Digital subtraction angiography in the community hospital.
Although digital angiography may involve the same physician processes in the university as in the community hospital, it can be seen that the indications, approaches, and utility of DSA are somewhat different in the two environments. DSA is presently in a state of change, in part because of the maturing of other modalities and also because of the present emphasis on cost-saving in medical imaging. As referring physicians become used to digital arteriographic images, more and more procedures will be performed with DSA. We believe the DSA will have an important role in the community hospital for years to come. Its emergence as the first of the "conventional" imaging techniques to be digitized can be seen as an initial step toward the total digital imaging department of the future.


[Specific targeting cytotoxicity to resistant leukemia cells mediated by anti-Pgp/anti-CD3 diabody].
To study the specific targeting cytotoxicity to drug-resistant leukemia cells mediated by anti-Pgp/anti-CD3 diabody. The diabody was purified by affinity chromatography and identified by SDS-PAGE and FACS. The effect of the anti-Pgp/anti-CD3 diabody mediated lysis of Pgp-expressing tumor cells was assayed by human leukemia nude mice xenograft model in vivo. The diabody was produced in E.coli in a soluble functional form and could bind both Jurkat cells (CD3(+)) and K562/A02 cells (Pgp(+)). The binding rates were 86.25% and 86.26%, respectively. It could inhibit tumor growth by 98.57% and prolonged the survival of mice bearing xenografted K562/A02 cells. The diabody was proved to be a potent agent for mediating T lymphocyte cytotoxicity to lyse Pgp expressing tumor cells in vitro and in vivo.


Stent-free rates in cutaneous ureterostomy urinary diversion after radical cystectomy.
Cutaneous ureterostomy (CU) urinary diversion after radical cystectomy has been relegated to highly comorbid patients due to presumed rates of stenosis and drainage tube dependence. Rates of stricture as high as 70% have been reported. Though a variety of techniques have been developed to obviate the need for prolonged stenting, CU remains uncommonly performed. Herein, we present our experience with CU diversion after radical cystectomy and stent-free rates post-operatively. We retrospectively reviewed the records of consecutive patients undergoing radical cystectomy with single-stoma cutaneous ureterostomy from June 2020 to December 2022 at our institution. Demographic and clinical data were summarized. We recorded the presence of ureteral stent, nephrostomy, or nephroureteral catheter at the last follow-up. The primary outcome was "stent-free survival" incorporating all modalities of tube-dependent urinary drainage. Kaplan-Meier analysis was performed to determine stent-free survival at 12 months. We identified 28 patients meeting inclusion criteria with median age of 73 years (IQR: 66-78) and median body mass index of 25 (IQR: 22-28). Of patients that underwent stent-free trial (N = 23), the stent-free survival at 12 months was 74%. Five of 28 patients had continued tube dependence due to locally advanced disease with hydronephrosis rather than CU stenosis. These results suggest that single-stoma CU should be considered a viable option for patients undergoing radical cystectomy. Longer follow-up is needed to assess durability of stent-free rates.


Use of caffeine in infants unresponsive to theophylline in apnea of prematurity.
Eleven premature infants with severe apnea unresponsive to therapeutic theophylline levels were studied to determine if caffeine is an effective treatment in such cases. Apnea was documented and quantitated with thermistor-pneumocardiograms measuring heart rate, thoracic impedance, and nasal air flow. Infants with prolonged central or mixed apnea were then treated with caffeine and restudied. Caffeine reduced the total number of apneic episodes of greater than 10 sec duration by 80% (P less than 0.01) and prolonged episodes of apnea (greater than 20 sec) by 88% (P less than 0.05). These data suggest that caffeine may be effective in the management of apnea of prematurity, particularly the prolonged type, unresponsive to theophylline.


Ectopic automatic atrial tachycardia in children: clinical characteristics, management and follow-up.
Ectopic automatic atrial tachycardia, an uncommon type of supraventricular tachycardia in children and adults, has been reported to be resistant to medical therapy, and surgical or cryoblation has been recommended. This report describes 10 infants and children (median age 6 months; range birth to 7.5 years) with automatic atrial tachycardia and their management and follow-up. Digoxin alone was unsuccessful in controlling tachycardia in all 10 patients but decreased the tachycardia rate by 5 to 20% in 8. Intravenous (0.1 mg/kg body weight per dose) and oral propranolol successfully suppressed tachycardia in three of five patients and oral propranolol successfully controlled tachycardia in two of five other patients. Class I antiarrhythmic agents--quinidine (three patients), procainamide (four patients) and phenytoin (three patients)--did not control tachycardia in any patients but made the tachycardia rate worse in three patients. Intravenous (5 mg/kg per dose) and oral amiodarone suppressed tachycardia in three of four patients and oral amiodarone suppressed it in another patient. Thus, intravenous propranolol and amiodarone were effective in acutely suppressing automatic ectopic atrial tachycardia and predicted the response to long-term oral therapy. One patient had persistent tachycardia after surgical ablation of the high right atrial ectopic focus, and another patient had unsuccessful catheter ablation of the high right atrial ectopic focus (25 J). During follow-up (10 to 28 months), ectopic atrial tachycardia resolved completely in four patients and was well controlled in four patients.


Acute appendicitis with superior mesenteric vein septic thrombophlebitis.
Septic thrombophlebitis of the superior mesenteric vein (SMV) is rarely caused by acute appendicitis. The clinical symptoms of SMV thrombophlebitis are varied and atypical, so the diagnosis is commonly delayed, resulting in a reported mortality rate of 30%-50%. We report a case of SMV septic thrombophlebitis caused by acute appendicitis in which the patient was successfully treated with surgical intervention, appropriate antibiotics, and anticoagulation therapy. A follow-up abdominal computed tomography scan after 3 months of treatment showed that the SMV thrombosis had been resolved.


[RNA-ligase of bacteriophage T4. IV. Synthesis of pentadecaribonucleotide ApUpG(pU)6(pA)5pAp].
Oligoribonucleotide ApUpG(pU)6(pA)5pAp (I) has been prepared by means of RNA ligase. ApUpG, synthesised by the phosphotriester approach, was elongated in the 3'-direction by adding (pU)6 and then (pA)6, which was 3'-blocked with the phosphate or with the periodate-oxidized AMP residue, the latter giving considerably lower level of by-products. Condensation of ApUpG(pU)6 with blocked (pA)6 was carried out under conditions optimal for poor acceptors (20 degrees C, 48 h, pH 8,7) to afford (I) with the yield of 20% (105 OE260); ApUpG(pU)6(pA)10pAp was identified as a byproduct.


Anticoccidial activity of 9-(2-chloro-6-fluorobenzyl)-6-methylaminopurine and 9-(2-chloro-6-fluorobenzyl)-6-dimethylaminopurine against Eimeria tenella, E. acervulina, and E. maxima in battery trials.
In a series of battery experiments utilizing 9-day-old White Leghorn male chicks, 9-(2-chloro-6-fluorobenzyl)-6-methylaminopurine (VM 6387) and 9-(2-chloro-6-fluorobenzyl)-6-dimethylaminopurine (VM 6736) showed remarkable anticoccidial activity against Eimeria tenella, E. acervulina, and E. maxima. The effective dose range was estimated from the results of the efficacy test against E. tenella on the basis of improvement of body weight gain and clinical signs of infection. The tests included dietary levels of 60-100 ppm of VM 6387 and 70-110 ppm of VM 6736. Both compounds gave good protection against E. acervulina and E. maxima at the same dose range. The sporulation of oocysts obtained from cecal contents of birds fed lower levels of VM 6387 was inhibited. Studies of the effects of VM 6387 on stages of the E. tenella life cycle demonstrated that the compound possesses remarkable activity at 1-5 days post-infection corresponding to the period of schizogony, as well as prolonged activity thereafter, when the parasite was undergoing gametogenesis.


Chemical fingerprint and metabolic profile analysis of ethyl acetate fraction of Gastrodia elata by ultra performance liquid chromatography/quadrupole-time of flight mass spectrometry.
The chemical fingerprint and metabolic profile of traditional Chinese medicine is very complicated and has been a great challenge. In the present study, chemical fingerprint of ethyl acetate fraction of Gastrodia elata (EtAcGE) and metabolic profile of rat plasma sample after intragastric administration of EtAcGE (2.5g/kg) were investigated using ultra-high performance liquid chromatography coupled with quadrupole-time of flight mass spectrometry (UPLC/Q-TOF MS). A total of 38 chemical constituents of EtAcGE were identified by comparing their retention time, accurate molecular mass and characteristic fragment ions with those of references, or tentatively characterized by comparing molecular formula, fragment ions with that of known compound or information available in literature. And 40 compounds were detected in dosed rat plasma sample, including 16 prototypes and 24 metabolites underwent metabolic process of glucuronidation, glucosylation, sulfation, methylation, hydroxylation, dehydrogenation or mixed modes. The metabolic "soft spots" was hydroxyl or carboxy group. This is the first research for chemical fingerprint and metabolic profile of EtAcGE, which lay a foundation for the further investigation of EtAcGE.


Water use and the thermoregulatory behaviour of kangaroos in arid regions: insights into the colonisation of arid rangelands in Australia by the Eastern Grey Kangaroo (Macropus giganteus).
The Eastern Grey Kangaroo (Macropus giganteus) occurs mostly in the wetter regions of eastern Australia. However, in the past 30-40 years it has moved into more arid regions (rainfall < 250 mm), thus increasing its overlap zone with the xeric adapted Red Kangaroo (Macropus rufus). An increased access to water (supplied for domestic stock) may explain this range extension, but changes in the availability of preferred feed could also be involved. The water use, drinking patterns and thermoregulatory behaviour of these two species of kangaroo have been examined in a semi-free range study, during summer at an arid rangeland site. Foraging was largely nocturnal in both species and during the day they behaved to reduce heat loads. This was especially so for M. giganteus, which showed greater shade seeking. However, it still used more water (72 +/- 2.6 mL kg(-1) day(-1), mean +/- SE) than M. rufus (56 +/- 7.6 mL kg(-1) day(-1)) and drank twice as frequently. Although M. giganteus produced a less concentrated urine (1422 +/- 36 mosmol kg(-1)) than M. rufus (1843 +/- 28 mosmol kg(-1)), kidney physiology did not explain all of the differences in water metabolism between the species. Water from the feed and faecal water retention also appear to be involved. Broadly, a better access to reliable water and the utilisation of mesic microhabitats has enabled M. giganteus to make inroads into the changing rangelands of eastern Australia. However, changes in the vegetation, due to stock grazing, have also favoured M. giganteus, which is a grass eating specialist.


A novel linear tracking integrator with integral compensation and its application.
A novel linear tracking integrator (LTI) with integral compensation is proposed for efficient integral estimation from a contaminated measurement with a constant or time-varying bias. The limitation of finite-time convergent integral observer (FTCIO) in ruling out the integral drift is firstly revealed via describing function method. Subsequently, by the utilization of integral action in the feedback path, a simple but effective linear tracking integrator is established to provide a practical solution in achieving a drift-free integral estimate. The highlight is that the proposed LTI can simultaneously give the accurate integral and tracking estimates from a noisy measurement without relying on the condition of observability. In addition, frequency-domain analysis of LTI is investigated to give a viable guideline of parameter tuning. Illustrative simulations and comparison with Kalman filter are included to demonstrate the superiority of LTI in accomplishing precise integral tracking in the presence of constant or time-varying bias. Finally, the effectiveness of LTI is also confirmed by an application on autopilot design for aircraft.


Psychological maltreatment and adolescent internet harassment perpetration: The mediating role of deviant peer affiliation and the moderating role of self-compassion.
Psychological maltreatment has been regarded as a risk factor for adolescent internet harassment. However, previous studies failed to take family, peer, and individual factors into account comprehensively when comes to adolescent internet harassment perpetration. Based on the Social-Ecological Diathesis-Stress Model, the present study established a moderated mediation model to investigate the mediating role of deviant peer affiliation in the association between psychological maltreatment and adolescent internet harassment perpetration, as well as the moderating role of self-compassion. A total of 1,592 Chinese adolescents (51.07 % girls, Mage = 13.23 years) participated in the current study. The participants completed questionnaires regarding demographics, psychological maltreatment, internet harassment perpetration, deviant peer affiliation, and self-compassion. Psychological maltreatment was positively related to adolescent internet harassment perpetration. Mediation analyses revealed that deviant peer affiliation partially mediated this relationship (indirect effect = 0.14, 95 % CI = [0.09, 0.20]). Moderated mediation analyses further indicated that self-compassion not only moderated the link between psychological maltreatment and adolescent internet harassment perpetration, with the effect being significant only for adolescents with low levels of self-compassion, but also moderated the indirect association between psychological maltreatment and internet harassment perpetration via deviant peer affiliation, with the association being much more potent for adolescents with low levels of self-compassion. This study highlights the importance of considering multiple circumstantial and individual factors to understand the development of adolescents' externalizing problems.


Factors Associated With Health Care Professionals' Choice to Practice in Rural Minnesota.
Rural health inequities are due in part to a shortage of health care professionals in these areas. To determine the factors associated with health care professionals' decisions about where to practice. This prospective, cross-sectional survey study of health care professionals in Minnesota was administered by the Minnesota Department of Health from October 18, 2021, to July 25, 2022. Advanced practice registered nurses (APRNs), physicians, physician assistants (PAs), and registered nurses (RNs) renewing their professional licenses were eligible. Individuals' ratings on survey items related to their choice of practice location. Rural or urban practice location as defined by the US Department of Agriculture's Rural-Urban Commuting Area typology. A total of 32 086 respondents were included in the analysis (mean [SD] age, 44.4 [12.2] years; 22 728 identified as female [70.8%]). Response rates were 60.2% for APRNs (n = 2174), 97.7% for PAs (n = 2210), 95.1% for physicians (n = 11 019), and 61.6% for RNs (n = 16 663). The mean (SD) age of APRNs was 45.0 (10.3) years (1833 [84.3%] female); PAs, 39.0 (9.4) years (1648 [74.6%] female); physicians, 48.0 (11.9) years (4455 [40.4%] female); and RNs, 42.6 (12.3) years (14 792 [88.8%] female). Most respondents worked in urban (29 456 [91.8%]) vs rural (2630 [8.2%]) areas. Bivariate analysis suggested that family considerations are the most important determinant of practice location. Multivariate analysis revealed that having grown up in a rural area was the strongest factor associated with rural practice (odds ratio [OR] for APRNs, 3.44 [95% CI, 2.68-4.42]; OR for PAs, 3.75 [95% CI, 2.81-5.00]; OR for physicians, 2.44 [95% CI, 2.18-2.73]; OR for RNs, 3.77 [95% CI, 3.44-4.15]). When controlling for rural background, other associated factors included the availability of loan forgiveness (OR for APRNs, 1.42 [95% CI, 1.19-1.69]; OR for PAs, 1.60 [95% CI, 1.31-1.94]; OR for physicians, 1.54 [95% CI, 1.38-1.71]; OR for RNs, 1.20 [95% CI, 1.12-1.28]) and an educational program that prepared for rural practice (OR for APRNs, 1.44 [95% CI, 1.18-1.76]; OR for PAs. 1.70 [95% CI, 1.34-2.15]; OR for physicians, 1.31 [95% CI, 1.17-1.47]; OR for RNs, 1.23 [95% CI, 1.15-1.31]). Autonomy in one's work (OR for APRNs, 1.42 [95% CI, 1.08-1.86]; OR for PAs, 1.18 [95% CI, 0.89-1.58]; OR for physicians, 1.53 [95% CI, 1.31-1.78]; OR for RNs, 1.16 [95% CI, 1.07-1.25]) and a broad scope of practice (OR for APRNs, 1.46 [95% CI, 1.15-1.86]; OR for PAs, 0.96 [95% CI, 0.74-1.24]; OR for physicians, 1.62 [95% CI, 1.40-1.87]; OR for RNs, 0.96 [95% CI, 0.89-1.03]) were important factors associated with rural practice. Lifestyle and area considerations were not associated with rural practice; family considerations were associated with rural practice for RNs only (OR for APRNs, 0.97 [95% CI, 0.90-1.06]; OR for PAs, 0.95 [95% CI, 0.87-1.04]; OR for physicians, 0.92 [95% CI, 0.88-0.96]; OR for RNs, 1.05 [95% CI, 1.02-1.07]). Understanding the interconnected factors involved in rural practice requires modeling relevant factors. The findings of this survey study suggest that loan forgiveness, rural training, autonomy, and a broad scope of practice are factors associated with rural practice for most health care professionals. Other factors associated with rural practice vary by profession, suggesting that there may not be a one-size-fits-all approach to recruitment of rural health care professionals.


Galectin-1 induces 12/15-lipoxygenase expression in murine macrophages and favors their conversion toward a pro-resolving phenotype.
During the resolution of inflammation macrophages undergo functional changes upon exposure to pro-resolving agents in their microenvironment. Primarily, engulfment of apoptotic polymorphonuclear (PMN) cells promotes conversion of macrophages toward a pro-resolving phenotype characterized by reduced CD11b expression. These macrophages are not phagocytic, do not respond to TLR ligands, and express relatively high levels of the pro-resolving enzyme 12/15-lipoxygenase (LO). Here, we report that the immuno-regulatory lectin galectin-1 is selectively expressed by CD11b(high), but not CD11b(low) macrophages. Upon exposure in vivo and ex vivo, galectin-1 directly promoted macrophage conversion from a CD11b(high) to a CD11b(low) phenotype and up-regulated the expression and activity of 12/15-LO. Moreover, galectin-1 treatment in vivo promoted the loss of phagocytic capacity (efferocytic satiation) in peritoneal macrophages and down-regulated secretion of TNF-α, IL-1β, and IL-10 upon LPS exposure. Our results suggest that galectin-1 could be an essential mediator in the control of macrophage function during the resolution of inflammation.


The impact of internet-delivered cognitive behavioural therapy for health anxiety on cyberchondria.
Cyberchondria refers to an emotional-behavioural pattern whereby excessive online searches lead to increased anxiety about one's own health status. It has been shown to be associated with health anxiety, however it is unknown whether existing cognitive behavioural therapy (CBT) interventions targeting health anxiety also improve cyberchondria. This study aimed to determine whether internet-delivered cognitive behavioural therapy (iCBT) for severe health anxiety led to improvements in self-reported cyberchondria and whether improvements in cyberchondria were associated with improvements in health anxiety observed during treatment. Methods: We analysed secondary data from a randomised controlled trial (RCT) comparing an iCBT group (n = 41) to an active control group who underwent psychoeducation, monitoring and clinical support (n = 41) in health anxious patients with a DSM-5 diagnosis of Illness Anxiety Disorder and/or Somatic Symptom Disorder. The iCBT group showed a significantly greater reduction in cyberchondria compared to the control group, with large differences at post-treatment on the Cyberchondria Severity Scale Total scale (CSS; Hedges g = 1.09), and the Compulsion, Distress, Excessiveness subscales of the CSS (g's: 0.8-1.13). Mediation analyses showed improvements in health anxiety in the iCBT group were mediated by improvements in all of the CSS subscales, except for the Mistrust subscale. Conclusions: Internet CBT for health anxiety improves cyberchondria.


Delayed management of Grade III blunt aortic injury: Series from a Level I trauma center.
Blunt aortic injuries (BAIs) are traditionally treated as surgical emergencies, with the majority of repairs performed in an urgent fashion within 24 hours, irrespective of the grade of aortic injury. These patients are often underresuscitated and often have multiple other trauma issues that need to be addressed. This study reviews a single center's experience comparing urgent (<24 hours) thoracic endovascular aneurysm repair (TEVAR) versus delayed (>24 hours) TEVAR for Grade III BAI. All patients undergoing TEVAR for BAI at a single institution between March 2004 and March 2014 were reviewed (n = 43). Patients with Grade I, II, or IV aortic injuries as well as those who were repaired with an open procedure or who lacked preoperative imaging were excluded from the analysis. Demographics, intraoperative data, postoperative survival, and complications were compared. During this period, there were 43 patients with blunt thoracic aortic injury. There were 29 patients with Grade III or higher aortic injuries. Of these 29 patients, 1 declined surgery, 2 were repaired with an open procedure, 10 underwent urgent TEVAR, and 16 had initial observation. Of these 16, 13 underwent TEVAR in a delayed fashion (median, 9 days; range, 2-91 days), and 3 died of non-aortic-related pathology. Comparing the immediate repair group versus the delayed repair group, there were no significant demographic differences. Trauma classification scores were similar, although patients in the delayed group had a higher number of nonaortic injuries. The 30-day survival was similar between the two groups (9 of 10 vs. 12 of 16), with no mortalities caused by aortic pathology in either group. Watchful waiting may be permissible in patients with Grade III BAI with other associated multisystem trauma. This allows for a repair in a more controlled environment. Therapeutic study, level V.


The costs of changing an intended action: movement planning, but not execution, interferes with verbal working memory.
How much cognitive effort does it take to change a movement plan? In previous studies, it has been shown that humans plan and represent actions in advance, but it remains unclear whether or not action planning and verbal working memory share cognitive resources. Using a novel experimental paradigm, we combined in two experiments a grasp-to-place task with a verbal working memory task. Participants planned a placing movement toward one of two target positions and subsequently encoded and maintained visually presented letters. Both experiments revealed that re-planning the intended action reduced letter recall performance; execution time, however, was not influenced by action modifications. The results of Experiment 2 suggest that the action's interference with verbal working memory arose during the planning rather than the execution phase of the movement. Together, our results strongly suggest that movement planning and verbal working memory share common cognitive resources.


Is executive function associated with symptom severity in schizophrenia?
This paper reports on a study that was designed to investigate the relationship between psychopathology and executive functions in schizophrenia. Correlations were sparse and mostly weak. The most robust finding was the association between letter fluency and negative symptoms; however, most other applied tasks were not associated with symptom level. Our results support previous findings of differential relationships between impaired executive functions and symptom level.


Human B cell activation and cell cycle progression: stimulation with anti-mu and Staphylococcus aureus Cowan strain I.
The responses of resting human B lymphocytes to a variety of activation signals were studied. Human tonsillar B lymphocytes were separated according to size by countercurrent elutriation. The small B lymphocytes were then stimulated in vitro with various concentrations of anti-mu antibody in the presence or absence of B cell growth factor (BCGF) or with Staphylococcus aureus Cowan strain I (SAC). Cellular volume changes and RNA synthesis were measured over the first 24 h of stimulation and were similar with either 15 micrograms/ml of anti-mu, 100 micrograms/ml of anti-mu, or SAC. In the subsequent 24 h, however, substantial increases occurred in the amount of RNA synthesis and cell enlargement only in those cultures stimulated with 100 micrograms/ml of anti-mu or SAC, but not in the cultures stimulated with 15 micrograms/ml of anti-mu. The addition of BCGF to those cultures stimulated with 15 micrograms/ml of anti-mu did not alter the increases in cellular volume and RNA synthesis found 24 h after stimulation with anti-mu alone. However, over the subsequent 24 h, the presence of BCGF in culture enhanced both B cell volume changes and RNA synthesis, when compared to cultures stimulated with 15 micrograms/ml of anti-mu alone. In addition, BCGF enhanced DNA synthesis in cultures stimulated with low and high concentrations of anti-mu. DNA content changes following stimulation with anti-mu, anti-mu plus BCGF, and SAC were also measured using propidium iodide staining and flow cytometry. Optimal concentrations of anti-mu induced 20% of the resting B cells to enter S phase, while optimal concentrations of anti-mu plus BCGF or SAC induced approximately 40%. Finally, prestimulation of resting B cells for 24 h with a low concentration of anti-mu, sufficient for cell enlargement but not S phase progression, allowed for rapid entrance of the prestimulated B cells into S phase when a high concentration of anti-mu or SAC was added. These findings suggest the existence of a control point in the progression of human B cells through the cell cycle. This control point is located in the G1 phase of the cycle and is reached 24 to 36 h after a surface immunoglobulin-mediated stimulus.


The utility of clinical examination in screening for pelvic fractures in blunt trauma.
Current recommendations of the American College of Surgeons Advanced Trauma Life Support course is routine radiographic screening of the pelvis for all patients who suffer blunt torso trauma. The purpose of this study is to evaluate in a prospective manner the sensitivity of clinical examination as a screening modality for pelvic fractures in awake and alert blunt trauma patients. During a 32-month period, 2,176 consecutive blunt trauma patients who presented with Glasgow Coma Scores of 14 or 15 were evaluated at an urban Level I trauma center. Clinical examination of all patients was prospectively performed by trauma resident housestaff. The clinical examination of each patient was documented in a study form before performance of a standard anterior-posterior (A-P) pelvic x-ray. We evaluated 2,176 blunt trauma patients, 97 (4.5%) of whom were diagnosed with pelvic fracture. There were seven missed injuries on clinical examination (sensitivity 93%). None of the missed injuries on clinical examination required surgical intervention. The sensitivity of A-P pelvic x-ray was 87%, with 13 missed injuries. There were 463 patients who entered with ethanol levels equal or greater than 100 mg/dL (range 100 to 480 mg/dL). There were 20 pelvic fractures diagnosed in this group, with only 1 missed injury on clinical examination (sensitivity 95%). 1) Clinical examination of the pelvis can reliably rule out significant pelvic fracture in the awake and alert blunt trauma patient. 2) The addition of routine A-P pelvic x-ray does not improve the sensitivity in diagnosis of surgically significant pelvic fractures nor does it have significant impact on outcomes of pelvic fracture patients. 3) Elevated ethanol level is not a contraindication to use of clinical examination as a screening modality for pelvic fractures in the awake and alert blunt trauma patient.


The Utility of Smartphone-Based Thermal Imaging in the Management and Monitoring of Microvascular Flap Procedures: A Systematic Review and Meta-Analysis.
Smartphone-based thermal imaging (SBTI) has been reported in the literature to be an easy-to-use, contactless, cost-friendly alternative to standard imaging modalities in identifying flap perforators, monitoring flap perfusion, and detecting flap failure. Our systematic review and meta-analysis aimed to evaluate SBTI's accuracy in perforator identification and secondarily evaluate SBTI's utility in flap perfusion monitoring as well as ability to predict flap compromise, failure, and survival. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic review was performed using PubMed from inception to 2021. Articles were uploaded into Covidence and, following duplicate deletion, were initially screened for use of SBTI in flap procedures through title and abstract screening followed by full-text review. The following data points, if provided, were extracted from each included study: study design, number of patients, patient demographics, perforator number and location, flap number and location, room temperature, cooling method, imaging distance, time from cloth removal, primary (SBTI's accuracy in perforator identification), and secondary outcomes (prediction of flap compromise/failure/survival and cost analysis). Meta-analysis was performed using RevMan v.5. The initial search yielded 153 articles. Eleven applicable studies with a total of 430 flaps from 416 patients were ultimately included. The SBTI device assessed in all included studies was FLIR ONE. Four studies assessed the SBTI's perforated detection ability and were included in meta-analysis. Smartphone-based thermal imaging correctly identified 378 (93.3%; n = 405) perforators, and computed tomography angiography (CTA) correctly identified 402 (99.2%; n = 402), although in one study SBTI found additional perforators not detected on CTA. A random-effects model was used (I2 = 65%), and no significant difference in perforator detection ability was found between SBTI and CTA (P = 0.27). This systematic review and meta-analysis supports SBTI as user- and cost-friendly ($229.99), contactless imaging modality with perforator detection ability comparable to current criterion-standard CTA. Postoperatively, SBTI outperformed Doppler ultrasound in early detection of microvascular changes causing flap compromise, allowing for prompt tissue salvage. With a minimal learning curve, SBTI seems to be a promising method of postoperative flap perfusion monitoring able to be used by all hospital ranks. Smartphone-based thermal imaging could thus increase flap monitoring frequency and lower complication rates, although further study is warranted.


Randomized trial of hemiarthroplasty versus internal fixation for femoral neck fractures: no differences at 6 years.
Hemiarthroplasty has been shown superior to internal fixation for displaced femoral neck fractures (FNF) in the first 2 years. However, there are unanswered questions about the performance of hemiarthroplasty over the longer term compared with internal fixation. We sought to compare hemiarthroplasty with internal fixation in terms of (1) outcomes scores for pain, hip function, and quality of life at a minimum of 5 years after surgery in a randomized trial. A secondary purpose was to compare (2) patient survival and (3) frequency of reoperation in the two groups. A total of 222 consecutive patients older than 60 years, including those cognitively impaired, with FNF were randomized to either internal fixation with two parallel screws or bipolar hemiarthroplasty. At a minimum followup of 4.9 years (mean, 5.9 years; range, 4.9-7.2 years), 68 of the 70 surviving patients were examined by a study nurse and study physiotherapist blinded to initial treatment. Questionnaires on hip function (Harris hip score), quality of life (Eq5D), and activity of daily living function (Barthel ADL) were administered. The Barthel ADL index score was split into good function (score 95 or 100) and reduced function (score below 95). The mean survival of the groups was similar with 66.4% (73 of 110) of the patients undergoing hemiarthroplasty and 70.5% (79 of 112) of the patients undergoing internal fixation having died since surgery (p = 0.51). Only 12 of 31 living patients in the internal fixation group had retained their native hips at a mean of 6 years. Between 2 and 6 years, there were two new major reoperations (both in the internal fixation group, for avascular necrosis and deep wound infection). The mean Harris hip score was 66 (SD 19) and 67 (SD 20) in the internal fixation and hemiarthroplasty groups, respectively (p = 0.96). The mean Eq5D index was 0.50 (SD 0.40) in the internal fixation group and 0.34 (SD 0.36) in the hemiarthroplasty group (p = 0.10). Function in terms of ADLs was comparable between the groups; of the patients in the internal fixation group, 42% reported good function on the Barthel ADL index, and the corresponding number in the hemiarthroplasty group was 51% (p = 0.44). Hemiarthroplasty has predictable and good long-term results after FNF and is the treatment of choice compared with internal fixation. Further studies will evaluate if total hip arthroplasty has advantages over hemiarthroplasty in patients with fracture with long life expectancy.


A comparison of phase unwrapping methods in velocity-encoded MRI for aortic flows.
The phase of a MRI signal is used to encode the velocity of blood flow. Phase unwrapping artifacts may appear when aiming to improve the velocity-to-noise ratio (VNR) of the measured velocity field. This study aims to compare various unwrapping algorithms on ground-truth synthetic data generated using computational fluid dynamics (CFD) simulations. We compare four different phase unwrapping algorithms on two different synthetic datasets of four-dimensional flow MRI and 26 datasets of 2D PC-MRI acquisitions including the ascending and descending aorta. The synthetic datasets are constructed using CFD simulations of an aorta with a coarctation, with different levels of spatiotemporal resolutions and noise. The error of the unwrapped images was assessed by comparison against the ground truth velocity field in the synthetic data and dual-VENC reconstructions in the in vivo data. Using the unwrapping algorithms, we were able to remove aliased voxels in the data almost entirely, reducing the L2-error compared to the ground truth by 50%-80%. Results indicated that the best choice of algorithm depend on the spatiotemporal resolution and noise level of the dataset. Temporal unwrapping is most successful with a high temporal and low spatial resolution ( δ t = 30 $$ \delta t=30 $$ ms, h = 2 . 5 $$ h=2.5 $$ mm), reducing the L2-error by 70%-85%, while Laplacian unwrapping performs better with a lower temporal or better spatial resolution ( δ t = 60 $$ \delta t=60 $$ ms, h = 1 . 5 $$ h=1.5 $$ mm), especially for signal-to-noise ratio (SNR) 12 as opposed to SNR 15, with an error reduction of 55%-85% compared to the 50%-75% achieved by the Temporal method. The differences in performance between the methods are statistically significant. The temporal method and spatiotemporal Laplacian method provide the best results, with the spatiotemporal Laplacian being more robust. However, single- V enc $$ {V}_{\mathrm{enc}} $$ methods only situationally and not generally reach the performance of dual- V enc $$ {V}_{\mathrm{enc}} $$ unwrapping methods.


Respiratory control of body temperature: a theoretical model.
The two-compartment model of a ventilatory CO2 chemostat of Grodins et al. (1954) is modified to describe a ventilatory thermostat fitting the requirements of panting. Allowance for the extra heat production during panting leads to a second order third degree differential equation which by introducing the ventilation/perfusion ratio can be reduced to the second degree. From the steady-state solutions calculated for dogs using experimentally determined constants it is concluded that: (1) the ventilation/perfusion ratio has no influence; (2) the ambient temperature leads to a marked panting only above 30 degree C; (3) the relative humidity of the air increases the panting; (4) due to the oxygen cost of panting, the regulation of the body temperature is possible only within limits. The limitation depends upon the energy requirements of the respiratory muscles, upon the set-point temperature and the controller gain. The unsteady-state solution is given by approximation. The ventilatory reaction to the heat stress appears to be slow with a half-time of about 15 min for a 20 kg dog. All properties of the model are mainly determined by the high specific heat of tissues relative to expired air.


Effects of the ABC pathway on clinical outcomes in a secondary prevention population of Chinese patients with atrial fibrillation: A report from the Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry.
The atrial fibrillation better care (ABC) pathway is a simple, comprehensive framework that facilitates provision of integrated care for atrial fibrillation (AF) patients. We evaluated management of AF patients in a secondary prevention cohort using the ABC pathway and examined the impact of ABC adherence on clinical outcomes. The Chinese Patients with Atrial Fibrillation registry is a prospective registry conducted in 44 sites across China between October 2014 and December 2018. The primary outcome was the composite of all-cause mortality/any thromboembolism (TE), all-cause death, any TE and major bleeding at 1 year. Of the 6420 patients, 1588 (24.7%) had a prior stroke or transient ischemic attack and were identified as the secondary prevention cohort. After excluding 793 patients due to insufficient data, 358 (22.5%) were ABC compliant and 437 (27.5%) ABC noncompliant. ABC adherence was associated with a significantly lower risk of the composite outcome of all-cause death/TE, odds ratio (OR) 0.28 (95% confidence interval [CI]: 0.11-0.71) and all-cause death, OR 0.29 (95% CI: 0.09-0.90). Significant differences were not observed for TE, OR 0.27 (95% CI: 0.06-1.27) and major bleeding, OR 2.09 (95% CI: 0.55-7.97). Age and prior major bleeding were significant predictors of ABC noncompliance. Health-related quality of life (QOL) was higher in the ABC compliant group versus the noncompliant group (EQ score 0.83 ± 0.17 vs. 0.78 ± 0.20; p = .004). ABC pathway adherence in secondary prevention AF patients was associated with a significantly lower risk of the composite outcome of all-cause death/TE and all-cause death, as well as better health-related QOL.


An allylic ketyl radical intermediate in clostridial amino-acid fermentation.
The human pathogenic bacterium Clostridium difficile thrives by the fermentation of l-leucine to ammonia, CO(2), 3-methylbutanoate and 4-methylpentanoate under anaerobic conditions. The reductive branch to 4-methylpentanoate proceeds by means of the dehydration of (R)-2-hydroxy-4-methylpentanoyl-CoA to 4-methylpent-2-enoyl-CoA, which is chemically the most demanding step. Ketyl radicals have been proposed to mediate this reaction catalysed by an iron-sulphur-cluster-containing dehydratase, which requires activation by ATP-dependent electron transfer from a second iron-sulphur protein functionally similar to the iron protein of nitrogenase. Here we identify a kinetically competent product-related allylic ketyl radical bound to the enzyme by electron paramagnetic resonance spectroscopy employing isotope-labelled (R)-2-hydroxy-4-methylpentanoyl-CoA species. We also found that the enzyme generated the stabilized pentadienoyl ketyl radical from the substrate analogue 2-hydroxypent-4-enoyl-CoA, supporting the proposed mechanism. Our results imply that also other 2-hydroxyacyl-CoA dehydratases and the related benzoyl-CoA reductases-present in anaerobically living bacteria-employ ketyl radical intermediates. The absence of radical generators such as coenzyme B12, S-adenosylmethionine or oxygen makes these enzymes unprecedented in biochemistry.


Fluid-solid coupling dynamic model for oscillatory growth of multicellular lumens.
The development of multicellular lumens involves the interplay of cell proliferation, oscillation, and fluid transport. In this paper, a fluid-solid coupling dynamic model is proposed to investigate the physical mechanisms underlying the oscillatory growth of lumens. On the basis of experimental observations, the periodic oscillation of a lumen is interpreted by the fracturing-healing mechanism of cell-cell contacts, which induces a hydraulic-controlled outward flow switch. This model reproduces the oscillations of lumen sizes, in agreement with the experimental results of Hydra regeneration. It is found that the overall change trend of the lumen volume is determined by the tissue development induced by cell proliferation and the fluid transport induced by the osmotic pressure, while the outward flow due to the fracturing of cell-cell contacts regulates the oscillatory volume and the stress level in an appropriate scope. This work not only deepens our understanding of biomechanical mechanisms under the development of fluid-containing lumens, but also provides a theoretical framework to rationalize the dynamics of lumen-like tissues.


S-(4-Chlorophenyl) 3-aryl-3-hydroxypropanethioates as antibacterial agents.
A series of S-(4-chlorophenyl) 3-aryl-3-hydroxypropanethioates was prepared and shown to have in vitro activity against several selected bacterial species.


Nicotine antagonizes the effects of reserpine on the striatal metabolism of dopamine, 5-hydroxytryptamine and noradrenaline in hypothermic but not in normothermic mice.
Our previous studies indicate that repeated nicotine administration inhibits the release of striatal dopamine in hypothermic mice. To study if similar inhibition occurs in noradrenergic and serotoninergic neurons mice were given (-)-nicotine (3 mg/kg, s.c.) repeatedly at 110, 80, 50, and 20 min before sacrifice. The interactions of nicotine with reserpine were also investigated. Reserpine (5 mg/kg, i.p.) was administered after the second nicotine dose at 60 min before sacrifice. To prevent the effects of nicotine on autonomic ganglia all mice were given hexamethonium (10 mg/kg, i.p.). Experiments were carried out at 20-22 degrees C at which ambient temperature nicotine induced deep hypothermia or at 32-34 degrees C to prevent the drug-induced hypothermia. The changes in striatal metabolism of dopamine, noradrenaline and 5-hydroxytryptamine (5-HT) we Nicotine had temperature dependent effects on the dopamine metabolism which indicates a block of dopaminergic neurons as suggested in our earlier studies. Reserpine per se increased the homovanillic acid (HVA) and 3,4-dihydroxyphenylacetic acid (DOPAC) contents and decreased the 3-methoxytyramine (3-MT) and dopamine contents at both ambient temperatures. In hypothermic but not in "normothermic", nicotine-treated mice reserpine's effect on dopamine metabolism was almost totally vanished. Nicotine and reserpine per se increased the 3-methoxy-4-hydroxyphenylethylglycol (MOPEG) content and decreased the noradrenaline content at both ambient temperatures. In hypothermic but not in "normothermic" mice nicotine antagonized the reserpine-induced decrease of noradrenaline content. Nicotine tended to decrease the 5-hydroxy-indoleacetic acid (5-HIAA) content in hypothermic mice but increased it in "normothermic" ones.(ABSTRACT TRUNCATED AT 250 WORDS)


Convexity dural cavernous haemangioma mimicking meningioma: A case report.
Dural cavernous haemangiomas are rare, and they do not display a classical ring of haemosiderin on MRI as parenchymal cavernous haemangiomas. Sometimes, they are misinterpreted as meningiomas with a dural tail sign. In this short report, a 37-year-old woman was diagnosed with a convexity cavernous haemangioma, and the tumour was totally resected.


Anal sphincteric pressure studies in complete rectal prolapse.
Anal sphincteric pressure studies of patients with complete rectal prolapse demonstrated that: 1) The resting yield pressure of the internal anal sphincter in patients with complete rectal prolapse was not significantly different from that of control subjects. Thus, it seems to have no role in the etiology of prolapse. 2) The maximal sphincteric pressure of the external anal sphincter was significantly less in patients with prolapse than in controls. This suggested weakness in the effective functional power of the external anal sphincter in complete prolapse. 3) Anal continence could be achieved by the ability to maintain full contraction of the external anal sphincter for more than 40 seconds, which was the minimum for control subjects. Incontinent patients could not do this.


Difficulty in placement of a left-sided double-lumen tube due to aberrant tracheobronchial anatomy.
A rare case of a tracheal bronchus coexisting with a left-shifted carina and an acute angle of left main bronchus is presented. A 66 year old man with a history of colon cancer was scheduled for right thoracoscopic pericardial window due to recurrent pericardial effusion. After induction of anesthesia, the trachea was intubated using a 39-French, left-sided double lumen tube (DLT); the DLT was positioned with fiberoptic bronchoscopic guidance. Significantly high airway pressure was noticed as we initiated one-lung ventilation after the patient was positioned in the left lateral decubitus position. While repositioning the DLT, we found an aberrant tracheal bronchus. Although multiple attempts were made to adjust the DLT so as to achieve lung isolation, we could not place the DLT in the appropriate position due to abnormal and distorted anatomy. Lung isolation was unsuccessful; both lungs were carefully ventilated with small tidal volumes.


Establishment and Application of an Indirect Enzyme-Linked Immunosorbent Assay for Measuring GPI-Anchored Protein 52 (P52) Antibodies in Babesia gibsoni-Infected Dogs.
Babesia gibsoni is a malaria-like protozoan that parasitizes the red blood cells of canids to cause babesiosis. Due to its high expression and essential function in the survival of parasites, the Glycosylphosphatidylinositol (GPI) anchor protein family is considered an excellent immunodiagnostic marker. Herein, we identified a novel GPI-anchored protein named as BgGPI52-WH with a size of 52 kDa; the recombinant BgGPI52-WH with high antigenicity and immunogenicity was used as a diagnostic antigen to establish a new iELISA method. The iELISA had a sensitivity of 1:400, and no cross-reaction with other apicomplexan parasites occurred. We further demonstrated that the degree of variation was less than 10% using the same samples from the same or different batches of an enzyme-labeled strip. It was found that the method was able to detect early infection (6 days after infection) in the sera of the B. gibsoni-infected experimental dogs in which antibody response to rBgGPI52-WH was evaluated. Clinical sera from pet hospitals were further tested, and the average positive rate was about 11.41% (17/149). The results indicate that BgGPI52-WH is a reliable diagnostic antigen, and the new iELISA could be used as a practical method for the early diagnosis of B. gibsoni.


Trace amounts of Cu²⁺ ions influence ROS production and cytotoxicity of ZnO quantum dots.
3-Aminopropyltrimethoxysilane (APTMS) was used as ligand to prepare ZnO@APTMS, Cu(2+)-doped ZnO (ZnO:Cu@APTMS) and ZnO quantum dots (QDs) with chemisorbed Cu(2+) ions at their surface (ZnO@APTMS/Cu). The dots have a diameter of ca. 5 nm and their crystalline and phase purities and composition were established by X-ray diffraction, transmission electron microscopy, UV-visible and fluorescence spectroscopies and by X-ray photoelectron spectroscopy. The effect of Cu(2+) location on the ability of the QDs to generate reactive oxygen species (ROS) under light irradiation was investigated. Results obtained demonstrate that all dots are able to produce ROS (OH, O2(-), H2O2 and (1)O2) and that ZnO@APTMS/Cu QDs generate more OH and O2(-) radicals and H2O2 than ZnO@APTMS and ZnO:Cu@APTMS QDs probably via mechanisms associating photo-induced charge carriers and Fenton reactions. In cytotoxicity experiments conducted in the dark or under light exposure, ZnO@APTMS/Cu QDs appeared slightly more deleterious to Escherichia coli cells than the two other QDs, therefore pointing out the importance of the presence of Cu(2+) ions at the periphery of the nanocrystals. On the other hand, with the lack of photo-induced toxicity, it can be inferred that ROS production cannot explain the cytotoxicity associated to the QDs. Our study demonstrates that both the production of ROS from ZnO QDs and their toxicity may be enhanced by chemisorbed Cu(2+) ions, which could be useful for medical or photocatalytic applications.


Tissue-specifically regulated site-specific excision of selectable marker genes in bivalent insecticidal, genetically-modified rice.
Marker-free, genetically-modified rice was created by the tissue-specifically regulated Cre/loxP system, in which the Cre recombinase gene and hygromycin phosphotransferase gene (hpt) were flanked by two directly oriented loxP sites. Cre expression was activated by the tissue-specific promoter OsMADS45 in flower or napin in seed, resulting in simultaneous excision of the recombinase and marker genes. Segregation of T1 progeny was performed to select recombined plants. The excision was confirmed by PCR, Southern blot and sequence analyses indicating that efficiency varied from 10 to 53 % for OsMADS45 and from 12 to 36 % for napin. The expression of cry1Ac and vip3A was detected by RT-PCR analysis in marker-free transgenic rice. These results suggested that our tissue-specifically regulated Cre/loxP system could auto-excise marker genes from transgenic rice and alleviate public concerns about the security of GM crops.


Fall in the number of myenteric neurons in aging guinea pigs.
The neurons of the myenteric plexus of the entire small intestine were stained in young adult (3-4 mo old) and aging guinea pigs (26-30 mo old). Total length and circumference of the intestine were measured in the same experiments. The small intestine of the aging guinea pigs was longer, and (in the conditions of distention used) had a total serosal surface approximately 70% greater than in young adult animals. The spatial density of myenteric neurons per unit of serosal surface fell dramatically in aging animals, and the total number of myenteric neurons in the small intestine ranged between 1.1 and 1.6 million, i.e., it was only 40%-60% of the value obtained in young adult guinea pigs (2.75 million). The light microscope appearance of the neurons of the two groups of animals was markedly different and the suggestion is put forward that in aging guinea pigs the substantial reduction in neuron number is accompanied by structural changes and reorganization of the neurons that are left.


Baseline findings and safety of infrequent vs. frequent screening of human papillomavirus vaccinated women.
Less frequent cervical cancer screening in human papillomavirus (HPV) vaccinated birth cohorts could produce considerable savings without increasing cervical cancer incidence and loss of life-years. We report here the baseline findings and interim results of safety and accuracy of infrequent screening among HPV16/18 vaccinated females. The entire 1992-1994 birth-cohorts (30,139 females) were invited to a community-randomized HPV16/18-vaccination trial. A total of 9,482 female trial participants received HPV16/18-vaccination in 2007-2009 at age of 13-15. At age 22, 4,273 (45%) of these females consented to attend a randomized trial on frequent (ages 22/25/28; Arm 1: 2,073 females) vs. infrequent screening (age 28; Arm 2: 2,200 females) in 2014-2017. Females (1,329), who had got HPV16/18 vaccination at age 18 comprised the safety Arm 3. Baseline prevalence and incidence of HPV16/18 and other high-risk HPV types were: 0.5% (53/1,000 follow-up years, 104 ) and 25% (2,530/104 ) in the frequently screened Arm 1; 0.2% (23/104 ) and 24% (2,413/104 ) in the infrequently screened Arm 2; and 3.1% (304/104 ) and 23% (2,284/104 ) in the safety Arm 3. Corresponding prevalence of HSIL/ASC-H and of any abnormal cytological findings were: 0.3 and 4.2% (Arm 1), 0.4 and 5.3% (Arm 2) and 0.3 and 4.7% (Arm 3). Equally rare HSIL/CIN3 findings in the infrequently screened safety Arm A3 (0.4%) and in the frequently screened Arm 1 (0.4%) indicate no safety concerns on infrequent screening despite the up to 10 times higher HPV16/18 baseline prevalence and incidence in the former.


Face bow and articulator for planning orthognathic surgery: 2 articulator.
Patients who require orthognathic surgery may have asymmetry of the position of the temporomandibular joints relative to the maxilla, which is impossible to reproduce on the current semiadjustable articulators used for surgical planning. We describe a highly-adjustable spirit level orthognathic face bow that allows records to be made of patients with asymmetrical maxillae. The orthognathic articulator also allows the position of the condylar components of the articulator to be adjusted in three dimensions. The use of the new face bow and articulator made it possible to mount the dental casts of asymmetrical faces to reproduce their clinical appearance. The devices were evaluated by comparing the measurements of anatomical variables obtained from cephalometric radiographs with equivalent values obtained from the orthognathic articulator and casts mounted on the articulator. Although the measurements showed significant intersubject variability, the angle between the horizontal and maxillary occlusal plane, occlusal cant angle, and intercondylar widths, were not significantly different.


Intraoperative sentinel node identification in early stage cervical cancer using a combination of radiolabeled albumin injection and isosulfan blue dye injection.
We investigated the feasibility of sentinel lymph node identification using radioisotopic lymphatic mapping with technetium-99m-labeled human serum albumin and isosulfan blue dye injection in patients undergoing radical hysterectomy with pelvic lymphadenectomy for treatment of early cervical cancer. Between September 2000 and October 2002, 25 patients with cervical cancer FIGO stage I (n=24) or stage II (n=1) underwent sentinel lymph node detection with preoperative lymphoscintigraphy (technetium-99m colloid albumin injection around the tumor) and intraoperative lymphatic mapping with blue dye and a handheld or laparoscopic gamma probe. Complete pelvic or paraaortic lymphadenectomy was performed in all cases by open surgery or laparoscopic surgery. In 23 evaluable patients, a total of 51 sentinel lymph nodes were detected by lymphoscintigraphy (mean 2.21 nodes per patient). Intraoperatively, 61 sentinel lymph nodes were identified, with a mean of 2.52 nodes per patient by gamma probe and a mean of 1.94 nodes per patient after isosulfan blue injection. Forty percent of sentinel nodes were found in the interiliac region and 25% in the external iliac area. Microscopic nodal metastases (four nodes) were confirmed in 12% of cases. All these lymph nodes were previously detected as sentinel lymph nodes. The remaining 419 nodes after pelvic lymphadenectomy were histologically negative. Sentinel lymph node identification with technetium-99m-labeled nanocolloid combined with blue dye injection is feasible and showed a 100% negative predictive value, and potentially identified women in whom lymph node dissection can be avoided.


The performance of non-NAAT point-of-care (POC) tests and rapid NAAT tests for chlamydia and gonorrhoea infections. An assessment of currently available assays.
To identify point-of-care (POC) and rapid nucleic acid amplification techniques (NAATs) for the diagnosis of chlamydia and gonorrhoea and assess their utility. Literature search for available POC and rapid NAATs. The performance from the best-performing assays were applied hypothetically to patients in the clinic in which 100 consecutive patients with chlamydia and 100 with gonorrhoea were diagnosed in 1737 and 4575 patients respectively, with 44/100 and 54/100 treated at first attendance, respectively. 11 POC and 1 rapid NAAT were identified. Published performances for the best POC for chlamydia (CRT) were: sensitivity 41%-87%, specificity 89%-99.6%. Our data suggest that if this assay was used instead of our current NAAT, for every 100 patients diagnosed currently, 23-46 extra patients would be treated at first attendance; 10-35 would go undiagnosed with 7-191 false-positives. Best chlamydia rapid NAAT (GeneXpert): sensitivity 97.5%-98.7%, specificity 99.4%-99.9%. Anticipated performance for every 100 patients diagnosed currently: 0 extra patients treated at first attendance, 1-3 undiagnosed, 0-2 false-positives. Best POC for gonorrhoea (GC Check): sensitivity 54%-70%, specificity 97%-98%. Anticipated performance for every 100 patients diagnosed currently: 14-18 extra patients treated at first attendance, 28-32 undiagnosed, 92-137 false-positives. Best rapid NAAT for gonorrhoea (GeneXpert): sensitivity 96%-100%, specificity 99.9%-100%. Anticipated performance for every 100 patients diagnosed currently: 0 extra patients treated at first attendance, 0-4 undiagnosed, 0-5 false-positives. Rapid NAAT would reduce time to treatment by 4 days for initially untreated patients. POC assays would need to be used in conjunction with a NAAT, increasing early treatment rates expense and false-positive results. The rapid NAAT could be used alone, with a reduction in average time-to-treat and a small reduction in sensitivity and specificity.


Synthesis and biological evaluation of 6-aryl-6H-pyrrolo[3,4-d]pyridazine derivatives: high-affinity ligands to the alpha 2 delta subunit of voltage gated calcium channels.
A novel class of 6-aryl-6H-pyrrolo[3,4-d]pyridazine ligands for the alpha2delta subunit of voltage-gated calcium channels has been described. Substitutions in the aryl ring of the molecule were generally not tolerated, and resulted in diminished binding to the alpha2delta subunit. Modifications to the pyridazine ring revealed numerous permissive substitutions, and detailed SAR studies were carried out in this portion of the molecule. Replacement of the pyridazine ring methyl group with an aminomethyl functionality provided greatly improved potency over the initial lead. The initial lead compound displayed good rat pharmacokinetic properties, and was shown to be efficacious in the Chung model for neuropathic pain in rats.


Radiation dose to patient and personnel during extracorporeal shock wave lithotripsy.
Radiation dose to the patient and personnel was determined during extracorporeal shock wave lithotripsy treatment of 60 patients. Surface radiation dose to the patient's back from the fluoroscopy unit on the side with the kidney stone averaged 10 rem (100 mSv.) per case, although the range was wide (1 to 30 rem). The surface dose from the opposing biplane x-ray unit was less, averaging 5.5 rem (55 mSv.) per case but again with a wide range (0.1 to 21 rem). Exit dose at the lower abdomen averaged 13 mrem. (0.13 mSv.) per case and estimated female gonad dose averaged 100 mrem. (1.2 mSv.). Radiation dose to personnel working in the extracorporeal shock wave lithotripsy suite averaged less than 2 mrem. (0.02 mSv.) per case, making it a procedure that is safe in regard to radiation exposure.


How do magnitude and frequency of monetary reward guide visual search?
How does reward guide spatial attention during visual search? In the present study, we examine whether and how two types of reward information-magnitude and frequency-guide search behavior. Observers were asked to find a target among distractors in a search display to earn points. We manipulated multiple levels of value across the search display quadrants in two ways: For reward magnitude, targets appeared equally often in each quadrant, and the value of each quadrant was determined by the average points earned per target; for reward frequency, we varied how often the target appeared in each quadrant but held the average points earned per target constant across the quadrants. In Experiment 1, we found that observers were highly sensitive to the reward frequency information, and prioritized their search accordingly, whereas we did not find much prioritization based on magnitude information. In Experiment 2, we found that magnitude information for a nonspatial feature (color) could bias search performance, showing that the relative insensitivity to magnitude information during visual search is not generalized across all types of information. In Experiment 3, we replicated the negligible use of spatial magnitude information even when we used limited-exposure displays to incentivize the expression of learning. In Experiment 4, we found participants used the spatial magnitude information during a modified choice task-but again not during search. Taken together, these findings suggest that the visual search apparatus does not equally exploit all potential sources of spatial value information; instead, it favors spatial reward frequency information over spatial reward magnitude information.


Exploring COVID-19 transmission patterns and key factors during epidemics caused by three major strains in Asia.
The COVID-19 epidemic has lasted for more than two years since the outbreak in late 2019. An urgent and challenging question is how to systematically evaluate epidemic developments in different countries, during different periods, and to determine which measures that could be implemented are key for successful epidemic prevention. In this study, SBD distance-based K-shape clustering and hierarchical clustering methods were used to analyse epidemics in Asian countries. For the hierarchical clustering, epidemic time series were divided into three periods (epidemics induced by the Original/Alpha, Delta and Omicron variants separately). Standard deviations, the Hurst index, mortality rates, peak value of confirmed cases per capita, average growth rates, and the control efficiency of each period were used to characterize the epidemics. In addition, the total numbers of cases in the different countries were analysed by correlation and regression in relation to 15 variables that could have impacts on COVID-19. Finally, some suggestions on prevention and control measures for each category of country are given. We found that the total numbers of cases per million of a population, total deaths per million and mortality rates were highly correlated with the proportion of people aged over 65 years, the prevalence of multiple diseases, and the national GDP. We also found significant associations between case numbers and vaccination rates, health expenditures, and stringency of control measures. Vaccinations have played a positive role in COVID-19, with a gradual decline in mortality rates in later periods, and are still playing protective roles against the Delta and Omicron strains. The stringency of control measures taken by a government is not an indicator of the appropriateness of a country's response to the outbreak, and a higher index does not necessarily mean more effective measures; a combination of factors such as national vaccination rates, the country's economic foundation and the availability of medical equipment is also needed. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".


Evaluation of the Patient with Markedly Abnormal Liver Enzymes.
Liver enzyme tests are very commonly ordered by physicians, and when they return as abnormal, they can pose a clinical challenge to the provider. Markedly abnormal liver enzymes indicate severe hepatic injury and require immediate evaluation. There are various causes for abnormal liver tests, including infectious, autoimmune, genetic, metabolic, drug, and vascular causes. An understanding of the patterns of aminotransferase and alkaline phosphatase elevations is useful in narrowing the differential diagnosis. A thorough history and physical examination, appropriate blood testing, and imaging are typically key to evaluating the patient with abnormal liver enzymes.


Adsorption characteristics of Pb(II) using biochar derived from spent mushroom substrate.
As a multifunctional material, biochar is considered a potential adsorbent for removing heavy metals from wastewater. Most biochars with high adsorption capacities have been modified, but this modification is uneconomical, and modifying biochar may cause secondary pollution. Thus, it is necessary to develop an efficient biochar without modification. In this study, spent P. ostreatus substrate and spent shiitake substrate were used as the raw materials to prepare biochar. Then, the physicochemical properties of the biochars and their removal efficiencies for Pb(II) were investigated. The results showed that the physicochemical properties (e.g., large BET surface area, small pore structure and abundant functional groups) contributed to the large adsorption capacity for Pb(II); the maximum adsorption capacities were 326 mg g-1 (spent P. ostreatus substrate-derived biochar) and 398 mg g-1 (spent shiitake substrate-derived biochar), which are 1.6-10 times larger than those of other modified biochars. The Pb(II) adsorption data could be well described by the pseudo-second-order kinetic model and the Langmuir model. This study provides a new method to comprehensively utilize spent mushroom substrates for the sustainable development of the edible mushroom industry.


Structurally diverse (9β-H)-pimarane derivatives with six frameworks from the leaves of Icacina oliviformis and their cytotoxic activities.
Thirteen previously undescribed (9β-H)-pimarane derivatives, icacinolides A-G (1-7) and oliviformislactones C-H (8-13), together with four known analogs (14-17), were isolated from the leaves of Icacina oliviformis. Their structures were constructed by extensive spectroscopic analysis, 13C NMR-DP4+ analysis, ECD calculation, single-crystal X-ray diffraction, and chemical methods. These structurally diverse isolates were classified into six framework types: rearranged 3-epi-17-nor-(9β-H)-pimarane, rearranged 17-nor-(9β-H)-pimarane, 16-nor-(9β-H)-pimarane, 17-nor-(9β-H)-pimarane, 17,19-di-nor-(9β-H)-pimarane, and (9β-H)-pimarane. Among them, compounds 1, 5, and 7 were the first examples of three rearranged 3-epi-17-nor-(9β-H)-pimaranes featuring a unique (11S)-carboxyl-9-oxatricyclo[5.3.1.02,7]dodecane motif with contiguous stereogenic centers, whereas their C-3 epimers, compounds 2-4 and 6 were the second examples of four rearranged 17-nor-(9β-H)-pimaranes. Additionally, compounds 8 and 12/13 represented the second examples of a 16-nor-(9β-H)-pimarane and two 17,19-di-nor-(9β-H)-pimaranes, respectively. In cytotoxic bioassay, compound 2 exhibited significant cytotoxic against HT-29 with IC50 values of 7.88 μM, even stronger than 5-fluorouracil, and 15 showed broad-spectrum cytotoxic activities against HepG2, HT-29, and MIA PaCa-2 with IC50 values of 11.62, 9.77, and 4.91 μM, respectively. Meanwhile, a preliminary structure-activity relationship suggested that 3,20-epoxy, 6,19-lactone, 2-OH, 7-OH, and 8-OH in (9β-H)-pimarane derivatives might be active groups, whereas ring C aromatization may decrease the cytotoxic activities.


A comparative study of the binding properties, dipeptidyl peptidase-4 (DPP-4) inhibitory activity and glucose-lowering efficacy of the DPP-4 inhibitors alogliptin, linagliptin, saxagliptin, sitagliptin and vildagliptin in mice.
Since 2006, DPP-4 inhibitors have become established therapy for the treatment of type 2 diabetes. Despite sharing a common mechanism of action, considerable chemical diversity exists amongst members of the DPP-4 inhibitor class, raising the question as to whether structural differences may result in differentiated enzyme inhibition and antihyperglycaemic activity. We have compared the binding properties of the most commonly used inhibitors and have investigated the relationship between their inhibitory potency at the level of the enzyme and their acute glucose-lowering efficacy. Firstly, using a combination of published crystal structures and in-house data, we demonstrated that the binding site utilized by all of the DPP-4 inhibitors assessed was the same as that used by neuropeptide Y, supporting the hypothesis that DPP-4 inhibitors are able to competitively inhibit endogenous substrates for the enzyme. Secondly, we ascertained that the enzymatic cleft of DPP-4 is a relatively large cavity which displays conformational flexibility to accommodate structurally diverse inhibitor molecules. Finally, we found that for all inhibitors, irrespective of their chemical structure, the inhibition of plasma DPP-4 enzyme activity correlates directly with acute plasma glucose lowering in mice. The common binding site utilized by different DPP-4 inhibitors enables similar competitive inhibition of the cleavage of the endogenous DPP-4 substrates. Furthermore, despite chemical diversity and a range of binding potencies observed amongst the DPP-4 inhibitors, a direct relationship between enzyme inhibition in the plasma and glucose lowering is evident in mice for each member of the classes studied.


Trace element bioaccumulation in edible red seaweeds (Rhodophyta): A risk assessment for consumers.
As a precursor to risk assessment and risk management through consuming contaminated seafood, food safety needs to be quantified and assured. Seaweed is an increasing dietary component, especially in developing countries, but there are few studies assessing uptake rates of contaminants from this route. As such, the present study determined likely human uptake due to the trace elemental (Fe, Mn, Ni, Cu, Zn, Se, Hg, and As) concentrations in the edible red seaweeds (Rhodophyta) Gelidium pusillum and Hypnea musciformis, growing in the industrialised Cox's Bazar coastal area of Bangladesh. Metal and metalloid concentrations in G. pusillum were in the order (mg/kg): Fe (797 ± 67) > Mn (69 ± 4) > Ni (12 ± 5) > Zn (9 ± 4) > Cu (9 ± 4) >Se (0.1 ± 0.1) > Hg (0.1 ± 0.01), and in H. musciformis: Fe (668 ± 58) > Mn (28 ± 5) > Ni (14 ± 2) > Zn (11 ± 5) > Cu (6 ± 4) >Se (0.2 ± 0.03) > Hg (0.04 ± 0.01). Despite the industrial activities in the area, and based on 10 g. day-1 seaweed consumption, it is concluded that these concentrations pose no risk to human health as part of a normal diet according to the targeted hazard quotient and hazard index (THQ and HI) (values < 1). In addition, and as a novel aspect for seaweeds, Selenium Health Benefit Values (Se-HBV) were determined and found to have positive values. Seaweed can be used as an absorber of inorganic metals for removing contamination in coastal waters. The results are a precursor to further research regarding the efficiency and rate at which seaweeds can sequester metal contamination in water. In addition, management techniques need to be developed thereby to control the contaminant inputs.


Carnitine dynamics and their effects on hyperammonemia in cirrhotic Japanese patients.
Supplementation with levocarnitine preparations has been reported to improve hepatic encephalopathy, but no detailed investigations have addressed the dynamics of carnitine or its supplementation indication in cirrhosis patients. We studied carnitine dynamics in cirrhotic patients by measuring serum and liver tissue carnitine levels and tested the effects of levocarnitine supplementation on concurrent hyperammonemia. In a pilot cohort of seven patients with liver cirrhosis and five patients without cirrhosis, the serum and liver carnitine concentrations were measured. Then the serum carnitine fractions were analyzed in 70 liver cirrhosis patients. Among them, a levocarnitine preparation (1800 mg/day) was supplemented orally for 3 months in 27 patients with refractory hyperammonemia, and the effects were evaluated. A significant correlation was observed between serum and liver tissue carnitine concentrations (r = 0.69, P < 0.05). The serum total carnitine concentration was 68.4 ± 4.7 μmol/L, the free carnitine concentration was 53.2 ± 2.6 μmol/L, and the acylcarnitine concentration was 13.2 ± 1.1 μmol/L in 70 cirrhotic patients (reference values are 45-91, 36-74, 6-23 μmol/L, respectively). There was no correlation between blood ammonia and serum carnitine concentrations. The serum carnitine concentration rose with levocarnitine supplementation, reaching steady state after 1 month and, in parallel, refractory hyperammonemia was significantly improved. The cut-off level for a 20% decrease in blood ammonia was identified as 62.0 μmol/L total carnitine concentration by receiver-operating characteristic curve analysis, with an area under the curve of 0.69. Serum carnitine concentrations were within standard levels in the majority of liver cirrhosis patients. In patients with concurrent hyperammonemia, the levocarnitine supplementation reduced blood ammonia levels.


Studies on carbohydrate-binding proteins using liposome-based systems--I. Preparation of neoglycoprotein-conjugated liposomes and the feasibility of their use as drug-targeting devices.
1. Five types of neoglycoprotein-coupled liposomes were prepared in order to investigate their potential utility as new types of drug-targeting devices which exploit cellular functions of carbohydrate-binding proteins. 2. These preparations were shown to be stable at 37 degrees C for 24 hr and at 7 degrees C over 4 months. 3. An inhibition assay in an in vitro system using human adenocarcinoma cells indicated the high affinity binding of neoglycoprotein-conjugated liposomes. The inhibitory potency correlated with both the type and the amount of immobilized neoglycoproteins on liposomes. 4. A tissue distribution assay in an in vivo system using Ehrlich solid tumor-bearing mice showed the feasibility of the application of [125I]neoglycoprotein-conjugated liposomes as drug-targeting devices, based on carbohydrate-protein interactions.


The prevalence and associated factors of birth asphyxia among neonates delivered in Public Hospitals, Northern Ethiopia.
A body of evidences showed that birth asphyxia is a serious public health problem in low income countries including Ethiopia. There are sparse data on the prevalence of birth asphyxia and its associated factors among neonates in low income countries like Ethiopia, as well as the research area. Therefore, this study determined the prevalence and associated factors of birth asphyxia among newborns administered in public hospitals in Northern Ethiopia, 2019. A cross-sectional study of health institution was carried out in December 2019. Systematic sampling technique was used. Data was collected through interviews and chart review. Multivariate logistical regression analysis was done to control confounders and identify significantly associated variable. AOR with 95% confidence intervals were computed to identify the factors independently assoiated with birth asphyxia. The finding showed that the prevalence of birth asphyxia was 20.0%. Induction of labor (AOR=3.59, 95% CI: 1.36-9.46), Prolonged labor (AOR=3.59, 95% CI: 1.36-9.46), meconium-stained amniotic fluid (AOR=3.49), referred mothers (AOR=3.68, 95 % CI: 1.46-9.28), instrumental delivery (AOR=2.87, 95% CI: 1.09-7.55)and primiparous mothers (AOR=2.048 95% CI: 1.10-3.80). were significantly associated with birth asphyxia. The Prevalence of birth asphyxia notable high. Therefore; intra-partum care services should be strengthened to prevent birth asphyxia.


Visceral ischemia secondary to gastric dilatation: a rare complication of Nissen fundoplication.
Antireflux operations are now commonly performed for severe gastroesophageal reflux with life-threatening presentations like recurrent aspiration pneumonia and apnea. We report a child who presented 2 years after Nissen fundoplication with jejunal volvulus resulting in massive gastric dilatation, gastric rupture, pneumoretroperitoneum, pneumomediastinum, and severely compromised circulation to the lower extremities. Because of the intense intraabdominal pressure from the gastric dilatation, there was severe ischemia of the pancreas, duodenum, small bowel, colon, and gallbladder. We suggest that gastrointestinal symptoms in a child who has had Nissen fundoplication should be promptly evaluated to avoid delay in recognition of acute gastric dilatation and to prevent a fatal outcome.


Interrupted Pummerer Reaction in Latent-Active Glycosylation: Glycosyl Donors with a Recyclable and Regenerative Leaving Group.
Latent O-glycosides, 2-(2-propylthiol)benzyl (PTB) glycosides, were converted into the corresponding active glycosyl donors, 2-(2-propylsulfinyl)benzyl (PSB) glycosides, by a simple and efficient oxidation. Treatment of the PSB donor and various acceptors with triflic anhydride provided the desired glycosides in good to excellent yields. The leaving group, which was activated by an interrupted Pummerer reaction, can be recycled (PSB-OH) and regenerated as the precursor (PTB-OH). A natural hepatoprotective glycoside, leonoside F, was efficiently synthesized in a convergent [3+1] manner with this newly developed method. The present total synthesis also led to a structural revision of this phenylethanoid glycoside.


Body size of terrestrial arthropods and biomass of their populations in relation to the abiotic parameters of their milieu.
From collections made in very different biotopes of very different zoogeographical regions it is concluded that the biomass per area, the average body size, and the number of winged insects and spiders are primarily governed by the relative humidity of the biotope. From this finding several predictions are put forward on parental care, social systems, activity time and predators in different biotopes all of which seem to support the hypothesis.


Neurological complications prevalence and long-term survival after liver transplantation.
Neurological postsurgical complications are a significant cause of morbidity and mortality occur in transplant recipients impacting their survival. We analyzed the medical records of 269 patients who underwent transplantation between 2000 and 2011, after application of the exclusion criteria Neurological complications were examined according to the period in which they appeared: immediate (1-30 day) early (31-180 days), and late (after 180 days). The survival analysis was based on the first complication. The majority of transplant recipients were males (73.2%) and white (97.1%) with an overall median age of 49 (range, 18-73) years. Regarding the etiology for transplantation, the most common causes were hepatitis C virus (56.5%) and alcohol (33.1%). Complications, appearing in 29.4% (immediate), 31.5% (early), and 39.1% (late) cases, were encephalopathy, confusion, tremors, headache, and stroke. Patients who had the first complication between 1 and 6 months showed greater mortality than those who had one after 6 months. Neurological complications led to longer hospital stays with greater early morbidity and mortality. Knowledge of these complications appears to be extremely important for the multidisciplinary transplantation team to decrease its prevalence as well as to diagnose and treat early.


Early experience with the TriMed fragment-specific fracture fixation system in intraarticular distal radius fractures.
This paper reports the results of fixation of intraarticular fractures of the distal radius using the TriMed fragment-specific fixation system by surgeons early in their experience with the system. A consecutive series of 22 AO types C2 and C3 fractures in 21 patients were internally fixed with the system. Restoration of articular congruity to less than 2 mm was possible in 20 fractures. At a minimum of 6 months follow-up, mean volar and radial inclination were 8 degrees and 25 degrees , respectively, with no loss of reduction. The patients had a mean of 50 degrees flexion, 63 degrees extension and a pronation-supination arc of 149 degrees . The mean subjective Patient Rated Wrist Score was 20. Our complication rate was comparable to other published series despite long operating times. Therefore, we commend the system as a powerful tool to treat these difficult fractures but acknowledge the significant learning curve.


Conductive keratoplasty to treat complications of LASIK and photorefractive keratectomy.
To assess the outcomes of conductive keratoplasty (CK) for patients with complications related to LASIK or photorefractive keratectomy (PRK). Retrospective, noncomparative, interventional case series. Sixteen eyes of 15 patients were treated using CK after complications of initial LASIK or PRK surgeries. Five cases are described in detail. Rehabilitative CK was performed. Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), refractive error, keratometry, topography analysis, and a subjective assessment of visual quality. After CK treatment, there was a mean improvement in UCVA of 2 lines; 1 eye lost >1 line of UCVA. Best-corrected visual acuity improved or remained the same in 12 of 15 eyes; no eyes lost >1 line of BSCVA. There was a mean reduction in astigmatism of 54%. Videokeratography generally demonstrated improved quality of the corneal optical surface, and patients reported a reduction in optical symptoms such as glare and halo. Conductive keratoplasty may give improved corneal optics and vision in patients with complications of LASIK or PRK. This application of CK offers an alternative in cases in which further flap manipulation or laser treatments are contraindicated.


Significant variables associated with epilepsy.
To study the characteristics of the epileptics and the risk factors contributing to the development of epilepsy. Descriptive study. Epilepsy Clinic at Ahbab Hospital, Lahore, from June 2002 to August 2002. Data was collected from 158 subjects, 89 males and 69 females, suffering from epilepsy. The information about socio-demographic characteristics and family history of illness, perinatal morbidity, birth place and mother s age at the time of delivery was obtained using a pre-tested questionnaire. Data was analyzed on SPSS version 10. Majority of the subjects were single (77.84%), 1st born among their siblings (25.95%), belonged to low social class (50.63%), and unemployed (25.31%). The major risk factors were family history of illness (23.52%) and positive medical problem around birth (12.66%). The presence of family history of illness, positive medical problem around birth and advanced maternal age at birth were associated with early onset of epilepsy. Vulnerability for the epilepsy also increases among hospital deliveries. Although the present study has identified various risk factors, yet the results need to be further confirmed through case-control studies.


Pure erythroid leukemia.
The diagnosis of pure erythroid leukemia (PEL) can be challenging. Prompt identification of CD45+, CD34-, CD71+, CD117+, and E-cadherin+ erythroblasts is important. The differential diagnosis is broad and includes megaloblastic anemia.


Copper-oxide nanoparticles exert persistent changes in the structural and functional microbial diversity: A 60-day mesocosm study of zinc-oxide and copper-oxide nanoparticles in the soil-microorganism-nanoparticle system.
Recent advances in nanotechnology and development of nanoformulation methods, has enabled the emergence of precision farming - a novel farming method that involves nanopesticides and nanoferilizers. Zinc-oxide nanoparticles serve as a Zn source for plants, but they are also used as nanocarriers for other agents, whereas copper-oxide nanoparticles possess antifungal activity, but in some cases may also serve as a micronutrient providing Cu ions. Excessive application of metal-containing agents leads to their accumulation in soil, where they pose a threat to non-target soil organisms. In this study, soils obtained from the environment were amended with commercial zinc-oxide nanoparticles: Zn-OxNPs(10-30), and newly-synthesized copper-oxide nanoparticles: Cu-OxNPs(1-10). Nanoparticles (NPs) in 100 and 1000 mg kg-1 concentrations were added in separate set-ups, representing a soil-microorganism-nanoparticle system in a 60-day laboratory mesocosm experiment. To track environmental footprint of NPs on soil microorganisms, a Phospholipd Fatty Acid biomarker analysis was employed to study microbial community structure, whereas Community-Level Physiological Profiles of bacterial and fungal fractions were measured with Biolog Eco and FF microplates, respectively. The results revealed a prominent and persistent effects exerted by copper-containing nanoparticles on non-target microbial communities. A severe loss of Gram-positive bacteria was observed in conjunction with disturbances in bacterial and fungal CLPPs. These effects persisted till the end of a 60-day experiment, demonstrating detrimental rearrangements in microbial community structure and functions. The effects imposed by zinc-oxide NPs were less pronounced. As persistent changes were observed for newly synthesized Cu-containing NPs, this work stresses the need for obligatory testing of nanoparticle interactions with non-target microbial communities in long-term experiments, especially during the approval procedures of novel nano-substances. It also underlines the role of in-depth physical and chemical studies of NP-containing agents, which may be tweaked to mitigate the unwanted behavior of such substances in the environment and preselect their beneficial characteristics.


Ribonuclease-1 treatment after traumatic brain injury preserves blood-brain barrier integrity and delays secondary brain damage in mice.
Traumatic brain injury (TBI) involves primary mechanical damage and delayed secondary damage caused by vascular dysfunction and neuroinflammation. Intracellular components released into the parenchyma and systemic circulation, termed danger-associated molecular patterns (DAMPs), are major drivers of vascular dysfunction and neuroinflammation. These DAMPs include cell-free RNAs (cfRNAs), which damage the blood-brain barrier (BBB), thereby promoting edema, procoagulatory processes, and infiltration of inflammatory cells. We tested the hypothesis that intraperitoneal injection of Ribonuclease-1 (RNase1, two doses of 20, 60, or 180 µg/kg) at 30 min and 12 h after controlled-cortical-impact (CCI) can reduce secondary lesion expansion compared to vehicle treatment 24 h and 120 h post-CCI. The lowest total dose (40 µg/kg) was most effective at reducing lesion volume (- 31% RNase 40 µg/kg vs. vehicle), brain water accumulation (- 5.5%), and loss of BBB integrity (- 21.6%) at 24 h post-CCI. RNase1 also reduced perilesional leukocyte recruitment (- 53.3%) and microglial activation (- 18.3%) at 120 h post-CCI, but there was no difference in lesion volume at this time and no functional benefit. Treatment with RNase1 in the early phase following TBI stabilizes the BBB and impedes leukocyte immigration, thereby suppressing neuroinflammation. RNase1-treatment may be a novel approach to delay brain injury to extend the window for treatment opportunities after TBI.


[Surgical interventions in diffuse pulmonary tuberculosis in undisciplined patients].
The experience with surgical treatment of 134 patients with extended destructive tuberculosis of the lungs was studied. Among them 79 patients were subjected to lung resection in combination with thoracoplasty, 14 patients were subjected to thoracoplasty and 41 patients were subjected to various forms of cavernoplasty. It was shown that corrective thoracoplasty carried out simultaneously with lung resection lowered the risk of tuberculosis aggravation.


Consensus insertion/deletions and amino acid variations of all coding and noncoding regions of the SARS-CoV-2 Omicron clades, including the XBB and BQ.1 lineages.
The currently dominant Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has swiftly diverged into clades. To predict the probable impact of these clades, the consensus insertions/deletions (indels) and amino acid substitutions of the whole genome of clades were compared with the original SARS-CoV-2 strain. The evolutionary history of representatives of clades and lineages was inferred using the maximum-likelihood method and tested using the bootstrap method. The indels and polymorphic amino acids were found to be either clade-specific or shared among clades. The 21K clade has unique indels and substitutions, which probably represent reverted indels/substitutions. Three variations that appear to be associated with SARS-CoV-2 attenuation in the Omicron clades included a deletion in the nucleocapsid gene, a deletion in the 3'untranslated region, and a truncation in open reading frame 8. Phylogenetic analysis showed that the Omicron clades and lineages form three separate clusters.


Increased monocyte expression of sialoadhesin during acute cellular rejection and other enteritides after intestine transplantation in children.
Sialoadhesin (CD169) facilitates T-cell priming when overexpressed on inflammatory monocytes. Monocyte-derived macrophages prime acute cellular rejection after intestine transplantation (ITx).The purpose of this study was to evaluate whether CD169-expressing activated monocytes associate with or predict ITx rejection. After informed consent (ClinicalTrials.gov NCT No. 01163578), activated CD169+CD14+monocytes were measured by flow cytometry in five normal healthy adult volunteers (group A), and 56 children with ITx sampled cross-sectionally (group B, 26), longitudinally (group C, 18), or during infection/inflammation without rejection (group D: acute enteritis, 9; Helicobacter pylori, 1; Streptococcal pharyngitis 1; and posttransplant lymphoma, 1). Activated monocytes were tested for correlations with donor-specific alloreactivity in simultaneous mixed lymphocyte co-cultures. Median age was 3 years (range 0.5-21 yr), and distribution of ITx-alone:combined liver-ITx was 25:31. Higher frequencies (%) of activated monocytes were seen during rejection in group B and infection/inflammation without rejection in group D (58 ± 28 and 73 ± 26), compared with nonrejectors or normal controls (10.6 ± 7.9 or 10.7 ± 6.5, P=0.001). In longitudinal monitoring, rejectors also showed higher activated monocyte frequencies (%) before ITx (64 ± 26 vs. 13.4 ± 8.6, P=0.0007) and during acute cellular rejection (55 ± 28 vs. 22.4 ± 15, P=0.006) when compared with nonrejectors. Activated monocytes correlated significantly with allospecific CD154+T-cytotoxic memory cells (Spearman r=0.688, P=7.1E-05) and CD154+B cells (r=0.518, P=0.005) in ITx recipients without inflammation/infection but not in group D. Monocytes overexpress sialoadhesin nonspecifically during ITx rejection and systemic or enteritic inflammatory states. When combined with allospecific T and B cells, this information may differentiate between rejection and other enteritides.


[Results of a National survey on antibiotic prophylaxis and antisepsis in cataract surgery].
We present the results of a national survey carried out in 1997 among French ophthalmologists on prophylactic antibiotic and antiseptic therapy in cataract surgery. Among the 6050 questionnaires sent by post, 1082 answers recorded between January and February 1997. The results give precise details on French surgeons attitude as regards prophylactic antibiotics for: topical, subconjunctival, intra-ocular and systemic administration. This kind of study is frequent in English-speaking countries and is useful to help our profession to formulate important current questions and to collect answers.


Ectoparasites reduce scope for growth in a rocky-shore mussel (Perna perna) by raising maintenance costs.
Endolithic cyanobacteria are ubiquitous colonisers of organic and inorganic carbonate substrata that frequently attack the shells of mussels, eroding the shell to extract carbon, often with population infestation rates of >80%. This reduces host physiological condition and ultimately leads to shell collapse and mortality, compromising the services provided by these important ecosystem engineers. While the ecological implications of this and similar interactions have been examined, our understanding of the underlying mechanisms driving the physiological responses of infested hosts remains limited. Using field and laboratory experiments, we assessed the energetic costs of cyanobacterial infestation to the intertidal brown mussel (Perna perna). In the field we found that growth (measured as both increase in shell length and rate of biomineralization) and reproductive potential of clean mussels are greater than those of infested individuals. To explore the mechanisms behind these effects, we compared the energy allocation of parasite-free and infested mussels using the scope for growth (SFG) framework. This revealed a lower SFG in parasitized mussels attributed to an energetic imbalance caused by increased standard metabolic rates, without compensation through increased feeding or reduced excretion of ammonia. Separate laboratory assays showed no differences in calcium uptake rates, indicating that infested mussels do not compensate for shell erosion through increased mineralization. This suggests that the increased maintenance costs detected reflect repair of the organic component of the inner nacreous layer of the shell, an energetically more demanding process than mineralization. Thus, parasite-inflicted damage reduces SFG directly through the need for increased basal metabolic rate to drive shell repair without compensatory increases in energy intake. This study provides a first perspective of the physiological mechanisms underlying this parasite-host interaction, a critical step towards a comprehensive understanding of the ecological processes driving dynamics of this intertidal ecosystem engineer.


The two-stage factors driving changes in China's industrial SO2 emission intensity: A production-theoretical decomposition analysis.
Exploring the efficiency and technology related driving factors of China's industrial sulfur dioxide (SO2) emission intensity change from a staged perspective is significant for reducing emissions in an efficient way. This study shows how efficiency and technology related factors at two stages, cleaner production and end-of-pipe treatment, influence changes in China's industrial SO2 emission intensity, by implementing a two-stage production-theoretical decomposition analysis (PDA) approach. The empirical research was conducted by decomposing changes in China's industrial SO2 emission intensity during 2011-2015. The results show that potential pollution intensity and treatment technological change substantially benefited the industrial SO2 emission intensity reduction, while changes in the treatment technical efficiency largely inhibited decreases in the industrial SO2 emission intensity. At the regional level, the decrease in industrial SO2 emission intensity created by production technological change occurred in the eastern and north-eastern regions, while this factor increased industrial SO2 emission intensity in the western and central regions. This study also found that changes in treatment technological change reduced industrial SO2 emission intensity in all four regions. Based on the decomposition results, this paper makes targeted policy recommendations for different levels of governments.


MicroRNA-675 promotes glioma cell proliferation and motility by negatively regulating retinoblastoma 1.
Previous studies indicated that microRNA (miR)-675 and its precursor lncRNA H19 were both overexpressed in glioma tissues, and H19 might play an oncogenic role. To investigate the involvement of miR-675 in gliomas and its underlying mechanisms, we here collected candidate target genes of miR-675-5p from miRTarBase (http://mirtarbase.mbc.nctu.edu.tw/, Release 6.0), which contains the experimentally validated microRNA-target interactions. Then, regulatory effects of miR-675 on its target genes were validated using clinical samples and glioma cell lines. Involvement of the miR-675-target axis deregulation in cell proliferation, migration and invasion of glioma was demonstrated by both gain- and loss-of-function experiments. As a result, retinoblastoma 1 (RB1) was identified as a candidate target gene of miR-675-5p. Expression levels of miR-675-5p in glioma tissues and cells were negatively correlated with RB1 expression at both mRNA and protein levels. Importantly, deregulation of the miR-675-5p-RB1 axis was significantly associated with advanced World Health Organization (WHO) grade and low Karnofsky performance score (KPS) score of glioma patients. Luciferase reporter assay verified that RB1 was a direct target gene of miR-675 in glioma cells. Functionally, miR-675 promoted glioma cell proliferation, migration and invasion. Notably, simulation of RB1 antagonized the effects induced by miR-675 up-regulation in glioma cells. In conclusion, our data suggest that miR-675 may be a key negative regulator of RB1 and the imbalance of the miR-675-RB1 axis may be clinically associated with aggressive progression of glioma patients. In addition, miR-675 may act as an oncogenic miRNA in glioma cells via regulating its target gene RB1.