A systematic review of inhaled intranasal therapy for central nervous system neoplasms: an emerging therapeutic option.
The intranasal route for drug delivery is rapidly evolving as a viable means for treating selected central nervous system (CNS) conditions. We aimed to identify studies pertaining to the application of intranasal drug administration for the treatment of primary CNS tumors. A systematic literature review was conducted to identify all studies published in the English language pertaining to intranasal therapy for CNS neoplasms, and/or general mechanisms and pharmacokinetics regarding targeted intranasal CNS drug delivery. A total of 194 abstracts were identified and screened. Thirty-seven studies met inclusion criteria. Of these, 21 focused on intranasal treatment of specific primary CNS tumors, including gliomas (11), meningiomas (1), and pituitary adenomas (4). An additional 16 studies focused on general mechanisms of intranasal therapy and drug delivery to the CNS using copolymer micelles, viral vectors, and nanoparticles. Inhaled compounds/substances investigated included perillyl alcohol, vesicular stomatitis virus, parvovirus, telomerase inhibitors, neural stem and progenitor cells, antimetabolites, somatostatin analogues, and dopamine agonists. Radiolabeling, CSF concentration measurement, imaging studies, and histological examination were utilized to clarify the mechanism and distribution by which drugs were delivered to the CNS. Successful drug delivery and tumor/symptom response was reported in all 21 tumor-specific studies. The intranasal route holds tremendous potential as a viable option for drug delivery for CNS neoplasms. A variety of antitumoral agents may be delivered via this route, thereby potentially offering a more direct delivery approach and ameliorating the adverse effects associated with systemic drug delivery.


Different modes of aggregation in organoaluminium and -gallium hydroxylamides.
The organoaluminium and -gallium hydroxylamides (Me2GaONMe2)2, (tBu2AlONMe2)2, (tBu2GaONMe2)2 and (Me2AlONiPr2)2 have been prepared by the reaction of the hydroxylamines Me2NOH and iPr2NOH with the trialkylmetal compounds trimethylgallium, tri-tbutylaluminium and tri-tbutylgallium, respectively. All compounds have been characterised by NMR spectroscopy (1H, 13C, 15N, 17O and 27Al), by mass spectrometry and elemental analyses. The crystal structures of the four compounds have been determined, showing that they all form dimers but with different modes of aggregation: (Me2GaONMe2)2 has a Ga2O2N2 six-membered ring, (tBu2AlONMe2)2 and (Me2AlONiPr2)2 have Al2O2 four-membered rings, (tBu2GaONMe2)2 forms a Ga2O2N five-membered ring.


Synthesis of Single Crystal 2D Cu2FeSnS4 Nanosheets with High-Energy Facets (111) as a Pt-Free Counter Electrode for Dye-Sensitized Solar Cells.
Two-dimensional Cu2FeSnS4 (CFTS) nanosheets with exposed high-energy facets (111) have been synthesized by a facile, scalable, and cost-effective one-pot heating process. The CFTS phase formation is confirmed by both X-ray diffraction and Raman spectroscopy. The formation mechanism of exposed high-energy facet CFTS growth is proposed and its electrochemical and photoelectrochemical properties are investigated in detail to reveal the origin of the anisotropic effect of the high-energy facets. Dye-sensitized solar cells (DSSC) achieve a favorable power conversion efficiency of 5.92% when employing CFTS thin film as a counter electrode, suggesting its potential as a cost-effective substitute for Pt in DSSCs.


Temporomandibular joint internal derangements: CT diagnosis.
Two hundred patients with suspected displaced temporomandibular joint meniscus were studied with computed tomography. In 75 cases confirmation of the CT diagnosis was subsequently obtained via surgery or arthrography; correlation was found in 73 cases (97%), with one false-negative and one false-positive examination. When meniscus displacement was graded as "mild," "moderate," or "severe," those cases diagnosed as moderate or severe were more likely to require surgery. The technique and interpretation of this technique is described; in most cases CT can replace arthrography in diagnosing displaced temporomandibular joint menisci.


Ureteroscopic Stone Extraction in Cross-Fused Renal Ectopia.
Background: Urinary stone disease in cross-fused renal ectopia is rare and the aberrant anatomy poses challenges to treatment options. The available literature on treatment modalities remains limited. In this study, we present a case of ureteral stone in a cross-fused renal ectopia managed through retrograde approach. Case Presentation: We present a case of a 69-year-old woman with an obstructing ureteral stone in a cross-fused renal ectopia managed with ureteroscopic stone extraction. With the use of a ureteral access sheath, holmium laser, and Nitonol basket, the stone was fragmented and removed through retrograde access. The stone composition was 100% calcium oxalate monohydrate and her 24-hour urine collection was only significant for low volume. Conclusion: With special modifications and attention to the individual patient's anatomy, retrograde approach with the use of an access sheath is safe and effective for treatment of ureteral stones in patients with cross-fused renal ectopia.


An opportunistic pre-diabetes screening program offered with existing hypertension screening.
Diabetes mellitus refers to a group of metabolic diseases that share the hallmark characteristic of hyperglycemia. Generally, Diabetes is categorized as type I, or type II. Type I results from the body's failure to synthesize insulin, and requires insulin injections. Type II, also known as adult-onset or non-insulin dependent diabetes mellitus (NIDDM), occurs when the body's cells fail to use insulin properly due to a defective insulin receptor, and may also be combined with a relatively reduced insulin secretion. Type II can be managed with healthy lifestyle habits and early detection of high sugar levels. Most local health departments across New York State offer hypertension screening but no pre-diabetes screening programs. The US preventive Services Task Force recommends that asymptomatic adults with sustained blood pressure greater than 135/80 mm Hg should be screened for type II diabetes. Since high blood sugar levels can be controlled, and in some cases reduced, there exist strong benefits in offering pre-diabetic screening for individuals who are hypertensive.


Wide excision and free flap reconstruction of two cases with adult form of Juvenile Hyalin Fibromatosis localized on the foot.
Juvenile Hyalin Fibromatosis (JHF) or systemic hyalinosis is a rare, sporadic or hereditary disorder characterized by skin lesions, gingival hypertrophy, muscle weakness, and flexion contractures of large joints. There is still dispute in its pathogenesis and treatment. We described two cases with adult form of Juvenile Hyalin Fibromatosis localized in the foot and discussed the local control we achieved by surgery.


Pain Assessment for Nursing Home Residents: A Systematic Review Protocol.
The burden of pain in nursing homes is substantial; however, pain assessment for both acute and chronic conditions remains inadequate, resulting in inappropriate or inadequate treatment. Complexities in assessing resident pain have been attributed to factors (barriers and facilitators) arising at the resident, healthcare provider, and healthcare system levels. In this systematic review protocol, we identify our research approach that will be used to critically appraise and synthesize data in order to assess barriers and facilitators to pain assessment in nursing home residents aged ≥65 years. This is a Cochrane style systematic review protocol adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocols reporting standards. This review will include primary (original) qualitative literature concerning either barriers or facilitators to pain assessment in older adult nursing home residents. A thematic analysis approach will be employed in collating and summarizing included data and will be categorized into resident, healthcare provider, and system-level factors. Database searches will include Abstracts in Social Gerontology, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, and Web of Science. The identification of barriers and facilitators to pain assessment in older adult nursing home residents may assist healthcare providers across all platforms and levels of education to improve pain assessment among nursing home residents. Improving the assessment of pain has the potential to improve quality of care and ultimately quality of life for older adult nursing home residents.


Application of Hansen solubility parameters for understanding and prediction of drug distribution in microspheres.
In an emulsion solvent extraction/evaporation process for the preparation of microspheres the employed solvents have a tremendous influence on the characteristics of the resulting particles. Nevertheless the solvent selection is often based on empirical data rather than on calculated values. The purpose of this investigation was to use the concept of solubility parameters for interpretation and improved understanding of solvent effects in the process of microparticle preparation. Partial solubility parameters of 3-{2-[4-(6-Fluor-1,2-benzisoxazol-3-yl)piperidino]ethyl}-2-methyl-6,7,8,9-tetrahydro-4H-pyrido[1,2-a]pyrimidin-4-on, which was used as a model drug, were determined experimentally using an extended Hansen regression model. Poly(lactide-co-glycolide) microparticles were prepared with an emulsion solvent removal process employing methylene chloride and its mixtures with benzyl alcohol and n-butanol. It could be shown, that the encapsulation efficiency was influenced by the change of the solvent composition during the extraction process. Furthermore the solvent selection had an essential influence on the morphological state of the drug and it could be shown and explained, that by a decrease of the dissolving power a completely amorphous product was obtained.


Life stress impairs self-control in early adolescence.
The importance of self-control to a wide range of developmental outcomes prompted the current investigation of negative life events and self-control in early adolescence. In three prospective, longitudinal studies, negative life events reported by the mother (in Study 1) or child (in Studies 2 and 3) predicted rank-order decreases in self-control over time. In all studies, self-control was measured at two different time points using questionnaires completed by three separate raters, including a classroom teacher who knew the child well and two other raters (parents, caregivers, and/or the child himself/herself). Psychological distress measured in Studies 2 and 3 mediated the deleterious effects of negative life events on self-control. These findings extend prior experimental laboratory research documenting the acute effects of stress on self-control.


Diversity in people's reluctance to use medical artificial intelligence: Identifying subgroups through latent profile analysis.
Medical artificial intelligence (AI) is important for future health care systems. Research on medical AI has examined people's reluctance to use medical AI from the knowledge, attitude, and behavioral levels in isolation using a variable-centered approach while overlooking the possibility that there are subpopulations of people who may differ in their combined level of knowledge, attitude and behavior. To address this gap in the literature, we adopt a person-centered approach employing latent profile analysis to consider people's medical AI objective knowledge, subjective knowledge, negative attitudes and behavioral intentions. Across two studies, we identified three distinct medical AI profiles that systemically varied according to people's trust in and perceived risk imposed by medical AI. Our results revealed new insights into the nature of people's reluctance to use medical AI and how individuals with different profiles may characteristically have distinct knowledge, attitudes and behaviors regarding medical AI.


Reduction in Antimicrobial Use and Resistance to Salmonella, Campylobacter, and Escherichia coli in Broiler Chickens, Canada, 2013-2019.
Antimicrobial use contributes to the global rise of antimicrobial resistance (AMR). In 2014, the poultry industry in Canada initiated its Antimicrobial Use Reduction Strategy to mitigate AMR in the poultry sector. We monitored trends in antimicrobial use and AMR of foodborne bacteria (Salmonella, Escherichia coli, and Campylobacter) in broiler chickens during 2013 and 2019. We quantified the effect of antimicrobial use and management factors on AMR by using LASSO regression and generalized mixed-effect models. AMR in broiler chickens declined by 6%-38% after the decrease in prophylactic antimicrobial use. However, the withdrawal of individual compounds, such as cephalosporins and fluoroquinolones, prompted an increase in use of and resistance levels for other drug classes, such as aminoglycosides. Canada's experience with antimicrobial use reduction illustrates the potential for progressive transitions from conventional antimicrobial-dependent broiler production to more sustainable production with respect to antimicrobial use.


Tungsten determination in biological fluids, hair and nails by plasma emission spectrometry in a case of severe acute intoxication in man.
A healthy 19-year-old recruit in a French artillery regiment drank 250 mL of a mixture of beer and wine that had rinsed in a hot 155-mm gun-barrel. Fifteen minutes later, he complained of nausea followed by seizures. He was comatose for 24 h, presenting signs of encephalopathy. A moderate renal failure was noted initially and worsened to an extensive tubular necrosis with anuria on the day after the incident. The first toxicological investigations only showed a 0.31 g/L blood ethanol. Then inductively-coupled plasma (ICP) emission-spectrometry revealed very high concentrations of tungsten in the "beverage" as well as in gastric content, blood and urine (1540 mg/L, 8 mg/L, 5 mg/L, and 101 mg/L, respectively). The nature of the metal was confirmed by ICP coupled to mass spectrometry. A simple and reliable ICP quantitative assay of tungsten in biological fluids, hair and nails was then developed. It showed high blood levels (> 0.005 mg/L) until day 13 in spite of six hemodialyses, and in urine until D33. Tungsten was also incorporated in hair and nails. To the best of our knowledge, such an intoxication has never been reported before though this drinking seems to be traditional in the French Artillery. It has probably been favored by the unusually high volume of beverage absorbed and by the new alloy of the gun, containing tungsten. The clinical evolution was satisfactory over weeks and the patient was declared totally cured after five months.


Structure and function of ornithine carbamoyltransferases.
The reaction catalyzed by ornithine carbamoyltransferase can participate in either the anabolism or the catabolism of arginine. The carbamoylation of ornithine, yielding citrulline, is involved in the biosynthetic sequence; the reverse reaction, the phosphorolysis of citrulline, is the second step of the arginine deiminase pathway. The ornithine carbamoyltransferases of a number of microorganisms which can fulfil both of these functions have been studied in this work. This group of organisms was found to possess two distinct ornithine carbamoyltransferases. The functions of these enzymes were surmised by determining the type of genetic regulation to which they were subjected. The kinetic properties of these various enzymes have been determined. All of them, regardless of the role they play in the cell, catalyze both the synthesis and arsenolysis of citrulline. The anabolic transferase of Pseudomonas is the only enzyme which displays functional irreversibility. A comparison of the quaternary structure of these transferases was performed and reveals interesting features in relation to the metabolic function of these enzymes. All well-characterized anabolic enzymes have low molecular weights (from 150000--105000) and are likely to be trimers. Catabolic enzymes, with the exception of those of Bacillus licheniformis and Halobacterium salinarium, display much higher molecular weights and more elaborate quaternary structure. The properties of these two groups of transferases are discussed in relation to their metabolic role in the cells.


A rule-based electronic phenotyping algorithm for detecting clinically relevant cardiovascular disease cases.
The implementation of electronic medical records (EMR) is becoming increasingly common. Error and data loss reduction, patient-care efficiency increase, decision-making assistance and facilitation of event surveillance, are some of the many processes that EMRs help improve. In addition, they show a lot of promise in terms of data collection to facilitate observational epidemiological studies and their use for this purpose has increased significantly over the recent years. Even though the quantity and availability of the data are clearly improved thanks to EMRs, still, the problem of the quality of the data remains. This is especially important when attempting to determine if an event has actually occurred or not. We sought to assess the sensitivity, specificity, and agreement level of a codes-based algorithm for the detection of clinically relevant cardiovascular (CaVD) and cerebrovascular (CeVD) disease cases, using data from EMRs. Three family physicians from the research group selected clinically relevant CaVD and CeVD terms from the international classification of primary care, Second Edition (ICPC-2), the ICD 10 version 2015 and SNOMED-CT 2015 Edition. These terms included both signs, symptoms, diagnoses and procedures associated with CaVD and CeVD. Terms not related to symptoms, signs, diagnoses or procedures of CaVD or CeVD and also those describing incidental findings without clinical relevance were excluded. The algorithm yielded a positive result if the patient had at least one of the selected terms in their medical records, as long as it was not recorded as an error. Else, if no terms were found, the patient was classified as negative. This algorithm was applied to a randomly selected sample of the active patients within the hospital's HMO by 1/1/2005 that were 40-79 years old, had at least one year of seniority in the HMO and at least one clinical encounter. Thus, patients were classified into four groups: (1) Negative patients (2) Patients with CaVD but without CeVD; (3) Patients with CeVD but without disease CaVD; (4) Patients with both diseases. To facilitate the validation process, a stratified sample was taken so that each of the groups represented approximately 25% of the sample. Manual chart review was used as the gold standard for assessing the algorithm's performance. One-third of the patients were assigned randomly to each reviewer (Cohen's kappa 0.91). Both coded and un-coded (free text) sections of the EMR were reviewed. This was done from the first present clinical note in the patients chart to the last one registered prior to 1/1/2005. The performance of the algorithm was compared against manual chart review. It yielded high sensitivity (0.99, 95% CI 0.938-0.9971) and acceptable specificity (0.86, 95% CI 0.818-0.895) for detecting cases of CaVD and CeVD combined. A qualitative analysis of the false positives and false negatives was performed. We developed a simple algorithm, using only standardized and non-standardized coded terms within an EMR that can properly detect clinically relevant events and symptoms of CaVD and CeVD. We believe that combining it with an analysis of the free text using an NLP approach would yield even better results.


Resilient Output Synchronization of Heterogeneous Multiagent Systems With DoS Attacks Under Distributed Event-/Self-Triggered Control.
This article investigates the resilient output synchronization problem of a class of linear heterogeneous multiagent systems subjected to denial-of-service (DoS) attacks. Two types of control mechanisms, namely, event- and self-triggered control mechanisms, are presented so as to cut down unnecessary information transmission. Both of these two mechanisms are distributed, and thus, only local information of each agent and its neighboring agents is adopted for the event condition design. The DoS attacks are considered to be aperiodic, and the quantitative relationship between the attributes of the DoS attacks and the synchronization is also revealed. It is shown that the output synchronization can be achieved exponentially in the presence of DoS attacks under the proposed control mechanisms. The validness of the provided mechanisms is certified by a simulation example.


Comparison of fluoroscopic Guided Transforaminal Epidural Injections of Steroid and Local Anaesthetic with Conservative Management in Patients with Chronic Lumbar Radiculopathies.
Chronic lumbar radiculopathy is a common medical problem and the treatment modalities used over years have been many ranging from conservative or symptomatic management to open decompression surgery. This study was aimed at to compare two modalities of treatment, i.e., conservative and lumbar transforaminal epidural steroid injections (TFESIs). A total of 120 patients of American Society of Anesthesiology class - (a healthy patient or a patient with mild systemic disease) were randomized to two groups. Group C (n = 60) were managed conservatively with bed rest, analgesics, and physiotherapy. Group T (n = 60) received lumbar TFESIs with methylprednisolone 40 mg with 2 ml bupivacaine (0.5%). Measurements using visual analog scale (VAS) were taken before treatment and at various time intervals after the start of treatment. There was no statistically significant difference regarding the demographic characteristics of both groups. The VAS scores were less and statistically significant in Group T after 30 min postinjection, at the 2nd week and after 1 month. Recovery rate of straight leg raise test was found to be 98% in those treated with TFESI. The Group T had significantly better patient satisfaction score and additionally there was drug dose intake reduction before and after the treatment. Patients treated with fluoroscopic-guided TFESI have better pain relief, quality-of-life, and less analgesic requirement than those managed conservatively.


Assembly and ecological function of the root microbiome across angiosperm plant species.
Across plants and animals, host-associated microbial communities play fundamental roles in host nutrition, development, and immunity. The factors that shape host-microbiome interactions are poorly understood, yet essential for understanding the evolution and ecology of these symbioses. Plant roots assemble two distinct microbial compartments from surrounding soil: the rhizosphere (microbes surrounding roots) and the endosphere (microbes within roots). Root-associated microbes were key for the evolution of land plants and underlie fundamental ecosystem processes. However, it is largely unknown how plant evolution has shaped root microbial communities, and in turn, how these microbes affect plant ecology, such as the ability to mitigate biotic and abiotic stressors. Here we show that variation among 30 angiosperm species, which have diverged for up to 140 million years, affects root bacterial diversity and composition. Greater similarity in root microbiomes between hosts leads to negative effects on plant performance through soil feedback, with specific microbial taxa in the endosphere and rhizosphere potentially affecting competitive interactions among plant species. Drought also shifts the composition of root microbiomes, most notably by increasing the relative abundance of the Actinobacteria. However, this drought response varies across host plant species, and host-specific changes in the relative abundance of endosphere Streptomyces are associated with host drought tolerance. Our results emphasize the causes of variation in root microbiomes and their ecological importance for plant performance in response to biotic and abiotic stressors.


Validation of the prognosis in palliative care study predictor models in terminal cancer patients.
Prognosis in Palliative Care Study (PiPS) predictor models were developed in 2011 to estimate the survival of terminal cancer patients in the United Kingdom. The aim of this study was to validate the PiPS model for terminal cancer patients in Korea, and evaluate its value in clinical practice. This study included 202 advanced cancer patients who were admitted to the cancer hospital's palliative care ward from November 2011 to February 2013. On admission, physicians recorded the PiPS-A, PiPS-B, and doctor's survival estimates in inpatients. The median survival across PiPS-A categories was 9, 28, and 33 days, and the median survival across PiPS-B was 9.5, 27, and 43 days. The median actual survival was 25 days; overall accuracy between the PiPS-A, PiPS-B, doctor's estimates of survival, and actual survival was 52.0%, 49.5%, and 46.5%, respectively. The PiPS-A and PiPS-B groups for survival in 'days' showed a sensitivity of 48.4% and 64.1%, and specificity of 87.7%, and 77.5%, respectively. The PiPS-A and PiPS-B groups for survival in 'weeks' showed a sensitivity of 59.2%, and 44.7%, and specificity of 61.6%, and 64.7%, respectively. The PiPS-A and PiPS-B 'months' group showed a sensitivity of 37.1% and 37.1%, and specificity of 74.9% and 78.4%, respectively. The 'weeks' and 'months' groups showed significantly prolonged survival rates than 'days' group did in both PiPS-A and PiPS-B, by the Kaplan-Meier method. The PiPS predictor models effectively predicted the survival ≥14 days in terminal cancer patients, and were superior to doctor's estimates.


Aceclofenac oil drops: characterization and evaluation against ocular inflammation.
Ocular inflammatory diseases, such as uveitis, scleritis, episcleritis and dry eye syndrome are commonly treated with eye drop formulations. In the present study, attempts were made to prepare aceclofenac oil formulations to evaluate its transcorneal permeation and anti-inflammatory effect. Ophthalmic solutions of aceclofenac with or without (0.5% v/v) benzyl alcohol were formulated in different vegetable oils and permeation studies were carried out. Aceclofenac ophthalmic solution in linseed oil containing benzyl alcohol exhibited maximum permeation (4.42% in goat, 4.26% in sheep and 3.94% in buffalo) through corneas under study. The partition characteristics of aceclofenac in linseed oil reinforced the results of permeation studies. The optimized formulation (linseed oil containing benzyl alcohol) showed better stability profile. Linseed oil aceclofenac formulation showed significant inhibitory effect on ocular inflammation induced by arachidonic acid in rabbit eyes (p < .05) and hence it can be considered as a potential approach for treatment of ocular inflammatory conditions.


[Use of multicellular spheroids in studies based on the NSD (nominal standard dose) concept].
The authors discuss the possibility of application of multicellular spheroids as a model system in studies based on NSD conception. The death rate of spheroids from cells of Chinese hamster V79-4 was shown to depend upon cumulative dose of gamma- and neutron (0.7 MeV)-radiation (the number of fractions was 1, 5 and 10). With fractionated irradiation, the reoxygenation effect was observed. A good coincidence was obtained between the dependence of the cumulative dose upon the number of fractions for multicellular spheroids and clinical data.


Comprehensive Profile of Acute Mitochondrial Dysfunction in a Preclinical Model of Severe Penetrating TBI.
Mitochondria constitute a central role in brain energy metabolism, and play a pivotal role in the development of secondary pathophysiology and subsequent neuronal cell death following traumatic brain injury (TBI). Under normal circumstances, the brain consumes glucose as the preferred energy source for adenosine triphosphate (ATP) production over ketones. To understand the comprehensive picture of substrate-specific mitochondrial bioenergetics responses following TBI, adult male rats were subjected to either 10% unilateral penetrating ballistic-like brain injury (PBBI) or sham craniectomy (n = 5 animals per group). At 24 h post-injury, mitochondria were isolated from pooled brain regions (frontal cortex and striatum) of the ipsilateral hemisphere. Mitochondrial bioenergetics parameters were measured ex vivo in the presence of four sets of metabolic substrates: pyruvate+malate (PM), glutamate+malate (GM), succinate (Succ), and β-hydroxybutyrate+malate (BHBM). Additionally, mitochondrial matrix dehydrogenase activities [i.e., pyruvate dehydrogenase complex (PDHC), alpha-ketoglutarate dehydrogenase complex (α-KGDHC), and glutamate dehydrogenase (GDH)] and mitochondrial membrane-bound dehydrogenase activities [i.e., electron transport chain (ETC) Complex I, II, and IV] were compared between PBBI and sham groups. Furthermore, mitochondrial coenzyme contents, including NAD(t) and FAD(t), were quantitatively measured in both groups. Collectively, PBBI led to an overall significant decline in the ATP synthesis rates (43-50%; * p < 0.05 vs. sham) when measured using each of the four sets of substrates. The PDHC and GDH activities were significantly reduced in the PBBI group (42-53%; * p < 0.05 vs. sham), whereas no significant differences were noted in α-KGDHC activity between groups. Both Complex I and Complex IV activities were significantly reduced following PBBI (47-81%; * p < 0.05 vs. sham), whereas, Complex II activity was comparable between groups. The NAD(t) and FAD(t) contents were significantly decreased in the PBBI group (27-35%; * p < 0.05 vs. sham). The decreased ATP synthesis rates may be due to the significant reductions in brain mitochondrial dehydrogenase activities and coenzyme contents observed acutely following PBBI. These results provide a basis for the use of "alternative biofuels" for achieving higher ATP production following severe penetrating brain trauma.


101 oesophageal cancers: a surgeon uses radiotherapy.
One hundred and one consecutive patients with oesophageal cancer, cancer of the cardia and gastric cancer extending upwards from the stomach to the oesophagus were treated from 1979 to 1985 with a policy that included radiotherapy treatment for 58. This heterogeneous group, which was considered together as oesophageal cancer, was subdivided according to anatomical location, histology and pretreatment staging. Those patients who could be treated surgically by a resection and anastomosis performed below the diaphragm were excluded. Thirty-five had surgery which was either an oesophagogastrectomy or oesophagojejunostomy with an intrathoracic anastomosis, except for two who were nonresectable. Eight patients were to ill or refused treatment. The role of radiotherapy was assessed in three groups: i. Operable squamous cell carcinoma of the oesophagus was treated by radical radiotherapy (22) with a 46% 1-year and 14% 5-year survival. ii. Inoperable squamous cell carcinoma of the oesophagus was given radical or palliative radiotherapy (25) with a 16% 1-year and 4% 5-year survival. iii. Non-resectable adenocarcinoma of the stomach or oesophagus was treated palliatively by radiotherapy to debulk the intraluminal tumour (11), all of whom had symptomatic relief of dysphagia. The results of radical radiotherapy for operable squamous cell carcinoma of the oesophagus were similar to the best results achieved by surgical resection in other series in which there is comparable staging. Radiotherapy should be included in the treatment options for oesophageal cancer.


Association of the cardiac neural crest with development of the coronary arteries in the chick embryo.
Chick coronary arteries originate as penetrating channels from a subepithelial peritruncal ring into the wall of all three aortic coronary sinuses. Two of these capillaries develop a muscular wall and become the definitive coronary arteries. Since cardiac neural crest (CNC) contributes ectomesenchyme to the tunica media (TM) of the aortic arch vessels, we wished to learn if the CNC also contributes to the media of the coronary arteries and if CNC plays an inductive role in determining the site of aortic penetrations and influences which channels persist to hatching. Quail-to-chick chimeras were made by bilaterally removing the chick CNC and replacing it with quail CNC. The chimeras and unoperated controls were collected on embryonic days (ED) 7-18, fixed in Carnoy's fixative, serially sectioned, stained with Feulgen-Rossenbeck stain, and analyzed. Several ED 18 controls and chimeras were also stained with Gomori's trichrome stain, or labeled with antineurofilament or antivascular smooth muscle alpha actin. The TM of the coronary arteries and the aortic coronary sinuses did not consist of CNC cells. The media of the surviving coronary arteries was disrupted by clusters of CNC cells scattered in the wall of the base of the coronary artery on ED 14 and 18. Persisting coronary arteries were always associated with large neural crest-derived parasympathetic ganglia near their origin. Branches from parasympathetic nerves entered the base of the coronary arteries where the clusters of neural crest cells were located. Quail cells were also associated with tiny vessels exiting the ostia of the coronary arteries and traveling in the outer aortic wall. Labeling with antibodies confirmed a disruption of the TM at the base of the coronary arteries, and showed innervated clusters of quail cells in the disrupted part of the TM. Although the TM of the coronary arteries and the aortic coronary sinuses contained no CNC cells, clusters of innervated quail cells disrupted the TM at the base of the coronary arteries. CNC does not appear to induce capillary penetration directly; however, the exclusive association of CNC-derived parasympathetic ganglia and nerves with persisting coronary arteries suggests that the presence of parasympathetic ganglia is essential to the survival of the definitive coronary arteries. CNC cells may also be associated with the development of the aortic vasa vasorum.


Laboratory evaluation of Isaria fumosorosea against Spodoptera littoralis.
Isaria fumosorosea (syn. Paecilomyces fumosoroseus) is potentially useful for the biological control of economically important agricultural and forest insect pests. We evaluated efficacy of two strains of this entomopathogenic fungus against last instar larvae and pupae of Egyptian cotton leafworm, Spodoptera littoralis. The first strain was Apopka 97 which is an active ingredient of commercial biopesticide PreFeRal WG (Biobest, Belgium). The second strain was isolated from Cameraria ohridella and is currently deposited under number CCM 8367 as a patent culture in the Czech Collection of Microorganisms in Brno. Blastospores of both strains were obtained after 120 hours submerged cultivation in grow media using orbital shaker. The concentration of blastospores was adjusted to 5 x 10(7) spores/ml of suspension. Soaking agent Tween 80 was added to the suspension at concentration 0.02%. Lethal effects of both fungal strains on S. littoralis were evaluated using standard dip test. Treated insects were individually placed into plastic Petri dishes (diam. 9 cm) and kept at constant laboratory conditions (temperature 23 degrees C, R.H. approx. 100%, 16L:8D photoperiod). Virulence of the strains was expressed as percentages of cumulative daily mortality corrected for mortality in the control variant. Obtained results revealed higher virulence of CCM 8367 blastospores to the last instar larvae of S. littoralis (93.1% mortality) on the 7th day after the treatment compared to Apopka 97 (65.5% mortality). Even more obvious difference was found in pupae, where corrected mortality of CCM 8367-treated pupae was 80.0% while mortality in Apopka 97-treated pupae reached only 3.3% on the 8th day after the treatment. We can conclude that the strain I. fumosorosea CCM 8367 has strong insecticidal effects on S. littoralis and has a potential to be implemented as a novel biocontrol agent.


Evaluation of anaemia in booked antenatal mothers during the last trimester.
Anaemia occurring during pregnancy is an important public health problem in developing countries. In India, anaemia is one of the most common causes of maternal death, accounting for 20% of total maternal deaths. This study was conducted with the aim of evaluating anaemia among booked antenatal mothers during the last trimester, its possible impact on pregnancy and its outcome in antenatal mothers, visiting antenatal clinic in a teaching tertiary care hospital at Pondicherry, India. This hospital based, descriptive, cross sectional study was conducted in the Department of Clinical Pathology and Pharmacology at Sri Manakula Vinayagar Medical College Hospital in Pondicherry, India. Socio-economic and gestational status data was collected with the help of structured questionnaire from booked antenatal mothers in third trimester. Venous blood was collected for the estimation of Haemoglobin by using Sahli's Haemoglobinometer and morphological typing of anaemia was estimated by using Leishmann Stain peripheral blood smears. The women were followed-up till delivery and their antenatal, neonatal and other birth outcomes were recorded. Seventy five booked antenatal women, aged 19 - 40 years, with gestational ages of 27- 40 weeks, were recruited for the study. We observed that among 75 antenatal mothers, the Haemoglobin level was less than 10grams% in 83% cases and that it was more than 10 grams% in 17% cases. Iron deficiency anaemia and dimorphic anaemia were recorded in 37% and 19% of the women respectively. High percentage of anaemia was noted in women of higher age group (23-27 years), in those with multi-parity (55%) and low educational levels (100%) and in mothers of low socio-economic status (100%). In the pregnancy outcomes, 85% and 60% anaemic mothers reported maternal and foetal complications respectively. In spite of regular antenatal visits in third trimester, maternal anaemia is still high and it is often associated with low education status, socio-economic status and multi-parity, based on our study. There is a need of health education programmes with respect to haematinics compliance and adequate intake of iron rich diet during pregnancy, to be strengthened for safe maternal and foetal outcomes.


2 Gbps/3 m air-underwater optical wireless communication based on a single-layer quantum dot blue micro-LED.
Blue/green light-emitting diodes (LEDs) show great potential in medium/short distance underwater optical wireless communication (UOWC) while suffering limited bandwidth caused by a long radiative recombination carrier lifetime and large resistance-capacitance (RC) constant. We designed, fabricated, and packaged a 75-µm single-layer quantum dot (QD) blue micro-LED with a record high modulation bandwidth up to 1.03 GHz. The single-layer structure of QD reduces the carrier lifetime and RC delay. A data rate of 2 Gbps over a 3-m air-underwater channel using a non-return-to-zero on-off-keying modulation format with a low bit-error rate of 2.03×10-3 was achieved below the forward error correction limit, which is the highest data rate of micro-LED-based UOWC systems, to the best of our knowledge.


[Totally laparoscopic gastrectomy for gastric cancer].
To evaluate the feasibility and clinical efficacy of totally laparoscopic gastrectomy (TLG) for gastric cancer. The investigators retrospectively analyzed 37 cases undergoing TLG for gastric cancer from March 2007 to April 2009 at Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University. All 37 cases underwent successful TLG. There was neither transfer to open nor laparoscopic assisted surgery. Twenty-nine cases underwent distal gastrectomy with Billroth II reconstruction, 8 cases total gastrectomy with Roux-en-Y reconstruction, including 5 cases with end-to-side esophageal jejunostomy and 3 cases with side-to-side esophageal jejunostomy. Nineteen cases assisted by intraoperative gastroscopy for tumor locating. The operation duration was 210 - 355 min [mean (284 +/- 43) min]. The blood loss was 80 - 450 ml [mean (175 +/- 62) ml]. The number of dissected lymph nodes was 18 - 55 [mean (31 +/- 9)]. Two cases had post-operative complications, with 1 case of pulmonary infection recovering well after symptomatic treatment and 1 case of temporary delayed gastric emptying recovering well after gastrointestinal decompression for 6 days. No mortality was reported. The hospital stay was 6 - 14 d [mean (9 +/- 2) d]. There was no recurrence during the follow-up period of 2 - 25 months. For surgeons with rich experiences of laparoscopic surgery, TLG for gastric cancer is both safe and feasible. The short-term efficacy of TLG is satisfactory. Furthermore, TLG conforms more to the concept of minimally invasive surgery and the principle of tumor-free technique.


Ilizarov technique in the treatment of chronic osteomyelitis caused by Vibrio alginolyticus.
We present a case of 26-year-old woman with posttraumatic chronic osteomyelitis caused by Vibrio alginolyticus, contracted after contamination of a tibial fracture with seawater. The patient underwent bone resection and bifocal osteosynthesis according to Ilizarov and was treated with a combination of ciprofloxacin and tetracycline. The patient responded in the same way to distraction osteogenesis as any other patient with chronic osteomyelitis with large defects.


Methamphetamine oxidative stress, neurotoxicity, and functional deficits are modulated by nuclear factor-E2-related factor 2.
Activation of redox-sensitive transcription factors like nuclear factor-E2-related factor 2 (Nrf2) can enhance the transcription of cytoprotective genes during oxidative stress. We investigated whether Nrf2 is activated by methamphetamine (METH) thereby altering neurotoxicity in Nrf2 +/+ and -/- adult mouse brain. A single dose of METH can induce the mRNA levels of Nrf2-regulated antioxidant and cytoprotective proteins in mouse brain. Multiple-day dosing with METH enhanced DNA oxidation and decreased tyrosine hydroxylase and dopamine transporter staining in the striatum, indicating dopaminergic nerve terminal toxicity, which was more severe in -/- mice, as were deficits in motor coordination and olfactory discrimination. These Nrf2-dependent effects were independent of changes in METH metabolism or the induction of hyperthermia. Similarly, METH increased striatal glial fibrillary acidic protein, indicating neurotoxicity. METH neurotoxicity was also observed in the glial cells and in the GABAergic system of the olfactory bulbs and was enhanced in -/- mice, whereas dopaminergic parameters were unaffected. With one-day dosing of METH, there were no differences between +/+ and -/- mice in either basal or METH-enhanced DNA oxidation and neurotoxicity markers. Nrf2-mediated pathways accordingly may protect against the neurodegenerative effects and functional deficits initiated by METH and perhaps other reactive oxygen species-enhancing neurotoxicants, when there is time for transcriptional activation and protein induction. In human users of METH, this mechanism may be essential when differences in drug abuse patterns may alter the induction and duration of Nrf2 activation thereby modulating susceptibility to the neurotoxic effects of METH.


Associations Between Patient and Anthropometric Characteristics and Aromatase Inhibitor Discontinuation.
Toxicity can lead to noncontinuation of adjuvant endocrine therapy. We hypothesized that endocrine therapy-induced changes in grip strength would predict for early discontinuation of therapy because of musculoskeletal toxicity and would be associated with a patient's body mass index. Postmenopausal women with breast cancer starting a new adjuvant endocrine therapy were enrolled in the present study. The patients were monitored for 12 months to assess their symptoms, endocrine therapy adherence and change in grip strength and baseline body mass index. The association between the change in grip strength and interval to discontinuation was assessed using a joint longitudinal and survival model. Of the 93 aromatase inhibitor (AI)-treated and 22 tamoxifen-treated patients, 40.9% and 9% discontinued endocrine therapy within 12 months because of toxicity, respectively (P = .019). A trend was seen toward a greater decrease in grip strength in the AI-treated patients over time (P = .055); however, the decrease was not significantly associated with the interval to discontinuation (P = .96). Receipt of an AI (hazard ratio, 5.49; P = .019) and baseline pain (hazard ratio, 1.19; P = .004) significantly decreased the interval to discontinuation. In contrast with the findings from previous reports, the change in grip strength in our study was not associated with the interval to discontinuation of AI therapy. Future research should focus on proactive treatment of patients at increased risk of AI intolerance, such as those with high levels of pre-existing pain.


Coxsackievirus B4 Exposure Results in Variable Pattern Recognition Response in the Kidneys of Female Non-Obese Diabetic Mice Before Establishment of Diabetes.
End-stage renal disease (ESRD) is described by four primary diagnoses, diabetes, hypertension, glomerulonephritis, and cystic kidney disease, all of which have viruses implicated as causative agents. Enteroviruses, such as coxsackievirus (CV), are a common genus of viruses that have been implicated in both diabetes and cystic kidney disease; however, little is known about how CVs cause kidney injury and ESRD or predispose individuals with a genetic susceptibility to type 1 diabetes (T1D) to kidney injury. This study evaluated kidney injury resulting from coxsackievirus B4 (CVB4) inoculation of non-obese diabetic (NOD) mice to glean a better understanding of how viral exposure may predispose individuals with a genetic susceptibility to T1D to kidney injury. The objectives were to assess acute and chronic kidney damage in CVB4-inoculated NOD mice without diabetes. Results indicated the presence of CVB4 RNA in the kidney for at least 14 days post-CVB4 inoculation and a coordinated pattern recognition receptor response, but the absence of an immune response or cytotoxicity. CVB4-inoculated NOD mice also had a higher propensity to develop an increase in mesangial area 17 weeks post-CVB4 inoculation. These studies identified initial gene expression changes in the kidney resulting from CVB4 exposure that may predispose to ESRD. Thus, this study provides an initial characterization of kidney injury resulting from CVB4 inoculation of mice that are genetically susceptible to developing T1D that may one day provide better therapeutic options and predictive measures for patients who are at risk for developing kidney disease from T1D.


In Vitro Study on the Effect of Maraviroc or Dolutegravir on Bilirubin to Albumin Binding.
We performed an in vitro evaluation of the effect of maraviroc or dolutegravir on bilirubin to albumin binding. At typical treatment and low albumin concentrations, maraviroc had no impact, while dolutegravir affected bilirubin to albumin binding to an equivalent extent as sulfisoxazole. However in vivo, neither is likely to significantly impact bilirubin to albumin binding because of their low concentrations relative to albumin.


Comparing the Effects of Speech-Generating Device Display Organization on Symbol Comprehension and Use by Three Children With Developmental Delays.
Three children ages 3;6 to 5;3 with developmental and language delays were provided experience with a traditional grid-based display and a contextually organized visual scene display on a speech-generating device to illustrate considerations for practice and future research in augmentative and alternative communication assessment and intervention. Twelve symbols were taught in a grid display and visual scene display using aided input during dramatic play routines. Teaching sessions were 30 minutes a day, 5 days a week for 3 weeks. Symbol comprehension and use was assessed pre and post 3 weeks of experience. Comprehension of symbol vocabulary on both displays increased after 3 weeks of experience. Participants 1 and 2 used both displays largely for initiation. Participant 3 had limited expressive use of either display. The methods used in this study demonstrate one way to inform individual differences in learning and preference for speech-generating device displays when making clinical decisions regarding augmentative and alternative communication supports for a child and their family. Future research should systematically examine the role of extant comprehension, symbol experience, functional communication needs, and the role of vocabulary type in the learning and use of grid displays versus visual scene displays.


Nondegenerate two-beam coupling in Kerr nonlinear photonic crystals.
We show that the energy-transfer efficiency by nondegenerate two-beam coupling in a one-dimensional Kerr-nonlinear superlattice can be enhanced by several orders of magnitude as compared with that in a homogeneous medium of the same nonlinearity and length. This significant enhancement utilizes the strong localized field at the band-edge state, two-frequency localized state, or defect state. Due to the intensity-induced index modulation, the bistability is observed, and because of the energy transfer between different wavelength components, the tristability behavior is induced.


Women's information needs about menopause: a cross-sectional survey in Norwegian general practice.
Research indicates that providing women with information about menopause can improve their attitude towards menopause and symptom experience. Nevertheless, information shared on this topic is often arbitrary. Examine women's information needs about menopause, and understand if, when, and from whom they want information. A cross-sectional study among women in the waiting room of 54 general practice clinics in South-Eastern Norway, autumn 2022. Medical students recruited women in the clinics waiting room. A one-page study specific questionnaire was used, focusing on need for information about menopause. A total of 625 women were included, with a mean age of 44.4 years (SD 8.7). In all, 59% answered that they wanted information about menopause, and 81% of these wanted their general practitioner (GP) to inform them, from a median age of 45. According to the women, only 10% of GPs had addressed the topic. Higher education was a predictor for wanting information. A main driver of information needs was to help oneself in the present and in the future. In all, 33% did not want information. The main reasons were that they already possessed sufficient information, would take menopause as it comes, were too young, or were already postmenopausal. The gender of the GP did not influence the results. Most women wanted information about menopause from their GP. The study emphasises the need for GPs to consider prioritising this discussion, and to keep up to date on recommendations and treatment options.


Atroposelective Access to Dihydropyridinones with C-N Axial and Point Chirality via NHC-Catalyzed [3 + 3] Annulation.
An N-heterocyclic carbene-catalyzed atroposelective [3 + 3] annulation of enals with 2-aminomaleate derivatives is described. A series of substituted dihydropyridones bearing both C-N axis and point chirality were synthesized with good diastereo- and enantioselectivity under mild conditions. This efficient strategy successfully superpositions an extra point chiral element with an axial backbone, and the generated structurally interesting atropisomers may have potential application in drug discovery.


First Report of Leaf Black Spot Caused by Alternaria alternata on Rosemary (Rosmarinus officinalis L.) in China.
Rosemary (Rosmarinus officinalis L.) is an aromatic, evergreen, medicinally important shrub and widely used for cooking, tea, cosmetics as well as medicinal materials. It is grown in many countries including China that had more than 9300 hm2 of commercial cultivation area in 2021. In March 2020, a leaf spot disease sporadic occurred in field rosemarry plants in Nanyang City (32º51´ N, 111º36´ E), Henan Province, China. The disease outbreaked in September with a disease incidence of 57-83%. Symptoms initially appeared as small brown leaf spots that gradually expanded into dark blackbrown irregular lesions. Most of the spots started from the leaf tip or leaf margin, and gradually spread to the leaf base, resulting in heavy defoliation especially on rainy days. Diseased leaf segments (1×3 mm) were surface-sterilized by dipping in 1% sodium hypochlorite for 1 min, rinsed three times with sterile distilled water, and plated on potato dextrose agar, then incubated at 28°C in the dark for 5 days. Twelve fungal isolates with the same morphological characteristics were obtained from nine affected leaves. The fungal colonies were initially white and turned gray brown with flocculent aerial mycelia and a whorled back. Conidia were frequently born in a long chain, with a short beak, brown or light-brown, 13.2 to 48. 7 (average 26.1) × 4.0 to 13.1 (average 8.0) μm in size (n=148) with 0 to 8 transverse and 0 to 3 longitudinal/oblique septa. Phenotypic features of the isolates agreed with those of Alternaria alternata (Simmons et al. 2007). Two isolates Aa1 and Aa2 were randomly selected for molecular and pathogenicity tests. DNA was extracted from mycelia. Partial sequences of internal transcribed spacer (ITS) and translation elongation factor 1-alpha (TEF1-α) were amplified using the primer pairs ITS1/ITS4 and EFI-728F/EFI-986R (Wei et al. 2022), respectively. The GenBank accession nos. were OK036714 and OK036715 for ITS, and ON951980 and ON951981 for TEF1-α of Aa1 and Aa2, respectively, with a maximal identity of greater than 99% to multiple A. alternata strains. In the neighbour joining phylogenetic tree of the amplified ITS and TEF1-α sequences both Aa1 and Aa2 clustered with A. alternata strains, clearly separating them from other Alternaria spp. For pathogenicity test, conidial suspensions (1×106 spores /mL) of Aa1 and Aa2 were separately sprayed on healthy one-year-old rosemary plants (n=3) with their leaves slightly wounded with a sterilized needle. Control plants (n=3) were sprayed with sterile water. Both inoculated and control plants were incubated at 90% RH, 28 °C. After 14 days, all the inoculated leaves showed black brown lesions similar to those on naturally affected field plants, whereas controls remained symptomless. Fungal cultures with the same phenotypic features as the inocula were constantly re-isolated from the infected leaves. A. alternata was reported as pathogen causing foliar necrosis on rosemary in Italy (Perello et al.1995) and leaf spot (or leaf blight) on multiple plant species such as Actaea dahurica (Hai et al. 2022), and Ligustrum japonicum (Wei et al. 2022) in China. This is the first report of A. alternata causing leaf black spot on rosemary in China.


Prediction of aqueous solubility based on large datasets using several QSPR models utilizing topological structure representation.
Several QSPR models were developed for predicting intrinsic aqueous solubility, S(o). A data set of 5,964 neutral compounds was sub-divided into two classes, aromatic and non-aromatic compounds. Three models were created with different methods on both data sets: two regression models (multiple linear regression and partial least squares) and an artificial neural network model. These models were based on 3343 aromatic and 1674 non-aromatic compounds for training sets; 938 compounds were used in external validation testing. The range in -log S(o) is -1.6 to 10. Topological structure descriptors were used with all models. A genetic algorithm was used for descriptor selection for regression models. For the artificial neural network (ANN) model, descriptor selection was done with a backward elimination process. All models performed well with r2 values ranging 0.72 to 0.84 in external validation testing. The mean absolute errors in validation ranged from 0.44 to 0.80 for the classes of compounds for all the models. These statistical results indicate a sound ANN model. Furthermore, in a comparison with eight other available models, based on predictions using a validation test set (442 compounds), the artificial neural network model presented in this work (CSLogWS) was clearly superior based on both the mean absolute error and the percentage of residuals less than one log unit. In the ANN model both E-State and hydrogen E-State descriptors were found to be important.


Effect of nerve growth factor on neuronal apoptosis after spinal cord injury in rats.
To explore the molecular mechanism of the protective effect of nerve growth factor (NGF) on injured spinal cord. The posterior T(8) (the 8th thoracic segment) spinal cords of 60 Wistar rats were injured by impacts caused by objects (weighing 10 g) falling from a height of 2.5 cm with Allen's way. Solution with nerve growth factors (NGF) was given to 30 rats (the NGF group) through a microtubule inserted into the subarachnoid cavity immediately, and at 2, 4, 8, 12 and 24 hours after spinal cord injury (SCI) respectively. Normal saline (NS) with same volume was given to the other 30 rats (the NS group) with the same method. And 5 normal rats were taken as the normal controls. The expression of bcl-2 and bax proteins in spinal cord was detected with immunohistochemistry. The apoptotic neurons in spinal cord were measured with terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling of DNA fragments (TUNEL) staining. The positive expression of bcl-2 protein was strong in the normal controls, but decreased in the NS group, and increased significantly in the NGF group as compared with that of the NS group (P<0.01). The positive expression of bax protein was also strong in the normal controls, but increased in the NS group, and decreased significantly in the NGF group as compared with that of the NS group (P<0.01). Apoptotic neurons were found in the NS group, and they decreased significantly in the NGF group as compared with that of the NS group (P<0.01). NGF can protect the injured nerve tissues through stimulating the expression of bcl-2 protein, inhibiting the expression of bax protein and inhibiting the neuronal apoptosis after SCI.


Time-action profiles of insulin degludec in healthy dogs and its effects on glycemic control in diabetic dogs.
Insulin degludec (IDeg) is a new insulin formulation that facilitates long-term control of glucose level in humans. In this study, we investigated the effects of IDeg on glycemic control in dogs. Its time-action profiles were monitored in healthy dogs using an artificial pancreas apparatus under euglycemic conditions. At 9.0-13.5 hr post-IDeg injection, an indistinct peak of glucose level was detected. Moreover, the action of IDeg was persistent for >20 hr. Both IDeg and neutral protamine Hagedorn insulin (NPH) lowered blood glucose concentrations in diabetic dogs, but IDeg caused postprandial hyperglycemia and a somewhat lower preprandial glucose level than that caused by NPH. IDeg might be ineffective in concurrently preventing postprandial hyperglycemia and preprandial hypoglycemia in a single-agent administration.


Astroglia-mediated effects of uric acid to protect spinal cord neurons from glutamate toxicity.
Uric acid (UA) has been demonstrated to reduce damage to neurons elicited by oxidative stress. However, our studies utilizing cultures derived from embryonic rat spinal cord indicate that an astroglia-mediated mechanism is involved in the effects of UA to protect neurons from glutamate toxicity. The damage elicted by glutamate to neurons in a mixed culture of spinal cord cells can be reversed by UA. Furthermore, addition of UA after the termination of glutamate exposure suggests that UA plays an active role in mediating neuroprotection rather than purely binding peroxynitrite, as previously thought. Importantly, in pure neuron cultures from the same tissue, UA does not protect against glutamate toxicity. Addition of astroglia to the pure neuron cultures restores the ability of UA to protect the neurons from glutamate-induced toxicity. Our results also suggest that glia provide EAAT-1 and EAAT-2 glutamate transporters to protect neurons from glutamate, that functional EAATs may be necessary to mediate the effects of UA, and that treatment with UA results in upregulation of EAAT-1 protein. Taken together, our data strongly suggest that astroglia in mixed cultures are essential for mediating the effects of UA, revealing a novel mechanism by which UA, a naturally produced substance in the body, may act to protect neurons from damage during insults such as spinal cord injury.


Equation for peak capacity estimation in two-dimensional liquid chromatography.
Two-dimensional liquid chromatography (2DLC) is a very powerful way to greatly increase the resolving power and overall peak capacity of liquid chromatography. The traditional "product rule" for peak capacity usually overestimates the true resolving power due to neglect of the often quite severe under-sampling effect and thus provides poor guidance for optimizing the separation and biases comparisons to optimized one-dimensional gradient liquid chromatography. Here we derive a simple yet accurate equation for the effective two-dimensional peak capacity that incorporates a correction for under-sampling of the first dimension. The results show that not only is the speed of the second dimension separation important for reducing the overall analysis time, but it plays a vital role in determining the overall peak capacity when the first dimension is under-sampled. A surprising subsidiary finding is that for relatively short 2DLC separations (much less than a couple of hours), the first dimension peak capacity is far less important than is commonly believed and need not be highly optimized, for example, through use of long columns or very small particles.


[A case of pseudomembranous enterocolitis caused by methicillin-resistant Staphylococcus aureus].
A 47-year-old woman was hospitalized because of urinary-tract infection. She was treated with antibiotics for 6 days. However, severe watery diarrhea and pyrexia developed 6 days after stopping administration of antibiotics. Stool, throat and blood cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA) and negative for Clostridium difficile DI toxin. In spite of administration of VCM, she died of septic shock. At autopsy, macroscopic observation revealed a pseudomembrane in the ileum. MRSA enterocolitis can occur in patients with antibiotic-related diarrhea, and physicians should be aware of its rapid clinical course and possible lethal outcome.


Frequency of sleep-disordered breathing in a referral population of Somali-Americans.
To study the frequency of obstructive sleep apnea (OSA) in individuals of Somali ancestry referred to a clinical sleep laboratory. This was a retrospective study using a large registry of patients who underwent diagnostic polysomnography between 17 November 2009 and 15 April 2017. Adult patients self-reporting as being of Somali origin were confirmed using the electronic medical record. Somali-American patients comprised approximately 0.2% of all patients undergoing polysomnography at the Mayo Clinic Center for Sleep Medicine. The median (interquartile range) age was 52.6 (35, 64) years with 66% males and a median (interquartile range) body mass index of 31.2 (27, 34) kg/m². OSA was diagnosed in 77% of patients, with approximately 50% having moderate to severe OSA. OSA was more frequent in older patients and similar between men and women, and only age predicted an OSA diagnosis while sex and body mass index did not. All patients with diabetes mellitus type 2 (n = 7) and all but one of the hypertensive patients (n = 11) had significant OSA. Less than 0.2% of all patients undergoing polysomnography at Mayo Clinic were of Somali origin. Moderate-to-severe OSA was frequent in this select sample of individuals who underwent polysomnography. Hypertension and diabetes were present in most Somali-Americans with OSA. Given the rising prevalence of diabetes and hypertension in Somali-Americans, and the likely high prevalence of undiagnosed OSA, screening Somali-Americans for sleep disorders may contribute importantly to prevention, early detection, and reduction of cardiovascular and metabolic diseases in this population.


Trends in detection of new leprosy cases at two centres in Himachal Pradesh, India: a ten-year study.
An impressive decline in leprosy prevalence rate (PR) in all endemic districts of India is seen in the post-MDT era. However, the new case-detection rate, an important statistical indicator in leprosy control programmes, has not shown significant decline in spite of all efforts. In Himachal Pradesh, a decline in PR from 7.8 to 0.56/10000 between 1991 to 2000 is seen, and recently the State has won national acclaim for having achieved the goal of elimination of leprosy in all the districts. The vertical leprosy programme has been integrated into general health services of the state. An analysis of data from 1991 to 2000 of two leprosy control units of Himachal Pradesh, the Urban Leprosy Clinic in Shimla (ULC-S) and the District Leprosy Control Unit in Mandi (DLCU-M), showed no significant decline in the new cases detected. 277 and 271 new cases were detected at these centres respectively; these included 2.2% and 1.5% children of less than 14 years of age. Almost 75% of these cases were males and of MB type. A steadily increasing trend in the annual detection of new cases was seen at both the centres during the decade. The cases registered at DLCU-M were mainly indigenous to the district. At ULC-S, 45 migrant cases from other endemic areas-mainly from Nepal, Bihar, and Uttar Pradesh-had also contributed to the increased number of new cases. Other possible causes discussed for this higher new case detection, e.g. overdiagnosis, detection of backlog "hidden cases" and voluntary reporting of patients, do not differ from those seen in other parts of the country or the world.


ExoBCD: a comprehensive database for exosomal biomarker discovery in breast cancer.
Effective and safe implementation of precision oncology for breast cancer is a vital strategy to improve patient outcomes, which relies on the application of reliable biomarkers. As 'liquid biopsy' and novel resource for biomarkers, exosomes provide a promising avenue for the diagnosis and treatment of breast cancer. Although several exosome-related databases have been developed, there is still lacking of an integrated database for exosome-based biomarker discovery. To this end, a comprehensive database ExoBCD (https://exobcd.liumwei.org) was constructed with the combination of robust analysis of four high-throughput datasets, transcriptome validation of 1191 TCGA cases and manual mining of 950 studies. In ExoBCD, approximately 20 900 annotation entries were integrated from 25 external sources and 306 exosomal molecules (49 potential biomarkers and 257 biologically interesting molecules). The latter could be divided into 3 molecule types, including 121 mRNAs, 172 miRNAs and 13 lncRNAs. Thus, the well-linked information about molecular characters, experimental biology, gene expression patterns, overall survival, functional evidence, tumour stage and clinical use were fully integrated. As a data-driven and literature-based paradigm proposed of biomarker discovery, this study also demonstrated the corroborative analysis and identified 36 promising molecules, as well as the most promising prognostic biomarkers, IGF1R and FRS2. Taken together, ExoBCD is the first well-corroborated knowledge base for exosomal studies of breast cancer. It not only lays a foundation for subsequent studies but also strengthens the studies of probing molecular mechanisms, discovering biomarkers and developing meaningful clinical use.


Late Sodium Current Inhibitors as Potential Antiarrhythmic Agents.
Based on recent findings, an increased late sodium current (INa,late) plays an important pathophysiological role in cardiac diseases, including rhythm disorders. The article first describes what is INa,late and how it functions under physiological circumstances. Next, it shows the wide range of cellular mechanisms that can contribute to an increased INa,late in heart diseases, and also discusses how the upregulated INa,late can play a role in the generation of cardiac arrhythmias. The last part of the article is about INa,late inhibiting drugs as potential antiarrhythmic agents, based on experimental and preclinical data as well as in the light of clinical trials.


Use of high-speed size-exclusion chromatography for the study of protein folding and stability.
The urea denaturation of sperm whale myoglobin and thermal denaturation of ribonuclease have been studied by following the associated volume changes by size-exclusion chromatography on a Toya Soda TSK 3000SW gel permeation column. The permeation properties of the gel have been shown to be invariant in the following solvent systems: 0.2 M NaCl; 8.0 M urea-0.2 M NaCl; and 6.0 M guanidinium chloride ( GdmCl ). A precise measurement of the volume changes associated with solvent-induced protein denaturation is thus practicable. The column was calibrated in the above solvent systems by using 12 well-characterized proteins as standards. In the case of the denaturation of myoglobin by urea, the rate of equilibration of folded and unfolded species is slow on the time scale of the chromatographic experiment, and the two forms are well separated on the column in the transition region. Both the folded and unfolded species are shown to undergo significant swelling in urea. This result suggests that the view of denaturation based solely on the preferential solvation of the unfolded protein is incorrect. The rate of interconversion between folded and unfolded ribonuclease is fast relative to the time scale of the chromatographic experiments performed in this study. This is reflected in the fact that only one peak is observed in the elution profiles of ribonuclease in the transition region. Thermally unfolded ribonuclease has a smaller volume than the unfolded state in urea or GdmCl , suggesting that it has residual structure. The van't Hoff delta H for the thermal unfolding of ribonuclease calculated from the size-exclusion chromatographic experiments (36 +/- 3 kcal/mol) is significantly lower than previously reported values.(ABSTRACT TRUNCATED AT 250 WORDS)


Microbial metal resistance and metabolism across dynamic landscapes: high-throughput environmental microbiology.
Multidimensional gradients of inorganic compounds influence microbial activity in diverse pristine and anthropogenically perturbed environments. Here, we suggest that high-throughput cultivation and genetics can be systematically applied to generate quantitative models linking gene function, microbial community activity, and geochemical parameters. Metal resistance determinants represent a uniquely universal set of parameters around which to study and evaluate microbial fitness because they represent a record of the environment in which all microbial life evolved. By cultivating microbial isolates and enrichments in laboratory gradients of inorganic ions, we can generate quantitative predictions of limits on microbial range in the environment, obtain more accurate gene annotations, and identify useful strategies for predicting and engineering the trajectory of natural ecosystems.


Core-Shell Ferromagnetic Nanorod Based on Amine Polymer Composite (Fe3O4@DAPF) for Fast Removal of Pb(II) from Aqueous Solutions.
Heavy metal ion removal from wastewater constitutes an important issue in the water treatment industry. Although a variety of nanomaterials have been developed for heavy metal removal via adsorption, the adsorption capacity, removal efficiency, and material recyclability still remain a challenge. Here, we present novel Fe3O4@DAPF core-shell ferromagnetic nanorods (CSFMNRs) for the removal of Pb(II) from aqueous solutions; they were prepared by the facile surface modification of twin-like ferromagnetic Fe3O4 nanorods using a 2,3-diaminophenol and formaldehyde (DAPF)-based polymer. The crystallinity and structure of the Fe3O4 nanorods were confirmed via X-ray diffraction (XRD). Transmission electron microscopy (TEM) and X-ray photoelectron spectroscopy (XPS) revealed the core-shell morphology and composition of the materials. Pb(II) removal using the prepared Fe3O4@DAPF CSFMNRs was assessed, and comparable adsorption capacities (83.3 mg g(-1)) to the largest value were demonstrated. A thermodynamic study of the adsorption clearly indicated that the adsorption was exothermic and spontaneous. Due to the ferromagnetic properties with a high saturation magnetization value (56.1 emu g(-1)) of the nanorods, the nanorods exhibited excellent reusability with one of the fastest recovery times (25 s) among reported materials. Therefore, the Fe3O4@DAPF CSFMNRs can serve as recyclable adsorbent materials and as an alternative to commonly used sorbent materials for the rapid removal of heavy metals from aqueous solutions.


Improving outpatient phlebotomy service efficiency and patient experience using discrete-event simulation.
Purpose - The purpose of this paper is to present a simulation modeling application to reconfigure the outpatient phlebotomy service of an acute regional and teaching hospital in Hong Kong, with an aim to improve service efficiency, shorten patient queuing time and enhance workforce utilization. Design/methodology/approach - The system was modeled as an inhomogeneous Poisson process and a discrete-event simulation model was developed to simulate the current setting, and to evaluate how various performance metrics would change if switched from a decentralized to a centralized model. Variations were then made to the model to test different workforce arrangements for the centralized service, so that managers could decide on the service's final configuration via an evidence-based and data-driven approach. Findings - This paper provides empirical insights about the relationship between staffing arrangement and system performance via a detailed scenario analysis. One particular staffing scenario was chosen by manages as it was considered to strike the best balance between performance and workforce scheduled. The resulting centralized phlebotomy service was successfully commissioned. Practical implications - This paper demonstrates how analytics could be used for operational planning at the hospital level. The authors show that a transparent and evidence-based scenario analysis, made available through analytics and simulation, greatly facilitates management and clinical stakeholders to arrive at the ideal service configuration. Originality/value - The authors provide a robust method in evaluating the relationship between workforce investment, queuing reduction and workforce utilization, which is crucial for managers when deciding the delivery model for any outpatient-related service.


[Making optimal operation for a BNR process: modeling prediction and experimental verification].
Based on the process model of a BNR system (BCFS), the effects of operational parameters on the effluent quality were predicted by modeling, and were testified simultaneously by a lab-scale experiment, from which almost the same results in the modeling and the experiment were obtained. This means that modeling can be realizably applied to make the optimal operation schemes regardless of pilot-scale and/or full-scale experiments. Both the modeling and the experiment demonstrated that the bio-P removal performance was not influenced by the biomass amount in the anaerobic tank when the returned ratio (rA ) reached 1.5 and that rA had no significant correlation with COD and N removals. After the returned mixed liquor ratio (rB) increased over 2, the TN removal efficiency was not improved any more, and the COD and TP removals were not influenced by the variations of the rB. The returned mixed liquor ratio rC had almost no influences on the COD, TP and TN removals. Further, the COD and TP removals were not influenced when the dissolved oxygen (DO(R5)) in the aerobic tank was in the range of 1-2.5 mg x L(-1), but the effluent NH4+ -N increased over 1 mg x L(-1) when DO(R5 ) was below 2 mg x L(-1). So, the optimal operational parameters for the BCFS should be set at rA = 2, rB 2-2.5, rC = 0, DO(R5) 2-2.5 mg x L(-1).


The correlation between ultrasonographic features, bFGF, and the local invasiveness of thyroid papillary carcinoma.
The present study aimed to investigate the correlation between ultrasonographic features, basic fibroblast growth factor (bFGF), and the local invasiveness of papillary thyroid carcinoma (PTC).A total of 350 samples of thyroid nodules were collected. Routine ultrasonography was performed before the operation and routine pathological diagnosis and bFGF detection were performed after the operation.'These 350 samples of thyroid nodules included 90 samples of nodular goiter, 36 samples of focal thyroiditis, and 224 samples of PTC. A total of 326 thyroid nodules were examined for bFGF. The results revealed that the difference in the expression of bFGF between the benign and malignant groups was statistically significant (P < .05) and the difference in the positive expression of bFGF between the invasive and non-invasive PTC groups was statistically significant (P < .05).Whether the shape of PTC is regular or not and whether there is micro-calcification in PTC and other ultrasonographic features, the size and location of the lesions and the age of the patient help make a preliminary prediction of local invasiveness before the operation. Postoperative detection of bFGF is helpful for further risk assessments of PTC.


Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep Apnea.
Introduction: Obstructive sleep apnea (OSA) is a disorder in which ventilation becomes disrupted due to a complete or partial upper airway obstruction Altered craniofacial morphology is one of the most important anatomical factors associated with obstructive sleep apnea (OSA). Studies have assessed craniofacial features in the non-syndromic pediatric population. The aim of this study was to analyze the orthodontic and facial characteristic of craniofacial syndromic children referred for polysomnography (PSG) and to assess the correlation with the apnea-hypopnea index (AHI). Methods: In the current cross-sectional study, consecutive syndromic patients referred for PSG were invited to participate. A systematic clinical examination including extra- and intra-oral orthodontic examination was performed by calibrated orthodontists. Standardized frontal and profile photographs with reference points were taken and analyzed using ImageJ® software to study the craniofacial morphology. PSG data were analyzed for correlation with craniofacial features. STROBE guidelines were strictly adopted during the research presentation. Results: The sample included 52 syndromic patients (50% females, mean age 9.38 ± 3.36 years) diagnosed with 17 different syndromes, of which 24 patients had craniofacial photography analysis carried out. Most of the sample (40%) had severe OSA, while only 5.8% had no OSA. Down's syndrome (DS) was the most common syndrome (40%) followed by Goldenhar syndrome (5%), Pierre Robin Sequence (5%), and other syndromes. The severity of AHI was significantly correlated with decreased midfacial height. increased thyromental angle and cervicomental angle, decreased mandibular angle, and decreased upper facial height. All patients with DS were diagnosed with OSA (57% severe OSA), and their ODI was significantly correlated with increased intercanthal distance. Obesity was not correlated to the severity of AHI for syndromic patients. Conclusions: Decreased midfacial height and obtuse thyromental angle were correlated with increased AHI for syndromic patients. Increased intercanthal distance of DS patients could be a major predictor of OSA severity. Obesity does not seem to play a major role in the severity of OSA for syndromic patients. Further studies with larger samples are necessary to confirm these findings.


[Dynamic changes in serum neuron-specific enolase levels in neonates].
To determine the postnatal changes in serum neuron-specific enolase (NSE) level in neonates. Twenty full-term infants and 30 preterm infants without a history of asphyxia or neurological disease born over the same period were enrolled. The 30 preterm infants consisted of 15 late preterm births and 15 early preterm births. Serum NSE levels were determined using electrochemical immunosensor array on postnatal days 1, 3 and 7. Ten healthy adults volunteered as controls. Serum NSE levels in neonates of the full-term group and two preterm groups gradually decreased with increasing birth age (P<0.01). All the three groups of neonates had significantly higher serum NSE levels on postnatal days 1, 3, and 7 than the healthy adult group (P<0.01). The early preterm group had significantly higher serum NSE levels than the full-term group on postnatal days 1, 3, and 7 (P<0.01). Serum NSE level in neonates during early postnatal days is related to gestational and birth ages and higher than the normal adult level. The reference value for normal serum NSE level in neonates should be determined according to gestational and birth ages, rather than the normal adult level.


[Self-expanding metal stents in the treatment of neoplastic esophageal stenosis. The technic and preliminary results].
Self-expanding metal stents have been recently used for the treatment of neoplastic esophageal stenoses. In our series, nitinol Strecker stents were implanted in ten patients with malignant esophageal intrinsic or extrinsic strictures, as a definitive palliation. Thirteen stents in all were used: two stents were positioned in three patients to recanalize the esophagus. The prostheses could always be inserted in the treated patients and in all of them swallowing was markedly improved. No major early complications were observed after stent insertion. All the stents but one were patent until the patient's death. Two patients are alive and bearing well-functioning stents. Self-expanding metal stents are to be preferred to plastic endoscopic tubes because their caliber is smaller at the time of insertion and they do not require general anesthesia, as endoscopic tubes sometimes require. Moreover, their complication rate is lower for both early and late complications. Tumor ingrowth through the stent mesh with stent occlusion is the major pitfall of these prostheses, together with the impossibility to use them when esophageal fistulas are present: these limitations will be soon overcome when silicone-coated expandable stents are on the market.


The Psychiatric Impact of HIV.
This Viewpoint is based on a recent panel featured at the 2017 Winter Conference on Brain Research in which the psychiatric comorbidities of HIV infection were discussed. Psychiatric comorbid conditions occur at high rates in HIV infected patients, complicating treatment and contributing to poor outcomes. A complex relationship between HIV infection and psychiatric comorbidity is an active area of investigation, but increased awareness of the impact of psychiatric complications of NeuroAIDS is needed in both the laboratory and the clinic to better understand and treat these interrelated conditions.


Fatty Acid Uptake in T Cell Subsets Using a Quantum Dot Fatty Acid Conjugate.
Fatty acid (FA) metabolism directly influences the functional capabilities of T cells in tumor microenvironments. Thus, developing tools to interrogate FA-uptake by T cell subsets is important for understanding tumor immunosuppression. Herein, we have generated a novel FA-Qdot 605 dye conjugate with superior sensitivity and flexibility to any of the previously commercially available alternatives. For the first time, we demonstrate that this nanoparticle can be used as a specific measure of fatty acid uptake by T cells both in-vitro and in-vivo. Flow cytometric analysis shows that both the location and activation status of T cells determines their FA uptake. Additionally, CD4+ Foxp3+ regulatory T cells (Tregs) uptake FA at a higher rate than effector T cell subsets, supporting the role of FA metabolism for Treg function. Furthermore, we are able to simultaneously detect glucose and fatty acid uptake directly within the tumor microenvironment. Cumulatively, our results suggest that this novel fluorescent probe is a powerful tool to understand FA utilization within the tumor, thereby providing an unprecedented opportunity to study T cell FA metabolism in-vivo.


Self-consistent theory of capillary-gravity-wave generation by small moving objects.
We investigate theoretically the onset of capillary-gravity waves created by a small object moving at the water-air interface. It is well established that, for straight uniform motion, no steady waves appear at velocities below the minimum phase velocity c(min)=23 cm/s. At higher velocities, the emission of capillary-gravity waves creates an additional drag force. The behavior of this force near the critical velocity is still poorly understood. A linear-response theory where the object is replaced by an effective pressure source predicts a singular behavior for the wave drag. However, experimental data tend to indicate a more continuous transition. In this paper, we show that a proper treatment of the flow equations around the obstacle can regularize wave emission, even in the linear wave approximation, thereby ensuring a continuous behavior of the drag force.


Grape Juice as a Bait for Anastrepha suspensa (Diptera: Tephritidae) and Zaprionus indianus (Diptera: Drosophilidae).
In field tests conducted in south Florida to test grape juice as a bait for the Caribbean fruit fly, Anastrepha suspensa Loew, high numbers of Zaprionus indianus Gupta were captured in traps with aqueous grape juice. These experiments included comparisons of grape juice bait with established A. suspensa protein-based baits (ammonium acetate + putrescine lures, or torula yeast) or wine, a bait found previously to be attractive to Z. indianus. Effects of different preservatives (polypropylene glycol, polyethylene glycol, proxel, or sodium tetraborate) and bait age were also tested. Traps with grape juice baits captured more A. suspensa than unbaited traps, but more were captured in traps with grape juice plus preservative baits and the highest numbers were captured in traps containing the established protein-based baits. In contrast, grape juice baits without preservative that were prepared on the day of deployment (0 d) or that were aged for 3-4 d in the laboratory captured the highest numbers of Z. indianus, while solutions that were aged in the laboratory for 6 or 9 d captured fewer. Although these studies found that aqueous grape juice is a poor bait for A. suspensa, we found that actively fermenting aqueous grape juice may be an effective bait for Z. indianus.


Is it home delivery or health facility? Community perceptions on place of childbirth in rural Northwest Tanzania using a qualitative approach.
In low and middle-income countries, pregnancy and delivery complications may deprive women and their newborns of life or the realization of their full potential. Provision of quality obstetric emergency and childbirth care can reduce maternal and newborn deaths. Underutilization of maternal and childbirth services remains a public health concern in Tanzania. The aim of this study was to explore elements of the local social, cultural, economic, and health systems that influenced the use of health facilities for delivery in a rural setting in Northwest Tanzania. A qualitative approach was used to explore community perceptions of issues related to low utilization of health facilities for childbirth. Between September and December 2017, 11 focus group discussions were conducted with women (n = 33), men (n = 5) and community health workers (CHWs; n = 28); key informant interviews were conducted with traditional birth attendants (TBAs; n = 2). Coding, identification, indexing, charting, and mapping of these interviews was done using NVIVO 12 after manual familiarization of the data. Data saturation was used to determine when no further interviews or discussions were required. Four themes emerge; self-perceived obstetric risk, socio-cultural issues, economic concerns and health facility related factors. Health facility delivery was perceived to be crucial for complicated labor. However, the idea that childbirth was a "normal" process and lack of social and cultural acceptability of facility services, made home delivery appealing to many women and their families. In addition, out of pocket payments for suboptimal quality of health care was reported to hinder facility delivery. Home delivery persists in rural settings due to economic and social issues, and the cultural meanings attached to childbirth. Accessibility to and affordability of respectful and culturally acceptable childbirth services remain challenging in this setting. Addressing barriers on both the demand and supply side could result in improved maternal and child outcomes during labor and delivery.


Fe2 O3 -TiO2 nanocomposites for enhanced charge separation and photocatalytic activity.
Photocatalysis provides a cost effective method for both renewable energy synthesis and environmental purification. Photocatalytic activity is dominated by the material design strategy and synthesis methods. Here, for the first time, we report very mild and effective photo-deposition procedures for the synthesis of novel Fe2 O3 -TiO2 nanocomposites. Their photocatalytic activities have been found to be dramatically enhanced for both contaminant decomposition and photoelectrochemical water splitting. When used to decompose a model contaminant herbicide, 2,4-dichlorophenoxyacetic acid (2,4-D), monitored by both UV/Vis and total organic carbon (TOC) analysis, 10% Fe-TiO2 -H2 O displayed a remarkable enhancement of more than 200 % in the kinetics of complete mineralisation in comparison to the commercial material P25 TiO2 photocatalyst. Furthermore, the photocurrent is nearly double that of P25. The mechanism for this improvement in activity was determined using density functional theory (DFT) and photoluminescence. These approaches ultimately reveal that the photoelectron transfer is from TiO2 to Fe2 O3 . This favours O2 reduction which is the rate-determining step in photocatalytic environmental purification. This in situ charge separation also allows for facile migration of holes from the valence band of TiO2 to the surface for the expected oxidation reactions, leading to higher photocurrent and better photocatalytic activity.


The Association Between Obstructive Sleep Apnea and Arrhythmias.
Obstructive sleep apnea (OSA) is caused by intermittent episodes of partial or complete closure of the upper airway, leading to apneic episodes while the patient is asleep. Atrial fibrillation (AF) leads to more than 750,000 hospitalizations per year and accounts for an estimated 130,000 deaths each year. The death rate from AF as the primary or a contributing cause of death has been rising for more than two decades. The material reviewed in this paper focuses on the association between OSA and arrhythmias. It goes into the details of the epidemiology, pathophysiology, and types of arrhythmias and the therapies seen in association with OSA.


Uterine segmentation and volume measurement in uterine fibroid patients' MRI using fuzzy C-mean algorithm and morphological operations.
Uterine fibroids are common benign tumors of the female pelvis. Uterine artery embolization (UAE) is an effective treatment of symptomatic uterine fibroids by shrinkage of the size of these tumors. Segmentation of the uterine region is essential for an accurate treatment strategy. In this paper, we will introduce a new method for uterine segmentation in T1W and enhanced T1W magnetic resonance (MR) images in a group of fibroid patients candidated for UAE in order to make a reliable tool for uterine volumetry. Uterine was initially segmented using Fuzzy C-Mean (FCM) method in T1W-enhanced images and some morphological operations were then applied to refine the initial segmentation. Finally redundant parts were removed by masking the segmented region in T1W-enhanced image over the registered T1W image and using histogram thresholding. This method was evaluated using a dataset with ten patients' images (sagittal, axial and coronal views). We compared manually segmented images with the output of our system and obtained a mean similarity of 80%, mean sensitivity of 75.32% and a mean specificity of 89.5%. The Pearson correlation coefficient between the areas measured by the manual method and the automated method was 0.99. The quantitative results illustrate good performance of this method. By uterine segmentation, fibroids in the uterine may be segmented and their properties may be analyzed.


Evaluation of interprofessional teamwork modules implementation in an emergency department - A mixed-methods case study of implementation fidelity.
The need for interprofessional collaboration has been emphasized by health organizations. This study was part of a mixed-methods evaluation of interprofessional teamwork modules implementation in an emergency department (ED), where a major intervention was didactic training of team roles and behaviours in combination with practice scenarios. The aim of the study was to evaluate the implementation of interprofessional teamwork modules from a staff perspective and focus on how implementation fidelity may be sustained. In this mixed-methods case study we triangulated staff data from structured observations, semi-structured interviews, and a questionnaire repeated at intervals over 5 years. A protocol of key team behaviours was used for the observations conducted in June 2016 and June 2018, 1½ and 3½ years after the initial implementation. A purposeful sample of central informants, including nursing and medical professionals and section managers, was interviewed from May to June 2018. The interview guide consisted of open-ended questions about the experiences of interprofessional teamwork modules and the implementation process. The questionnaire consisted of five statements about the perceived workload, interprofessional collaboration and patient satisfaction, where each was rated on a Likert scale. Good fidelity to four out of five key team behaviours was observed during the first year. However, fidelity was sustained only for one key team behaviour after 3 years. We conducted a qualitative content analysis of 18 individual interviews. The theme Enjoying working together, but feeling less efficient emerged of the interprofessional teamwork modules, despite shorter ED stays for the patients. Negative experiences of the staff included passive team leaders and slow care teams. The theme Stimulating to create, but challenging to sustain emerged of the implementation process, where barriers were not adressed and implementation fidelity not sustained. The staff questionnaire showed that the perceived work conditions was improved in periods of high fidelity, but deteriorated to pre-implementation levels as fidelity to the key team behaviours decayed in 2018. Extensive planning and successful initial implementation were not enough to sustain the key behaviour changes in the study. The use of implementation frameworks can be helpful in future projects.


[Epidemiological and clinical aspects of paediatric HIV infections in Albert-Royer Paediatric Hospital (Dakar, Senegal)].
Human Immunodeficiency Virus (HIV) infection prevalence rate is estimated at 1.4% in Senegal, and about 3,000 children could be infected. HIV positive children are followed up since 2000 in Albert Royer Hospital (Dakar, Senegal). To describe clinical and epidemiological aspects of HIV paediatric infection, and to evaluate the implementation of high active antiretroviral therapy in HIV positive children in our country. Over a period of three years, the medical reports of 98 infected patients have been collected, 96% with HIV 1 infection. Most of the patients had a maternally transmitted HIV infection (99%). At their enrollment, the median age was 60 months; malnutrition (79%), persistent lymphadenopathy (65%) and skin lesions (64%) were the common clinical manifestations. Thirty-nine percent of the patients were in class C (CDC) and 81% had CD4 cell count< or =25%. Median viral load were 421,852 copies/ml at presentation. Seven infants had a rapid progressive disease with encephalopathy. Thirty-six patients received high active antiretroviral therapy with high observance and good tolerance. This study allowed to define clinical and biological profile of paediatric HIV infection in our country and to update the implementation of high active antiretroviral therapy.


The exclusive effects of chaperonin on the behavior of proteins with 52 knot.
The folding of proteins with a complex knot is still an unresolved question. Based on representative members of Ubiquitin C-terminal Hydrolases (UCHs) that contain the 52 knot in the native state, we explain how UCHs are able to unfold and refold in vitro reversibly within the structure-based model. In particular, we identify two, topologically different folding/unfolding pathways and corroborate our results with experiment, recreating the chevron plot. We show that confinement effect of chaperonin or weak crowding greatly facilitates folding, simultaneously slowing down the unfolding process of UCHs, compared with bulk conditions. Finally, we analyze the existence of knots in the denaturated state of UCHs. The results of the work show that the crowded environment of the cell should have a positive effect on the kinetics of complex knotted proteins, especially when proteins with deeper knots are found in this family.