Investigation and analysis of porcine epidemic diarrhea cases and evaluation of different immunization strategies in the large-scale swine farming system.
Porcine epidemic diarrhea (PED) is a contagious intestinal disease caused by porcine epidemic diarrhea virus (PEDV) characterized by vomiting, diarrhea, anorexia, and dehydration, which has caused huge economic losses around the world. However, it is very hard to find completely valid approaches to control the transmission of PEDV. At present, vaccine immunity remains the most effective method. To better control the spread of PED and evaluate the validity of different immunization strategies, 240 PED outbreak cases from 577 swine breeding farms were collected and analyzed. The objective of the present study was to analyze the epidemic regularity of PEDV and evaluate two kinds of different immunization strategies for controlling PED. The results showed that the main reasons which led to the outbreak of PED were the movement of pig herds between different pig farms (41.7%) and delaying piglets from the normal production flow (15.8%). The prevalence of PEDV in the hot season (May to October) was obviously higher than that in the cold season (January to April, November to December). Results of different vaccine immunity cases showed that immunization with the highly virulent live vaccine (NH-TA2020 strain) and the commercial inactivated vaccine could significantly decrease the frequency of swine breeding farms (5.9%), the duration of PED epidemic (1.70 weeks), and the week batches of dead piglets (0.48 weeks weaned piglets), compared with immunization with commercial attenuated vaccines and inactivated vaccine of PED. Meanwhile, immunization with the highly virulent live vaccine and the commercial inactivated vaccine could bring us more cash flows of Y̶275,274 per year than immunization with commercial live attenuated vaccine and inactivated vaccine in one 3000 sow pig farm within one year. Therefore, immunization with highly virulent live vaccine and inactivated vaccine of PED is more effective and economical in the prevention and control of PED in the large-scale swine farming system.


Sorption and desorption behaviors of triphenyl phosphate (TPhP) and its degradation intermediates on aquatic sediments.
As triphenyl phosphate (TPhP) can biodegrade extensively in sediments, researches should further the understanding of the fate and transport of TPhP and its degradation intermediates in the environment. Therefore, the sorption/desorption behaviors of TPhP, diphenyl phosphate (DPhP) and phenyl phosphate (PhP) on sediments were investigated. The kinetic process was well-fitted by pseudo-second-order model, suggesting that chemisorption was involved. And the Langmuir model could describe the sorption isotherms of TPhP and DPhP well except for PhP. The redundancy analysis revealed that the sorption amount had a positive correlation with sediment organic matter, zeta potential and C/H of sediments. Besides the sorption/desorption behaviors were greatly influenced by the physicochemical properties of the sorbates. PhP with high molecular electrostatic potential (0.132 e0) was prone to protonation and formed hydrogen bonds, leading to higher sorption. Furthermore, hydrophobicity, π-π interactions, Lewis acid-base interaction and hydrogen bonding were involved in the sorption process and resulted in nonlinear sorption isotherms. TPhP, DPhP and PhP exhibited apparent desorption hysteresis on the sediments. Sediments with organic matter removed, which have complex pore distributions, exhibited more hysteresis. These results may contribute to the risk assessment and fate modeling of TPhP and its degradation products in sediments.


Atypical Functional Covariance Connectivity Between Gray and White Matter in Children With Autism Spectrum Disorder.
Autism spectrum disorder (ASD) is a type of neurodevelopmental disorder with atypical gray matter (GM) and white matter (WM) functional developmental course. However, the functional co-developmental pattern between GM and WM in ASD is unclear. Here, we utilized a functional covariance connectivity method to explore the concordance pattern between GM and WM function in individuals with ASD. A multi-center resting-state fMRI dataset composed of 105 male children with ASD and 102 well-matched healthy controls (HCs) from six sites of the ABIDE dataset was utilized. GM and WM ALFF maps were calculated for each subject. Voxel by voxel functional covariance connectivity of the ALFF values across subjects was calculated between GM and WM for children with ASD and HCs. A Z-test combining FDR multi-comparison correction was then employed to determine whether the functional covariance is significantly different between the two groups. A "bundling" strategy was utilized to ensure that the GM/WM clusters showing atypical functional covariance were larger than 5 voxels. Finally, canonical correlation analysis was conducted to explore whether the atypical GM/WM functional covariance is related to ASD symptoms. Results showed atypical functional covariance connections between specific GM and WM regions, whereas the ALFF values of these regions indicated no significant difference between the two groups. Canonical correlation analysis revealed a significant relationship between the atypical functional covariance and stereotyped behaviors of ASD. The results indicated an altered functional co-developmental pattern between WM and GM in ASD. LAY SUMMARY: White matter (WM) and gray matter (GM) are two major human brain organs supporting brain function. WM and GM functions show a specific co-developmental pattern in typical developed individuals. This study showed that this GM/WM co-developmental pattern was altered in children with ASD, while this altered GM/WM co-developmental pattern was related to stereotyped behaviors. These findings may help understand the GM/WM functional development of ASD.


Size-frequency distributions and physical properties of chondrules from x-ray computed microtomography and digital data extraction.
Within this work, we present the first true three-dimensional (3D) analysis of chondrule size. Knowledge about the physical properties of chondrules is important for validating astrophysical theories concerning chondrule formation and their aggregation into the chondritic meteorites (known as chondrites) that contain them. The classification of chondrites into chemical groups also relies on chondrule properties, including their dimensions. Within this work, we quantify the diameters of chondrules in five ordinary chondrites (OCs; comprised of the H, L, and LL chondrites) and one low-iron enstatite (EL) chondrite. To extract the chondrule size data, we use x-ray computed microtomography to image small (~1-2 cm3 ) chondrite samples followed by manual digital segmentation to isolate chondrules within the volumes or subvolumes. Our data yield true 3D results without stereographic corrections necessary for two-dimensional (2D) or petrographic thin section-based determinations of chondrule sizes. Our results are completely novel, but are consistent with previous surface analysis (2D) data for OCs. Within our OC chondrule diameter data, we find the trend of mean chondrule diameters increasing in the order H < L < LL. We also present the first detailed EL chondrite chondrule size-frequency distribution. Finally, we examine the shapes and collective orientations of the chondrules within the chondrites and show that chondrite petrofabrics can be explored with our methodology. Chondrule shape-preferred orientations are identical to the orientations of the metal and sulfide grains in the chondrites and this is likely due to impact-related compaction. HIGHLIGHTS: We present a first true three-dimensional analysis of chondrule size. Our ordinary chondrite chondrule diameter data demonstrate the trend of mean chondrule diameters increasing in the order H chondrites < L chondrites < LL chondrites. We also present the first detailed low-iron enstatite chondrite chondrule size-frequency distribution. We examine the shapes and collective orientations of the chondrules and show that chondrite petrofabrics can be explored with our methodology.


New induction and postinduction strategies in acute myeloid leukemia.
Improving or replacing the traditional induction (3 + 7) and consolidation (high-dose cytarabine; Ara-C) as the standard of care for acute myeloid leukemia (AML) has proved disappointing. Recent studies have raised the possibility that daunorubicin dose escalation might have the potential to improve survival. Antibody-directed therapy by means of gemtuzumab ozogamicin as an adjunct to induction chemotherapy may yet be a viable option in older patients, and alternative nucleoside analogues in induction could help higher risk subgroups. In consolidation, the number of courses and dose level of Ara-C required are being clarified. New treatments for older patients who will not be subjected to conventional chemotherapy are an active area, but randomized trials have not yet usurped low-dose Ara-C (LDAC). Recent information in these areas is reviewed.


RE: Biomechanical comparative analysis of temporomandibular joint, glenoid fossa and head of the condyle of conventional models prothesis with new PEEK design.
This is a Letter to the Editor that describes some of the biomechanical concerns with the statements made in This is a LTE that raises some biomechanical statements made in Genovesi W, Comenale IC, Genovesi Filho W, Veloso Fernandes M. Biomechanical comparative analysis of temporomandibular joint, glenoid fossa and head of the condyle of conventional models prothesis with new PEEK design. J Oral Biol Craniofac Res. 2022 Sep-Oct; 12(5):529-541.


Ebola virus disease: awareness among junior doctors in England.
The current Ebola virus epidemic continues to pose a threat to the UK. Junior clinicians are often at the frontline of medical care in hospitals and their awareness of the clinical features and management of the Ebola virus disease (EVD) may significantly influence the timely implementation of infection control measures. In view of this, we carried out a cross-sectional survey of 119 junior doctors across four different hospitals in England in order to assess their level of knowledge of EVD. We demonstrate that there is currently a deficiency of knowledge about critical aspects of EVD in this population.


The effect of alcohol consumption on risk-taking while driving.
Using a cover story of the effects of alcohol on perceptual and motor abilities, three levels of alcohol consumed (high, moderate, and none) were combined with three levels of alcohol expected (high, moderate, and none) to determine their effects on risk-taking while driving. Thirty-nine subjects were randomly assigned to six conditions. A driving simulation task was employed; dependent variables were cars passed and total time at high speed. Results indicated greatest risk-taking, measured by cars passed and time spent at high speed, by subjects who believed they had consumed a moderate amount of alcohol. Actual amount of alcohol consumed produced no significant differences.


Methotrexate cytotoxicity on MCF-7 breast cancer cells is not altered by exposure to 25 Hz, 1.5 mT magnetic field and iron (III) chloride hexahydrate.
The action of electromagnetic fields (EMF) on different pathways related to cell physiology, proliferation, toxicity of chemicals, gene expression, etc., are currently being investigated although the results are still not conclusive and even conflicting. In laboratory and animal studies, EMF has been found to produce a great variety of effects such as: increase in ornithine decarboxylase activity in breast, increase in beta-galactosidase gene expression and oncogene transcription after exposure to 50/60 Hz. Animal studies have shown that the use of EMF can enhance drug delivery across biological barriers (rat abdominal skin), using benzoic acid as the drug candidate. It has been reported by different authors that pulsed EMF (PEMF) can produce alterations in antineoplastic drugs potency. In the present study, we investigated the effects of PEMF on methotrexate cytotoxicity in MCF-7 breast cancer cells and the effects with simultaneous exposure to FeCl3. The data presented in the current report indicate that PEMF (25 Hz, 1.5 mT) do not induce modulation of the action of methotrexate (with and without iron-III) in MCF-7 cells when they are exposed to PEMF for 2 h/day during 3 days.


Outcome in patients with lung cancer found retrospectively to have had evidence of disease on past lung cancer mass screening roentgenograms.
This study enrolled 143 asymptomatic patients with lung cancer detected by mass screening during an 8-year period (January 1, 1993 to December 31, 2000) and who had received a lung cancer mass screening roentgenogram one year before the disease was found. There was no difference between the 5-year survival rates in patients with one-year delayed detection of lung cancer (n=62) and in patients without (n=81) (46 vs. 58%, log rank: P=0.1330, Wilcoxon: P=0.1008). However, according to the tumor size on the overlooked chest roentgenogram, the outcome in stage I+II patients with missed tumors >20 mm in dimension (n=20) was worse than those with missed tumors <10 mm (n=24) or those with missed tumors 10-20 mm (n=18) (40 vs. 82 or 81%, log rank: P=0.0047, Wilcoxon: P=0.0010). All missed tumors in the lung field that did not overlap thoracic components were <10 mm in dimension and appeared as patchy ground-glass opacities, and they could not have been recognized if there was no other information that the tumor developed in that location. This might also be related to the lack of mortality effectiveness of previous lung cancer mass screening problem. Although it may be difficult to find the tumors <10 mm on a chest roentgenogram on mass screening, one-year delayed detection of lung cancer < or = 20 mm will not affect the prognosis.


Assessing the accuracy of a new 3D2D registration algorithm based on a non-invasive skin marker model for navigated spine surgery.
We assessed the accuracy of a new 3D2D registration algorithm to be used for navigated spine surgery and explored anatomical and radiologic parameters affecting the registration accuracy. Compared to existing 3D2D registration algorithms, the algorithm does not need bone-mounted or table-mounted instruments for registration. Neither does the intraoperative imaging device have to be tracked or calibrated. The rigid registration algorithm required imaging data (a pre-existing CT scan (3D) and two angulated fluoroscopic images (2D)) to register positions of vertebrae in 3D and is based on non-invasive skin markers. The algorithm registered five adjacent vertebrae and was tested in the thoracic and lumbar spine from three human cadaveric specimens. The registration accuracy was calculated for each registered vertebra and measured with the target registration error (TRE) in millimeters. We used multivariable analysis to identify parameters independently affecting the algorithm's accuracy such as the angulation between the two fluoroscopic images (between 40° and 90°), the detector-skin distance, the number of skin markers applied, and waist circumference. The algorithm registered 780 vertebrae with a median TRE of 0.51 mm [interquartile range 0.32-0.73 mm] and a maximum TRE of 2.06 mm. The TRE was most affected by the angulation between the two fluoroscopic images obtained (p < 0.001): larger angulations resulted in higher accuracy. The algorithm was more accurate in thoracic vertebrae (p = 0.004) and in the specimen with the smallest waist circumference (p = 0.003). The algorithm registered all five adjacent vertebrae with similar accuracy. We studied the accuracy of a new 3D2D registration algorithm based on non-invasive skin markers. The algorithm registered five adjacent vertebrae with similar accuracy in the thoracic and lumbar spine and showed a maximum target registration error of approximately 2 mm. To further evaluate its potential for navigated spine surgery, the algorithm may now be integrated into a complete navigation system.


[Système International d'Unités = SI-units. Temporary prescriptions are finished now (author's transl)].
After a description of the legal basis for the use of the so-called SI-Units the problems of changing into the new system are discussed. The essential changes, especially in the ENT--field are demonstrated. According to the present international recommendations the new legal units should be used in medicine as soon as possible.


Prognostic implications of non-infarct-related territory unrecognized myocardial infarction in patients with non-ST-segment-elevation acute coronary syndrome.
Prognostic value of non-infarct-related territory (non-IR) unrecognized myocardial infarction (UMI) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) remains to be elucidated. We sought to evaluate the prognostic impact of non-IR UMI in patients with first NSTE-ACS presentation. This retrospective single-center analysis was conducted in patients with NSTE-ACS without prior history of coronary artery disease, who underwent uncomplicated urgent percutaneous coronary intervention (PCI) within 48 h of admission between August 2014 and January 2018. All patients underwent postprocedural cardiac magnetic resonance imaging (CMR) within 30 days after PCI. Non-IR UMI was defined as the presence of non-IR delayed gadolinium enhancement with an ischemic distribution pattern. We investigated the association of non-IR UMI, other CMR findings and baseline clinical characteristics with major adverse cardiac events (MACE), defined as death, non-fatal myocardial infarction, stroke, late revascularization, and hospitalization for congestive heart failure. A total of 168 NSTE-ACS patients were included [124 men (73.8 %); 66 ± 11 years]. Non-IR UMI was detected in 28 patients (16.7 %). During a median follow-up of 32 (15-58) months, MACE occurred in 10 (35.7 %) patients with non-IR UMI, and 20 (14.3 %) patients without (p = 0.013). Cox's proportional hazards analysis showed that the presence of non-IR UMI was an independent predictor of MACE (hazard ratio [HR], 2.37, 95 % confidence interval [CI], 1.09-5.18, p = 0.030). In patients with NSTE-ACS undergoing urgent PCI, the prevalence of non-IR UMI was 16.7 %. Non-IR UMI provided prognostic information independent of conventional risk factors and the extent of myocardial injury caused by NSTE-ACS.


On weighted k-mer dictionaries.
We consider the problem of representing a set of [Formula: see text]-mers and their abundance counts, or weights, in compressed space so that assessing membership and retrieving the weight of a [Formula: see text]-mer is efficient. The representation is called a weighted dictionary of [Formula: see text]-mers and finds application in numerous tasks in Bioinformatics that usually count [Formula: see text]-mers as a pre-processing step. In fact, [Formula: see text]-mer counting tools produce very large outputs that may result in a severe bottleneck for subsequent processing. In this work we extend the recently introduced SSHash dictionary (Pibiri in Bioinformatics 38:185-194, 2022) to also store compactly the weights of the [Formula: see text]-mers. From a technical perspective, we exploit the order of the [Formula: see text]-mers represented in SSHash to encode runs of weights, hence allowing much better compression than the empirical entropy of the weights. We study the problem of reducing the number of runs in the weights to improve compression even further and give an optimal algorithm for this problem. Lastly, we corroborate our findings with experiments on real-world datasets and comparison with competitive alternatives. Up to date, SSHash is the only [Formula: see text]-mer dictionary that is exact, weighted, associative, fast, and small.


Development of an aqueous ultrasound-assisted extraction process of bioactive compounds from beet leaves: a proposal for reducing losses and increasing biomass utilization.
Red beet plants are cultivated worldwide for the consumption of their roots, generating large amounts of unexploited by-products. In particular, beet leaves (BLs) represent about 50% of the whole plant and are usually discarded as waste. This constitutes not only an economic issue, since multiple resources invested in the production will be wasted, but also an environmental problem because of the pollution associated with their disposal. However, BLs comprise an important source of functional compounds (polyphenols and betalains) that could be recovered from the raw material, representing a sustainable solution for the underutilization of this by-product. This study proposes the recovery of polyphenols and betalains using an aqueous ultrasound-assisted extraction (UAE) process at different powers (35, 50, and 100 W) that was characterized and optimized. UAE significantly enhanced the recovery of bioactive compounds and shortened the time required for extraction in comparison with traditional macerations (35 < 50 < 100 W). During UAE, the temperature of the systems increased as a function of the power applied, favouring the recovery of these phytochemicals. Additionally, a Box-Behnken design and response surface methodology were employed to optimize UAE conditions (90 W ultrasound power, 1:20 solid:liquid ratio, 16 min extraction time), under which the yields were 14.9 mg g-1 (polyphenols), 949.1 μg g-1 (betaxanthins), and 562.2 μg g-1 (betacyanins), consistent with the values predicted by the models. This study enabled the development of a green-solvent UAE process that constitutes an effective post-harvest by-products strategy to minimize losses and increase biomass utilization through the recovery of bioactive compounds from BLs, promoting sustainability in the agri-food chain. © 2020 Society of Chemical Industry.


A single-arm, open-label study of alemtuzumab in treatment-refractory patients with multiple sclerosis.
Alemtuzumab (CD52-specific humanized monoclonal antibody) was found to be an effective therapy for treatment-naive patients with relapsing-remitting multiple sclerosis. Evaluate alemtuzumab's effects in patients with treatment-refractory relapsing-remitting multiple sclerosis. Forty-five relapsing-remitting multiple sclerosis patients who experienced ≥2 relapses during 2 years prior to the study entry whilst receiving interferon therapy were administered 24 mg i.v. alemtuzumab/day for 5 days at baseline and 3 days 12 months later. Patients received premedication with 1 g i.v. methylprednisolone on days 1-3 at both times. After 2-year follow-up, the annualized relapse rate was reduced by 94% compared to pre-treatment levels, from 1.6 (2 years prior to treatment) to 0.17 for the 2 years following (P<0.0001). Moreover, 86% of patients showed stable or improved scores on the Expanded Disability Status Scale, and only 1 experienced an increase in disability lasting ≥6 months. The majority (70-88%) showed stable or improved leg, arm and cognitive function as measured by the Multiple Sclerosis Functional Composite. Serious adverse events observed in single patients were transient neutropenia and pneumonia, pulmonary emboli and deep vein thrombosis. Five patients developed clinical thyroid disorders but no opportunistic infections or cases of immune thrombocytopenic purpura were observed. Alemtuzumab effectively reduced relapse rates and improved clinical scores in patients with active relapsing-remitting multiple sclerosis not controlled by interferon therapy.


An effective approach of lesion segmentation within the breast ultrasound image based on the cellular automata principle.
In this paper, a novel lesion segmentation within breast ultrasound (BUS) image based on the cellular automata principle is proposed. Its energy transition function is formulated based on global image information difference and local image information difference using different energy transfer strategies. First, an energy decrease strategy is used for modeling the spatial relation information of pixels. For modeling global image information difference, a seed information comparison function is developed using an energy preserve strategy. Then, a texture information comparison function is proposed for considering local image difference in different regions, which is helpful for handling blurry boundaries. Moreover, two neighborhood systems (von Neumann and Moore neighborhood systems) are integrated as the evolution environment, and a similarity-based criterion is used for suppressing noise and reducing computation complexity. The proposed method was applied to 205 clinical BUS images for studying its characteristic and functionality, and several overlapping area error metrics and statistical evaluation methods are utilized for evaluating its performance. The experimental results demonstrate that the proposed method can handle BUS images with blurry boundaries and low contrast well and can segment breast lesions accurately and effectively.


Humoral autoimmunity after solid organ transplantation: Germinal ideas may not be natural.
Non-HLA antibody responses following solid organ transplantation have become increasingly emphasised, with several large clinical series suggesting that such responses contribute to late graft failure. Many of the responses described recognise both recipient and donor moieties of the target antigen and thus represent auto-, rather than allo-immunity. Within this rapidly evolving field, many questions remain unanswered: what triggers the response; how innate and adaptive humoral autoimmunity integrate; and most pressingly, how autoimmunity contributes to graft damage and its relationship to other effector mechanisms of graft rejection. This review summarises recent clinical and experimental studies of humoral autoimmunity in transplant rejection, and considers some of the answers to these questions.


Bent versus straight tips in micropulsed longitudinal phacoemulsification.
The aim of this study was to evaluate bent and straight phacoemulsification tips to determine which tip is more efficient in removal of lens fragments, using micropulsed longitudinal ultrasound in phacoemulsification. In vitro laboratory study. The John A. Moran Eye Center Laboratories, University of Utah, Salt Lake City, Utah, was the study setting. Pig lenses hardened in a manner comparable with dense human cataracts were cut into 2-mm cubes and removed with micropulsed longitudinal ultrasound using settings previously shown to be optimally efficient (6 milliseconds on and 6 milliseconds off for a bent tip). To verify this time as most efficient for a straight tip, we also tested times of 5, 6, and 7 milliseconds time on and off. The tips were either straight or with a 20-degree bend. Twenty cubes were used for each comparative run. For the straight tip, 6 milliseconds on (1.56 ± 0.815 seconds) was significantly more efficient than 7 milliseconds on (2.45 ± 1.56 seconds, p = 0.001) and not significantly more efficient than 5 milliseconds on (1.69 ± 0.86 seconds, p = 0.43). Five milliseconds off time (1.45 ± 0.76s) was more efficient than 6 milliseconds (2.06 ± 1.37 seconds, p = 0.004) and 7 milliseconds off (2.18 ± 1.24s, p = 0.001). The straight tip was more efficient than the bent tip (1.38 ± 0.83 versus 2.93 ± 2.14 seconds, p = 0.006). Results are contrary to accepted common belief. Micropulsed longitudinal phacoemulsification is more efficient with a straight rather than a bent tip.


Intractable neurostenalgia of the ulnar nerve abolished by neurolysis 18 years after injury.
A 39 year-old farmer sustained a closed rupture of the left brachial artery, which was successfully managed by emergency vein graft repair of the artery. Adjacent nerve trunks were seen to be intact, but stretched. Burning pain in the distribution of the ulnar nerve started at day seven postoperatively, and worsened over the ensuing years. There was no response to membrane stabilising drugs, amitryptiline, nor to regional sympatholytic or local anaesthetic blocks. Neurolysis of the ulnar nerve, which was densely adherent to the dilated vein graft, abolished his pain.


Insertion of Penile Implants in Patients with Priapism: When Is the Right Time?
Acute ischaemic priapism is a urological emergency that requires prompt intervention. Refractory cases result in the development of fibrosis in the corpus cavernosum, which results in erectile dysfunction. Early insertion of a penile prosthesis in refractory cases allows easier dilatation and maintains the penile length and girth.


Novel carboxymethyl chitosan/N-acetylneuraminic acid hydrogel for the protection of Pediococcus pentosaceus.
In this study, carboxymethyl chitosan (CMCS) and N-acetylneuraminic acid (NeuAc) were used to develop C-NeuAc hydrogels to encapsulate Pediococcus pentosaceus QK-1. The mechanical properties, thermal stability, in vitro degradation, and pH sensitivity of the hydrogel were evaluated. The C-NeuAc concentration required for optimal hydrogel performance was 3% (w/v). Hydrogel swelling behaviour was effectively assessed by Fickian diffusion and Schott's second-order kinetic models. The hydrogel demonstrated excellent biocompatibility and low in vitro cytotoxicity. An in vitro assay revealed that the viability of Pediococcus pentosaceus QK-1 in C-NeuAc had decreased by only 1.41 log (CFU/ mL) after exposure to simulated acidic gastric fluid. Moreover, the survival rate of the encapsulated and free Pediococcus pentosaceus QK-1 cells were 80.1% and virtually zero, respectively, after passage through the gastrointestinal tract. It was empirically determined that low temperature and freeze-drying were the ideal condition and method to ensure storage longevity of the hydrogel-encapsulated probiotic. Hence, C-NeuAc hydrogel is highly desirable as a food-grade probiotic delivery vehicle.


Flying Cages in Traveling Wave Ion Mobility: Influence of the Instrumental Parameters on the Topology of the Host-Guest Complexes.
Supramolecular mass spectrometry has emerged in the last decade as an orthogonal method to access, at the molecular level, the structures of noncovalent complexes extracted from the condensed phase to the rarefied gas phase using electrospray ionization. It is often considered that the soft nature of the ESI source confers to the method the capability to generate structural data comparable to those in the condensed phase. In the present paper, using the ammonium ion/cucurbituril combination as a model system, we investigate using ion mobility and computational chemistry the influence of the instrumental parameters on the topology, i.e., internal versus external association, of gaseous host/guest complex ions. MS and theoretical data are confronted to condensed phase data derived from nuclear magnetic resonance spectroscopy to assess whether the instrumental parameters can play an insidious role when trying to derive condensed phase data from mass spectrometry results. Graphical Abstract .


Acromiohumeral Distance During Neuromuscular Electrical Stimulation of the Lower Trapezius and Serratus Anterior Muscles in Healthy Participants.
Compromise to the acromiohumeral distance has been reported in participants with subacromial impingement syndrome compared with healthy participants. In clinical practice, patients with subacromial shoulder impingement are given strengthening programs targeting the lower trapezius (LT) and serratus anterior (SA) muscles to increase scapular posterior tilt and upward rotation. We are the first to use neuromuscular electrical stimulation to stimulate these muscle groups and evaluate how the muscle contraction affects the acromiohumeral distance. To investigate if electrical muscle stimulation of the LT and SA muscles, both separately and simultaneously, increases the acromiohumeral distance and to identify which muscle-group contraction or combination most influences the acromiohumeral distance. Controlled laboratory study. Human performance laboratory. Twenty participants (10 men and 10 women, age = 26.9 ± 8.0 years, body mass index = 23.8) were screened. Neuromuscular electrical stimulation of the LT and SA. Ultrasound measurement of the acromiohumeral distance. Acromiohumeral distance increased during contraction via neuromuscular electrical stimulation of the LT muscle (t(19) = -3.89, P = .004), SA muscle (t(19) = -7.67, P = .001), and combined LT and SA muscles (t(19) = -5.09, P = .001). We observed no differences in the increased acromiohumeral distance among the 3 procedures (F(2,57) = 3.109, P = .08). Our results supported the hypothesis that the muscle force couple around the scapula is important in rehabilitation and scapular control and influences acromiohumeral distance.


Association between initial pattern of clozapine titration, concentration-to-dose ratio, and incidence of fever in patients with schizophrenia spectrum disorders in a Korean tertiary hospital.
Safe and effective administration of clozapine requires careful monitoring for inflammatory reactions during the initial titration. The concentration-to-dose (C/D) ratio must be taken into account, which may vary among ethnicities. In this retrospective study, 1408 Korean schizophrenia inpatients were examined for during the first 8 weeks of clozapine titration. The average doses of clozapine administered during weeks 1, 2, 4, and 8 were 77.37, 137.73, 193.20, and 212.83 mg/day, with significantly lower doses for females than males. The average C/D ratio was significantly higher in females (1.75 ± 1.04 and 1.11 ± 0.67 ng/mL per mg/day). Patients with higher C/D ratios were more likely to experience fever and were prescribed lower doses of clozapine starting from week 4. In total, 22.1 % of patients developed a fever at an average of 15.74 days after initiating clozapine. Patients who developed a fever were younger, used more antipsychotics at baseline, had a higher C/D ratio, and had a higher incidence of an elevated C-reactive protein level. A higher C/D ratio, use of a greater number of antipsychotics at baseline, and concomitant olanzapine use were risk factors for the development of inflammatory reactions. The incidence of pneumonia, agranulocytosis, and myocarditis within 8 weeks were 3.7 %, 0.3 %, and 0.1 %. In summary, the target dose of clozapine titration is lower for Korean schizophrenia patients, with a higher C/D ratio and more frequent fever compared to Western patients; however, myocarditis occurs rarely. Our findings may contribute to the titration methods for clozapine for the East Asian population.


Adenylyl cyclase subtype-specific compartmentalization: differential regulation of L-type Ca2+ current in ventricular myocytes.
Adenylyl cyclase (AC) represents one of the principal molecules in the β-adrenergic receptor signaling pathway, responsible for the conversion of ATP to the second messenger, cAMP. AC types 5 (ACV) and 6 (ACVI) are the 2 main isoforms in the heart. Although highly homologous in sequence, these 2 proteins play different roles during the development of heart failure. Caveolin-3 is a scaffolding protein, integrating many intracellular signaling molecules in specialized areas called caveolae. In cardiomyocytes, caveolin is located predominantly along invaginations of the cell membrane known as t-tubules. We take advantage of ACV and ACVI knockout mouse models to test the hypothesis that there is distinct compartmentalization of these isoforms in ventricular myocytes. We demonstrate that ACV and ACVI isoforms exhibit distinct subcellular localization. The ACVI isoform is localized in the plasma membrane outside the t-tubular region and is responsible for β1-adrenergic receptor signaling-mediated enhancement of the L-type Ca(2+) current (ICa,L) in ventricular myocytes. In contrast, the ACV isoform is localized mainly in the t-tubular region where its influence on ICa,L is restricted by phosphodiesterase. We further demonstrate that the interaction between caveolin-3 with ACV and phosphodiesterase is responsible for the compartmentalization of ACV signaling. Our results provide new insights into the compartmentalization of the 2 AC isoforms in the regulation of ICa,L in ventricular myocytes. Because caveolae are found in most mammalian cells, the mechanism of β- adrenergic receptor and AC compartmentalization may also be important for β-adrenergic receptor signaling in other cell types.


Development and testing of the rheumatoid arthritis quality of care survey.
The Rheumatoid Arthritis (RA) Quality of Care Survey (RAQCS) was developed to measure care quality according to a previously developed national RA quality improvement framework. The development of the RAQCS occurred over 3 phases. First, the survey was developed by a team of healthcare providers, researchers, and two patient partners based on the existing national quality framework's 21 performance measures (PMs) and strategic objectives. Second, cognitive debriefing interviews were conducted with individuals living with RA to identify survey clarity, appropriateness of survey questions, and response options. Third, the survey was revised and distributed to participants recruited from Rheum4U (rheumatology longitudinal cohort). Results were tabulated and compared with a chart audit of participant medical records. Fifty-three participants completed the RAQCS. High performance (i.e., ≥70% meeting PM) was observed for 13 of 20 PMs. Lower performance was seen for the remaining PMs, which included documentation of body mass index (BMI) and smoking status, discussion of physical activity goals, comorbidity management including risk assessments for cardiovascular health and fragility fractures and disease activity assessment. There was high agreement (≥70%) between the RAQCS and chart review for 9 of 20 PMs. High agreement was observed between the RAQCS and chart review for selected PMs. The RAQCS may also be a valuable tool for quality improvement for measures where data are not usually available through other sources. Further testing of the RAQCS is needed to ascertain its reliability and validity as a patient self-reported tool to measure RA care quality.


Correlation of SPECT and PET cardiac images by a surface matching registration technique.
Complementary information provided by Single Photon and Positron Emission Tomography (SPECT and PET) in nuclear cardiology allows a better comprehension of the physiopathology of the heart. In this work a surface matching registration technique is evaluated in the spatial correlation of SPECT and PET cardiac images. The method is based on matching correspondent anatomical surfaces extracted from transmission (TR) SPECT and PET studies, usually performed for attenuation correction. The accuracy of the technique was evaluated by phantom experiments and on patient data (201Tl SPECT and 13NH3 PET perfusion studies). An application of the method is presented for the correlation of SPECT 201Tl perfusion and PET 18FDG metabolic studies in the evaluation of myocardial viability.


Coexistence of two atypical variants of pityriasis rosea: a case report and review of literature.
We report the case of a 16-year-old Indian girl who presented with multiple small papular lesions and larger erythema multiforme-like plaques in a Christmas tree pattern over her body for 3 weeks. Histopathologic examination was performed, and she was diagnosed with pityriasis rosea presenting with two atypical morphological variants-generalized papular and erythema multiforme-like. A brief review of literature of these two rare types is also presented.


Cellular differentiation determines the expression of the hypoxia-inducible protein NDRG1 in pancreatic cancer.
N-myc downstream-regulated gene-1 (NDRG1) is a recently described hypoxia-inducible protein that is upregulated in various human cancers. Pancreatic ductal adenocarcinoma, called pancreatic cancer, is a highly aggressive cancer that is characterised by its avascular structure, which results in a severe hypoxic environment. In this study, we investigated whether NDRG1 is upregulated in these tumours, thus providing a novel marker for malignant cells in the pancreas. By immunohistochemistry, we observed that NDRG1 was highly expressed in well-differentiated cells of pancreatic cancer, whereas the poorly differentiated tumour cells were negative. In addition, hyperplastic islets and ducts of nonquiescent pancreatic tissue were positive. To further explore its selective expression in tumours, two well-established pancreatic cancer cell lines of unequal differentiation status were exposed to 2% oxygen. NDRG1 mRNA and protein were upregulated by hypoxia in the moderately differentiated Capan-1 cells; however, its levels remained unchanged in the poorly differentiated Panc-1 cell line. Taken together, our data suggest that NDRG1 will not serve as a reliable marker of tumour cells in the pancreas, but may serve as a marker of differentiation. Furthermore, we present the novel finding that cellular differentiation may be an important factor that determines the hypoxia-induced regulation of NDRG1.


Initial experience with 3D CT cinematic rendering of acute pancreatitis and associated complications.
Inflammation of the pancreas can present with a wide range of imaging findings from mild enlargement of the gland and surrounding infiltrative fat stranding through extensive glandular necrosis. Complications of pancreatitis are varied and include infected fluid collections, pseudocysts, and vascular findings such as pseudoaneurysms and thromboses. Cross-sectional imaging with computed tomography (CT) is one of the mainstays of evaluating patients with pancreatitis. New methods that allow novel visualization volumetric CT data may improve diagnostic yield for the detection of findings that provide prognostic information in pancreatitis patients or can drive new avenues of research such as machine learning. Cinematic rendering (CR) is a photorealistic visualization method for volumetric imaging data that are being investigated for a variety of potential applications including the life-like display of complex anatomy and visual characterization of mass lesions. In this review, we describe the CR appearance of different types of pancreatitis and complications of pancreatitis. We also note possible future directions for research into the utility of CR for pancreatitis.


The pharmacokinetic interaction between levofloxacin and sunitinib.
The aim of this study was to evaluate the impact of sunitinib on pharmacokinetics of levofloxacin. The previous study proved that levofloxacin co-administered with sunitib changes the following pharmacokinetic parameters i.e. Cmax and AUC for both sunitinib and SU012662 (sunitinib metabolite). We will also investigate if the limited sample strategy can be applied for levofloxacin. Rabbits were divided into two groups. In both groups there were six animals. In the control group levofloxacin was administered and in investigated group levofloxacin and sunitinib were co-administered. The dose of levofloxacin was 20mg/kg and the dose of sunitinib was 25mg. The concentration in plasma was determined by HPLC-FLD. The pharmacokinetic parameters were evaluated by WinNonLin software. The results were evaluated by the following statistical tests: Shapiro-Wilk, t-Student and Mann-Whitney test. Pharmacokinetics of levofloxacin obeys the two-compartment model. Sunitinib influences the following pharmacokinetic parameters of levofloxacin: half-life, elimination constant and volume of distribution. Statistical analysis proved that there is a correlation between AUC and the following five time-points: 0.25 h, 4h, 6h, 10h and 12h. The study proved that there is a potential pharmacokinetic interaction between sunitinib and levofloxacin. The statistical analysis proved that the limited sample strategy can be applied for levofloxacin.


Use of antidepressants and the risk of type 2 diabetes mellitus: a nested case-control study.
Recent evidence from case reports, observational studies, and randomized trials suggests that long-term use of antidepressants increases the risk of developing diabetes. However, the nature of the relationship between antidepressants and diabetes remains unclear. To determine whether there is an association between antidepressant use and the risk of developing type 2 diabetes mellitus. A nested case-control study using the Texas Medicaid prescription claims database was conducted. Data were extracted for new users of either antidepressant agents (exposed) or benzodiazepines (unexposed) from January 1, 2002 through December 31, 2009. Patients aged 18-64 years without a history of diabetes were included in the cohort. The adjusted odds ratio (OR) and 95% confidence interval (CI) for the risk of diabetes associated with antidepressant exposure was computed using conditional logistic regression, controlling for demographic and clinical covariates. Development of type 2 diabetes mellitus. Among the total sample (N = 44,715), the majority were in the exposed (N = 35,552) vs. the unexposed (N = 9,163) group. A total of 2,943 cases of type 2 diabetes mellitus and 11,748 matched controls (1:4) were identified using risk-set sampling. Cases and controls were matched using age and gender. Antidepressant use was associated with an increase in the risk of (type-2) diabetes when compared to benzodiazepine use [Adjusted Odds Ratio (OR) = 1.512; 95% CI 1.345-1.700]. The association was observed with serotonin-norepinephrine reuptake inhibitors (OR = 1.742; 95% CI 1.472-2.060), tricyclic antidepressants (OR = 1.533; 95% CI 1.295-1.814), selective serotonin reuptake inhibitors (OR = 1.457; 95% CI 1.279-1.659), "Other" antidepressants (OR = 1.318; 95% CI 1.129-1.540). Antidepressant use was associated with an increased risk of (type-2) diabetes. This association was observed for tricyclic antidepressants, serotonin-reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and other antidepressants.


[Similarities between cultured human fetal glia cells and cell types from gliomas; cell culture studies].
Authors carried out a comparative study of cell-cultures of human fetal brain tissue and gliomas of various histological structures. In 180-days long cultures of fetal brain tissue four types of cells could be distinguished: 1. large, polygonal cells, 2. small, round, immature glia-cells, 3. bipolar spongioblasts, 4. gliant astrocytes. These types of cells could not be identified with the cell types of adult human brain culture, but similar types of cells were found in cultures prepared of gliomas of different degree of malignancy. There is some evidence to suggest, that among these types of cells the most important are immature glial cells, since they seem to be multipotent and may play a part in the gliogenesis and in the formation of gliomas as well.


Prevalence and characteristics of the aberrant anterior tibial artery: a single-center magnetic resonance imaging study and scoping review.
Planning surgical procedures of the lower leg benefits from considering the possibility of an aberrant anterior tibial artery (AATA), but previously published data on the frequency of this anatomic variant shows heterogeneity. We assessed the prevalence of AATA in a Latin American cohort using magnetic resonance imaging (MRI) and compared these with other studies reported in the literature. We retrospectively included consecutive patients who had undergone multiplanar knee MRI at a radiology department in Lima, Peru. The MRI protocol included coronal T1 weighted, axial, sagittal and coronal proton density fat-saturated (PDFS) and sagittal T2 weighted images. Two experienced radiologists assessed all images and were blinded to each other's findings. The frequency of the AATA was compared to previous cohorts. A scoping review was undertaken to provide an overview of previously published data on the prevalence of ATAA. We analyzed 280 knee MRI examinations of 253 patients (median age 41 years (IQR 31-52), 53.8% male). The aberrant anterior tibial artery variant was present in 8 of 280 (2.9%) evaluated knees, resulting in a prevalence of 3.2% in our study population. The PDFS sequence in the axial or sagittal orientation was most effective to identify AATA. The frequency of AATA in the reviewed literature using different radiological modalities ranged from 0.4 to 6% (median 1%, IQR (0.5-2.3%). The AATA is a frequent vascular variant that can be detected by MRI in the preparation of invasive interventions of the lower leg.


Sealing of cystic duct with bipolar electrocoagulation.
The cystic duct leakage rate is still high. The aim of this study was to evaluate an alternative technique for securing the cystic duct using the Ligasure vessel sealing system. Eight pigs were included in this pilot study. We performed a cholecystectomy, using the Ligasure system to sealing the cystic duct and artery. The pigs were killed 8 days after operation, and specimens of the cystic duct and common bile duct were removed for pathologic examination. There were no clinical complications other than two superficial wound infections. The sealing of the cystic duct and artery were both macroscopically and microscopically 100% sufficient. The maximum extension of the coagulative process in the sealed ducts was 0.25 mm on each side of the sealed area. The Ligasure system seems promising for securing the cystic duct and artery during cholecystectomy. Future studies should evaluate safety with this technique on a larger scale.


Differential effects of intermittent or continuous exposure to cocaine on the hypothalamic-pituitary-adrenal axis and c-fos expression.
Accumulating evidence indicates that acute administration of cocaine alters neuroendocrine functions. In order to ascertain the long-term effects of cocaine on the male rat's hypothalamic-pituitary-adrenal (HPA) axis, a series of experiments were performed utilizing two different paradigms of cocaine administration for 6 days. In the first paradigm, rats received daily intravenous injections of cocaine (5 mg/kg), while in the second, they were continuously exposed to the drug (5 or 100 mg/kg/day) via osmotic pumps. We measured plasma adrenocorticotropin hormone (ACTH) and corticosterone levels, as well as the brain pattern of the proto-oncogene c-fos expression in response to either mode of drug administration. Repeated, intermittent injections of cocaine caused consistent increases in ACTH and corticosterone secretion over a 30-min sampling period on days 2, 4 and 6. This paradigm of drug administration also induced considerable, short-lasting and reversible c-fos expression in the caudate putamen but not in hypothalamic regions associated with endocrine function. In contrast, we consistently failed to observe any measurable increases in ACTH or corticosterone secretion at any time during continuous exposure to the drug. Administration of cocaine by osmotic pumps also had no effect on c-fos expression in the caudate putamen, indicating that c-fos expression as well as activation of the HPA axis are dependent upon the mode and frequency in which cocaine is administered. We conclude that continuous exposure to cocaine does not appear to activate the HPA axis, while intermittent injections of the drug induce repeated increases in plasma ACTH and corticosterone levels.(ABSTRACT TRUNCATED AT 250 WORDS)


2020 FDA Drug-drug Interaction Guidance: A Comparison Analysis and Action Plan by Pharmaceutical Industrial Scientists.
In January 2020, the US FDA published two final guidelines, one entitled "In vitro Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions Guidance for Industry" and the other entitled "Clinical Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions Guidance for Industry". These were updated from the 2017 draft in vitro and clinical DDI guidance. This study is aimed to provide an analysis of the updates along with a comparison of the DDI guidelines published by the European Medicines Agency (EMA) and Japanese Pharmaceuticals and Medical Devices Agency (PMDA) along with the current literature. The updates were provided in the final FDA DDI guidelines and explained the rationale of those changes based on the understanding from research and literature. Furthermore, a comparison among the FDA, EMA, and PMDA DDI guidelines are presented in Tables 1, 2 and 3. The new 2020 clinical DDI guidance from the FDA now has even higher harmonization with the guidance (or guidelines) from the EMA and PMDA. A comparison of DDI guidance from the FDA 2017, 2020, EMA, and PMDA on CYP and transporter based DDI, mathematical models, PBPK, and clinical evaluation of DDI is presented in this review.


Subglottic cysts in preterm infants: superficially located cysts versus deeply buried cysts in the mucosa.
To analyze the reason for the diversity of the clinical course of subglottic cysts and discuss their pre- and coexistence with subglottic stenosis. The medical records of patients who were treated for subglottic cysts between 2003 and 2020 were retrospectively reviewed and direct laryngoscopy videos were analyzed to assess the healing patterns of their disease. Of the 15 patients, 10 had a history of intubation in the neonatal period. In 11 patients, the cysts were transparent and well defined, and no recurrence of subglottic cysts occurred after the initial surgery. In four patients, the cysts were located deep in the mucosa and did not have the typical appearance of a cyst, but rather of a stenotic segment; all of them had a history of intubation and three of them required laryngotracheal reconstruction. Transparent, thin-walled superficial subglottic cysts with healthy surrounding mucosa can easily be treated with endoscopic marsupialization; however, the treatment of deep subglottic cysts can be challenging. The coexistence of subglottic cysts and subglottic stenosis is not rare. We point out the need for considering the possibility of a missed deep submucosal cyst in a seemingly refractory case of pediatric subglottic stenosis with atypical endoscopic findings and with a background history of prior intubation.


The impact of cemented layers and hardpans on oxygen diffusivity in mining waste heaps: a field study of the Halsbrücke lead-zinc mine tailings (Germany).
This article reports fibre-optic oxygen measurements on a reactive mine waste heap located in the polymetallic sulphide mine district of Freiberg in south-eastern Germany. The heaped material consists of sulphide-bearing tailings from a processing plant of a lead-zinc mine. Mine waste material was deposited in the water phase after separation of mining ores in a flotation process. The tailing impoundment is partly covered with coarse sand and topsoil. Oxygen profiles were monitored during one year at eleven locations showing different physical and mineralogical compositions. At each location a borehole was drilled where the optic sensors were installed at 2-5 different depths. After installation the oxygen profiles were monitored seven times during one year from 2006-2007 and three to five oxygen profiles at each location were obtained. Oxygen measurements were accompanied by physical, chemical and mineralogical data of the tailing material. Additionally, a detailed mineralogical profile was analysed at a location representative for the central part of the heap, where the cemented layers show lateral continuity. Results showed that cemented layers have a significant influence on natural attenuation of the toxic As and Pb species owing to their capacity of water retention. The measured oxygen profiles are controlled by the zone of active pyrite weathering as well as by the higher water content in the cemented layers which reduces gaseous atmospheric oxygen supply. In contrast, gypsum bearing hardpans detected at three other locations have no detectable influence on oxygen profiles. Furthermore, the grain size distribution was proved to have a major effect on oxygen diffusivity due to its control on the water saturation. Temporal changes of the oxygen profiles were only observed at locations with coarse sediment material indicating also an important advective part of gas flux.


Inhibition of ribonuclease contamination in preparations of T4 RNA ligase, polynucleotide kinase, and bacterial alkaline phosphatase with bentonite.
Commercial preparations of the enzymes used in the analysis of RNA primary structure (bacterial alkaline phosphatase, polynucleotide kinase, and RNA ligase) are virtually always more or less contaminated with RNases. This leads to degradation of initial RNAs in the course of labeling and formation of a set of spurious labeled fragments. We have shown that bentonite present in the incubation medium in a concentration of 0.04% selectively inhibits the contaminating RNases, not affecting the activities of bacterial alkaline phosphatase, polynucleotide kinase, and RNA ligase.


Recommendations from paediatric dentistry associations of the Americas on breastfeeding and sugar consumption and oral hygiene in infants for the prevention of dental caries: A bibliometric review.
The Internet provides a plethora of information on health issues related to children's oral health. Identify online recommendations of paediatric dentistry associations of the Americas (PDAAs) regarding breastfeeding practices, weaning, sugar introduction and initiating oral hygiene. Websites of PDAAs were accessed to record recommendations/questions (Q) relevant to early childhood that specifically covered issues about exclusive breastfeeding-Q1, indications of bottle feeding-Q2, when and how to start weaning-Q3 and Q4, respectively, association of breast milk and dental caries-Q5, when to start oral hygiene and how to introduce it-Q6 and Q7, respectively, and guidance on the introduction of sugar-Q8. Similarity/dissimilarity frequencies between the associations (Euclidean distances) were calculated. From 35 countries on the two American continents, 21 associations were affiliated with the International Association of Paediatric Dentistry and/or the Latin American Pediatric Dentistry Association, whereas eight did not have websites. Higher (P < .05) dissimilarities for Q6 (68.2%), Q7 (72.7%), and Q8 (62.1%) were observed. Results were similar for Q1 and Q5 (P > .05). No association mentioned Q2, Q3 or Q4 responses, whereas Q7 was the most frequently discussed issue. Not all of the investigated issues are mentioned on websites of PDAAs, potentially stymieing efforts by both the layperson and health professional to gather information.


Development of a rat model of sexual performance anxiety: effect of behavioural and pharmacological hyperadrenergic stimulation on APO-induced erections.
As part of the multifactorial nature of erectile dysfunction, anxiety associated with sexual performance (SPA) remains a major contributing factor to its progression. In fact, the heightened sympathetic activity associated with sexual performance anxiety may be a key early component of this disruption of normal erectile responses. We are not aware that any animal models have been developed to assess this phenomenon. Using apomorphine (APO, 80 microg/kg s.c.)-induced erections in rats we characterised the effects of behavioural or pharmacological hyperadrenergic stimulation (that is, anxiety) on erections and hemodynamics. We developed an experimental SPA paradigm by exposing male rats to the stress of being observed by a larger, older male rat placed in close proximity to test rats during APO testing. In a separate group, adrenergic stress was simulated using a sympathomimetic, methoxamine (MXA) given prior to APO testing. In a third group, the changes in circulatory parameters (mean arterial pressure, heart rate) were determined following instrumentation with radiotelemetric transducers for each scenario. APO-induced erections were significantly lower in both the behavioural (1.25+/-0.8) and pharmacological (0.33+/-0.5) stressor paradigms compared to controls (2.81+/-0.9). Further, erections in MXA-treated rats were significantly lower than in the observed scenario. Despite the differences in erections hemodynamic assessments showed no differences in MAP or HR changes between the different experimental conditions. Thus, both the behavioural and pharmacological paradigms of SPA decreased erections, but did not affect the circulation. This suggests that the level of hyperadrenergic input required to induce erectile dysfunction can be subtle, and target only erectogenic pathways.


Mechanisms of copper tolerance by Armeria maritima in Dolfrwyong Bog, north Wales--initial studies.
Preliminary field studies were carried out at Dolfrwynog Bog in July 2000. Replicate samples of water, Armeria maritima plants and the soils adhering to its roots were collected and analysed for copper. Concentrations of up to 6486 mg kg-1 of copper in the soils were recorded. Accumulation of copper by the plant as expressed by concentration factors (CF) show that it is acting mainly as a copper excluder. Of the copper that is taken up, most of it is retained within the roots with very little being transported to the shoots of the plant. Moreover, a further possible mechanism of tolerance is exhibited by the excretion of copper through its decaying leaves. Towards the use of in vitro cultures to study the copper tolerance mechanisms in A. maritima a micropropagation protocol has been developed. The ex vitro plants have been rooted and established in compost.


The impact of online synchronous versus asynchronous classes on nursing students' knowledge and ability to make legal and ethical decisions.
Educating nursing students on laws and ethics is essential since the nursing profession requires providing services that have many legal and ethical implications. The goal of this study was to measure the effectiveness of two teaching strategies (providing online synchronous classes versus asynchronous classes) on nursing students' knowledge of legal and ethical issues and their ability to make legal and ethical decisions. This study used a randomized control trial (RCT) design. A total of 127 students from two governmental universities in Jordan participated in and completed the current study. The students were randomly assigned either to the experimental group which received the synchronous classes (n = 60, 47.2%) or the control group which received asynchronous classes (n = 67, 52.8%). The two study groups were given a pre-test to measure their knowledge and ability to make legal and ethical decisions. After the pre-test, an online synchronous educational class about legal and ethical issues in nursing was carried out by the same educator twice a week and lasted for approximately 1.5 h each. At the same time, the students in the control group were provided with the same material but as asynchronous classes and were encouraged to watch the classes during the lecture. After completing the educational classes, both groups were asked to complete the post-test questionnaire. The results indicated significant outcomes in terms of increasing the knowledge and the ability to make an ethical decision of students who attended the educational classes. However, the synchronous and asynchronous classes did not result in significant differences in students' learning outcomes. Educating nursing students about legal and ethical issues in the nursing profession is important to prepare them to make legal and ethical decisions. In addition, using different teaching strategies is quite important in educating nursing students.


Molecular dynamics study of solvation effect on diffusivity changes of DNA fragments.
DNA sequence analyzing and base pair separation techniques have attracted much attention, such as denaturing gradient gel electrophoresis, temperature gradient gel electrophoresis, and capillary electrophoresis. However, details of sequence separation mechanisms in electrophoresis are not clarified enough. Understanding and controlling flow characteristics of DNA are important not only for fundamental research but also for further developments of bio-nano technologies. In the present study, we theoretically discuss the relationship between diffusivity and hydrated structures of DNA fragments in water solvent using molecular dynamics methods. In particular, influence of base pair substitutions on the diffusivity is investigated, focusing on an adenine-thymine (AT) rich B-DNA decamer 5'-dCGTATATATA-3'. Consequently, it is found that water molecules that concentrate on dissociated base pairs form hydrated structures and change the diffusivity of DNA decamers. The diffusion coefficients are affected by the substitution of GC for AT because of the different manner of interactions between the base molecules and water solvent. This result predicts a possibility of base pair separation according to differences in the diffusivity.


Construction and validation of a scale to measure consumers knowledge of food processing and acceptance of processed food.
Negative impressions related to food processing can compromise consumer acceptance. Thus, the aim of this study was to validate a tool to assess consumer knowledge and acceptance of food processing. Semantic evaluation was performed with a lay public (n=13). Experts with experience in the area (n=9) participated in the content validation and semantic evaluation, using the Delphi Technique. Overall, there was strong agreement between the judges (Gwet's AC2 = 0.96 [clarity] and 0.81 [relevance]), with Fleiss Kappa equivalent to 0.78, indicating almost perfect agreement. After these phases, the instrument that totaled 37 items approved (W > 0.8) was applied for validation among Brazilian consumers (n = 200). An exploratory factor analysis offered a six-factor solution. The Kaiser-Meyer-Olkin (KMO) index found was 0.90. The Bartlett Sphericity Test was statistically significant (p<0.001). The final instrument contained 34 items. The calculated Cronbach's Alpha was 0.92, indicating an excellent reliability. The developed Consumers Knowledge of Food Processing and Acceptance of Processed Food (CKAFPAPF) was consistently validated and has proven to be a tool that can help identify information asymmetries, allowing the development of strategies that help consumers to have the correct information to make their food choices more consciously.


Reverse total shoulder arthroplasty for failed shoulder arthroplasty.
Shoulder arthroplasty provides excellent outcomes for most patients; however, a subset of these patients with a failed arthroplasty will require revision. Recently, the reverse total shoulder arthroplasty (rTSA) has been used in these difficult clinical situations. Therefore, we sought to examine our initial experience using rTSA as a treatment for failed shoulder arthroplasty. During a 5-year period, 31 patients (mean age, 68.7 years) underwent rTSA for treatment of a failed shoulder arthroplasty and their presurgical and operative data were analyzed. Of the 31 patients, 28 were available for an average follow-up of 40.7 months. Their outcomes were assessed with American Shoulder and Elbow Surgeons (ASES), University of California-Los Angeles (UCLA), and Simple Shoulder Test (SST) scores, and the visual analog scale (VAS) for pain. Compared with preoperative status, there were statistically significant improvements in all outcome measurements, including the ASES (24.0 to 66.2), UCLA (7.4 to 23.5), SST (1.5 to 7.6), and VAS (7.0 to 2.6). Active forward elevation improved from 44° preoperatively to 108° postoperatively (P < .001). Results were rated as good or excellent by 19 patients (67.9%), satisfactory by 4 (14.3%), and unsatisfactory by 5 (17.8%). Among the types of failed arthroplasty, patients with failed TSA noted the greatest improvement in their outcome, but this improvement was not statistically significant. The data suggest that patients can expect improved functional outcome and decreased pain after revision of previous arthroplasty to rTSA and that this procedure can provide a reliable salvage option for a challenging clinical problem.


An immune-protein score combining TRAIL, IP-10 and CRP for predicting severe COVID-19 disease.
COVID-19 patients are oftentimes over- or under-treated due to a deficit in predictive management tools. This study reports derivation of an algorithm that integrates the host levels of TRAIL, IP-10, and CRP into a single numeric score that is an early indicator of severe outcome for COVID-19 patients and can identify patients at-risk to deteriorate. 394 COVID-19 patients were eligible; 29% meeting a severe outcome (intensive care unit admission/non-invasive or invasive ventilation/death). The score's area under the receiver operating characteristic curve (AUC) was 0.86, superior to IL-6 (AUC 0.77; p = 0.033) and CRP (AUC 0.78; p < 0.001). Likelihood of severe outcome increased significantly (p < 0.001) with higher scores. The score differentiated severe patients who further deteriorated from those who improved (p = 0.004) and projected 14-day survival probabilities (p < 0.001). The score accurately predicted COVID-19 patients at-risk for severe outcome, and therefore has potential to facilitate timely care escalation and de-escalation and appropriate resource allocation.


In Vivo Follicular and Uterine Arterial Indices as an Indicator of Successful Hormonal Stimulation for Inactive Ovaries in Repeat-Breeder Crossbred Dairy Cows Using a Short-Term Progesterone-Based Programme.
An investigation of vascularity of ovarian and uterine arteries after hormonal treatment for inactive ovaries using the short-term progesterone-based programme had not yet been explored in repeat-breeder crossbred dairy cows. To investigate the in vivo follicular and uterine arterial indices as an indicator of successful hormonal stimulation for inactive ovaries in repeat-breeder crossbred dairy cattle, 59 cows with inactive ovaries were induced with a 5-day progesterone-based protocol. At the completion of hormonal synchronisation, cows were divided into two groups according to the size of the largest follicle (LF) on their ovary: small (≤10.0 mm) and large (>10.0 mm) LFs. Vascularities of LF and uterine artery (UtA) were evaluated using a colour Doppler tool. Cows that presented with large LF had greater follicular and UtA vascular indices (p < 0.001) and pregnancy rate (p < 0.01) than cows bearing small LF on their ovary. There was a positive correlation (p < 0.001) between follicular size and LF and UtA vascular indices. Our findings highlighted that in vivo LF and UtA vascular indices at the completion of hormonal stimulation might be a promising indicator for predicting success in ovarian response to hormonal stimulation for inactive ovaries of infertile crossbred dairy cows.


Simultaneous UPLC-MS/MS assay for the detection of the traditional antipsychotics haloperidol, fluphenazine, perphenazine, and thiothixene in serum and plasma.
Most antipsychotic drugs that are commonly prescribed in the USA are monitored by liquid and gas chromatographic methods. Method performance has been improved using ultra high pressure liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). A rapid and simple procedure for monitoring haloperidol, thiothixene, fluphenazine, and perphenazine is described here. Antipsychotic drug concentrations in serum and plasma were determined by LCMS/MS (Waters Acquity UPLC TQD). The instrument is operated with an ESI interface, in multiple reaction monitoring (MRM), and positive ion mode. The resolution of both quadrupoles was maintained at unit mass with a peak width at half height of 0.7amu. Data analysis was performed using the Waters Quanlynx software. Serum or plasma samples were thawed at room temperature and a 100μL aliquot was placed in a tube. Then 300μL of precipitating reagent (acetonitrile-methanol [50:50, volume: volume]) containing the internal standard (0.12ng/μL Imipramine-D3) was added to each tube. The samples were vortexed and centrifuged. The supernatant was transferred to an autosampler vial and 8μL was injected into the UPLC-MS/MS. Utilizing a Waters Acquity UPLC HSS T3 1.8μm, 2.1×50mm column at 25ºC, the analytes were separated using a timed, linear gradient of acetonitrile and water, each having 0.1% formic acid added. The column is eluted into the LC-MS/MS to detect imipramine D3 at transition 284.25>89.10, haloperidol at 376.18>165.06, thiothixene at 444.27>139.24, fluphenazine at 438.27>171.11, and perphenazine at 404.19>143.07. Secondary transitions for each analyte are also monitored for imipramine D3 at 284.25>193.10, haloperidol at 376.18>122.97, thiothixene at 444.27>97.93, fluphenazine at 438.27>143.08, and perphenazine at 404.19>171.11. The run-time is 1.8min per injection with baseline resolved chromatographic separation. The analytical measurement range was 0.2 to 12.0ng/mL for fluphenazine and perphenazine, and was 1 to 60.0ng/mL for haloperidol and thiothixene. Intra-assay and inter-assay imprecisions (CV) were less than 15% at two concentrations for each analyte. By utilizing a LC-MS/MS method we combined two previously established analytical assays into one, yielding a 75% time-savings on set-up, and a significantly shortened analytical run-time. These changes reduced the turn-around time for analysis and eliminated interference issues resulting in fewer injections and increased column lifetime.


The clinical characteristics and prognosis of lesions with in-stent eccentric tissue proliferation and strong signal attenuation detected by optical coherence tomography.
There are still some patients who require repeat revascularization despite of drug-eluting stent (DES) implantation. The present study aimed to investigate the relationship between optical coherence tomography (OCT) findings and recurring target lesion revascularization (TLR) after percutaneous coronary intervention (PCI) for in-stent restenosis (ISR). We reviewed 50 patients (54 coronary lesions) who underwent PCI for ISR, which included 25 DES-ISR lesions. The PCI strategy depended on the interventionalist's discretion, and DES implantation was performed for 38 (70 %) lesions. Tissue characteristics were assessed qualitatively and quantitatively using the frame showing maximal lumen narrowing (minimal lumen area). In qualitative analysis, OCT detected coexistence of eccentric tissue proliferation and strong signal attenuation (ESA). ESA was observed in six lesions (11 %) in five patients (10 %). Hemodialysis (80 vs. 20 %, p = 0.013) and DES-ISR (100 vs. 40 %, p = 0.0069) were significantly more frequent in ESA patients/lesions than in others. One-year follow-up revealed that re-TLR was more frequently performed for ESA lesions (83 vs. 8 %, p = 0.0002). The findings reveal that ESA detected in OCT images of ISR is related to TLR after PCI for DES-ISR especially in patients undergoing maintenance hemodialysis.


Physical Exercise and Liver Autophagy: Potential Roles of IL-6 and Irisin.
Autophagic dysregulation contributes to liver diseases. Although some investigations have examined the effects of endurance and resistance exercise on autophagy activation, potential myokines responsible for skeletal muscle-liver crosstalk are still unknown. Based on experimental studies and bioinformatics, we hypothesized that interleukin 6 (IL-6) and irisin might be key players in the contraction-induced release of molecules that regulate liver autophagic responses.


Microbial genome (Illumina MiSeq) sequencing of drinking water treatment residuals to evaluate compatibility with environmental applications.
The clarification of drinking water leads to the production of large quantities of water treatment residuals (WTRs). DNA was extracted from six WTR samples collected from water treatment plants within the UK to compare their bacterial communities and examine whether factors such as coagulant usage (aluminium versus iron salt), the type of water source (reservoir or river), or leachable chemical composition influence these communities. Bacterial 16S variable region 4 (V4) was amplified and sequenced using Illumina MiSeq sequencing. The most abundant phyla in WTR samples were Proteobacteria, Actinobacteria, Bacteroidetes, Acidobacteria, and Firmicutes, collectively representing 92.77-97.8% of the total bacterial sequences. Statistical analysis of microbial profiles indicated that water source played a significant role in microbial community structure, diversity, and richness, however coagulant type did not. PERMANOVA analysis showed that no single chemical variable (pH, organic matter, or extractable element concentration) influenced microbial composition significantly; however, canonical correspondence analysis of WTR microbiomes yielded a model using all these variables that could be used to explain variations in microbial community structures of WTRs (p < 0.05). No common, potentially toxic cyanobacteria, or related pathogens of concern were found. Analysis with PICRUSt showed that WTRs all had similar predicted microbial functional profiles. Overall, the results indicate that WTRs analysed in this study are unlikely to pose any threat to soil microbial community structure when applied to land as a soil conditioner or enhancer and may help to enhance the soil microbial community.


Identification of endogenous surrogate ligands for human P2Y12 receptors by in silico and in vitro methods.
Endogenous ligands acting on a human P2Y12 receptor, one of the G-protein coupled receptors, were searched by in silico screening against our own database, which contains more than 500 animal metabolites. The in silico screening using the docking software AutoDock resulted in selection of cysteinylleukotrienes (CysLTs) and 5-phosphoribosyl 1-pyrophosphate (PRPP), with high free energy changes, in addition to the known P2Y12 ligands such as 2MeSADP and ADP. These candidates were subjected to an in vitro Ca2+ assay using the CHO cells stably expressing P2Y12-G16alpha fusion proteins. We found that CysLTE4 and PRPP acted on the P2Y12 receptor as agonists with the EC50 values of 1.3 and 7.8 nM, respectively. Furthermore, we analyzed the phylogenetic relationship of the P2Y, P2Y-like, and CysLT receptors based on sequence alignment followed by evolutionary analyses. The analyses showed that the P2Y12, P2Y13, P2Y14, GPR87, CysLT-1, and CysLT-2 receptors formed a P2Y-related receptor subfamily with common sequence motifs in the transmembrane regions.


Is there any correlation between the recovery rate of JOA and the increasing of cervical spinal cord area after single-door cervical laminoplasty?
The aim of the study is to investigate the clinical and radiologic factors represented by the increasing of spinal cord area associated with the prognosis of the patients at long-term follow-up by multivariate analysis after single-door cervical laminoplasty (SDCL). A total of 115 patients who underwent cervical laminoplasty with miniplate fixation were included from November 2008 to June 2018. The average postoperative follow-up period was 17.3 months (range, 12-105 months). The prognosis of the patients following cervical laminoplasty was evaluated by the recovery rate of Japanese Orthopedic Association (JOA) at the final follow-up. The recovery rate of JOA ≤ 50% were classified as poor prognosis group (PP group) whose prognosis is relatively poor, and those> 50% were classified as good prognosis group (GP group) whose have a better prognosis. The clinical factors including gender, age, duration of symptoms, diagnosis type, blood loss, operative time, pre- and post-JOA score, etc. were recorded. The radiologic factors including sagittal canal diameter (SCD), the cervical curvature index (CCI), the range of motion (ROM), the spinal canal area and the increasing of cervical spinal cord area, etc. were collected before and after operation and measured by X-ray plain and computed tomography (CT) scan images. The univariate analysis and multivariate logistic regression analysis were performed. There were 62 patients in PP group and 53 patients in GP group. The multivariate analysis showed that the preoperative (OR=6.875, P = 0.001) and postoperative JOA scores (OR=24.000, P = 0.001), preoperative spinal canal area (OR=2.464, P = 0.023) and the increasing of cervical spinal cord area (OR=5.438, P = 0.001) maybe related factors to the recovery rate of JOA at the final follow-up. The preoperative spinal canal area, the increasing of cervical spinal cord area, preoperative and postoperative JOA scores play important roles in long-term prognosis after SDCL.


Anti-rhinoviral activity of recombinant and hybrid species of interferon alpha.
To define further differences in antiviral activity as well as to identify candidate interferons for study in the prevention of rhinovirus colds, the antiviral activities of nine species of recombinant interferon alpha (IFN-alpha A, IFN-alpha B, IFN-alpha C, IFN-alpha D, IFN-alpha J, [Ser-116]IFN-alpha J1, IFN-alpha K, IFN-alpha J/C(Fnu4HI), and IFN-alpha A/D(BglII)) were evaluated against rhinovirus types 39 (RV 39) and 1A (RV 1A). WI-38 cells were exposed to various concentrations of each interferon and were then infected with RV 39, RV 1A, or VSV. Efficacy was determined by protection from cytopathic effect using a tetrazolium dye assay. The 50% inhibitory concentrations ranged from 4 +/- 3 pg/ml for IFN-alpha C to > 3000 pg/ml for IFN-alpha D against RV 39, and from 6 +/- 4 pg/ml for IFN-alpha J/C(Fnu4HI) to > 3000 pg/ml for IFN-alpha D against RV 1A. IFN-alpha J/C(Fnu4HI), [Ser-116]IFN-alpha J1, and IFN-alpha C were the most active of the interferons, and were all more active than IFN-alpha A, against RV 39, RV 1A, and VSV. These interferons warrant further study against rhinoviruses and other viruses.


Serum adenosine deaminase activity as a predictor of disease severity in ulcerative colitis.
Ulcerative colitis (UC) is a chronic inflammatory disease characterized by recurrent inflammation and ulcerations of colonic mucosa and an inappropriate and delayed healing. Adenosine deaminase (ADA) is a cytoplasmic enzyme involved in the catabolism of purine bases, capable of catalyzing the deamination of adenosine, forming inosine in the result process. Although ADA has been shown to increase in several inflammatory conditions, there are no literature data indicating an alteration in UC. This study evaluated the activity of total ADA in serum of 43 patients with UC and 18 healthy controls. Patients' age, disease duration, drug intake, and other medical history were all noted for each subject. Complete blood count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were determined for both patients and controls. Correlation analysis was also performed between ADA and other inflammation markers of UC. Serum mean ADA levels were 11.12 ± 2.03 and 7.99 ± 2.04 U/l for patients with UC in active state and in remission and 8.55 ± 2.26 U/l in the healthy control group. Mean serum ADA levels were significantly elevated in active UC patients compared with patients with UC in remission and control groups. Overall accuracy of ADA in determination of active UC was 83.7 with sensitivity 83.3%, specificity 84.2%. Serum ADA levels were found to be elevated in UC patients in active state suggesting a partial role of activated T-cell response in the disease pathophysiology. Further randomized controlled studies are warranted to demonstrate the role of ADA in UC patients, with a special interest in specifically targeted therapies against ADA for achieving disease remission.


Expanding the consumer base for behavior-analytic services: meeting the needs of consumers in the 21st century.
A growing workforce of behavior analysts provides services to individuals with autism and intellectual disabilities as legislative initiatives have spurred a growth of funding options to support these services. Though many opportunities currently exist for serving individuals with autism, the growing demand for these services may wane or, at some point, the growth in service providers will meet that demand. Other consumer groups could benefit from behavior analytic services, but typically have limited access to qualified providers. Individuals with dementia and traumatic brain injury are used as example consumer groups to illustrate the necessary tasks for a behavior analyst to expand their scope of practice to a new population. This paper provides strategies for developing competence and creating employment opportunities with new consumer groups.


Cochlear damage and increased threshold in alpha-difluoromethylornithine (DFMO) treated guinea pigs.
Alpha-difluoromethylornithine (DFMO) inhibits polyamine synthesis and is used as an antineoplastic and antiparasitic drug. In early human trials DFMO unexpectedly caused a sensorineural hearing loss. In the current study DFMO was administered to guinea pigs to investigate its effects on organ of Corti histology and on auditory thresholds. Histologic examination revealed that DFMO caused greatest damage in the hook and first turn. Damage in the second and third turns was minimal. Animals treated for 12 weeks with DFMO differed significantly (P less than 0.05) from controls in the hook and first turn in that: 1) DFMO caused a loss of hair cells in all rows. Loss of inner hair cells was greater than that of outer hair cells. 2) The remaining outer hair cells were shorter and contained a greater number of Hensen bodies. 3) The Deiters' cell bodies were longer and this increased length was associated with the decreased length of the corresponding outer hair cells. Brainstem audiometry showed that DFMO produced a hearing loss and the magnitude of this loss increased over twelve weeks of DFMO administration.


Sweet corn cob as a functional ingredient in bakery products.
Gluten free (GF) products are often inferior in quality attributes, nutritional content and consumer acceptability. The use of GF by-products is a novel strategy to improve the structure and nutritional profile of these products. Sweet corn cob (SCC) is a by-product of sweet corn processing containing a considerable amount of fibre and ferulic acid. The effect of baking on ferulic acid content, colour, texture and physical characteristics on muffins incorporated with SCC flour (SCCF) as a value-added food ingredient was investigated using a GF model system. The freeze-dried SCCF, containing ferulic acid (6.02 mg g-1) was used to replace the rice flour at varying levels of 10, 20, and 30%. In general, SCCF increased dietary fibre and free ferulic acid content of muffins. Inclusion of 20% SCCF showed an increase in terms of the height of the muffin and number of air cells in the crumb, along with a decrease in the hardness of muffins. Muffins with SCCF showed higher mean overall liking scores than rice flour muffin.


Four decades of water quality change in the upper San Francisco Estuary.
Quantitative descriptions of chemical, physical, and biological characteristics of estuaries are critical for developing an ecological understanding of drivers of change. Historical trends and relationships between key species of dissolved inorganic nitrogen (ammonium, nitrate/nitrite, total) from the Delta region of the San Francisco Estuary were modeled with an estuarine adaptation of the Weighted Regressions on Time, Discharge, and Season (WRTDS). Analysis of flow-normalized data revealed trends that were different from those in the observed time-series. Flow-normalized data exhibited changes in magnitude and even reversal of trends relative to the observed data. Modelled trends demonstrated that nutrient concentrations were on average higher in the last twenty years relative to the earlier periods of observation, although concentrations have been slowly declining since the mid-1990s and early 2000s. We further describe mechanisms of change with two case studies that evaluated 1) downstream changes in nitrogen following upgrades at a wastewater treatment plant, and 2) interactions between biological invaders, chlorophyll, macro-nutrients (nitrogen and silica), and flow in Suisun Bay. WRTDS results for ammonium trends showed a distinct signal as a result of upstream wastewater treatment plant upgrades, with specific reductions observed in the winter months during low-flow conditions. Results for Suisun Bay showed that chlorophyll a production in early years was directly stimulated by flow, whereas the relationship with flow in later years was indirect and influenced by grazing pressure. Although these trends and potential causes of change have been described in the literature, results from WRTDS provided an approach to test alternative hypotheses of spatiotemporal drivers of nutrient dynamics in the Delta.


Clinical Significance of Down-Regulated CD70 and CD27 Expression in Poor Prognosis of Esophageal Squamous Cell Carcinoma.
CD27 is a co-stimulatory immune checkpoint molecule in the tumor necrosis factor receptor superfamily. CD27 regulates the generation and maintenance of T cell immunity by binding to CD70 and regulating B-cell activation and immunoglobulin synthesis. CD27 and CD70 expression were assessed in esophageal squamous cell carcinoma (ESCC) compared to normal tissue samples in the GSE53625 dataset of 179 paired cases and in 153 Chinese cases using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry. The correlation was also investigated between CD27 and CD70 expression and immune-related pathways, including CD8+ T cell recruitment, function, and other inhibitory immune checkpoints. Levels of both CD27 and CD70 expression were down-regulated in ESCC compared to the paired normal tissues. CD27 and CD70 expression was mainly present in lymphocytes surrounding and infiltrating the tumor lesions but rarely expressed in tumor cells. Lost expression of CD27 and CD70 was associated with clinicopathological features, including depth of tumor invasion and better patient survival. Furthermore, CD27 expression was significantly associated with levels of CD8A, GZMB, IFNG, the CD8+ T cell recruitment-associated chemokines (CXCL9, CXCL10, and CXCL11), and CD8 receptors (CCR5, CXCR6, and CXCR3), while CD70 expression was inversely associated with levels of immunosuppressive checkpoints (PD-L1, PD-L2, and HHLA2). Detection of CD70/CD27 expression could be further verified as a biomarker for ESCC early detection and prognosis prediction.


Free intraperitoneal rupture of a pancreatic pseudocyst: a presentation of acute abdominal trauma.
A rare case of traumatic rupture of a pancreatic pseudocyst is presented. Its unique aspect is definitive pseudocyst drainage via a Roux-en-Y cystjejunostomy at initial laparotomy.


Fine structure of myotendinous junction between the anterior belly of the digastric muscle and intermediate tendon in adults rats.
This study analyzed the ultrastructural characteristics of the myotendinous junction (MTJ) between anterior belly of digastrics muscle and the intermediate tendon in adult rats. Six male Wistar rats were used and were anesthetized with an overdose of urethane and sacrificed by intracardiac perfusion with modified Karnovsky solution, postfixed in 1% osmium tetroxide, dehydrated in increasing series of alcohols and embedded in Spurr resin for transmission electron microscopic analysis. Ultrastructural analysis showed conical shape of the fiber extremity in MTJ region, highlighting the presence of numerous mitochondria arranged in groups in the subsarcolemmal and intermyofibrillary regions. Atypical MTJ characteristics were seen interspersed with bundles of collagen fibers. Classic characteristics such as finger-like processes by means of sarcoplasmic projections were observed among interdigitations. Terminals and periphericals bundles of myofibrils showed close relationship with the adjacent muscle fiber's endomysium through lateral junctions. In the distal portion, it was observed that the communication region of microtendons forming the intermediate tendon of digastric muscle, and it can highlight the columns disposition of tenocytes. In conclusion, the MTJ ultrastructure between the anterior belly of digastric muscle and intermediate tendon of adult rats showed classical morphologic descriptions and presented an atypical region revealed by the subspecialization between the myofibrils bundles and collagen fibers in the MTJ region.


The impact of perception on institutional delivery service utilization in Northwest Ethiopia: the health belief model.
Ethiopia has been striving to promote institutional delivery through community wide programs. However, home is still the preferred place of delivery for most women encouraged by the community`s perception that delivery is a normal process and home is the ideal environment. The proportion of women using institutional delivery service is below the expected level. Therefore, we examined the impact of perception on institutional delivery service use by using the health belief model. A community-based cross-sectional study was conducted among 1,394 women who gave birth during the past 1 year from September to December 2019. A multistage sampling technique was used to select the study participants. Data were collected by using health belief model constructs, and structured and pretested questionnaire. Binary logistic regression was performed to identify factors associated with the outcome variable at 95% confidence level. Institutional delivery service was used by 58.17% (95% CI: 55.57- 60.77%) of women. The study showed that high perceived susceptibility (AOR = 1.87; 95% CI 1.19-2.92), high cues to action (AOR = 1.57; 95% CI: 1.04-2.36), husbands with primary school education (AOR = 1.43; 95% CI 1.06-1.94), multiparty(5 or more) (AOR = 2.96; 95% CI 1.85-4.72), discussion on institutional delivery at home (AOR = 4.25; 95% CI 2.85-6.35), no close follow-up by health workers (AOR = 0.59;95% CI 0.39-0.88), regular antenatal care follow-up (AOR = 1.77;95% CI 1.23,2.58), health professionals lack of respect to clients (AOR = 2.32; 95% CI 1.45-3.79), and lack of health workers (AOR = 0.43;95% CI 0.29-0.61) were significantly associated with the utilization health behavior of institutional delivery service. The prevalence of institutional delivery in the study area was low. The current study revealed that among the health belief model construct perceived susceptibility and cues to action were significantly associated with the utilization behavior of institutional delivery service. On top of that strong follow-up of the community and home based discussion was a significant factor for the utilization behavior of institutional delivery service.


Adjuvant therapy in primary breast cancer.
This article considers the role of adjuvant therapy in primary breast cancer, utilizing data from randomized prospective clinical trials as illustrative examples. The ongoing efforts targeted toward addressing some of the unresolved issues are underscored.


Recurrent Differentiated Thyroid Cancer: The Current Treatment Options.
Differentiated thyroid carcinomas (DTC) have an excellent prognosis, but this is sometimes overshadowed by tumor recurrences following initial treatment (approximately 15% of cases during follow-up), due to unrecognized disease extent at initial diagnosis or a more aggressive tumor biology, which are the usual risk factors. The possible sites of recurrence are local, regional, or distant. Local and regional recurrences can usually be successfully managed with surgery and radioiodine therapy, as are some isolated distant recurrences, such as bone metastases. If these treatments are not possible, other therapeutic options such as external beam radiation therapy or systemic treatments should be considered. Major advances in systemic treatments have led to improved progression-free survival in patients previously considered for palliative treatments; among these treatments, the most promising results have been achieved with tyrosine kinase inhibitors (TKI). This review attempts to give a comprehensive overview of the current treatment options suited for recurrences and the new treatments that are available in cases where salvage surgery is not possible or in cases resistant to radioiodine.


Tissue donation: the benefit of a positive approach.
Unlike organ donation, which enjoys a worthy public profile, tissue transplantation remains relatively unheard of. Here, the authors argue that nurses should promote the value of tissue donation, not only to patients but to colleagues as well.


Participation of hepatocytes in the production of basement membrane components in human and rat liver during the perinatal period.
Little is known about the role of the extracellular matrix in cellular growth, migration and differentiation in the developing liver. The distribution and origin of the main constituents of the hepatic extracellular matrix have never been studied during liver differentiation. We have investigated the extracellular and intracellular distribution of fibronectin, laminin and types I, III and IV collagen in both rat and human liver during the perinatal period by light and electron microscopy, using the indirect immunoperoxidase method. All these components were demonstrated extracellularly, located mainly in portal spaces and, to a lesser extent, surrounding central veins. In perisinusoidal spaces, variations in distribution were observed depending on the matrix protein, the age of the donor and the species. In fetal rat liver, fibronectin formed a continuous layer around hepatocyte clusters while laminin and type III procollagen were present in small amounts. Collagens and laminin were visualized more easily in newborn rat liver. Fetal and newborn human liver contained higher amounts of matrix components than their rat counterparts. Fibronectin also reacted strongly in the sinusoid, and laminin and collagens formed discontinuous deposits. The source of this extracellular matrix was demonstrated to be of mixed origin. The major finding was the presence of immunoreactive laminin in the rough endoplasmic reticulum of hepatocytes irrespective of the age or species. In addition, hepatocytes contained large amounts of fibronectin and little of type I collagen. Another basement membrane component, type IV collagen, was also found in hepatocytes from all groups except fetal rat. Perisinusoidal cells also contained various matrix components including laminin, type III procollagen and, again with the exception of fetal rat liver, type IV collagen. The greater amounts of basement membrane components in the sinusoids of developing liver than in adult tissue and the participation of immature hepatocytes in the production of laminin and to a lesser degree of type IV collagen suggest that these matrix proteins play a critical role during liver differentiation.