Selected anteromedial coronoid fractures can be treated nonoperatively.

Abstract:
BACKGROUND
Surgical fixation is currently recommended for unstable anteromedial coronoid fractures, but the role of nonoperative management is not well defined. Our purpose was to report the functional and radiographic outcomes of select patients managed nonoperatively.

METHODS
Between 2006 and 2012, 10 patients with anteromedial coronoid fractures underwent nonoperative treatment. Outcomes assessed included elbow range of motion (ROM), stability, strength, radiographs, and 3 functional questionnaires, including the Patient-Rated Elbow Evaluation, Disabilities of Arm, Shoulder and Hand, and Mayo Elbow Performance Index.

RESULTS
There were 9 anteromedial subtype 2 coronoid fractures and 1 subtype 3. Mean fragment size was 5 mm, with a mean displacement of 3 mm for the subtype 2 fractures. The subtype 3 fracture was 9 mm in size with 1 mm of maximal gap displacement. At a mean follow-up of 50 months (range, 12-83 months), the average ROM of the affected elbow was 137° ± 8° of flexion, 2° ± 5° of extension, 88° ± 5° of pronation, and 86° ± 10° of supination. The mean Patient-Rated Elbow Evaluation score was 9 ± 13, Mayo Elbow Performance Index score was 94 ± 8, and the Disabilities of Arm, Shoulder and Hand score was 7 ± 9. All patients had bony union without radiographic arthrosis. There were no cases of recurrent instability or delayed surgical intervention.

CONCLUSIONS
Current indications for nonoperative management, based on the results of this study, include fractures that are small, minimally displaced, and most importantly, demonstrate no evidence of elbow subluxation. The elbow joint must be congruent and demonstrate a stable ROM to a minimum of 30° of extension. For selected anteromedial coronoid fractures, nonoperative management is an option that can lead to good clinical and radiographic outcomes.

Chan|Kevin|K|
Faber|Kenneth J|KJ|
King|Graham J W|GJ|
Athwal|George S|GS|

anteromedial coronoid
coronoid
fracture
elbow
instability
varus posteromedial instability


Self-Adjuvanted Molecular Activator (SeaMac) Nanovaccines Promote Cancer Immunotherapy.

Abstract: Neoantigen-based immunotherapy is a promising treatment option for many types of cancer. However, its efficacy and abscopal effect are limited by impotent neoantigens, high treatment costs, and complications due to action of adjuvants. Here, the design and synthesis of nanovaccines are reported, based on self-adjuvanted, polymer nanoparticles with in vivo neoantigen-harvesting and molecular activating capabilities. These nanovaccines inhibit tumor growth significantly and prolong the survival of tumor-bearing mice in both colon carcinoma 26 (CT26) and B16-F10 tumor models. Mechanistic studies suggest that as-synthesized nanovaccines can promote dendritic cell maturation and accumulation expeditiously in lymph nodes, leading to the expansion of cytotoxic CD8+ T cells. Moreover, these nanovaccines elicit abscopal effects in CT26 and B16-F10 tumors without the need for adjuvants or immune checkpoint inhibitors. Combined with an anti-PD-L1 antibody, nanovaccines can evoke robust, long-term memory immune response, as evidenced by tumor growth inhibition and high survival rates (∼ 67%) over 90 days. These results highlight the potential of using self-adjuvanted nanovaccines as a simple, safe, and affordable strategy to boost neoantigen-based cancer immunotherapy.

Luo|Zichao|Z| He|Tao|T| Liu|Peng|P| Yi|Zhigao|Z| Zhu|Shunyao|S| Liang|Xiuqi|X| Kang|Entang|E| Gong|Changyang|C| Liu|Xiaogang|X|0000-0003-2517-5790

self-adjuvanted
nanovaccine
abscopal effect
neoantigen-harvesting
tumor immunotherapy


Implicit representation of the auditory space: contribution of the left and right hemispheres.

Abstract: Spatial cues contribute to the ability to segregate sound sources and thus facilitate their detection and recognition. This implicit use of spatial cues can be preserved in cases of cortical spatial deafness, suggesting that partially distinct neural networks underlie the explicit sound localization and the implicit use of spatial cues. We addressed this issue by assessing 40 patients, 20 patients with left and 20 patients with right hemispheric damage, for their ability to use auditory spatial cues implicitly in a paradigm of spatial release from masking (SRM) and explicitly in sound localization. The anatomical correlates of their performance were determined with voxel-based lesion-symptom mapping (VLSM). During the SRM task, the target was always presented at the centre, whereas the masker was presented at the centre or at one of the two lateral positions on the right or left side. The SRM effect was absent in some but not all patients; the inability to perceive the target when the masker was at one of the lateral positions correlated with lesions of the left temporo-parieto-frontal cortex or of the right inferior parietal lobule and the underlying white matter. As previously reported, sound localization depended critically on the right parietal and opercular cortex. Thus, explicit and implicit use of spatial cues depends on at least partially distinct neural networks. Our results suggest that the implicit use may rely on the left-dominant position-linked representation of sound objects, which has been demonstrated in previous EEG and fMRI studies.

Attention
Auditory spatial processing
Lesion studies
Sound object segregation
Unilateral neglect


Cyclooxygenase-2 regulates HPS patient serum induced-directional collective HPMVEC migration via PKC/Rac signaling pathway.

Abstract: Hepatopulmonary syndrome (HPS) is a serious complication in patients with advanced liver disease. The pathological pulmonary angiogenesis contributes to the progression of HPS. Importantly, directional collective migration of endothelial cells is a critical event for pathological angiogenesis. Previously, we have demonstrated that the over-expression of Cyclooxygenase-2 (COX-2) was an important factor in the experimental HPS. However, the role of COX-2 in the directional collective migration of human pulmonary microvascular endothelial cells (HPMVECs) is unclear. Our study aims to evaluate the potential effect of COX-2 in the directional collective migration of HPMVECs under the stimulation of HPS patient serum. In this study, 9 patients with stable liver cirrhosis were screened for presence of HPS. We confirmed that HPS patient serum dramatically promoted the directional collective migration and angiogenesis of HPMVECs, while the COX-2 selective antagonist parecoxib significantly inhibited the directional collective migration of HPMVEC under the stimulation of HPS patient serum. In addition, HPS patient serum significantly upregulated the phosphorylation of PKC and promoted the activation of Rac via COX-2/PGE2 signaling pathway. Notably, silencing PKC activation attenuated the directional collective migration of HPMVEC induced by HPS patient serum. In conclusion, these results indicate that PKC/Rac signaling induced by COX-2 modulates collective directional migration of HPMVEC during pathological pulmonary angiogenesis in HPS patients.

Tang|Xi|X| Liu|Chang|C| Chen|Lin|L| Yang|Zhiyong|Z| Belguise|Karine|K| Wang|Xiaobo|X| Lu|Kaizhi|K| Yan|Hong|H| Yi|Bin|B|

Cyclooxygenase-2
Hepatopulmonary syndrome
Angiogenesis
Collective cell migration
Pulmonary vascular endothelial cells


Improving scheduling performance in congested networks.

Abstract: With continuously rising trends in applications of information and communication technologies in diverse sectors of life, the networks are challenged to meet the stringent performance requirements. Increasing the bandwidth is one of the most common solutions to ensure that suitable resources are available to meet performance objectives such as sustained high data rates, minimal delays, and restricted delay variations. Guaranteed throughput, minimal latency, and the lowest probability of loss of the packets can ensure the quality of services over the networks. However, the traffic volumes that networks need to handle are not fixed and it changes with time, origin, and other factors. The traffic distributions generally follow some peak intervals and most of the time traffic remains on moderate levels. The network capacity determined by peak interval demands often requires higher capacities in comparison to the capacities required during the moderate intervals. Such an approach increases the cost of the network infrastructure and results in underutilized networks in moderate intervals. Suitable methods that can increase the network utilization in peak and moderate intervals can help the operators to contain the cost of network intrastate. This article proposes a novel technique to improve the network utilization and quality of services over networks by exploiting the packet scheduling-based erlang distribution of different serving areas. The experimental results show that significant improvement can be achieved in congested networks during the peak intervals with the proposed approach both in terms of utilization and quality of service in comparison to the traditional approaches of packet scheduling in the networks. Extensive experiments have been conducted to study the effects of the erlang-based packet scheduling in terms of packet-loss, end-to-end latency, delay variance and network utilization.

Congestion
Erlang
Packet scheduling
Adaptive scheduling
Machine learning aided scheduling
Network performance
Self-organizing
TIPS


Experimental and theoretical calculation studies on the structure elucidation and absolute configuration of calyxins from Alpinia katsumadai.

Abstract: Six novel calyxins, named calyxin T-W, ent-calyxin T and ent-calyxin U were isolated from the seeds of Alpinia katsumadai Hayata. Their relative configurations were elucidated by means of detailed UV, IR, NMR and MS spectroscopic data. Their absolute configurations were assigned by collaborative studies on single crystal X-ray diffraction analysis, Mosher's method, electronic circular dichroism (ECD), optical rotation and theoretical calculations. These compounds are Friedel-Cranft alkylation adducts composed of coexisted diarylheptanoids and flavanone from the seeds of Alpinia katsumadai. The antiproliferative activity of the six compounds against NCI-H460, HeLa, SMMC-7721 and HCT-116 cell lines was also reported, and most of them showed moderate to strong activities.

Wang|Xiao-Bing|XB| Yang|Chang-Shui|CS| Luo|Jian-Guang|JG| Zhang|Chao|C| Luo|Jun|J| Yang|Ming-Hua|MH| Kong|Ling-Yi|LY|

Theoretical calculation
Absolute configuration
Calyxin
Alpinia katsumadai


Elisabeth Kübler-Ross and the "Five Stages" Model in a Sampling of Recent Textbooks Published in 10 Countries Outside the United States.

Abstract: A previous article in this journal examined some aspects of the enduring influence of Elisabeth Kübler-Ross's "five stages" model through a sampling of recent American textbooks in selected academic disciplines and professional fields. This article offers a parallel sampling of 47 textbooks published in 10 different countries outside the United States. The questions to be answered are as follows: Does the "five stages" model appear without significant change in the textbooks described here?Is the "five stages" model applied in these textbooks to issues involving loss, grief, and bereavement as well as to those involving terminal illness and dying?Is the "five stages" model criticized in some or all of these textbooks?If so, is the criticism sufficient to argue that, while the "five stages" model might be presented as an important historical framework, it should no longer be regarded as a sound theory to guide contemporary education and practice?

Elisabeth Kübler-Ross
textbooks
grief
dying
the “five stages” model


Interleukin-6 and Interleukin-10 in mood disorders: A population-based study.

Abstract:
OBJECTIVE
The aim of this study was to assess if cytokines levels (IL-6 and IL-10) are related to major depressive disorder (MDD) and bipolar disorder (BD), in a population-based study.

METHODS
This was a cross-sectional study population-based, involving 1037 people aged 18-35. MDD, BD, anxiety and suicide risk were assessed using the Mini International Neuropsychiatric Interview. Serum IL-6 and IL-10 were measured by ELISA using a commercial kit.

RESULTS
The total sample comprised 1034 young adults, being 14.4% with MDD and 13.7% with BD. MDD and BD groups showed significantly higher serum IL-6 levels (p ≤ 0.001) and IL-10 levels (p ≤ 0.001) when compared to healthy control group. No correlation was found between serum IL-6 and IL-10 levels in health control group (p = 0.830; r = -0.008), non-suicide risk (p = 0.337; r = 0.032) and non-anxiety disorder (p = 0.375; r = 0.031). Covariance analysis showed that mood disorders alone, increase both interleukin levels (IL-6, p = 0.019; and IL-10, p = 0.026), whilst the interaction of mood disorders and suicide risk or anxiety disorders did not.

CONCLUSION
Our results suggest that inflammatory dysregulation may be involved in the physiopathology of mood disorders and serum IL-6 and IL-10 levels are putative biomarkers for these disorders.

Wiener|Carolina David|CD|
Moreira|Fernanda Pedrotti|FP|
Portela|Luis Valmor|LV|
Strogulski|Nathan R|NR|
Lara|Diogo R|DR|
da Silva|Ricardo Azevedo|RA|
Souza|Luciano Dias de Mattos|LDM|
Jansen|Karen|K|
Oses|Jean Pierre|JP|

D011569:Psychiatric Status Rating Scales


Long-Term Survey Is Necessary to Reveal Various Shifts of Microbial Composition in Corals.

Abstract: The coral holobiont is the assemblage of coral host and its microbial symbionts, which functions as a unit and is responsive to host species and environmental factors. Although monitoring surveys have been done to determine bacteria associated with coral, none have persisted for >1 year. Therefore, potential variations in minor or dominant community members that occur over extended intervals have not been characterized. In this study, 16S rRNA gene amplicon pyrosequencing was used to investigate the relationship between bacterial communities in healthy Stylophora pistillata in tropical and subtropical Taiwan over 2 years, apparently one of the longest surveys of coral-associated microbes. Dominant bacterial genera in S. pistillata had disparate changes in different geographical setups, whereas the constitution of minor bacteria fluctuated in abundance over time. We concluded that dominant bacteria (Acinetobacter, Propionibacterium, and Pseudomonas) were stable in composition, regardless of seasonal and geographical variations, whereas Endozoicomonas had a geographical preference. In addition, by combining current data with previous studies, we concluded that a minor bacteria symbiont, Ralstonia, was a keystone species in coral. Finally, we concluded that long-term surveys for coral microbial communities were necessary to detect compositional shifts, especially for minor bacterial members in corals.

Yang|Shan-Hua|SH|
Tseng|Ching-Hung|CH|
Huang|Chang-Rung|CR|
Chen|Chung-Pin|CP|
Tandon|Kshitij|K|
Lee|Sonny T M|STM|
Chiang|Pei-Wen|PW|
Shiu|Jia-Ho|JH|
Chen|Chaolun A|CA|
Tang|Sen-Lin|SL|

long-term survey
shifts
microbial composition
corals
Stylophora pistillata


Computed tomographic colonography (CTC); colorectal cancer diagnosis with CTC in an Auckland population.

Abstract:
AIM
To determine the sensitivity of computed tomographic colonography (CTC) in the detection of colorectal cancer in our population and evaluate the reasons why these lesions may be missed on CTC.

METHODS
All patients who underwent CTC in the 65-month period from 1 January 2004 to 1 July 2009 were included in the analysis. Demographic data and CTC findings were recorded, according to the CT Colonography Reporting and Data System. Data were cross-matched with the National Cancer Registry results for colorectal cancer cases between 1 January 2004 and 1 October 2009, 3 months longer to include any delayed diagnoses.

RESULTS
There were 2026 consecutive CTC patients, comprising 52.6% female, average age of 60 years; range 19-87. Approximately 84% were symptomatic. There were 45 confirmed colorectal cancers among this patient group in the National Cancer Registry during the relevant time period compared with 43 suspected cancers on CTC, giving a miss rate of 2 of 45, or 4.4%.

CONCLUSION
The sensitivity of 95% for CTC in the detection of colorectal cancer compares favourably with the published national and international data.

body CT
gastrointestinal imaging
quality assurance


Cognitive Heterogeneity across Schizophrenia and Bipolar Disorder: A Cluster Analysis of Intellectual Trajectories.

Abstract:
OBJECTIVE
Cognitive dysfunction cut across diagnostic categories and is present in both schizophrenia and bipolar disorder, although with considerable heterogeneity in both disorders. This study examined if distinct cognitive subgroups could be identified across schizophrenia and bipolar disorder based on the intellectual trajectory from the premorbid phase to after illness onset.

METHOD
Three hundred and ninety-eight individuals with schizophrenia (n = 223) or bipolar I disorder (n = 175) underwent clinical and neuropsychological assessment. Hierarchical and k-means cluster analyses using premorbid (National Adult Reading Test) and current IQ (Wechsler Abbreviated Scale of Intelligence) estimates were performed for each diagnostic category, and the whole sample collapsed. Resulting clusters were compared on neuropsychological, functional, and clinical variables. Healthy controls (n = 476) were included for analyses of neuropsychological performance.

RESULTS
Cluster analyses consistently yielded three clusters: a relatively intact group (36% of whole sample), an intermediate group with mild cognitive impairment (44%), and an impaired group with global deficits (20%). The clusters were validated by multinomial logistic regression and differed significantly for neuropsychological, functional, and clinical measures. The relatively intact group (32% of the schizophrenia sample and 42% of the bipolar sample) performed below healthy controls for speeded neuropsychological tests.

CONCLUSIONS
Three cognitive clusters were identified across schizophrenia and bipolar disorder using premorbid and current IQ estimates. Groups differed for clinical, functional, and neuropsychological variables, implying their meaningfulness. One-third of the schizophrenia sample belonged to the relatively intact group, highlighting that neuropsychological assessment is needed for the precise characterization of the individual.

Vaskinn|Anja|A|0000-0003-0339-6170
Haatveit|Beathe|B|
Melle|Ingrid|I|
Andreassen|Ole A|OA|
Ueland|Torill|T|
Sundet|Kjetil|K|

D000328:Adult
D001714:Bipolar Disorder
D016022:Case-Control Studies
D016000:Cluster Analysis
D060825:Cognitive Dysfunction
D005260:Female
D006801:Humans
D008297:Male
D008875:Middle Aged
D009483:Neuropsychological Tests
D012565:Schizophrenic Psychology
D055815:Young Adult

Cognition
Heterogeneity
Schizophrenia
Bipolar disorder
Neuropsychology
Psychosis


Synthesis, characterization and in-vitro prolonged release of L-DOPA using a novel amphiphilic hydrogel based on sodium alginate-polypyrrole.

Abstract: As a serious neurodegenerative disorder, the prevalence of Parkinson's disease is predicted to dramatically increase in the coming decades. Despite the development of numerous drugs for its treatment, oral administration of levodopa has remained the simplest and most effective pharmacological approach in the management of Parkinson's disease. In this research, the levodopa-imprinted hydrogel was synthesized by reverse emulsion polymerization in the presence of levodopa followed by modification with polypyrrole. The antioxidant activity of amphiphilic non-levodopa-imprinted hydrogel was studied by 2,2-Diphenyl-1-picrylhydrazyl active radicals, which indicated 100% efficiency in the applied amount. Amphiphilic non-levodopa-imprinted hydrogel cytotoxicity was evaluated by MTT assay, which confirmed no significant toxicity after 24 and 48 h even at high concentrations. Moreover, in vitro releasing property of the levodopa-imprinted hydrogel was studied in the pH range of 4 to 7.4, which reached 60 and 80% within 160 h, respectively.

Lakouraj|Moslem Mansour|MM|
Rezaei|Masoume|M|
Hasantabar|Vahid|V|

Amphiphilic
Levodopa
Polypyrrole
In vitro releasing
Imprinted hydrogel


An Intervention Program Targeting Daily Adaptive Skills Through Executive Function Training for Adults with Autism Spectrum Disorder: A Pilot Study.

Abstract:
OBJECTIVE
Adults with autism spectrum disorders (ASD) experience significant difficulties with executive functioning (EF) and related adaptive skills, yet the lack of interventions in South Korea targeting these areas has resulted in a heightened need to develop an evidence- based program. Therefore, we developed a novel intervention aiming to enhance everyday EF and daily adaptive skills in adults with high-functioning ASD and conducted a pilot study to evaluate the validity and feasibility of the program.

METHODS
A behavioral intervention of 10-weekly sessions was developed based on literature searches and focus group interviews. Seven adults with high-functioning ASD (mean age=20.29) participated in a single-group pilot trial. We used self and parent-report questionnaires as well as skills measured by assessment instruments to analyze differences before and after the intervention.

RESULTS
Significant improvements were shown in everyday EF, including time management, organization, self-restraint, and regulation of emotions. Additionally, results demonstrated an enhancement in adaptive functioning, especially in the subdomains of daily living skills. Analyses of parental outcomes only revealed a significant decrease in the scores of emotion regulation.

CONCLUSION
The current study provides good evidence for the validity and feasibility of an intervention to improve everyday EF and adaptive skills in adults with ASD.

Kim|Joo Hyun|JH|
Kim|Young Ah|YA|
Song|Da-Yea|DY|
Cho|Hwi Bin|HB|
Lee|Han Bit|HB|
Park|Ji Hye|JH|
Lim|Jung In|JI|
Hong|Min Hee|MH|
Chae|Paul Kyuman|PK|
Yoo|Hee Jeong|HJ|

Adaptive skills
Executive function
Autism spectrum disorders
Behavioral intervention.


Local Anesthesia Alone for Postaxial Polydactyly Surgery in Infants.

Abstract:
BACKGROUND
Surgical excision for postaxial polydactyly type B is advocated to avoid long-term complications. Excision with local anesthesia (LA) in infancy represents a safe and effective treatment for this condition, although general anesthesia (GA) is employed by many surgeons. We present a comparison of surgical outcomes, cost, and time between LA and GA to support widespread change in management.

METHODS
A retrospective review of patients under 12 months of age undergoing surgical polydactyly excision by a single surgeon was performed. Anesthesia type, patient demographics, and complications were recorded. Comparisons were made between LA and GA groups on procedure cost, operating time, length of stay (LOS), and time from procedure end to discharge. Stepwise forward regression was used to identify the best model for predicting total costs.

RESULTS
Ninety-one infants with a mean age of 3 months (±1.9) were examined; 51 (56%) underwent LA alone, 40 (44%) underwent GA. Mean operating time was 11.53 ± 4.36 minutes, with no difference observed between anesthesia groups (P = .39). LA infants had a significantly shorter LOS (2.5 vs 3.5 hours; P < .05), quicker postoperative discharge (32 vs 65 minutes, P < .05), and fewer overall expenses, 2803 vs 6067 U.S. dollars (USD), P < .05. Two minor surgical complications (1 in each group) were reported.

CONCLUSIONS
This study demonstrates significantly decreased cost, LOS, and time to discharge using LA alone for surgical excision of postaxial polydactyly type B. Results suggest the approach is quick, economical, and avoids the risks of GA in early infancy.


Astaxanthin diferulate as a bifunctional antioxidant.

Abstract: Astaxanthin when esterified with ferulic acid is better singlet oxygen quencher with k2 = (1.58 ± 0.1) 10(10) L mol(-1)s(-1) in ethanol at 25°C compared with astaxanthin with k2 = (1.12 ± 0.01) 10(9) L mol(-1)s(-1). The ferulate moiety in the astaxanthin diester is a better radical scavenger than free ferulic acid as seen from the rate constant of scavenging of 1-hydroxyethyl radicals in ethanol at 25°C with a second-order rate constant of (1.68 ± 0.1) 10(8) L mol(-1)s(-1) compared with (1.60 ± 0.03) 10(7) L mol(-1)s(-1) for the astaxanthin:ferulic acid mixture, 1:2 equivalents. The mutual enhancement of antioxidant activity for the newly synthetized astaxanthin diferulate becoming a bifunctional antioxidant is rationalized according to a two-dimensional classification plot for electron donation and electron acceptance capability.

Papa|T B R|TB|
Pinho|V D|VD|
do Nascimento|E S P|ES|
Santos|W G|WG|
Burtoloso|A C B|AC|
Skibsted|L H|LH|
Cardoso|D R|DR|

astaxanthin
antioxidant
antiradical
carotenoid
plant phenol


Histological analysis of arteriovenous anastomosis-like vessels established in the corpus luteum of cows during luteolysis.

Abstract:
BACKGROUND
The mechanisms regulating the function and regression of the corpus luteum (CL) have not yet been elucidated in detail. The regressed CL of cows was previously reported to be filled with unusual vessels like arteriovenous anastomosis (AVA); however how these vessels are being established during luteolysis remains unknown.

METHODS
The bovine CL at different luteal stages and regressing bovine CL induced by prostaglandin F2α (PGF) were histologically analyzed using light and electron microscopic levels. The changes in mRNA expression of genes encoding α-smooth muscle actin (SMA; Acta2) and transforming growth factor β1 (Tgfb1) in luteal tissues were analyzed by quantitative RT-PCR.

RESULTS
AVA-like vessels appeared in the regressed CL with a diameter less than 1.5 cm in which no functional luteal cells and macrophages were observed. Epithelioid cells in the AVA-like vessel wall were immunoreactive for SMA, and the lumen of the vessels were narrow. Immunoreaction for SMA was found in the tunica media of typical arteries and arterioles, and pericytes around capillary vessel. Cells with elongated cytoplasmic processes -resident fibroblasts expressing vimentin- distributed in the CL parenchyma without any association with blood vessels are also immunoreactive for SMA, and accumulated around arteries and arterioles during the late-luteal stage. In the regressed CL, walls of arteries and arterioles consisted of more than two layers of epithelioid cells positive for both SMA and desmin, suggesting that they are myofibroblasts transformed from fibroblasts. The percentage of the area positive for SMA and the mRNA expression of Acta2 were significantly increased in the regressed CL; however, they did not alter when a luteolytic dose of PGF was injected in vivo and collected within 24 h after the injection. On the other hand, Tgfb1, a known regulator for myofibroblast transformation, was significantly increased in PGF-induced regressing CL as well as in the CL during the late-luteal stage.

CONCLUSIONS
SMA-positive myofibroblasts accumulates around the arteries and arterioles to form AVA-like vessels during luteolysis in cows. PGF indirectly regulates myofibroblast transformation through enhancing the expression of TGFβ1. These peculiar AVA-like vessels may be involved in the regulation of blood flow in the bovine CL during luteolysis.

Nio-Kobayashi|Junko|J| Miyazaki|Kaya|K| Hashiba|Kazuhisa|K| Okuda|Kiyoshi|K| Iwanaga|Toshihiko|T|

D053773:Transforming Growth Factor beta1


Aberrant methylation of Pax3 gene and neural tube defects in association with exposure to polycyclic aromatic hydrocarbons.

Abstract:
BACKGROUND
Neural tube defects (NTDs) are common and severe congenital malformations. Pax3 is an essential gene for neural tube closure in mice but it is unknown whether altered expression or methylation of PAX3 contributes to human NTDs. We examined the potential role of hypermethylation of Pax3 in the development of NTDs by analyzing human NTD cases and a mouse model in which NTDs were induced by benzo[a]pyrene (BaP), a widely studied polycyclic aromatic hydrocarbon (PAH).

METHODS
We extracted methylation information of PAX3 in neural tissues from array data of ten NTD cases and eight non-malformed controls. A validation study was then performed in a larger independent population comprising 73 NTD cases and 29 controls. Finally, we examined methylation patterns and expression of Pax3 in neural tissues from mouse embryos of dams exposed to BaP or BaP and vitamin E.

RESULTS
Seven CpG sites in PAX3 were hypermethylated in NTD fetuses as compared to controls in the array data. In the validation phase, significantly higher methylation levels in the body region of PAX3 were observed in NTD cases than in controls (P = 0.003). And mean methylation intensity in the body region of PAX3 in fetal neural tissues was positively correlated with median concentrations of PAH in maternal serum. In the mouse model, BaP-induced NTDs were associated with hypermethylation of specific CpG sites within both the promoter and body region of Pax3. Supplementation with vitamin E via chow decreased the rate of NTDs, partly recovered the repressed total antioxidant capacity in mouse embryos exposed to BaP, and this was accompanied by the normalization of Pax3 methylation level and gene expression.

CONCLUSION
Hypermethylation of Pax3 may play a role in the development of NTDs; DNA methylation aberration may be caused by exposure to BaP, with possible involvement of oxidative stress.

Lin|Shanshan|S|
Ren|Aiguo|A|0000-0001-9115-5638
Wang|Linlin|L|
Santos|Chloe|C|
Huang|Yun|Y|
Jin|Lei|L|
Li|Zhiwen|Z|
Greene|Nicholas D E|NDE|

Methylation
Pax3 gene
Neural tube defects
Polycyclic aromatic hydrocarbon
Benzo[a]pyrene


A new method for assessing squash tactics using 15 court areas for ball locations.

Abstract: Tactics in squash have typically been assessed using the frequency of different shot types played at different locations on the court either without reference to other relevant information or on the basis of the preceding shot. This paper presents a new squash specific method for categorizing court locations in which the ball was played, a novel techniques for assessing the reliability of this method and presents typical shots responses in these new areas controlled for preceding shot as well as the time between shots and the handedness of the players. Twelve games were viewed using the SAGIT/Squash software and 2907 shots viewed a second time from a video image taken from behind the court with an overall agreement of 88.90% for the court location data and 99.52% for shot type. 3192 shots from 9 matches from the 2003 World Team Championships were analyzed in SAGIT/Squash. In the court areas analyzed between 2 and 7 shot responses were predominant suggesting tactical patterns were evident. This was supported by differences evident between shot responses played from the two back corners where the backhand side was characterized by a predominance of straight drives whereas straight and crosscourt drives were played on the forehand side. These results tended to confirm that tactics i.e., consistent shot types, are played although these are only apparent when factors that determine shot selection are accounted for. This paper has controlled for some of these factors but others need to be considered e.g., if individual player profiles are to be ascertained.

Vučković|Goran|G| James|Nic|N| Hughes|Mike|M| Murray|Stafford|S| Milanović|Zoran|Z| Perš|Janez|J| Sporiš|Goran|G|

D001185:Artificial Intelligence
D054874:Athletic Performance
D006801:Humans
D009949:Orientation
D015865:Racquet Sports
D015203:Reproducibility of Results
D012984:Software
D062206:Spatial Analysis
D013037:Spatial Behavior
D014741:Video Recording

Method
Squash tactics
Shot types
Ball analysis


TransCelerate's Clinical Quality Management System: From a Vision to a Conceptual Framework.

Abstract: The Quality Management System (QMS) initiative of TransCelerate BioPharma Inc has identified potential benefits that could be captured from the development of a flexible, proactive clinical QMS conceptual framework for clinical research. Such a framework would aid organizations in seamlessly managing the complex clinical trial environment and, ultimately, in expediting delivery of needed treatments to patients. This article chronicles the evolution of a TransCelerate concept paper describing a proposed clinical QMS framework and reviews feedback from varied global clinical trial stakeholders during socialization of the concept paper. Many stakeholders recognized the potential for the concept paper to inform development of a harmonized International Council for Harmonisation (ICH) guideline, providing needed clarity from regulators on their expectations for QMS in the clinical realm. Accordingly, the article also describes TransCelerate's efforts to work with regulators to facilitate harmonization on this important topic and reviews ongoing work to develop additional tools and resources that may support organizations in evaluating whether and how they might translate the conceptual framework principles into practice.

Meeker-O'Connell|Ann|A|
Sam|Leslie M|LM|
Bergamo|Nanci|N|
Little|Janis A|JA|

TransCelerate
clinical quality
QMS
clinical development
issue management
knowledge management
risk management


Synthesis and structure--activity relationships of N²-alkylated quaternary β-carbolines as novel antitumor agents.

Abstract: A series of novel N(2)-alkylated quaternary β-carbolines was synthesized by modification of position-1, 2, 7 and 9 of β-carboline nucleus with various alkyl and arylated alkyl substituents, and their cytotoxic activities in vitro and antitumor potencies in mice were evaluated. Compound 3m was found to be the most potent antitumor agent. SARs analysis revealed that (1) the substituents in position-2 and 9 of β-carboline nucleus played a vital role in modulation of antitumor activity; (2) the benzyl and 3-phenylpropyl substituents in position-2 and 9 of β-carboline ring were the optimal substituents giving rise to significant antitumor agent. These compounds might be a novel promising class of antitumor agents with clinical development potential.

Zhang|Guoxian|G| Cao|Rihui|R| Guo|Liang|L| Ma|Qin|Q| Fan|Wenxi|W| Chen|Xuemei|X| Li|Jianru|J| Shao|Guang|G| Qiu|Liqin|L| Ren|Zhenghua|Z|

D004354:Drug Screening Assays, Antitumor

Synthesis
β-Carboline
Antitumor
Cytotoxic
Structure–activity relationships


Host Serum Proteins as Potential Biomarkers of Bovine Tuberculosis Resistance Phenotype.

Abstract: Eradication of bovine tuberculosis (bTB) continues to be a worldwide challenge. The lack of reliable vaccines dampens the control and eradication programs of Mycobacterium bovis infection and spread. Selection and breeding of cattle resistant to M. bovis infection would greatly enhance the effectiveness of bTB eradication programs. Here, we have evaluated the potential of serum proteins as biomarkers of cattle resistance to bTB in Holstein-Friesian cows, 6-8-year-old, born and raised in similar conditions in herds with bTB prevalence >30%. Serum proteins obtained from uninfected cows (bTB-resistant; R) were compared to those from infected cows (bTB-susceptible; S), defined by a negative or positive bTB diagnosis, respectively. bTB diagnosis included: (i) single intradermal (caudal fold) tuberculin test, (ii) whole blood IFN-gamma test, (iii) gross visible lesions in lymph nodes and lungs by inspection at the abattoir, and (iv) a bacteriological culture for M. bovis. Using 2D-GE and LC-ESI-MS/MS, we found higher expression levels of primary amine oxidase (AO), complement component 5 (C5), and serotransferrin (TF) in R cattle than S cattle. In-house developed and standardized ELISAs for these novel biomarkers showed the best sensitivities of 72, 77, 77%, and specificities of 94, 94, 83%, for AO, C5, and TF, respectively. AUC-ROC (95% CI) values of 0.8935 (0.7906-0.9964), 0.9290 (0.8484-1.010), and 0.8580 (0.7291-0.9869) were obtained at cut-off points of 192.0, 176.5 ng/ml, and 2.1 mg/ml for AO, C5, and TF, respectively. These proteins are involved in inflammatory/immunomodulatory responses to infections and may provide a novel avenue of research to determine the mechanisms of protection against bTB. Overall, our results indicate that these proteins could be novel biomarkers to help identify cattle resistant to bTB, which in turn could be used to strengthen the effectiveness of existing eradication programs against bTB.

Mazorra-Carrillo|Jorge Luis|JL|
Alcaraz-López|Omar Antonio|OA|
López-Rincón|Gonzalo|G|
Villarreal-Ramos|Bernardo|B|
Gutiérrez-Pabello|José A|JA|
Esquivel-Solís|Hugo|H|

biomarkers
bovine tuberculosis
Mycobacterium bovis
cattle
ELISA
host resistance to infection
proteome


Female and male decision-making regarding whether to continue or abort an unintended pregnancy: a secondary analysis of the FECOND study.

Abstract:
OBJECTIVE
We aimed to explore partner agreement in unintended pregnancy decisions and to describe predictors of female and male perceived agreement with their partner regarding the decision to continue or terminate the pregnancy.

METHODS
This is a secondary analysis of the FECOND study, a population-based probability telephone survey conducted in France in 2010 comprising 8645 respondents aged 15-49 years. Pregnancy data were reported by individuals (not couple-level data). For female- and male-reported unintended pregnancies, we used generalised estimation equation models to estimate the odds of a female-only (disagreement) versus a joint (agreement) decision to continue or terminate an unintended pregnancy.

RESULTS
The decision to continue an unintended pregnancy was reported as joint in 82% of female- and 88% of male-reported pregnancies. Pregnancy continuation was more likely to be perceived as female-only versus a joint decision if men perceived initial pregnancy intention disagreement (adjusted odds ratio [aOR] 5.9; 95% confidence intervals [CI] 2.0, 16.9), if women indicated finances were very difficult at the time of conception (aOR 3.0; 95% CI 1.7, 5.2) and if women or men reported an unstable relationship at the time of conception (aOR 10.0; 95% CI 6.1, 16.4; aOR 55.3; 95% CI 15.8, 193.0). The decision to terminate an unintended pregnancy was reported as joint in 61% of female- and 74% of male-reported pregnancies. Pregnancy termination was more likely to be perceived as a female-only decision if women reported an unstable relationship at the time of conception (aOR 3.8; 95% CI 2.3, 6.2).

CONCLUSION
Pregnancy intention disagreement and finance/relationship status at the time of conception inform partner agreement about the decision to continue or end an unintended pregnancy.

Lee|Jessica K|JK|
Burke|Anne E|AE|
Moreau|Caroline|C|

unintended pregnancy
pregnancy decisions
Pregnancy continuation
pregnancy termination


Right ventricular regional deformation analysis in patients operated for tetralogy of Fallot.

Abstract:
PURPOSE
We aimed to compare the findings of a segmental speckle-tracking strain of right ventricle with those of cardiac magnetic resonance imaging in this setting.

METHODS
In 26 patients with operated tetralogy of Fallot (mean age, 15.35 ± 2.3 years; range 11-18 years), right ventricular segmental speckle-straining (the basal, mid, apical segments of right ventricular septum and lateral free wall, and right ventricular apex) were determined using two-dimensional echocardiography. The echocardiographic findings were compared to right ventricular ejection fraction, right ventricular indexed end-diastolic volume, indexed end-systolic volume and pulmonary regurgitation fraction at cardiac magnetic resonance.

RESULTS
Right ventricular global speckle strain was -18.6 ± 3.7and lateral free wall strain was -17.8 ± 4.9. Indexed right ventricular end diastolic volume was 171.7 ± 23.3 ml/m2, indexed right ventricular end systolic volume was 95.1 ± 35.0 ml/m2 and right ventricular ejection fraction was 44.76 ± 9.39%. Basal inferior septum is correlated with indexed right ventricular end-diastolic volume (RVEDV; r = -0.521, p = 0.015) and pulmonary regurgitation fraction (r = -0.584, p = 0.015). Cardiac magnetic resonance (CMR)-derived RVEDV is correlated with lateral free wall (r = -0.465, p = 0.034) and Global RV (r = 0.442, p = 0.045).

CONCLUSION
Right ventricular basal inferior septal and apical longitudinal strain correlates with the measures of right ventricular performance on CMR. These parameters would be useful to monitor right ventricular performance in patients after tetralogy of Fallot repair.

Guven|Baris|B|
Mese|Timur|T|
Yilmazer|Murat Muhtar|MM|
Ozdemir|Rahmi|R|
Demirpence|Savas|S|
Doksoz|Onder|O|

tetralogy of Fallot
strain
right ventricle
cardiac magnetic resonance imaging
Echocardiography
congenital heart disease


Nature and extent of external-cause deaths of nursing home residents in Victoria, Australia.

Abstract:
OBJECTIVES
To describe the nature and extent of external-cause deaths of residents of nursing homes in Victoria, Australia.

DESIGN
A retrospective cohort study of all decedents using routinely collected data contained within the National Coronial Information System.

SETTING
Accredited nursing homes in Victoria.

PARTICIPANTS
Nursing home residents who had died from external causes and whose deaths were reported to the Coroners Court between July 1, 2000, and December 31, 2012.

MEASUREMENTS
Basic descriptive analysis was conducted to measure frequencies and proportion of exposures within each outcome group, and rates were calculated using population data.

RESULTS
One thousand two hundred ninety-six external cause deaths of nursing home residents were identified. Deaths were due to falls (n=1,155, 89.1%), choking (n=89, 6.9%), suicide (n=17, 1.3%), complications of clinical care (n=8, 0.6%) and resident-on-resident assault (n=7, 0.5%). Deaths occurred more frequently in women (n=814, 62.8%), in keeping with the sex distribution in nursing homes, and residents aged 85 and older (n=923, 71.2%). The number of inquests held to investigate a death as a matter of public interest was small (n=24, 1.9%).

CONCLUSION
A significant proportion of nursing home resident deaths are from external causes and are potentially preventable. A shift in community attitudes is required toward an understanding that premature death of a resident from injury is not a natural part of life.

Ibrahim|Joseph E|JE|
Murphy|Briony J|BJ|
Bugeja|Lyndal|L|
Ranson|David|D|

death
nursing home
resident
external cause


The impact of the coronavirus disease 2019 pandemic on the utilisation of emergency urological services.

Abstract:
OBJECTIVES
To compare the number of patients attending the Urology Emergency Department (ED) of the Centro Hospitalar Universitário do Porto (CHUP), as well as their demographic characteristics, the reasons for admission, the clinical severity under the Manchester triage system (MTS), and the need for emergency surgery or hospitalisation, during the coronavirus disease 2019 (COVID-19) pandemic and the equivalent period in 2019.

PATIENTS AND METHODS
Data were collected from patients attending the Urology ED of the CHUP over 3 weeks, from 11 March to 1 April 2020, and from the same period in the previous year (from 11 March to 1 April 2019).

RESULTS
During the pandemic, 46.4% fewer patients visited our urological ED (122 vs 263). There was no significant difference in the mean age or the number of old patients (aged ≥65 years) between the two periods. However, significantly fewer female patients sought emergency urological services during the COVID-19 pandemic period (32.7% vs 14.8%, P < 0.05). No significant differences were noted between different clinical severity groups under the MTS. In 2019, significantly less patients required hospitalisation. The most common reasons for admission, during both periods, were haematuria, renal colic and urinary tract infections. The authors recognise that the study has several limitations, namely, those inherent to its retrospective nature.

CONCLUSION
COVID-19 significantly influenced people's urological care-seeking behaviour. Understanding the present situation is helpful for predicting future urological needs. Based on the results of this study, we have reason to speculate that people's requirements for urological services might grow explosively in the post-COVID-19 period. There should be further studies about the real state of long-term urological services and the consequences that this pandemic may have in terms of morbimortality not directly related to the severe acute respiratory syndrome coronavirus 2.

Madanelo|Mariana|M|0000-0001-8429-7785
Ferreira|Carlos|C|
Nunes-Carneiro|Diogo|D|
Pinto|André|A|
Rocha|Maria Alexandra|MA|
Correia|Jorge|J|
Teixeira|Bernardo|B|
Mendes|Gonçalo|G|
Tavares|Catarina|C|
Mesquita|Sofia|S|
Fraga|Avelino|A|

severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2)


Utility of combined gray-scale and perflubutane contrast-enhanced ultrasound for diagnosing early hepatocellular carcinomas: Comparison of well differentiated and distinctly nodular types.

Abstract:
AIM
To clarify the value of gray-scale ultrasound (US) combined with contrast-enhanced US (CEUS) with perflubutane in diagnosing early hepatocellular carcinoma (HCC).

METHODS
A total of 57 surgically resected, well differentiated HCCs were analyzed. Hepatocellular carcinomas were macroscopically diagnosed as vaguely nodular or distinctly nodular types, which correspond to early HCC or progressed HCC, respectively. Gray-scale US findings were evaluated in terms of shape (round or roundish, or irregular), border and contour (well-defined and smooth, or poorly defined), and intratumor echo levels (hyper, hypo, iso, heterogeneous, or mosaic). Contrast-enhanced US findings were evaluated during the arterial phase (vascularity [finely homogeneous, dendritic, or chaotic] and perfusion enhancement [homogeneous or heterogeneous]), portal phase (presence or absence of washout), and post-vascular phase (echo intensity level [defect, incomplete defect, or iso-enhancing]).

RESULTS
Eighteen HCCs were categorized as early HCCs and the remaining 39 were categorized as progressed HCCs. Receiver operating characteristic curve analysis for the diagnosis of early HCC yielded area under the receiver operating characteristic curve (Az ) values for border and contour on gray-scale US and echo intensity level in the CEUS post-vascular phase of 0.782 and 0.828, respectively. Multiple logistic regression analysis also indicated that both of these gray-scale US and CEUS findings were independently associated with early HCC. The Az value for the combination of border and contour and echo intensity for the diagnosis of early HCC was 0.907, corresponding to a high diagnostic value.

CONCLUSION
The combination of gray-scale US and CEUS can provide high-quality imaging assessment for diagnosing early HCC.

Tada|Toshifumi|T| Kumada|Takashi|T| Toyoda|Hidenori|H| Sone|Yasuhiro|Y| Kaneoka|Yuji|Y| Maeda|Atsuyuki|A| Okuda|Seiji|S| Otobe|Katsuhiko|K| Tsuji|Nozomi|N|

well differentiated hepatocellular carcinoma


Mechanical properties of the flexor digitorum profundus tendon attachment.

Abstract: The current study was performed to determine the strength and rigidity of the intact flexor digitorum profundus (FDP) tendon attachment and compare the rigidity at the attachment site to the rigidity within a more proximal part of the tendon. Eight cadaveric index fingers were tested to failure of the FDP tendon. Lines were drawn on each tendon with India ink stain at the position of the attachment to bone and 5 mm and 10 mm proximally. Each test was recorded using a high resolution video camera. A minimum of six images per test were used for analysis of tissue deformation. The centroid of each line was computationally identified to characterize the deformation of the tendon between the lines. Force vs. deformation curves were generated for the 5 mm region representing the tendon attachment and the 5 mm region adjacent to the attachment. Stiffness measurements were generated for each curve, and normalized by the initial length to determine the rigidity. The failure strength ranged from 263 N to 548 N, with rigidity values ranging from 2201 N/(mm/mm) to 8714 N/(mm/mm) and from 3459 N/(mm/mm) to 6414 N/(mm/mm) for the attachment and the tendon proximal to the attachment, respectively. The rigidity did not vary significantly between the attachment and proximal tendon based on a Wilcoxon signed rank test (p = 0.2). The measured strength and rigidity establish biomechanical properties for the FDP tendon attachment to bone.

Felder|Jerrod J|JJ|
Guseila|Loredana M|LM|
Saranathan|Archana|A|
Shary|Timothy J|TJ|
Lippitt|Steven B|SB|
Elias|John J|JJ|

Flexor digitorum profundus tendon
Tendon attachment
Strength
Stiffness


A new hybrid anchoring balloon for direct peroral cholangioscopy using an ultraslim upper endoscope.

Abstract:
BACKGROUND AND AIM
Large impacted or residual invisible common bile duct (CBD) stones after mechanical lithotripsy are challenging. We aimed to evaluate the feasibility and success rate of a new hybrid anchoring balloon-guided direct peroral cholangioscopy (POC) for these conditions using an ultraslim endoscope.

METHODS
Sixty-five patients with large or residual invisible CBD stones for direct POC from July 2012 to July 2016 were identified, including six cases in whom an additional interventional procedure was required. There were altogether 55 cases undergoing a procedure with our new device, with a 0.021-inch guidewire tied to a balloon catheter at its distal end in this single-center retrospective study. Technical success, procedure time, diagnostic and therapeutic efficacy of direct POC, and procedure-related complications were studied.

RESULTS
The hybrid anchoring balloon-guided direct POC was successful in 51/55 (92.7%) procedures, including 18 cases in whom the conventional wire-guided method failed within 25 min. Mean time for technical success by our method was 12.4 ± 3.4 min. In total, of the 43 cases with previous removal of CBD stones, seven (16.3%) were found to have residual stones ≥4 mm, excluding three cases in whom direct POC failed. In another 25 cases for difficult stones, 24 lithotripsies were carried out, resulting in 23 complete fragmentations. No significant procedure-related complications were observed.

CONCLUSION
The new hybrid anchoring balloon device performs well in facilitating direct POC using an ultraslim endoscope for evaluation and extraction of residual or large impacted CBD stones.

Li|Jian|J| Guo|Shao-Ju|SJ| Zhang|Jing-Chao|JC| Wang|Hong-Yan|HY| Li|Kai|K| Niu|She-Hui|SH|

D057605:Natural Orifice Endoscopic Surgery

hybrid anchoring balloon
peroral cholangioscopy
ultraslim endoscope
residual stone
difficult stone


Dynamics and potential roles of abundant and rare subcommunities in the bioremediation of cadmium-contaminated paddy soil by Pseudomonas chenduensis.

Abstract: Microbial bioremediation of heavy metal-contaminated soil is a potential technique to reduce heavy metals in crop plants. However, the dynamics and roles of the local microbiota in bioremediation of heavy metal-contaminated soil following microbial application are rarely reported. In this study, we used Pseudomonas chenduensis strain MBR for bioremediation of Cd-contaminated paddy soil and investigated its effects on the dynamics of the local soil bacterial community and Cd accumulation in rice. Cd accumulation in rice grains and roots were significantly reduced by the addition of the strain MBR. The addition of the strain MBR caused greater changes in bacterial communities in rhizosphere soil than in bulk soil. MBR enhanced the roles of microbial communities in transformation of Cd fractions, especially in rhizosphere soil. The strain MBR likely regulated abundant subcommunities more than rare subcommunities to improve Cd bioremediation, especially in rhizosphere soil. Consequently, the dynamics and functional roles of the local microbial communities differed significantly during bioremediation between abundant and rare subcommunities and between rhizosphere soil and bulk soil. This study provides new insight into the microbiota-related mechanisms underlying bioremediation.

Paddy soil
Pseudomonas chenduensis
Abundant and rare bacteria
Cadmium contamination


Serum leptin level in women with polycystic ovary syndrome: correlation with adiposity, insulin, and circulating testosterone.

Abstract:
BACKGROUND
Leptin, an adipocyte-derived hormone encoded by 'ob' gene, serves as a link relaying metabolic signals to the neuronal networks in the brain to modulate hypothalamo-pituitary-ovarian axis. Circulating leptin correlates strongly with obesity, which is frequently associated with polycystic ovarian syndrome (PCOS), a major form of dysovulatory infertility in women, characterized by endocrine abnormalities such as hyperandrogenism and inappropriate LH secretion. PCOS is also often associated with insulin resistance and hyperinsulinemia, features that are linked to leptin and its receptors. However, the relationship between leptin and gonadotropins, androgens, and insulin in PCOS is still controversial.

AIM
Present investigation attempts to evaluate the interrelationship between serum leptin level with body mass index, insulin and with circulating testosterone in PCOS women.

SUBJECTS AND METHODS
Women diagnosed with either tubal block/male factor infertility (Control; n = 18) and with PCOS (n = 16), enrolled for in vitro fertilization and embryo transfer (IVF-ET), were recruited for this study. All were reviewed for body mass index (BMI), endocrine milieu (including pituitary gonadotropins, TSH, prolactin, gonadal steroids, and insulin) and for circulating serum leptin. Interpretation of data was done using PRISM Statistical Software Package (PRISM Version 4.03@1992-2005; GraphPad Software Inc).

RESULTS
Positive correlation was observed between serum leptin, BMI, and insulin in both the groups. Mean BMI, LH, and LH: FSH ratios were found elevated in the PCOS population. PCOS women also had significantly elevated androgens and fasting levels of insulin.

CONCLUSION
Hyperleptinemia in PCOS women appears to be due to the positive correlation between serum leptin, BMI, and insulin.

Leptin
Polycystic ovary syndrome
Insulin resistance
Body mass index
Hyperandrogenemia


Clinical course and therapeutic approach to varicella zoster virus infection in children with rheumatic autoimmune diseases under immunosuppression.

Abstract:
BACKGROUND
To analyze the clinical presentation and complications of varicella zoster virus (VZV) infection in children with rheumatic diseases treated with immunosuppressive medication such as biological disease-modifying antirheumatic drugs (bDMARDs) and/or conventional disease-modifying antirheumatic drugs (cDMARDs), and to analyze the therapeutic approach to VZV infections with respect to the concomitant immunosuppressive treatment.

METHODS
Retrospective multicenter study using the Swiss Pediatric Rheumatology registry. Children with rheumatic diseases followed in a Swiss center for pediatric rheumatology and treated with cDMARD and/or bDMARD with a clinical diagnosis of varicella or herpes zoster between January 2004 and December 2013 were included.

RESULTS
Twenty-two patients were identified, of whom 20 were treated for juvenile idiopathic arthritis, 1 for a polyglandular autoimmune syndrome type III, and 1 for uveitis. Of these 22 patients, 16 had varicella and 6 had herpes zoster. Median age at VZV disease was 7.6 years (range 2 to 17 years), with 6.3 years (range 2 to 17 years) for those with varicella and 11.6 years (range 5 to 16 years) for those with herpes zoster. The median interval between start of immunosuppression and VZV disease was 14.1 months (range 1 to 63 months). Two patients had received varicella vaccine (1 dose each) prior to start of immunosuppression. Concomitant immunosuppressive therapy was methotrexate (MTX) monotherapy (n = 9) or bDMARD monotherapy (n = 2), or a combination of bDMARD with prednisone, MTX or Leflunomide (n = 11). Four patients experienced VZV related complications: cellulitis in 1 patient treated with MTX, and cellulitis, sepsis and cerebellitis in 3 patients treated with biological agents and MTX combination therapy. Six children were admitted to hospital (range of duration: 4 to 9 days) and 12 were treated with valaciclovir or aciclovir.

CONCLUSION
The clinical course of varicella and herpes zoster in children under immunosuppression is variable, with 4 (18 %) of 22 children showing a complicated course. Thorough assessment of VZV disease and vaccination history and correct VZV vaccination according to national guidelines at diagnosis of a rheumatic autoimmune disease is essential to minimize VZV complications during a later immunosuppressive treatment.

Leuvenink|Raphael|R| Aeschlimann|Florence|F| Baer|Walter|W| Berthet|Gerald|G| Cannizzaro|Elvira|E| Hofer|Michael|M| Kaiser|Daniela|D| Schroeder|Silke|S| Heininger|Ulrich|U| Woerner|Andreas|A|

Varicella zoster virus
Rheumatic autoimmune disease
Immunosuppression
Pediatric


The Effect of Prolonged Culture of Chromosomally Abnormal Human Embryos on The Rate of Diploid Cells.

Abstract:
BACKGROUND
A decrease in aneuploidy rate following a prolonged co-culture of human blastocysts has been reported. As co-culture is not routinely used in assisted reproductive technology, the present study aimed to evaluate the effect of the prolonged single culture on the rate of diploid cells in human embryos with aneuploidies.

MATERIALS AND METHODS
In this cohort study, we used fluorescence in situ hybridi- zation (FISH) to reanalyze surplus blastocysts undergoing preimplantation genetic diagnosis (PGD) on day 3 postfertilization. They were randomly studied on days 6 or 7 following fertilization.

RESULTS
Of the 30 analyzed blastocysts, mosaicism was observed in 26(86.6%), while 2(6.7%) were diploid, and 2(6.7%) were triploid. Of those with mosaicism, 23(88.5%) were determined to be diploid-aneuploid and 3(11.5%) were aneuploid mosaic. The total frequency of embryos with more than 50% diploid cells was 33.3% that was lower on day 7 in comparison with the related value on day 6 (P<0.05); however, there were no differences when the embryos were classified according to maternal age, blastocyst developmental stage, total cell number on day 3, and embryo quality.

CONCLUSION
Although mosaicism is frequently observed in blastocysts, the prolonged single culture of blastocysts does not seem to increase the rate of normal cells.

Bazrgar|Masood|M|
Gourabi|Hamid|H|
Eftekhari-Yazdi|Poopak|P|
Vazirinasab|Hamed|H|
Fakhri|Mostafa|M|
Hassani|Fatemeh|F|
Chehrazi|Mohamad|M|
Valojerdi|Mojtaba Rezazadeh|MR|

Aneuploidy Blastocyst Mosaicism Self-Correction


ABCF ATPases Involved in Protein Synthesis, Ribosome Assembly and Antibiotic Resistance: Structural and Functional Diversification across the Tree of Life.

Abstract: Within the larger ABC superfamily of ATPases, ABCF family members eEF3 in Saccharomyces cerevisiae and EttA in Escherichia coli have been found to function as ribosomal translation factors. Several other ABCFs including biochemically characterized VgaA, LsaA and MsrE confer resistance to antibiotics that target the peptidyl transferase center and exit tunnel of the ribosome. However, the diversity of ABCF subfamilies, the relationships among subfamilies and the evolution of antibiotic resistance (ARE) factors from other ABCFs have not been explored. To address this, we analyzed the presence of ABCFs and their domain architectures in 4505 genomes across the tree of life. We find 45 distinct subfamilies of ABCFs that are widespread across bacterial and eukaryotic phyla, suggesting that they were present in the last common ancestor of both. Surprisingly, currently known ARE ABCFs are not confined to a distinct lineage of the ABCF family tree, suggesting that ARE can readily evolve from other ABCF functions. Our data suggest that there are a number of previously unidentified ARE ABCFs in antibiotic producers and important human pathogens. We also find that ATPase-deficient mutants of all four E. coli ABCFs (EttA, YbiT, YheS and Uup) inhibit protein synthesis, indicative of their ribosomal function, and demonstrate a genetic interaction of ABCFs Uup and YheS with translational GTPase BipA involved in assembly of the 50S ribosome subunit. Finally, we show that the ribosome-binding resistance factor VmlR from Bacillus subtilis is localized to the cytoplasm, ruling out a role in antibiotic efflux.

Murina|Victoriia|V|
Kasari|Marje|M|
Takada|Hiraku|H|
Hinnu|Mariliis|M|
Saha|Chayan Kumar|CK|
Grimshaw|James W|JW|
Seki|Takahiro|T|
Reith|Michael|M|
Putrinš|Marta|M|
Tenson|Tanel|T|
Strahl|Henrik|H|
Hauryliuk|Vasili|V|
Atkinson|Gemma Catherine|GC|

ABCF
ribosome
antibiotic resistance
translation
ARE


A Modular Approach for Interlocking Enzymes in Whatman Paper.

Abstract: A potentially universal approach is presented for enzyme attachment to cellulose that significantly enhances enzyme stability while retaining high activity, and involves no chemical functionalization of cellulose. Bovine serum albumin (BSA) was interlocked in cellulose to form a protein-friendly surface (named BSA-Paper), while also providing COOH and NH2 groups for subsequent attachment of enzymes. The desired enzyme is then mixed with additional BSA and interlocked on BSA-Paper. The second BSA layer dilutes and crosslinks the enzyme for improved stability. Laccase was tested as a model enzyme for interlocking on BSA-Paper, and was found to retain over 100 % activity and was 240 times more stable at 25 °C (half life=180 d) than laccase. This new approach was also tested with a few other enzymes with encouraging results, thus providing a potentially universal method for stabilization of enzymes on cellulose with retention of high activities.

cellulose
enzyme stability
laccase
biomaterials
biosensors


Mechanical bowel preparation and oral antibiotics versus mechanical bowel preparation only prior rectal surgery (MOBILE2): a multicentre, double-blinded, randomised controlled trial-study protocol.

Abstract:
INTRODUCTION
Mechanical bowel preparation (MBP) prior to rectal surgery is widely used. Based on retrospective data many guidelines recommend mechanical and oral antibiotic bowel preparation (MOABP) to reduce postoperative complications and specifically surgical site infections (SSIs). The primary aim of this study is to examine whether MOABP reduces complications of rectal surgery.

METHODS AND ANALYSIS
The MOBILE2 (Mechanical Bowel Preparation and Oral Antibiotics vs Mechanical Bowel Preparation Only Prior Rectal Surgery) trial is a multicentre, double-blinded, parallel group, superiority, randomised controlled trial comparing MOABP to MBP among patients scheduled for rectal surgery with colorectal or coloanal anastomosis. The patients randomised to the MOABP group receive 1 g neomycin and 1 g metronidazole two times on a day prior to surgery and patients randomised to the MBP group receive identical placebo. Based on power calculations, 604 patients will be enrolled in the study. The primary outcome is Comprehensive Complication Index within 30 days after surgery. Secondary outcomes are SSIs within 30 days after surgery, the number and classification of anastomosis dehiscences, the length of hospital stay, mortality within 90 days after surgery and the number of patients who received adjuvant treatment if needed. Tertiary outcomes are overall survival, disease-specific survival, recurrence-free survival and difference in quality-of-life before and 1 year after surgery. In addition, the microbiota differences in colon mucosa are analysed.

ETHICS AND DISSEMINATION
The Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.

TRIAL REGISTRATION NUMBER
NCT04281667.

Koskenvuo|Laura|L|0000-0001-8335-7942 Lunkka|Pipsa|P| Varpe|Pirita|P| Hyöty|Marja|M| Satokari|Reetta|R| Haapamäki|Carola|C| Lepistö|Anna|A| Sallinen|Ville|V|

D016032:Randomized Controlled Trials as Topic

surgery
colorectal surgery
gastrointestinal tumours


Evaluation of green lean production in textile industry: a hybrid fuzzy decision-making framework.

Abstract: Textile industry is an old and effective industry in Iran. However, due to its age and high energy consumption, this industry has low profitability and entrepreneurship. One of the most important problems of the weaving industry is the issue of waste regarding manpower, materials, machinery, and especially energy consumption. Another problem is environmental pollution. In this paper, using a multiple decision-making model for ranking and selecting criteria and sub-criteria, which is presented using the step-wise weight assessment ratio analysis (SWARA) and also by examining several industrial plants on weaving, the final ranking was performed using the fuzzy COPRAS method. According to the final result and using the opinions of experts and reviewing the studied cases, the environmental criterion was more important than other criteria, and also according to the existing sub-criteria, the amount of CO2 production and pH in the process of completion and washing and the types of pollution in the effluent and sewage were more important than other sub-criteria. Also, among the alternatives, company 5 is evaluated as the best alternative.

Green
Lean production
Textile industry
Fuzzy
Decision-making techniques
Evaluation framework


Genome-Based Infection Tracking Reveals Dynamics of Clostridium difficile Transmission and Disease Recurrence.

Abstract:
BACKGROUND
Accurate tracking of Clostridium difficile transmission within healthcare settings is key to its containment but is hindered by the lack of discriminatory power of standard genotyping methods. We describe a whole-genome phylogenetic-based method to track the transmission of individual clones in infected hospital patients from the epidemic C. difficile 027/ST1 lineage, and to distinguish between the 2 causes of recurrent disease, relapse (same strain), or reinfection (different strain).

METHODS
We monitored patients with C. difficile infection in a UK hospital over a 2-year period. We performed whole-genome sequencing and phylogenetic analysis of 108 strains isolated from symptomatic patients. High-resolution phylogeny was integrated with in-hospital transfers and contact data to create an infection network linking individual patients and specific hospital wards.

RESULTS
Epidemic C. difficile 027/ST1 caused the majority of infections during our sampling period. Integration of whole-genome single nucleotide polymorphism (SNP) phylogenetic analysis, which accurately discriminated between 27 distinct SNP genotypes, with patient movement and contact data identified 32 plausible transmission events, including ward-based contamination (66%) or direct donor-recipient contact (34%). Highly contagious donors were identified who contributed to the persistence of clones within distinct hospital wards and the spread of clones between wards, especially in areas of intense turnover. Recurrent cases were identified between 4 and 26 weeks, highlighting the limitation of the standard <8-week cutoff used for patient diagnosis and management.

CONCLUSIONS
Genome-based infection tracking to monitor the persistence and spread of C. difficile within healthcare facilities could inform infection control and patient management.

Kumar|Nitin|N|
Miyajima|Fabio|F|
He|Miao|M|
Roberts|Paul|P|
Swale|Andrew|A|
Ellison|Louise|L|
Pickard|Derek|D|
Smith|Godfrey|G|
Molyneux|Rebecca|R|
Dougan|Gordon|G|
Parkhill|Julian|J|
Wren|Brendan W|BW|
Parry|Christopher M|CM|
Pirmohamed|Munir|M|
Lawley|Trevor D|TD|

recurrence
C. difficile 027/ST1
whole-genome sequencing
highly contagious individuals
ward-based transmission


Time availability and housework: The effect of unemployment on couples' hours of household labor.

Abstract: Using data from the German Socio-Economic Panel (G-SOEP, 1991-2014), this study investigates how unemployment influences the hours of household labor performed by individuals and their partners. It is argued that by using longitudinal data on unemployed individuals, the time availability hypothesis, which explains individuals' hours of housework with their available time, can be tested more rigorously than in previous research, as concerns about simultaneity and unobserved heterogeneity can be addressed. The results show that while unemployed individuals increase the hours they spend on household labor, unemployed women tend to spend more time performing female-typed tasks, while unemployed men tend to spend more time doing male-typed tasks. It is concluded that couples' responses are in line with the time availability hypothesis, but that gendered expectations about household responsibilities also shape couples' reactions to unemployment.

Housework
Unemployment
Endogeneity
Fixed-effects
Gender norms


A rare case of intratesticular leiomyoma.

Abstract: A 47-year-old man presented with a scrotal swelling. Ultrasonography of the testes showed that it was an extratesticular swelling. However, the swelling was intraoperatively found to be intratesticular. Histology showed an intratesticular leiomyoma, which is extremely rare.

Yong|Zhan Peng|ZP|
Liu|Zhen Bang|ZB|
Chau|Cora|C|
Chong|Kian Tai|KT|

intratesticular leiomyoma
benign scrotal swellings
urinary tract leiomyoma


Isolation and partial characterization of bacteriophages infecting Pseudomonas syringae pv. actinidiae, causal agent of kiwifruit bacterial canker.

Abstract: The phytopathogen Pseudomonas syringae pv. actinidiae (Psa) is the causal agent of bacterial canker of kiwifruit. In the last years, it has caused severe economic losses to Actinidia spp. cultivations, mainly in Italy and New Zealand. Conventional strategies adopted did not provide adequate control of infection. Phage therapy may be a realistic and safe answer to the urgent need for novel antibacterial agents aiming to control this bacterial pathogen. In this study, we described the isolation and characterization of two bacteriophages able to specifically infect Psa. φPSA1, a member of the Siphoviridae family, is a temperate phage with a narrow host range, a long latency, and a burst size of 178; φPSA2 is a lytic phage of Podoviridae family with a broader host range, a short latency, a burst size of 92 and a higher bactericidal activity as determined by the TOD value. The genomic sequence of φPSA1 has a length of 51,090 bp and a low sequence homology with the other siphophages, whereas φPSA2 has a length of 40 472 bp with a 98% homology with Pseudomonas putida bacteriophage gh-1. Of the two phages examined, φPSA2 may be considered as a candidate for phage therapy of kiwifruit disease, while φPSA1 seems specific toward the recent outbreak's isolates and could be useful for Psa typing.

Di Lallo|Gustavo|G|
Evangelisti|Matteo|M|
Mancuso|Francesco|F|
Ferrante|Patrizia|P|
Marcelletti|Simone|S|
Tinari|Antonella|A|
Superti|Fabiana|F|
Migliore|Luciana|L|
D'Addabbo|Pietro|P|
Frezza|Domenico|D|
Scortichini|Marco|M|
Thaller|Maria Cristina|MC|

Bacteriophage
Pseudomonas syringae pv. actinidiae
Kiwifruit canker


Nuclear Magnetic Resonance Imaging in Endodontics: A Review.

Abstract:
INTRODUCTION
This review analyzes the increasing role of magnetic resonance imaging (MRI) in dentistry and its relevance in endodontics. Limits and new strategies to develop MRI protocols for endodontic purposes are reported and discussed.

METHODS
Eligible studies were identified by searching the PubMed databases. Only original articles on dental structures, anatomy, and endodontics investigated by in vitro and in vivo MRI were included in this review. Original articles on MRI in dentistry not concerning anatomy and endodontics were excluded.

RESULTS
All the consulted studies showed well-defined images of pathological conditions such as caries and microcracks. The enhanced contrast of pulp provided a high-quality reproduction of the tooth shape and root canal in vitro and in vivo. Assessment of periapical lesions is possible even without the use of contrast medium.

CONCLUSIONS
MRI is a nonionizing technique characterized by high tissue contrast and high image resolution of soft tissues; it could be considered a valid and safe diagnostic investigation in endodontics because of its potential to identify pulp tissues, define root canal shape, and locate periapical lesions.

Di Nardo|Dario|D|
Gambarini|Gianluca|G|
Capuani|Silvia|S|
Testarelli|Luca|L|

D003731:Dental Caries
D003786:Dental Pulp Cavity
D004708:Endodontics
D006801:Humans
D008279:Magnetic Resonance Imaging
D010483:Periapical Diseases

magnetic resonance imaging
endodontics
Dental anatomy
dental magnetic resonance imaging


Oligocene and early Miocene mammal biostratigraphy of the Valley of Lakes in Mongolia.

Abstract: The Taatsiin Gol Basin in Mongolia is a key area for understanding the evolution and dispersal of Central Asian mammal faunas during the Oligocene and early Miocene. After two decades of intense fieldwork, the area is extraordinarily well sampled and taxonomically well studied, yielding a large dataset of 19,042 specimens from 60 samples. The specimens represent 176 species-level and 99 genus-level taxa comprising 135 small mammal species and 47 large mammals. A detailed lithostratigraphy and new magnetostratigraphic and radiometric datings provide an excellent frame for these biotic data. Therefore, we test and evaluate the informal biozonation scheme that has been traditionally used for biostratigraphic correlations within the basin. Based on the analysis of the huge dataset, a formalised biostratigraphic scheme is proposed. It comprises the Cricetops dormitor Taxon Range Zone (Rupelian), subdivided into the Allosminthus khandae Taxon Range Subzone and the Huangomys frequens Abundance Subzone, the Amphechinus taatsiingolensis Abundance Zone (early Chattian), the Amphechinus major Taxon Range Zone (late Chattian), subdivided into the Yindirtemys deflexus Abundance Subzone and the Upper Amphechinus major T. R. Z., and the Tachyoryctoides kokonorensis Taxon Range Zone (Aquitanian). In statistical analyses, samples attributed to these biozones form distinct clusters, indicating that each biozone was also characterised by a distinct faunal type.

Harzhauser|Mathias|M|
Daxner-Höck|Gudrun|G|
Erbajeva|Margarita A|MA|
López-Guerrero|Paloma|P|
Maridet|Olivier|O|
Oliver|Adriana|A|
Piller|Werner E|WE|
Göhlich|Ursula B|UB|
Ziegler|Reinhard|R|

Oligocene Miocene Mammals Mongolia Biozones


Function analysis of proteins encoded by ORFs 1 to 8 of porcine circovirus-like virus P1 by microarray assay.

Abstract: Porcine circovirus-like agent P1 is a newly discovered virus containing a single-strand circular genome. The genome of P1 is a DNA molecule of 648 nucleotides which contains eight open reading frames (ORFs) that probably encode potential proteins or polypeptides. Thus it is very important to clarify these proteins' function. Here we provide the methods and analysis of microarray data in detail to characterize the transcriptome profile of P1 with and without the ORF. The relevant microarray data sets have been deposited in Gene Expression Omnibus (GEO) database under accession number GSE71945.

Wen|Libin|L| Wang|Fengzhi|F| Zhang|Dan|D| He|Kongwang|K|

Microarray
Porcine circovirus-like agent P1
Function of protein


Anatomical and biochemical analysis reveal the role of anthocyanins in flower coloration of herbaceous peony.

Abstract: Herbaceous peony (Paeonia lactiflora Pall.) is particularly appreciated because of its elegant and gorgeous flower color, but little is known about the underlying mechanisms of flower coloration. In this study, three P. lactiflora cultivars 'Xuefeng', 'Fenyulou' and 'Dahonglou' with white, pink and red flower were selected as the materials. Their anatomical structures, cell sap pH and metal elements were investigated, and the colored pigment mainly distributed in palisade mesophyll was only found in 'Fenyulou' and 'Dahonglou', and their shape of epidermal cells, cell sap pH and metal elements were not the key factors deciding phenotype color. Moreover, the qualitative and quantitative analysis of flavonoids were performed, their total anthocyanin, anthoxanthin and flavonoid contents were decreased during flower development, and only anthocyanin content in 'Dahonglou' was always higher than that in 'Xuefeng' and 'Fenyulou'. Subsequently, three anthocyanin compositions were found, and peonidin 3,5-di-O-glucoside (Pn3G5G) was identified as the main anthocyanin composition. In addition, the full-length of flavonol synthase gene (FLS) was isolated with the GenBank accession number KM259902, and the expression patterns of eight flavonoid biosynthetic genes showed that only PlDFR and PlANS basically had the highest levels in 'Dahonglou' and the lowest levels in 'Xuefeng', and they basically displayed a descended trend during flower development especially PlDFR, suggesting that these two genes might play a key role in the anthocyanin biosynthesis which resulted in the shift from white to pink and red in flowers. These results would contribute to understand the underlying molecular mechanisms of flower coloration in P. lactiflora.

Zhao|Da-Qiu|DQ| Wei|Meng-Ran|MR| Liu|Ding|D| Tao|Jun|J|

Anthocyanins
Herbaceous peony
Anatomical analysis
Red colour


The Functional Stability of FOXP3 and RORγt in Treg and Th17 and Their Therapeutic Applications.

Abstract: The balance of CD4+CD25+FOXP3+ regulatory T cells (Tregs) and effector T cells plays a key role in maintaining immune homeostasis, while the imbalance of them is related to many inflammatory diseases in both human and mice. Here we discuss about the plasticity of Tregs and Th17 cells, and the related human diseases resulted from the imbalance of them. Further, we will focus on the mechanisms regulating the plasticity between Tregs and Th17 cells and the potential therapeutic strategies by targeting regulators of the expression and activity of FOXP3 and RORγt or regulators of Treg/Th17 balance in autoimmune diseases, allergy, infection, and cancer.

D057132:Nuclear Receptor Subfamily 1, Group F, Member 3

FOXP3 RORγt Tregs Th17 Disease Plasticity


Poncirin and its metabolite ponciretin attenuate colitis in mice by inhibiting LPS binding on TLR4 of macrophages and correcting Th17/Treg imbalance.

Abstract:
ETHNOPHARMACOLOGICAL RELEVANCE
The fruit of Poncirus trifoliate, which contains poncirin as a main constituent, is frequently used in the traditional Chinese medicine for inflammation, asthma, and infection diseases.

AIM OF THE STUDY
To examine anti-colitic effects of poncirin and ponciretin, a metabolite of poncirin by gut microbiota.

MATERIALS AND METHODS
Colitis was induced in mice by the intrarectal injection of 2,4,6-trinitrobenzenesulfonic acid (TNBS). Inflammatory markers were analyzed by enzyme-linked immunosorbent assay, immunoblotting, quantitative polymerase chain reaction, confocal microscopy, and flow cytometry. Peritoneal macrophages were isolated from mice stimulated with 4% thioglycolate.

RESULTS
Poncirin was metabolized to ponciretin in vitro and in vivo by gut microbiota of mice. Orally administered poncirin and ponciretin suppressed TNBS-induced colitis in mice: these inhibited colon shortening, myeloperoxidase activity, NF-κB activation, and Th17 cell differentiation, but increased occludin, claudin-1, and ZO-1 expressions and Treg cell differentiation. Poncirin and ponciretin suppressed the differentiation of splenocytes into Th17 cells and expression of IL-17 and Foxp3 in vitro, as well as the activation of macrophages stimulated with lipopolysaccharide (LPS) by inhibiting the binding of LPS on TLR4 of macrophages. These increased the differentiation of splenocytes into Treg cells. The ant-inflammatory effect of ponciretin was superior to that of poncirin.

CONCLUSION
Orally administered poncirin is metabolized to ponciretin by gut microbiota and poncirin and ponciretin attenuates colitis by suppressing NF-κB activation through the inhibition of LPS binding on macrophages and correcting Th17/Treg cell imbalance.

Poncirin
Ponciretin
Colitis
Macrophages
Th17 cells


Dimensions of Religiosity and PTSD Symptom Clusters in US Veterans and Active Duty Military.

Abstract: We examined multiple dimensions of religiosity and their relationship to the four DSM-5 PTSD symptom clusters among US Veterans and Active Duty Military (ADM), hypothesizing that religiosity would be most strongly inversely related to negative cognitions/emotions (Criterion D symptoms) and less strongly to neurobiologically based symptom clusters (B, C, and E). This cross-sectional multisite study involved 591 Veterans and ADM from across the southern USA. Inclusion criteria were having served in a combat theater and the presence of PTSD symptoms. Measures of religious beliefs/practices, social involvement, and PTSD symptoms were administered, and bivariate and multivariate analyses were conducted in the overall sample, and in exploratory analyses, in the sample stratified by race (White, Black, and Hispanic). In the overall sample, multivariate analyses revealed that the only PTSD symptom cluster inversely related to religiosity was Criterion D, and only to organizational (b = - 0.08, P = 0.028) and cognitive/intrinsic religiosity (b = - 0.06, P = 0.049), relationships that were fully explained by social factors. Religious struggles, in contrast, were positively related to all four symptom clusters. Inverse relationships with Criterion D symptoms were particularly strong in Blacks, in whom inverse relationships were also present with Criterion E symptoms. In contrast, only positive relationships with PTSD symptom clusters were found in Hispanics, and no relationships (except for religious struggles) were present in Whites. As hypothesized, the inverse relationship between religious involvement and PTSD symptoms in Veterans and ADM was strongest (though modest) for Criterion D negative cognitions/emotions, especially in Blacks.

Religiosity
Symptom clusters
Veterans
Active Duty Military
Post-traumatic stress disorder


Outcomes of surgically managed recurrent parastomal hernia: the Sisyphean challenge of the hernia world.

Abstract:
PURPOSE
The management of a recurrent (symptomatic) parastomal hernia (PSH) presents a dilemma. The aim of this study was to review the outcome of patients who underwent a recurrent PSH repair.

METHODS
Retrospective review of consecutive patients undergoing recurrent PSH repairs at a single institution between 2010 and 2019. Primary outcome recorded was recurrence. Secondary outcomes recorded were 30-day post-operative complications, surgical site occurrence (SSO) incidence and to assess if EHS classification altered with each recurrence.

RESULTS
Thirty-eight patients underwent 59 recurrent PSH repairs during the study period. Median number of PSH repairs per patient from ostomy formation was 2 (2-8). Post-operative complications occurred following 52.5% of repairs. Recurrence rate for all recurrent PSH hernia repairs was 45.7%, with a median follow-up of 58 months (0-115). A trend was seen towards a shorter PSH recurrence-free survival in those who had at least two previous PSH repairs at the start of the study period when compared to those who had less. Recurrence was not associated with operative urgency, type of repair, mesh type or SSO occurrence. A significant decrease in recurrence was seen with retro-rectus mesh placement when compared to onlay (p = 0.003). EHS classification did not change between each recurrence in 70.8% of patients.

CONCLUSION
Recurrence rates after recurrent PSH repair are high. The recurrence-free survival was worse after the second or more attempt at repair for recurrence. Further studies are warranted to explore prophylaxis, optimal repair method, and where re-recurrence occurs, the benefit of repeated surgical intervention.

Harries|R L|RL|
Daniels|I R|IR|
Smart|N J|NJ|

Recurrence Parastomal Hernia Ostomy Mesh Stoma


Accelerating anodic biofilms formation and electron transfer in microbial fuel cells: Role of anionic biosurfactants and mechanism.

Abstract: Anodic electron transfer is the predominant electricity generation process of MFCs. To accelerate anodic biofilms formation and electron transfer, 40mg/L, 80mg/L, and 120mg/L of rhamnolipid biosurfactants were added to the anolyte, resulting in an increased abiotic capacitance from 15.12F/m2 (control) to 16.54F/m2, 18.00F/m2, and 19.39F/m2, respectively. Anodic biofilm formation was facilitated after dosing 40mg/L of rhamnolipids on the 7th day after inoculation, resulting in an increased anodic biofilm coverage from 0.43% to 42.51%, and an increased maximum power density from 6.92±1.18W/m3 to 9.93±0.88W/m3. Furthermore, the adsorption of rhamnolipids on the anode caused the Frumkin effect, leading to a decrease of equilibrium potential from -0.43V to -0.56V, and an increase of exchange current density from 5.09×10-3A/m2 to 8.72×10-3A/m2. However, electron transfer was blocked when the rhamnolipid concentration was further increased to 80mg/L, and 120mg/L. Analysis of the anodic bacterial communities revealed that rhamnolipids facilitated the enrichment of exoelectrogen, increasing the total proportion from 65% to 81%. Additionally, biosurfactants were found to have significant impacts on the composition of exoelectrogens.

Zhang|Yunshu|Y| Jiang|Junqiu|J| Zhao|Qingliang|Q| Gao|YunZhi|Y| Wang|Kun|K| Ding|Jing|J| Yu|Hang|H| Yao|Yue|Y|

Anodic electron transfer
MFC
Rhamnolipid
Frumkin effect
Exoelectrogen


Use of negative pressure wound therapy in burn patients.

Abstract: According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less-compliant patients. We propose an enhanced segmental compartment-covered technique, which uses NPWT adjunctively as first-line wound treatment to help manage postoperative infection. Moreover, NPWT promotes granulation tissue formation to prepare the wound bed for subsequent skin graft and may be used as a bolster over the graft, which helps to attain skin graft viability.

Negative pressure wound therapy
Burns
Skin grafts
Wound healing


Spinal cord stimulation: a real-world data analysis on outcomes and differences between rechargeable and non-rechargeable implantable pulse generators.

Abstract:
OBJECTIVE
In this analysis, we examined differences between rechargeable and non-rechargeable spinal cord stimulation (SCS) devices in patients with pain.

METHODS
We conducted a retrospective, longitudinal claims data analysis using a German research database comprising 5 million statutory insured patients (2012-2017). Outcomes of demographics, patient pathways, and health care resource utilization (HCRU) in patients with initial SCS were collected.

RESULTS
Of 150 patients in the database, 73 (49%) received a rechargeable device and 77 (51%) a non-rechargeable device. The average age was 62.5 years (51% female and 49% male patients). A significant decrease over a 3-year follow-up was observed in analgesic prescriptions (-18%), number of patient visits to a physician, and number of patients who were hospitalized. HCRU-related figures for patients with non-rechargeable neurostimulators increased in the last follow-up year whereas the group receiving rechargeable neurostimulators showed a steady decrease.

CONCLUSIONS
SCS seems to be an effective way for patients with chronic pain to decrease pain and improve quality of life. Rechargeable devices seem to be superior to non-rechargeable devices owing to greater longevity and were found to be associated with continuous reduction of pain diagnoses, hospitalization, physician visits, and use of pain medication in our study.

D059350:Chronic Pain
D000078332:Data Analysis
D005260:Female
D006801:Humans
D008297:Male
D008875:Middle Aged
D011788:Quality of Life
D012189:Retrospective Studies
D062187:Spinal Cord Stimulation

Spinal cord stimulation
real-world data
rechargeable
implantable pulse generator
pain
chronic pain
failed back surgery syndrome
post-laminectomy syndrome


Demographic and Clinical Features of Small-for-Gestational-Age Infants Born to Mothers With Gestational Diabetes Mellitus.

Abstract: We studied the demographic and clinical characteristic, risk factors, outcomes of full-term small-for-gestational-age (SGA) infants born to mothers with gestational diabetes mellitus (GDM) in China. A retrospective case-control study that included 1981 SGA infants was conducted; the demographic and clinical data between SGA infants born to mothers with and without GDM were compared. Of 383 SGA infants born to mothers with GDM, 221 (57.7%) were female, and the incidence of these infants was 1 in 155 live births. The risk of SGA siblings (RR, 1.88; 95% CI, [1.23-2.86]), low 1- and 5-min Apgar scores (RR,2.04 and 4.21; 95%CI [1.05-4.00] and [1.05-16.89], respectively), early thrombocytopenia (RR, 3.39; 95%CI, [1.33-8.64]), hypoglycemia(RR, 2.49; 95%CI, [1.55-3.98]), and hypoxic-ischemic encephalopathy (RR,5.61; 95%CI, [1.25-25.18]) were increased in SGA infants born to mothers with GDM compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had a significantly higher ratio of catch-up growth (CUG) (RR, 1.73; 95%CI, [1.18-2.54]) in the first year of life. These results show that genetic factors may be one of the etiologies of SGA infants born to mothers with GDM; and these infants have more adverse perinatal outcomes compared to SGA infants born to mothers without GDM. SGA girls born to mothers with GDM had accelerated CUG in the first year of life.

Chen|Juncao|J| Xiao|Huimin|H| Yang|Yong|Y| Tang|Yaping|Y| Yang|Xiaoqi|X| Zhang|Zhe|Z| Lu|Weineng|W| Yao|Jie|J| Huang|Longguang|L| Liu|Xiaoping|X| Zhou|Wei|W|

small-for-gestational-age
infants
gestational diabetes mellitus
clinical characteristic
risk factors
catch-up growth


Evaluation of a composite Gel-Alanine phantom on an end-to-end test to treat multiple brain metastases by a single isocenter VMAT technique.

Abstract:
PURPOSE
This work aims to evaluate the application of a cylindrical phantom made of dosimetric gel containing alanine pellets distributed inside the gel volume during an end-to-end test of a single isocenter VMAT for simultaneous treatment of multiple brain metastases. The evaluation is based on the comparison of the results obtained with the composite phantom with the treatment planning system (TPS) dose distribution validated by using the clinical conventional quality control with point and planar dose measurements.

METHODS
A cylindrical MAGIC-f gel phantom containing alanine dosimeters (composite phantom) was used to design the VMAT plan in the treatment planning system (TPS). The alanine dosimeters were pellets with radius of 2.5 mm and height of 3 mm, and played the role of brain metastasis inside the gel cylinder, which simulated the cerebral tissue. Five of the alanine dosimeters were selected to simulate five lesions; five planning target volumes (PTVs) were created including the dosimeters and irradiated with different doses. Conventional quality assurance (QA) was performed on the TPS plan and on the composite phantom; a phantom containing only gel (Gel 1 phantom) was also irradiated. One day after irradiation, magnetic resonance images were acquired for both phantoms on a 3T scanner. An electron spin resonance spectrometer was used to evaluate alanine doses. Calibration curves were constructed for the alanine and the gel dosimeters. All the gel only measurement was repeated (Gel 2 phantom) in order to confirm the previous gel measurement.

RESULTS
The VMAT treatment plan was approved by the conventional QA. The doses measured by alanine dosimeters on the composite gel phantom agreed to the TPS on average within 3.3%. The alanine dose for each lesion was used to calibrate the gel dosimeter measurements of the concerned PTV. Both gel dose volume histograms (DVH) achieved for each PTV were in agreement with the expected TPS DVH, except for a small discrepancy observed for the Gel 2 curve of PTV1 and the Gel 1 curve of PTV5. In a 3D gamma analyses performed for each PTV volume independently, comparing both the gels' measurements to the TPS and using 3%/3 mm, 5%/2 mm, and 7%/2 mm, more than 90% of the points were approved for all the PTVs, except for the PTV5 comparison in the Gel 1 measurement and for the PTV2 comparison in the Gel 2 measurement. A 3D gamma analysis was also applied for each PTV independently, to compare both gel measurements in order to evaluate the consistence of repeated gel measurements of the same plan, and more than 94.5% of the points were approved.

CONCLUSIONS
The composite Gel-Alanine phantom can be used for the end-to-end test of a single isocenter VMAT for simultaneous treatment of multiple brain metastases. The use of the alanine as the lesion cores for the treatment planning provided the precise dose measurements inside each lesion and allowed the conversion of the gel R2 values based on an accurate dose measurement inside the target.

VMAT
alanine
MAGIC-f
gel dosimetry
tridimensional dosimetry


Occipital Sinus Dural Arteriovenous Fistula Presenting with Cerebellar Hemorrhage.

Abstract:
BACKGROUND
Occipital sinus (OS) dural arteriovenous fistula (DAVF) is extremely rare, and we are aware of no case accompanied by cerebral hemorrhage. We present a case of OS DAVF presenting with cerebellar hemorrhage, treated successfully by transvenous embolization.

CASE DESCRIPTION
A 62-year-old female presented with headache and nausea of recent onset. Computed tomography revealed left cerebellar hemorrhage with perihematomal edema. Angiography showed OS DAVF fed by bilateral occipital and posterior meningeal arteries, with drainage into the left inferior hemispheric vein and right transverse sinus receiving the shunt flow from OS. The caudal side of the OS was occluded. The inferior hemispheric vein was dilated with 2 varices, and the junction between the OS and right transverse sinus was narrowed. Because the OS was not involved in normal cerebellar drainage, transvenous embolization of the OS was performed. The microcatheter was advanced to the OS from the transverse sinus during balloon occlusion at the confluence of sinuses. Coils were placed in the OS from the caudal to cranial side, and complete occlusion of the shunt was obtained.

CONCLUSIONS
This is the first report of OS DAVF presenting with cerebellar hemorrhage. Transvenous embolization of the affected OS appears ideal when transvenous access is feasible, and the OS is not involved in normal venous drainage of the cerebellum.

Kawauchi|Takeshi|T| Ikeda|Hiroyuki|H| Miyakoshi|Akinori|A| Go|Koichi|K| Oichi|Yuki|Y| Sano|Noritaka|N| Hayase|Makoto|M| Toda|Hiroki|H|

D020785:Central Nervous System Vascular Malformations

Occipital sinus
Dural arteriovenous fistula
Cerebellar hemorrhage


The experience and perspective of people with spinal cord injury about well-being interventions: a systematic review of qualitative studies.

Abstract:
PURPOSE
Promoting well-being is a key aim of rehabilitation. The intentional design of interventions to address well-being requires an understanding of the factors that affect this complex phenomenon. A growing body of qualitative literature has identified determinants that people with SCI report affect their well-being. It is unclear whether or how rehabilitation interventions can influence these well-being determinants. This study sought to explore the experience and perspective of people with SCI about interventions that target their well-being.

METHOD
Systematic search of seven databases. Deductive analysis to categorize findings related to well-being determinants, and further inductive coding to identify sub-themes, relationships and additional findings.

RESULTS
Twenty studies were selected, involving a wide range of interventions. Each intervention influenced a number of well-being determinants, which were inter-related. People with SCI reported improvements in both subjective and psychological well-being. However, well-being was not always well defined in the studies and people with SCI reported lack of priority for, and opportunity to engage in, well-being interventions in the current rehabilitation system.

CONCLUSIONS
Rehabilitation interventions can influence well-being determinants. These determinants form a useful framework for the intentional design of well-being interventions, which should be informed by a broad understanding of well-being.IMPLICATIONS FOR REHABILITATIONWell-being can be influenced by rehabilitation interventions, and a more explicit focus on well-being in intervention design and evaluation is recommended.Conceptual frameworks used to define and measure well-being should adopt a broad understanding of well-being.Well-being interventions should address the determinants identified by people with SCI (engaging in occupation, responsibility, values and perspectives, self-worth, self-continuity, relationships and the environment).People with SCI want a greater priority placed on well-being interventions, and more opportunities to engage in these interventions, especially in the community.

spinal cord injuries
rehabilitation
Quality of life