretory effect of aldosterone; low dosages of 5 alpha-DHAldo and larger dosages of 3 alpha,5 beta-THAldo did not. Thus, the 5 alpha-reduced derivatives of aldosterone not only lowered urinary Na+ and K+ excretion in their own right, but two of them blunted the kaliuretic response of the parent mineralocorticoid, aldosterone. Further experiments will be required to determine whether these aldosterone metabolites are further metabolized or interconverted during the expression of the regulatory properties described here and whether these properties are physiologically relevant.


Isolation of genetic material from Arabidopsis seeds.
Here, we describe a series of methods suitable for the reproducible and abundant isolation of total RNA, genomic DNA, and total protein from dry or imbibed Arabidopsis seeds. The resulting material is suitable for most standard molecular biology procedures.


Development of analytical ultrafast transmission electron microscopy based on laser-driven Schottky field emission.
A new design scheme for ultrafast transmission electron microscopy (UTEM) has been developed based on a Schottky-type field emission gun (FEG) at the Institute of Physics, Chinese Academy of Sciences (IOP CAS). In this UTEM setup, electron pulse emission is achieved by integrating a laser port between the electron gun and the column and the resulting microscope can operate in either continuous or pulsed mode. In pulsed mode, the optimized electron beam properties are an energy width of ~0.65 eV, micrometer-scale coherence lengths and sub-picosecond pulse durations. The potential applications of this UTEM, which include electron diffraction, high-resolution imaging, electron energy loss spectroscopy, and photon-induced near-field electron microscopy, are demonstrated using ultrafast electron pulses. Furthermore, we use a nanosecond laser (~10 ns) to show that the laser-driven FEG can support high-quality TEM imaging and electron holography when using a stroboscopic configuration. Our results also indicate that FEG-based ultrafast electron sources may enable high-performance analytical UTEM.


Noninvasive continuous positive airway pressure in elderly cardiogenic pulmonary edema patients.
To compare the physiological effects and the clinical efficacy of continuous positive airway pressure (CPAP) vs standard medical treatment in elderly patients (> or =75 years) with acute hypoxemic respiratory failure related to cardiogenic pulmonary edema. A prospective, randomized, concealed, and unblinded study of 89 consecutive patients who were admitted to the emergency departments of one general, and three teaching, hospitals. Patients were randomly assigned to receive standard medical treatment alone ( n=46) or standard medical treatment plus CPAP ( n=43). Improvement in PaO(2)/FIO(2) ratio, complications, length of hospital stay, early 48-h and overall mortality, compared between the CPAP and standard treatment groups. Study groups were comparable with regard to baseline physiological and clinical characteristics (age, sex ratio, autonomy, medical history, cause of pulmonary edema). Within 1 h, noninvasive continuous positive airway pressure led to decreased respiratory rate (respiratory rate, 27+/-7 vs 35+/-6 breaths/min; p=0.009), and improved oxygenation (PaO(2)/F(I)O(2), 306+/-104 vs 157+/-71; p=0.004) compared with baseline, whereas no differences were observed within the standard treatment group. Severe complications occurred in 17 patients in the standard treatment group, vs 4 patients in the noninvasive continuous positive airway pressure group ( p=0.002). Early 48-h mortality was 7% in the noninvasive continuous positive airway pressure group, compared with 24% in the standard treatment group ( p=0.017); however, no sustained benefits were observed during the overall hospital stay. Noninvasive continuous positive airway pressure promotes early clinical improvement in elderly patients attending emergency departments for a severe pulmonary edema, but only reduces early 48-h mortality.


Percutaneous absorption in experimental epidermal disease.
Little is known about the absorption of topical drugs in epidermal disease associated with epidermal proliferation and altered keratinization. An abnormal hairless mouse epidermis was produced by three different methods: ultraviolet light irradiation, topical vitamin A acid and topical acetic acid. An increased epidermal thickness resulted and the in vitro percutaneous absorption of 0.1% (4-14C) hydrocortisone was found to be increased when compared with normal hairless mouse epidermis. This is evidence for defective skin barrier function in experimental epidermal disease.


Odontoameloblastoma in the posterior maxilla of a -6-years-old Ardi goat (Capra aegagrus hircus).
A 6‑year‑old female Ardi goat was presented for evaluation of an expansile firm painless maxillary ovoid mass. Clinical and diagnostic imaging examination revealed a well‑ demarcated extensive mass occupying the left posterior maxilla and altering its anatomical features. Surgical excision was not deemed feasible with this apparently extensive infiltrative features of the tumor and the owner elected to euthanize the goat. Gross examination of the mass showed a grayish‑brown, multiloculated firm and gritty mass measuring 21 x 11 x 19 cm located on the left posterior maxilla. Histopathological examination revealed plexiform and follicular arranged, ameloblast ‑like odontogenic epithelium. Follicular epithelium was disintegrated leaving spaces, identical to solid multicystic ameloblastoma, intermingled with primitive myxoid stroma resembling dental papilla, teeth like hard structure as enamel and dentine, and osteodentine matrix. Based on these findings, the tumor was diagnosed as odontoameloblastoma (OA) and to our knowledge this is the first report of OA in goats.


Beyond the rodent model: Calorie restriction in rhesus monkeys.
Lifespan extension and reduction of age-related disease by calorie restriction (CR) are among the most consistent findings in gerontological research. The well known effects of CR have been demonstrated many times in rodents and other short-lived species. However, effects of CR on aging in longer-lived species, more closely related to humans, were unknown until recently. Studies of CR and aging using nonhuman primates (rhesus monkeys) were begun several years ago at the National Institute on Aging, the University of Wisconsin-Madison, and the University of Maryland. These studies are beginning to yield useful data regarding the effects of this nutritional intervention in primates. Several studies from these ongoing investigations have shown that rhesus monkeys on CR exhibit physiological responses to CR that parallel findings in rodents. In addition, several potential biomarkers of aging are being evaluated and preliminary findings suggest the possibility that CR in rhesus monkeys could slow the rate of aging and reduce age-related disease, specifically diabetes and cardiovascular disease. It will be several years before conclusive proof that CR slows aging and extends life span in primates is established, however, results from these exciting studies suggest the possibility that the anti-aging effects of CR reported in rodents also occur in longer-lived species such as nonhuman primates, strenghtening the possibility that this nutritional intervention will also prove beneficial in longer-lived species, including humans.


Thrombosed Arteriovenous Malformation of Umbilical Cord.
Arteriovenous malformation of umbilical cord is an extremely rare congenital malformation. Causes of this condition are unknown. AVM of umbilical cord can cause significant complications in the developing fetus. We report our management of the case with accurate ultrasound study that could improve and facilitate the approach to this pathology due to the lack of literature and with an overview of the available literature. There are only two cases of umbilical AVM diagnosed in the prenatal period with associated pathology. The mainstay of prenatal detection is the accurate study of umbilical cord also even if it is not requested from the actual guide lines in a way to improve the perinatal morbidity and mortality.


Elevated fluoride and selenium in west Texas groundwater.
Fluoride and selenium concentrations, along with total dissolved solids and depth of intake, were compiled, mapped, and analyzed for 634 water wells in the High Plains Aquifer, northwest Texas. Approximately 19% of fluoride observations exceeded the maximum contaminant level (MCL) for drinking water. Additionally, 4% of selenium observations exceeded the MCL for drinking water, and 19% exceeded the recommended limit for irrigation water. Concentrations were considerably higher in the southern part of the study area, especially in relatively deep public supply and irrigation wells. Though human activity may influence fluoride and selenium levels, natural sources largely account for patterns observed in this study.


Cancer patients' perspectives on participating in a community pharmacy-based hyperglycaemia screening service - A qualitative exploration of enablers and barriers.
Patients diagnosed with cancer are often treated with high dose glucocorticosteroids, increasing their risk of developing hyperglycaemia or steroid-induced diabetes, which can be reduced by regular monitoring of blood glucose levels. Community pharmacies can provide easily accessible monitoring services to patients, but may not be convenient or acceptable for people with a cancer diagnosis. To explore patients' motivations, perceptions of benefits and barriers influencing their decisions to participate in a novel community pharmacy-based hyperglycaemia screening and monitoring program. Patients initiated on high-dose-glucocorticosteroids at a quaternary cancer centre, who were meeting risk factor-based inclusion criteria and offered participation in a community-based blood glucose monitoring program, were purposively recruited to semi-structured interviews. Interview transcripts were analysed using content analysis and the Framework Method. Twenty-four patients participated in the interviews, of whom eighteen enrolled into the monitoring program and six declined participation. Interview analysis identified themes of motivators and barriers which were interpreted within the Health Belief Model. Patients individually balanced perceptions of risk and susceptibility to hyperglycaemia with the illness and treatment burden of a cancer diagnosis and the ability to access the program. Health concerns, accessibility of the community pharmacy, trust in healthcare professionals and altruism of patients (giving back) were identified as enablers to enrol. Barriers were inaccessibility of the community pharmacy, extra burden to deal with monitoring appointments, and initial misunderstandings about the screening and monitoring program. Ascertaining individual tipping points based on motivators or enablers and barriers with subsequent tailoring of supportive care programs will be more likely to meet patients' individual needs and may increase the likelihood of delivering appropriate care via community pharmacies.


Enhancement of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) toxicity by acetohydroxamic acid analogues of 3-nitropyrazole in vitro.
A series of acetohydroxamic acid derivatives of 3-nitropyrazole were synthesized and evaluated for their ability to potentiate (chemosensitization) the activity of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) against EMT-6 mouse mammary tumor cells in vitro. The compounds were designed to test the hypothesis that the chemosensitizing activity of the analogues would be proportional to the rate of isocyanate formation via a Lossen rearrangement, in part a function of the leaving group at the N terminus of each acetohydroxamate. Substitution of acetohydroxamic acid side chains at the N-1 position of the parent 3-nitropyrazole resulted in compounds which were preferentially toxic to cells treated under hypoxic conditions, and which were capable of enhancing the toxicity of CCNU in hypoxia. As was observed for cytotoxicity, the enhancement of CCNU toxicity by these sensitizing agents was significantly reduced under aerobic treatment conditions. A strong correlation was established between hypoxic toxicity and chemosensitizing potency. The activity of the analogue, however, was not proportional to their excepted rates of Lossen rearrangement. Nevertheless, several potent chemosensitizing compounds were identified; some of which were 10-50 X's more potent on a molar basis than Misonidazole, the reference chemosensitizing compound.


The cDNA-derived amino acid sequence of indoleamine dioxygenase like-myoglobin from the gastropod mollusc Omphalius pfeifferi.
Myoglobin was isolated from the radular muscle of the archaegastropod mollusc Omphalius pfeifferi (Trochidae). The molecular mass was estimated by SDS-PAGE to be about 40 kDa, 2.5 times larger than that of usual myoglobin. The cDNA for Omphalius myoglobin was amplified by polymerase chain reaction, and the cDNA-derived amino acid sequence of 375 residues was determined, of which 73 residues were identified directly by the chemical sequencing of internal peptides. The amino acid sequence of Omphalius myoglobin showed no significant homology with any other usual 16-kDa globins, but showed 84% and 36% identities with indoleamine dioxygenase-like myoglobins from Battilus (Turbinidae) and Sulculus (Haliotiidae), respectively. It also shows significant homology (26% identity) with human indoleamine 2,3-dioxygenase, a tryptophan-degrading enzyme containing heme. The distribution of indoleamine dioxygenase-like myoglobins suggests that they must have arisen exclusively along the specified lineage including the three families Haliotiidae, Turbinidae, and Trochidae of Archaegastropoda in molluscan evolution.


Galectin-1 is inversely associated with type 2 diabetes independently of obesity - A SCAPIS pilot study.
Galectin-1 is a recently discovered adipokine that increases with obesity and increased energy intake in adipose tissue. Our aim was to assess whether serum galectin-1 is associated with type 2 diabetes (T2D) and other parameters of the metabolic syndrome independently of body mass index (BMI) in a cohort from the general population. In this cross-sectional population-based cohort study from the western part of Sweden, we investigated associations between serum galectin-1, clinical characteristics and inflammatory markers in 989 women and men aged 50-65 years [part of the Swedish CArdioPulmonary bioImage Study (SCAPIS) pilot cohort]. We showed in linear models that serum galectin-1 was independently and: (1) inversely associated with T2D (p < 0.05) and glucose (p < 0.05); and (2) positively associated with age (p < 0.01), sex (p < 0.01), BMI (p < 0.01), insulin (p < 0.01) and C-reactive protein (p < 0.01). Furthermore, galectin-1 demonstrated univariate correlations with triglycerides (r = 0.20, p < 0.01), homeostasis model assessment for insulin resistance (r = 0.24, p < 0.01), tumor necrosis factor-α (r = 0.24, p < 0.01), interleukin-6 (IL-6; r = 0.20, p < 0.01) and HbA1c (r = 0.14, p < 0.01). In a cross-sectional study of a middle-aged population, we showed that serum galectin-1 is: (1) inversely associated with T2D independently of BMI; and (2) independently associated with other markers of the metabolic syndrome These results warrant prospective and functional studies on the role of galectin-1 in T2D.


Use of whey ultrafiltrate as a substrate for production of carotenoids by the yeast Rhodotorula rubra.
Carotenogenesis of the lactose-negative yeast Rhodotorula rubra GED5 was studied by cocultivation with Kluyveromyces lactis MP11 in whey ultrafiltrate (WU) (35, 50, and 70 g of lactose/L). Maximum yields of cell mass (24.3 g/L) and carotenoids (10.2 mg/L of culture fluid or 0.421 micro g/g of dry cells) were obtained by growing the microbial association in WU (50 g of lactose/L) in a fermentor with an airflow rate of 0.8 L/(L.min), agitation of 220 rpm, and temperature of 30 degrees C. The identified carotenoid pigments-beta-carotene, torulene, and torularhodin-reached maximum concentrations (133, 26.9, and 222.3 microg/g of dry cells, respectively) on d 5 for torulene and d 6 for beta-carotene and torularhodin.


Management of complications with hand fractures.
Both operative and nonoperative treatment of hand fractures can result in numerous complications, including stiffness, malunion, nonunion, arthritis, infection, and complex regional pain syndrome. These complications are frequently encountered and are often challenging to treat. This article systematically outlines the diagnosis and treatment of each of these complications to achieve the best possible outcome for the patient's overall hand function.


Maqui berry vs Sloe berry--liquor-based beverage for new development.
"Pacharin" is an aniseed liquor-based beverage made with sloe berry (Prunus spinosa L.) that has been produced in northern Spain. On the other hand, maqui berry (Aristotelia chilensis) is a common edible berry from Chile, and currently under study because of its multiple beneficial effects on health. The aim of this work was to design a new aniseed liquor-based beverage with maqui berry, as an industrial alternative to a traditional alcoholic product with bioactive berries. The characterization of its composition, compared with the traditional "Pacharin", and its evolution during maceration (6 and 12 months) showed that the new maqui liquor had significantly-higher anthocyanin retention over time. More studies on the organoleptic properties and bioactivity are underway.


In silico identification of immunodominant B-cell and T-cell epitopes of non-structural proteins of Usutu Virus.
Usutu Virus (USUV; flavivirus) is a re-emerging pathogen invading the territories of European countries, Asia, and Africa. It is a mosquito-borne zoonotic virus with a bi-directional transmission route from animal to human and vice versa, and causes neurological disorders such as meningoencephalitis in bats, Homo sapiens, birds and horses. Due to limited availability of information about USUV and its deleterious effects on neural cells causing neurologic impairments, it becomes imperative to study this virus in detail to equip ourselves with a solution beforehand. The current study aims to identify immunodominant peptides that could be exploited in future for designing global peptide vaccine for combating the infections caused by USUV. In this study, an immunoinformatics approach was applied to evaluate the immunogenicity of 7 non-structural proteins and determined 64 continuous B-cell epitopes, numerous probable discontinuous B-cell epitopes, 64 MHC Class-I binders, 126 MHC class-II binders and 52 promiscuous binders with a maximum population coverage of 98.55%(MHC Class-I binder ofYP_164815.1 NS4a) and 81.81% (MHC Class-II binders of YP_164812.1 NS2a, YP_164813.1 NS2b, YP_164814.1 NS3, YP_164817.1 NS4b, YP_164818.1 NS5). Further, studies involving experimental validation of these predicted epitopes is warranted to ensure the potential of B-cells and T-cells stimulation for their effective use as vaccine candidates, and as diagnostic agents against USUV.


Characterization of antibodies submitted to the B cell section of the 8th Human Leukocyte Differentiation Antigens Workshop by flow cytometry and immunohistochemistry.
The aim of this study was to characterize the reactivity of monoclonal antibodies (mAbs) that had been submitted to the HLDA8 Workshop. The lineage specificity of target molecules was tested by analyzing their expression patterns on blood cells, leukocytes, and lymphocyte subsets. The expression of target molecules during B cell development, ranging from early precursors to plasma cells, was analyzed using a large panel of B cell lines. Our results have permitted us to characterize the expression of 10 new CD molecules: CD316 (HM1.24, BST2), CD268 (BAFF-R, TNFRSF13C), CD269 (BCMA, TNFRF17), CD267 (TACI, TNFRSF13B), CD275 (ICOSL, B7H2), CD254 (TRANCE, TNFSF11), CD252 (OX40L TNFSF4), CD315 (CD9-P), CD316 (EWI-2, PGRL), and CD307 (IRTA-2 or FcRH5). Three of these new CDs, CD267, CD269, and CD307 presented a B cell-restricted expression pattern. MAbs against these novel cell-surface molecules may offer new tools for research, diagnosis, and therapy.


Visual impairment and employment in Norway.
Past studies have suggested lower employment of people with visual impairment. Reasons for this are less known. This study aimed to examine the employment rates among people with visual impairment, and its association with sociodemographic characteristics, vision-related factors, depression, and life satisfaction. This cross-sectional study included a stratified random sample of 574 working-age adults (18-67 years) who were members of the Norwegian Association of the Blind and Partially Sighted. Data were collected by telephone interviews between January and May 2017, and included information on work status, sociodemographic factors, vision-related characteristics, depression (Patient Health Questionnaire-9), and life satisfaction (Cantril's Ladder of Life Satisfaction). Associations with employment (full-time, part-time, or self-employment) were examined using regression analyses. Of the participants, 51.2% of males and 38.1% of females reported to be employed. Employment was associated with being of middle age, male gender, higher education, residing in high-income municipalities, having a moderate degree of vision loss, lower onset-age of vision loss, and having no additional impairments. Employed participants had lower levels of depression compared to others (adjusted exponentiated beta: 0.80, 95% confidence interval (CI): 0.67, 0.96). They also had a higher odds of scoring higher on life satisfaction (adjusted exponentiated beta (odds ratio): 1.85, 95% CI: 1.32, 2.59). Employment was lower in people with visual impairment than in the general population. Inclusion of the blind and partially sighted into the workforce could promote health and thus have socio-economic benefits.


111In-oxine labelling of tumour-cytotoxic macrophages generated in vitro from circulating blood monocytes: an in vitro evaluation.
The labelling of ex-vivo activated macrophages with doses of 111In-oxine sufficient for gamma camera imaging does not damage cell viability or the functional competence of cells (secretion of tumour necrosis factor-alpha and interleukin-6). The mean labelling efficiency was about 84%. Release of 111In equivalent to 15% occurred over 24 h under cell culture conditions, indicating good stability of the radioactive cell label. 111In-oxine-labelled macrophages are a suitable tool for biokinetic studies of adoptive immunotherapy.


Effective n-octane isomerization under exceptionally mild conditions using a novel class of superacidic ionic liquids.
Superacidic chloroaluminate ionic liquids of the general formula [cation]Cl/AlCl(3)[X(AlCl(3)) > 0.5] + H(2)SO(4) effectively isomerize n-octane to form branched liquid hydrocarbon isomers. Due to the highly acidic character of the ionic liquid the reaction proceeds under extremely mild conditions in a liquid-liquid biphasic reaction mode leading to a minimum of undesired cracking side-reactions.


Stochastic modulations of the pace and patterns of ageing: impacts on quasi-stochastic distributions of multiple geriatric pathologies.
All phenotypes result from interactions between Nature, Nurture and Chance. The constitutional genome is clearly the dominant factor in explaining the striking differences in the pace and patterns of ageing among species. We are now in a position to reveal salient features underlying these differential modulations, which are likely to be dominated by regulatory domains. By contrast, I shall argue that stochastic events are the major players underlying the surprisingly large intra-specific variations in lifespan and healthspan. I shall review well established as well as more speculative categories of chance events--somatic mutations, protein synthesis error catastrophe and variegations of gene expression (epigenetic drift), with special emphasis upon the latter. I shall argue that stochastic drifts in variegated gene expression are the major contributors to intra-specific differences in the pace and patterns of ageing within members of the same species. They may be responsible for the quasi-stochastic distributions of major types of geriatric pathologies, including the "big three" of Alzheimer's disease, atherosclerosis and, via the induction of hyperplasias, cancer. They may be responsible for altered stoichiometries of heteromultimeric mitochondrial complexes, potentially leading to such disorders as sarcopenia, nonischemic cardiomyopathy and Parkinson's disease.


Global trends and current status of distraction osteogenesis: Bibliometric analysis of publications from 1980 to 2021.
Introduction: Distraction osteogenesis (DO) has become an important technology for the correction of various congenital and acquired skeletal ridge deformities. It is widely used in oral and maxillofacial surgery, orthopedics, and other disciplines. From 1980 to 2021, the cutting-edge research of DO has been continuously promoted, and the interaction between disciplines has also been deepening. However, the analysis on the global trend and status of DO is relatively rare. Therefore, the aim of our study was to summarize the global trends and current status of DO through bibliometrics. Materials and methods: Web of Science (WOS) core collection database and Medline were used to search DO-related literatures published during 1980-2021. The collected data are imported into Microsoft Excel, Microsoft Word, VOSviewer software for analysis and drawing figure/table. Results: A total of 7,721 publications were included in this study. The United States is the main contributing country to DO (ranking first in terms of total publications, sum of times cited and H-index). Harvard University was the main contributing institution to DO. Journal of Craniofacial Surgery is the main contributing journal of DO related articles. Buchman, SR is the main contributing author to DO related articles. DO related publications can be summarized into 7 clusters: 1) "mechanism study", 2) "limb bone distraction study", 3) "alveolar bone distraction study", 4) "temporomandibular joint ankylosis study", 5) "maxillofacial surgery study", 6) "skull distraction study" and 7) "mandible distraction study". Mandible distraction study has been a hot topic in recent years. In addition, the "management", "osteogenesis" and "reconstruction" of DO have been the research hotspots from 1980 to 2021. Conclusion: From 1980 to 2021, the total number of DO articles has increased rapidly and maintained a steady trend. The United States is the predominant country in the field. Surgery, dental, and oral surgery and orthopaedics are hot fields of DO research. The study of mandible distraction has been paid more and more attention and will become a hotspot in the future. Our study is beneficial for scientists to specify the research hotspot and development direction of DO.


Mixed elicitation with salicylic acid and hydrogen peroxide modulates the phenolic and iridoid pathways in Castilleja tenuiflora plants.
SA and H2O2, in single and mixed elicitation stimulate specialized metabolism and activate oxidative stress in C. tenuiflora plants. Single elicitation with salicylic acid (SA at 75 µM) and, hydrogen peroxide (at 150 µM), and mixed elicitation (75 µM SA + 150 µM H2O2) were evaluated on specialized metabolism in Castilleja tenuiflora Benth. plants. Total phenolic content (TPC), phenylalanine ammonia-lyase (PAL) activity, antioxidant enzymes and specialized metabolite profiles, as well as the expression levels of eight genes involved in phenolic (Cte-TyrDC, Cte-GOT2, Cte-ADD, Cte-AO3, Cte-PAL1, Cte-CHS1) and terpene pathways (Cte-DXS1 and Cte-G10H) and their correlation with major metabolite (verbascoside and aucubin) concentrations were investigated. TPC content (three-fold) and PAL activity (11.5-fold) increased with mixed elicitation, as well as catalase and peroxidase activity (11.3-fold and 10.8-fold, respectively), compared to single elicitation. Phenylethanoid accumulation was greatest under mixed elicitation, followed by SA and H2O2. Lignan accumulation was differential, depending on the plant part and the elicitor. Flavonoids only appeared after mixed elicitation. The high concentration of verbascoside under mixed elicitation was related to a high gene expression. Single elicitation induced iridoid accumulation in specific parts (H2O2 in aerial parts and SA in roots), whereas under mixed elicitation, it accumulated in both parts. A high concentration of aucubin in the aerial part was related to a high expression level of genes of the terpene pathway Cte-DXS1 and Cte-G10H, and in the root with Cte-G10H, while Cte-DXS1 was downregulated in this tissue in all treatments. Mixed elicitation with SA and H2O2 represents an interesting tool to increase the production of specialized metabolites in plants.


Intrathecal and oral clonidine as prophylaxis for postoperative alcohol withdrawal syndrome: a randomized double-blinded study.
In this study, we evaluated the effect of intrathecal and oral clonidine as supplements to spinal anesthesia with lidocaine in patients at risk of postoperative alcohol withdrawal syndrome (AWS). We hypothesized that clonidine would have a prophylactic effect on postoperative AWS. Forty-five alcohol-dependent patients (daily ethanol intake >60 g) scheduled for transurethral resection of the prostate were double-blindly randomized into three groups. All patients received hyperbaric lidocaine 100 mg intrathecally. The diazepam group (DiazG) was premedicated with diazepam 10 mg orally; the intrathecal clonidine group (Clon(i/t)G) received a placebo (saline) tablet and clonidine 150 microg intrathecally; and the oral clonidine group (Clon(p/o)G) received clonidine 150 microg orally. For patients diagnosed with AWS, the Clinical Institute Withdrawal Assessment for Alcohol, revised scale, was used. Twelve patients in the DiazG had symptoms of AWS, compared with two in the Clon(i/t)G and one in the Clon(p/o)G. The median Clinical Institute Withdrawal Assessment for Alcohol, revised scale, score was 12 in the DiazG versus 1 in the clonidine-treated groups. Two patients in the DiazG had severe delirium. Patients receiving oral clonidine had a slightly decreased mean arterial blood pressure 6-12 h after spinal anesthesia (P < 0.05); patients in the DiazG had a hyperdynamic circulatory reaction 24-72 h after surgery. In conclusion, preoperative clonidine 150 microg, intrathecally or orally, prevented significant postoperative AWS in ethanol-dependent patients. In this randomized, double-blinded study, clonidine 150 microg both intrathecally and orally prevented postoperative alcohol-withdrawal symptoms in alcohol-dependent men. The effect was superior to that with a single dose of diazepam 10 mg orally.


Model of care and chance of spontaneous vaginal birth: a prospective, multicenter matched-pair analysis from North Rhine-Westphalia.
Advantages of midwife-led models of care have been reported; these include a higher vaginal birth rate and less interventions. In Germany, 98.4% of women are giving birth in obstetrician-led units. We compared the outcome of birth planned in alongside midwifery units (AMU) with a matched group of low-risk women who gave birth in obstetrician-led units. A prospective, controlled, multicenter study was conducted. Six of seven AMUs in North Rhine-Westphalia participated. Healthy women with a singleton term cephalic pregnancy booking for birth in AMU were eligible. For each woman in the study group a control was chosen who would have been eligible for birth in AMU but was booking for obstetrician-led care; matching for parity was performed. Mode of birth was chosen as primary outcome parameter. Secondary endpoints included a composite outcome of adverse outcome in the third stage and / or postpartum hemorrhage; higher-order obstetric lacerations; and for the neonate, a composite outcome (5-min Apgar < 7 and / or umbilical cord arterial pH < 7.10 and / or transfer to specialist neonatal care). Statistical analysis was by intention to treat. A non-inferiority analysis was performed. Five hundred eighty-nine case-control pairs were recruited, final analysis was performed with 391 case-control pairs. Nulliparous women constituted 56.0% of cases. For the primary endpoint vaginal birth superiority was established for the study group (5.66%, 95%-CI 0.42% - 10.88%). For the composite newborn outcome (1.28%, 95%-CI -1.86% - -4.47%) and for higher-order obstetric lacerations (2.33%, 95%-CI -0.45% - 5.37%) non-inferiority was established. Non-inferiority was not present for the composite maternal outcome (-1.56%, 95%-CI -6.69% - 3.57%). The epidural anesthesia rate was lower (22.9% vs. 41.1%), and the length of hospital stay was shorter in the study group (p < 0.001 for both). Transfer to obstetrician-led care occurred in 51.2% of cases, with a strong association to parity (p < 0.001). Request for regional anesthesia was the most common cause for transfer (47.1%). Our comparison between care in AMU and obstetrician-led care with respect to mode of birth and other outcomes confirmed the superiority of this model of care for low-risk women. This pertains to AMU where admission and transfer criteria are in place and adhered to.


Separation of cyclic AMP and cyclic GMP from thymidine, electrolytes and polyvalent nucleotides in tissue samples.
Cyclic AMP and cyclic GMP can be separated from thymidine and its possible metabolites, electrolytes, and polyvalent nucleotides using columns of acidic alumina. Electrolytes and thymidine are not adsorbed on acidic alumina at pH 4.4 while cyclic nucleotides and polyvalent nucleotides are adsorbed at this pH. Cyclic AMP and cyclic GMP are eluted together from acidic alumina with 0.2 M ammonium formate (pH 6.0) and the polyvalent nucleotides remain adsorbed. The cyclic nucleotides are separated by chromatography on Dowex AG 1 X 8 resin. Recovery is 60--64% for cyclic AMP and cyclic GMP isolated from renal tissue samples. This methodology permits the separation of tritiated thymidine from cyclic nucleotides which are present in tissue preparations used in studies on the role of cyclic nucleotides in cellular growth.


The human Y and inactive X chromosomes similarly modulate autosomal gene expression.
Somatic cells of human males and females have 45 chromosomes in common, including the "active" X chromosome. In males the 46th chromosome is a Y; in females it is an "inactive" X (Xi). Through linear modeling of autosomal gene expression in cells from individuals with zero to three Xi and zero to four Y chromosomes, we found that Xi and Y impact autosomal expression broadly and with remarkably similar effects. Studying sex-chromosome structural anomalies, promoters of Xi- and Y-responsive genes, and CRISPR inhibition, we traced part of this shared effect to homologous transcription factors - ZFX and ZFY - encoded by Chr X and Y. This demonstrates sex-shared mechanisms by which Xi and Y modulate autosomal expression. Combined with earlier analyses of sex-linked gene expression, our studies show that 21% of all genes expressed in lymphoblastoid cells or fibroblasts change expression significantly in response to Xi or Y chromosomes.


Properties of single potassium channels in cultured primary astrocytes.
The patch-clamp technique was used to characterize the single channel ion currents in primary cultures of rat astrocytes. The most dominant channel type, which was found in over half of the inside-out membrane patches, was a potassium channel. The measured reversal potential was -67 mV, which is close to the calculated Nernst potential for potassium ions (-80 mV). These potassium channels activated with bursts of very brief openings. Once activated the channels did not inactivate. The measured probabilities of the channels to be closed showed at least 3 different modes of channel behaviour: one voltage-independent and two voltage-dependent modes. During each activity-mode a 'main' conductance level plus two other conductance levels were observed. In some recordings a pronounced outward rectification could also be seen.


How much of antibiotics can enter surface water with treated wastewater and how it affects the resistance of waterborne bacteria: A case study of the Białka river sewage treatment plant.
This study aimed to gain insight into the presence of antibiotics, occurrence of antimicrobial resistance and prevalence of extended-spectrum β-lactamase (ESBL) genes in Escherichia coli in surface water, based on the example of the Białka river, located in one of the most attractive tourist destinations in Poland. Water samples were collected in three sites: in the Tatra National Park (TNP), by the sewage discharge from the local treatment plant (STP) and c.a. 3 km downstream (DSTP). The analyses included determination of antibiotic content, enumeration of bacterial indicators of poor water quality, isolation and identification of Escherichia coli, which was subjected to antimicrobial susceptibility tests and assessment of ESBL-determining genes. Fourteen antimicrobials out of 24 tested were detected in river waters in varying concentrations. Trimethoprim and ofloxacin were most frequently detected. Most antibiotics were absent in the TNP, the highest numbers and the highest concentrations of antibiotics were observed by the STP discharge to decrease their content downstream. Culture-based tests of microbiological contamination showed similar results. Resistance to ampicillin was most frequent (64.5% strains), followed by cefazolin (50%). 20.6% of strains were ESBL-positive, while ESBL-determining gene, blaTEM was detected in 23.8% of E. coli strains. The largest percentage of antibiotic resistant and MDR E. coli strains was detected nearby the STP, indicating that malfunctioning STP may contribute largely to river water contamination downstream, also having significant environmental and economic impact.


Antifungal therapy in the management of chronic candidiasis.
The most pathogenic Candida species are identified and the structure of imidazole compounds and their mechanism of action on yeast cells are described. Not all yeast species react in the same way to imidazole preparations, and these actions are documented.


Effect of ozone irrigation and powered toothbrushing on dental plaque, gingival inflammation, and microbial status in institutionalized mentally challenged individuals: A double-blinded, randomized, controlled clinical trial.
This study compares and evaluates the efficacy of ozonated water irrigation (OZI) and powered toothbrushing on the oral health and microbial status of mentally challenged individuals. Thirty individuals of age range 15-30 years with a mild-to-moderate level of mental retardation (MR) and gingival inflammation participated in this double-blind randomized controlled clinical trial. Total duration of the study was 45 days consisting of two clinical phases (phase I, i.e., aided) and phase II, i.e. unaided) of the duration of 21 days in each phase, with a washout period of 3 days between the two phases. With a split-mouth design, sites from each subject were randomly allocated into two treatment groups: Powered Toothbrushing (PB) and OZI were randomly done for each half side of the mouth of each subject. Subgingival plaque samples were collected from sites of both the treatment groups and sent for microbial analysis. Clinical and microbial parameters were measured before and after the treatment. Significant improvement of the clinical and microbial parameters was found in both treatment groups. However, intergroup differences in the parameters were statistically nonsignificant. OZI could serve as an alternative or adjunct to powered toothbrushes for people with MR.


Cleptes pallipes Lepeletier synonym of Cleptes semiauratus (Linnaeus) and description of Cleptes striatipleuris sp. nov. (Hymenoptera: Chrysididae, Cleptinae).
The interpretation of Linnaeus' name Sphex semiaurata Linnaeus, 1761 has been controversial. After type examinations, we conclude that it is identical with the common Cleptes pallipes Lepeletier, 1806 and thus re-establish the old synonymy: Cleptes semiauratus (Linnaeus, 1761) (=Cleptes pallipes Lepeletier, 1806, syn. reinst.). We have been unable to find an available name for the species with which it has been confused. In order to be able to designate a suitable type specimen, we prefer to describe it as a new species rather than suggest a replacement name: Cleptes striatipleuris Rosa, Forshage, Paukkunen & Soon sp. nov. (=Cleptes semiauratus sensu Lepeletier, 1806, nec Linnaeus, 1761; =C. splendens sensu Linsenmaier 1959, nec Fabricius, 1798).


Pelvic radiography in ATLS algorithms: A diminishing role?
Pelvic x-ray is a routine part of the primary survey of polytraumatized patients according to Advanced Trauma Life Support (ATLS) guidelines. However, pelvic CT is the gold standard imaging technique in the diagnosis of pelvic fractures. This study was conducted to confirm the safety of a modified ATLS algorithm omitting pelvic x-ray in hemodynamically stable polytraumatized patients with clinically stable pelvis in favour of later pelvic examination by CT scan. We conducted a retrospective analysis of all polytraumatized patients in our emergency room between 01.07.2004 and 31.01.2006. Inclusion criteria were blunt abdominal trauma, initial hemodynamic stability and a stable pelvis on clinical examination. We excluded patients requiring immediate intervention because of hemodynamic instability. We reviewed the records of n = 452 polytraumatized patients, of which n = 91 fulfilled inclusion criteria (56% male, mean age = 45 years). The mechanism of trauma included 43% road traffic accidents, 47% falls. In 68/91 (75%) patients, both a pelvic x-ray and a CT examination were performed; the remainder had only pelvic CT. In 6/68 (9%) patients, pelvic fracture was diagnosed by pelvic x-ray. None of these 6 patients was found having a false positive pelvic x-ray, i.e. there was no fracture on pelvic CT scan. In 3/68 (4%) cases a fracture was missed in the pelvic x-ray, but confirmed on CT (false negative on x-ray). None of the diagnosed fractures needed an immediate therapeutic intervention. 5 (56%) were classified type A fractures, and another 4 (44%) B 2.1 in computed tomography (AO classification). One A 2.1 fracture was found in a clinically stable patient who only received CT scan (1/23). While pelvic x-ray is an integral part of ATLS assessment, this retrospective study suggests that in hemodynamically stable patients with clinically stable pevis, its sensitivity is only 67% and it may safely be omitted in favor of a pelvic CT examination if such is planned in adjunct assessment and available. The results support the safety and utility of our modified ATLS algorithm. A randomized controlled trial using the algorithm can safely be conducted to confirm the results.


Core-shell MOFs-based composites of defect-functionalized for mixed-mode chromatographic separation.
The micropores of the metal-organic frameworks (MOFs) endow with the advantages of size selectivity and large specific surface area, etc., but they limit their applications toward the control of diffusion and transport processes. Here, we report a strategy to prepare the hierarchical porous material, functional defect, which allows incorporation of L-Cysteine in the MOF by defect-loading. Silica microspheres were modified with these materials to form core-shell composites and used as mixed-mode stationary phases for chromatographic separations. Compared with the traditional MOFs-based stationary phase, it exhibited superior efficiency and selectivity for separation of various analytes and highlighted the role of defect of MOFs and function of L-Cysteine. In addition to the rapid separation of hydrophobic compounds, the stationary phase showed great potential in the separation of hydrophilic analytes, especially for separation of ten carbohydrates and eight sulfonamides. It showed excellent chromatographic reproducibility and stability, and the repeatability of preparation was investigated by relative standard deviations of retention time and/or column efficiency of objective compounds, which was among different batches less than 1.81%. This demonstration provided deep understanding of separation mechanism between MOF-based composites with functional defect and analytes, and stimulated the wide applications of such defective MOFs complexes in separations and analysis.


Regulation of protein kinase D activity in adult myocardium: novel counter-regulatory roles for protein kinase Cepsilon and protein kinase A.
Protein kinase D (PKD) is activated downstream of protein kinase C (PKC) in many cell types, although little is known about the mechanisms that regulate PKD in adult myocardium. Exposure of cultured adult rat ventricular myocytes (ARVM) to phorbol 12-myristate 13-acetate (PMA; 100 nM for 5 min) activated PKD, as evidenced by significantly increased phosphorylation at Ser744/8 (PKC phosphorylation sites) and Ser916 (autophosphorylation site). PKD activation occurred concomitantly with translocation of the enzyme from the cytosolic to the particulate fraction. The role of PKC was confirmed by pretreatment (15 min) of ARVM with the PKC inhibitors GF109203X (1 microM) and Ro31-8220 (1 microM), both of which prevented PKD phosphorylation on subsequent exposure to PMA. Exposure of ARVM to endothelin-1 (ET1; 100 nM for 10 min) also activated PKD by a PKC-dependent mechanism. To determine the PKC isoform(s) involved in the ET1-induced PKD activation, ARVM were infected with adenoviral vectors encoding dominant-negative (DN) mutants of PKCalpha, PKCdelta and PKCepsilon. Expression of DN-PKCalpha and DN-PKCdelta had little effect on ET1-induced PKD activation, whilst this was significantly attenuated by expression of DN-PKCepsilon, indicating that PKCepsilon plays a predominant role in the pertinent ET1 signaling pathway. Intriguingly, prior exposure to the adenylyl cyclase activator forskolin (1 microM for 5 min) or the beta-adrenergic agonist isoprenaline (100 nM for 5 min) markedly attenuated ET1-induced PKD activation, but not PMA-induced PKD activation. The ET1-induced response was rescued when protein kinase A (PKA) was inhibited (H89, 10 microM) before exposure to isoprenaline. These results show that ET1-induced PKD activation in ARVM is mediated by PKC, primarily the PKCepsilon isoform, and is suppressed by PKA activation.


Exploring the spatial pattern of renewable energy technology innovation: evidence from China.
Considering the obvious regional differences in China, research on the drivers for renewable energy technology innovation (RETI) needs to fully consider the spatial factors. Based on the expanded function of knowledge production, which includes the human capital, institutional quality, and industrial scale, and using panel data from 29 provinces during 2006-2017, this study examines the factors promoting RETI by employing spatial regression methods. The results show that RETI presents moderate spatial agglomeration and spatial heterogeneity. Human capital, enterprise R&D intensity, and research institution R&D intensity have a significant driving effect on the local RETI, and the university R&D intensity, institutional quality, and industrial scale have no significant contribution. Human capital is the most important factor driving the local RETI, and enterprise R&D intensity has the strongest spatial spillover effect on the RETI of the surrounding provinces. In addition, the R&D intensity of enterprises and research institutions can enhance the local RETI and also significantly promote RETI in surrounding provinces through the spatial spillover effect. In contrast, human capital has played a significant driving role in the local RETI, whereas its spatial spillover effect on the surrounding provinces is not obvious. Therefore, the direct and spatial spillover effects of enterprise R&D intensity and research institution R&D intensity should be fully considered in policy making. In addition, effective policies should be formulated to break the block division of human capital investment and to promote the optimized allocation of talented people in order to better promote RETI in China.


Study of forced degradation behavior of enalapril maleate by LC and LC-MS and development of a validated stability-indicating assay method.
In the present study, comprehensive stress testing of enalapril maleate was carried out according to ICH guideline Q1A(R2). The drug was subjected to acid (0.1N HCl), neutral and alkaline (0.1N NaOH) hydrolytic conditions at 80 degrees C, as well as to oxidative decomposition at room temperature. Photolysis was carried out in 0.1N HCl, water and 0.1N NaOH at 40 degrees C. Additionally, the solid drug was subjected to 50 degrees C for 60 days in a dri-bath, and to the combined effect of temperature and humidity, with and without light, at 40 degrees C/75% RH. The products formed under different stress conditions were investigated by LC and LC-MS. The LC method that could separate all degradation products formed under various stress conditions involved a C18 column and a mobile phase comprising of ACN and phosphate buffer (pH 3). The flow rate and detection wavelength were 1 ml min(-1) and 210 nm, respectively. The developed method was found to be precise, accurate, specific and selective. It was suitably modified for LC-MS studies by replacing phosphate buffer with water, where pH was adjusted to 3.0 with formic acid. The drug showed instability in solution state (under acidic, neutral, alkaline and photolytic stress conditions), but was relatively stable in the solid-state, except formation of minor products under accelerated conditions. Primarily, maximum degradation products were formed in acid conditions, though the same were also produced variably under other stress conditions. The LC-MS m/z values and fragmentation patterns of two of the five products matched with enalaprilat and diketopiperazine derivative, previously known degradation products of enalapril. Also, m/z value of another product matched with an impurity listed in the drug monograph in European Pharmacopoeia. Rest two were hitherto unknown degradation products. The products were characterized through LC-MS fragmentation studies. Based on the results, a more complete degradation pathway for the drug could be proposed.


Prognostic implication of proteomic profiles in head and neck squamous cell carcinoma.
Head and neck squamous cell carcinoma (HNSCC) is one of the malignant cancers with poor prognosis. However, clinicopathologic and histological criteria were finite to predict the prognosis of HNSCC. We aimed to characterize the proteomic profile of prognosis from HNSCC patients. Reverse phase protein array (RPPA) data in HNSCC were downloaded from The Cancer Proteome Atlas (TCPA). Independent prognostic-related proteins (IPP) were screened by Cox regression model and Kaplan-Meier methods. IPP signature (IPPS) including selected proteins was conducted for prognostic prediction for HNSCC. Protein-protein network analysis and gene ontology (GO) enrichment were used to identify related functional proteins and pathways. Based on the IPP, IPPS for HNSCC was constructed: risk score = (1.541* IRF1) + (1.460 * SMAD4) + (1.396 * LKB1) + (0.746* Cyclin E2) + (0.618* Paxillin) + (0.499* p-PEA-15 (Ser116)). The IPPS in HNSCC showed good predictive performance (area under curve = 0.779) with moderate sensitivity and specificity. Protein-protein network analysis and functional enrichment indicated an implication of response to decreased oxygen levels in HNSCC. The identified proteomic signature might function as a prognostic tool for the management of HNSCC and provide novel target for the treatment of HNSCC.


Iatrogenic adrenaline induced mid-ventricular Takotsubo cardiomyopathy: a case-based review.
Takotsubo cardiomyopathy (TCM) is regarded as an acute and often reversible cardiac syndrome characterised by apical ballooning of the left ventricle that occurs in the absence of coronary artery obstruction and myocarditis. The underlying pathophysiology remains largely unknown, but the most widely accepted theory is catecholamine toxicity.More recently, atypical variants of TCM have been described, and are characterised by the regional wall motion abnormalities that are observed. Mid-ventricular Takotsubo cardiomyopathy (MVTCM) is characterised by hypokinesia/akinesia of the mid left ventricular wall segments with hyperdynamic basal and apical function. This report describes the first documented case of a patient who developed MVTCM after receiving a dose of intravenous adrenaline. This case provides further evidence to support the notion that catecholamine toxicity is implicated in the pathogenesis of TCM.


Preoperative sexual function in women with rectal cancer.
Even though sexual dysfunction has been reported after rectal cancer treatment, information on preoperative sexual function is scarce, particularly in female patients. To describe preoperative sexual function in women with rectal cancer, and to analyse potential sources of bias. The Female Sexual Function Index (FSFI) was administered to women with newly diagnosed non-metastatic rectal cancer, irrespective of whether they were sexually active or not. FSFI total and domain scores were calculated for women with complete responses to the corresponding items. Data were compared for those who did and did not complete all the FSFI domains, and for women in the study cohort, and those who were eligible for inclusion but not included. Sexual inactivity was common. Mean FSFI total score was low (16.4 ± 10.6 SD) among the women who completed all six FSFI domains. The proportion of women who had a partner was higher in this group compared with those who did not complete all the domains (49 of 57 vs 7 of 25, p < 0.001). Eighty-two of the 157 women eligible for inclusion were included. Included women were younger (p = 0.002) and had less co-morbidity than those who were not included (p = 0.025). The low FSFI total score indicates sexual dysfunction. However, the use of FSFI in both women who are and who are not sexually active complicates interpretation of the data and may result in an information bias hampering internal validity. External validity may be limited by selection bias.


Modulated expression of glycoprotein oligosaccharides identifies phenotypic differentiation in squamous carcinomas of the human cervix.
This study has examined changes in expression of complex oligosaccharides during the development of invasive squamous carcinoma of the human cervix to determine whether particular oligosaccharide structures that might influence the phenotypic behavior of individual human cervical cancers were expressed during neoplasia. An extensive panel of lectins capable of identifying all the core and antennary oligosaccharide structures commonly encountered in human epithelia was chosen to probe a range of 11 benign and 26 malignant cervical tissues, all of the latter being clinically stage I. Lectin histochemistry was performed both before and after tissue desialylation using the enzyme neuraminidase to identify masking of oligosaccharide determinants by sialic acid. Nonneoplastic cervical epithelial cells were found to express only type I antennary structures (Gal beta 1-->3GalNAc-) usually modified by sialic acid linked 2-->6 to terminal Gal- or GalNAc residues. Type II oligosaccharide structures (Gal beta 1-->4GlcNAc-) were not identified in these normal tissues. No other terminal antennary modifications were detected on nonneoplastic cervical squamous epithelia. Conversely, neosynthesis of type II oligosaccharides was detected by Erythrina cristagalli (ECG) binding in 50% of the squamous carcinomas. Five terminal antennary modifications were commonly identified in the carcinomas that were not identified in normal cervical epithelia and comprised the oligosaccharides bound by lectins RCA, SBA, BS-1, LTA, and UEA-1. Synthesis of these oligosaccharides resulted in expression of structures similar to those recognized as ligands for extracellular matrix-binding proteins. We suggest that expression of such novel oligosaccharide structures may be an important promotor of local invasion and further dissemination of human cervical carcinomas through enhanced binding of malignant cells to stromal matrix proteins. This study has demonstrated that identification of expressed oligosaccharide structures is an objective method of identifying individual tumor cell phenotypes and may form the basis of a useful functional classification of human cervical squamous carcinomas.


Silencing of Carbohydrate Sulfotransferase 15 Hinders Murine Pulmonary Fibrosis Development.
Pulmonary fibrosis is a progressive lung disorder characterized by interstitial fibrosis, for which no effective treatments are available. Chondroitin sulfate proteoglycan (CSPG) has been shown to be a mediator, but the specific component of glycosaminoglycan chains of CSPG has not been explored. We show that chondroitin sulfate E-type (CS-E) is involved in fibrogenesis. Small interfering RNA (siRNA) targeting carbohydrate sulfotransferase 15 (CHST15) was designed to inhibit CHST15 mRNA and its product, CS-E. CS-E augments cell contraction and CHST15 siRNA inhibits collagen production. We found that bleomycin treatment increased CHST15 expression in interstitial fibroblasts at day 14. CHST15 siRNA was injected intranasally on days 1, 4, 8, and 11, and CHST15 mRNA was significantly suppressed by day 14. CHST15 siRNA reduced lung CSPG and the grade of fibrosis. CHST15 siRNA repressed the activation of fibroblasts, as evidenced by suppressed expression of α smooth muscle actin (αSMA), connective tissue growth factor (CTGF), lysyl oxidase like 2 (LOXL2), and CC-chemokine ligand 2 (CCL2)/monocyte chemoattractant protein-1 (MCP-1). Inflammatory infiltrates in the bronchoalveolar lavage fluid (BALF) and interstitium were diminished by CHST15 siRNA. These results indicate a pivotal role for CHST15 in fibroblast-mediated lung fibrosis and suggest a possible new therapeutic role for CHST15 siRNA in pulmonary fibrosis.


Value of triglyceride-glucose index for the estimation of ischemic stroke risk: Insights from a general population.
Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent ischemic stroke, exploring the value of TyG to optimize the risk stratification of ischemic stroke. This cross-sectional study included 10,900 subjects (mean age: 59.95 years, 59.8% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The prevalence of ischemic stroke was 5.49%. After adjusting for all covariates, each SD increment of TyG caused 22.8% additional risk for ischemic stroke. When dividing TyG into quartiles, the top quartile had a 1.776 times risk for ischemic stroke against the bottom category. Furthermore, smoothing curve fitting demonstrated this association was linear in the whole range of TyG. Finally, AUC revealed an improvement when introducing TyG into clinical risk factors (0.746 vs 0.751, p = 0.029). Consistently, category-free net reclassification index (0.195, 95% CI: 0.112-0.277, P < 0.001) and integrated discrimination index (0.003, 95% CI: 0.001-0.004, P < 0.001) confirmed the improvement by TyG to stratify ischemic stroke risk. The prevent ischemic stroke correlated proportionally with the increment of TyG, implicating the linearity of TyG as an indicator of ischemic stroke. Our findings suggest the potential value of TyG to optimize the risk stratification of ischemic stroke in a general population.


Assessment of serum electrolytes and kidney function test for screening of chronic kidney disease among Ethiopian Public Health Institute staff members, Addis Ababa, Ethiopia.
Chronic kidney disease (CKD), which is characterized by its asymptomatic nature until an end stage, is one of the most common public health problems in the world. Thus, a regular checkup, especially for those individuals with high risk groups is inevitably important, and the screening has been done with laboratory findings. However, in developing countries, including Ethiopia screening for CKD are rarely done, and it is becoming common to hear sudden death from the kidney failure. Therefore, we aimed to screen serum electrolyte levels and estimated glomerular filtration rate (eGFR) among Ethiopian Public Health Institute (EPHI) staff members for an early detection of CKD and to identify the factors associated with it. A cross-sectional study was conducted from July 1 to October 28, 2018 among EPHI staff members. The level of serum creatinine and electrolytes were measured using COBAS 6000 analyzer. Then, eGFR was calculated using MDRD and CKD-EPI equations. Data analysis were done using SPSS version 20, and the factors associated with the outcome variable were assessed using logistic regression. P values < 0.05 were considered as statistically significant. This study found that 3.6 and 1.9% of the study participants were at CKD stage II by MDRD and CKD-EPI equations, respectively. Out of the total study participants, 9.5% had hyperkalemia (serum potassium level > 5.0 mmol/L) and 8.5% had hypocalcemia (serum calcium level < 2.15 mmol/L). An older age (P = 0.006), high BMI (P = 0.045) and previous history of CVDs (P = 0.033) were found to be significantly associated factors with reduced glomerular filtration rate. Nine percent of the study participants were obese, 6.1% had family history of kidney failure, 18% self-reported history of hypertension, 3.4% diabetic and 5.3% had CVDs. About 51.2% of the study participants were males, and the majorities, (66%) of the study participants were found to be alcohol consumers. The prevalence of a stage II kidney disease was relatively low and none of the participants was under serious kidney disease (GFR < 60 mmol/min/1.73m2). An older age, high BMI and previous history of CVDs were significantly associated with reduced GFR. Hyperkalemia and hypokalemia were the major electrolyte disorders in the study participants.


Trihalomethane concentrations in tap water as determinant of bottled water use in the city of Barcelona.
Bottled water consumption is increasing worldwide, despite its huge economic and environmental cost. We aim to describe personal and tap water quality determinants of bottled water use in the city of Barcelona. This cross-sectional study used data from the Health Survey of Barcelona in 2006 (N=5417 adults). The use of bottled water to drink and to cook was evaluated in relation to age, gender, educational level, district and levels of trihalomethanes (THMs), free chlorine, conductivity, chloride, sodium, pH, nitrate and aluminium in municipal tap water using Robust Poisson Regression. The prevalence of bottled water use to drink and cook was 53.9% and 6.7%, respectively. Chemical parameters in water had a large variability (interquartile range of THMs concentrations: 83.2-200.8μg/L) and were correlated between them, except aluminium. Drinking bottled water increased with educational level, while cooking with bottled water was higher among men than among women and decreased with age. After adjusting by these personal determinants, a dose-response relationship was found between concentrations of all chemicals except aluminium in tap water and bottled water use. The highest association was found for THMs, with a Prevalence Ratio of 2.00 (95%CI=1.86, 2.15) for drinking bottled water and 2.80 (95%CI=1.72, 4.58) for cooking with bottled water, among those with >150μg/L vs. <100μg/L THMs in tap water. More than half of Barcelona residents regularly drank bottled water, and the main determinant was the chemical composition of tap water, particularly THM level.


Platelet function abnormalities in qualified whole-blood donors: effects of medication and recent food intake.
Platelet function abnormalities have been reported in blood donors who have not consumed aspirin. Our objective was to identify factors other than aspirin that may contribute to impaired platelet function in qualified volunteer blood donors. Blood samples were obtained from 24 donors following routine blood donation. Donors completed a study questionnaire that included questions about recent food consumption, medication and medical history. Platelet activation was measured using monoclonal antibodies and flow cytometry. CD62P expression and PAC-1 binding on platelets were used as indicators of platelet activation. Platelet function was measured on a platelet function analyser (PFA-100) using both collagen/epinephrine (cEPI) and collagen/ADP (cADP) cartridges. Fifty-four per cent of donors (13 of 24) had normal platelet function. Thirty-eight per cent (nine of 24) had prolonged cEPI closure times, of whom four (17%) had no cEPI closure (> 300 seconds). No closure was associated with aspirin use (two donors) or chocolate consumption (two donors) before donation. Two donors (8%) had either a shortened cEPI or cADP closure time. Platelet dysfunction in qualified blood donors is underestimated. Platelet function screening can identify donors with diet-related platelet dysfunction or with poor recollection of aspirin use.


Advancing Patient Care: How Artificial Intelligence Is Transforming Healthcare.
Artificial Intelligence (AI) has emerged as a transformative technology with immense potential in the field of medicine. By leveraging machine learning and deep learning, AI can assist in diagnosis, treatment selection, and patient monitoring, enabling more accurate and efficient healthcare delivery. The widespread implementation of AI in healthcare has the role to revolutionize patients' outcomes and transform the way healthcare is practiced, leading to improved accessibility, affordability, and quality of care. This article explores the diverse applications and reviews the current state of AI adoption in healthcare. It concludes by emphasizing the need for collaboration between physicians and technology experts to harness the full potential of AI.


Biodegradable composite films based on mucilage from Opuntia ficus-indica (Cactaceae): Microstructural, functional and thermal properties.
This study evaluated the feasibility of using cactus mucilage (CM) to elaborate biobased composite films blended with styrene-butadiene rubber latex (SBL). The CM was extracted and precipitated with ethanol (CMET) and isopropanol (CMIS). Mucilage-based films were formulated using three levels of mucilage (4, 6, and 8 wt%). The microstructure, thickness, moisture content, density, water contact angle, water vapor permeability, film solubility, thermal stability, and toughness of mucilage films blended with SBL (SBL/CMET and SBL/CMIS) were measured. The properties of mucilage-based films varied systematically, depending on the concentration of mucilage. The addition of SBL to CM film produces compatible, hydrophobic, flexible, and stiffer films with low moisture contents and good barrier properties. The mucilage film incorporated with 6 wt% CMET and CMIS reached the highest Young's modulus of 1512 ± 21 and 1988 ± 55 MPa, respectively. The DSC of produced films reveals that the Tg of SBL/CMIS is lower than that of SBL/CMIS. The synthesized films were structurally stable at high temperatures. The biodegradability of the composite films buried in the ground shows that the produced films are 100 % biodegradable after 40 days. Thus, CM blended with SBL can benefit specific applications, especially food packaging.


Development of a mobile pulse waveform analyzer for cardiovascular health monitoring.
Noninvasive pulse waveforms contain rich pathophysiological information of cardiovascular system. It is hereby a tradition of interest to implement risk stratification by pulse waveform monitoring and analysis. In contrast to conventional computer- or network-based solutions, we attempt to accomplish pulse waveform monitoring and analysis within a self-contained mobile platform. It adopts a compact biosensor for pulse waveform acquisition. The collected signals are then submitted to a core board for pulse waveform processing and analysis. In addition, the core board coordinates user interaction and network communication too. Such compact pulse waveform analyzer is of great help for cardiovascular health monitoring at home. A carefully designed evaluation has been undertaken within our research group. The results confirmed its prospect in home healthcare.