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Conflict-climate-displacement: a cross-sectional ecological study determining the burden, risk and need for strategies for neglected tropical disease programmes in Africa.

Complex challenges such as political instability, climate change and population displacement are increasing threats to national disease control, elimination and eradication programmes. The objective of this study was to determine the burden and risk of conflict-related and climate-related internal displacements and the need for strategies for countries endemic with neglected tropical diseases (NTDs).

What proportion of clinical prediction models make it to clinical practice? Protocol for a two-track follow-up study of prediction model development publications.

It is known that only a limited proportion of developed clinical prediction models (CPMs) are implemented and/or used in clinical practice. This may result in a large amount of research waste, even when considering that some CPMs may demonstrate poor performance. Cross-sectional estimates of the numbers of CPMs that have been developed, validated, evaluated for impact or utilized in practice, have been made in specific medical fields, but studies across multiple fields and studies following up the fate of CPMs are lacking.

Efficacy of focal high-dose-rate brachytherapy in the treatment of patients diagnosed with low or favourable: intermediate-risk prostate cancer-a protocol for a randomised controlled trial.

Prostate cancer (PCa) is men's second most predominant cancer worldwide. Because the prostate-specific antigen test is used in diagnostics, PCa is more often diagnosed in the early stages, making radical treatment of the disease possible. However, it is estimated that over a million men worldwide suffer from radical treatment-related complications. Thus, focal treatment has been proposed as a solution, which aims to destroy the predominant lesson that determines the progression of the disease. The main objective of our study is to compare the quality of life and efficacy of patients diagnosed with PCa before and after the treatment with focal high-dose-rate brachytherapy and to compare results with focal low-dose-rate brachytherapy and active surveillance.

Efficacy and safety of carbon dioxide insufflation for brain protection for patients undergoing planned left-sided open heart valve surgery: protocol for a multicentre, placebo-controlled, blinded, randomised controlled trial (the CO2 Study).

Brain injury is common following open heart valve surgery. Carbon dioxide insufflation (CDI) has been proposed to reduce the incidence of brain injury by reducing the number of air microemboli entering the bloodstream in surgery. The CO2 Study will evaluate the efficacy and safety of CDI in patients undergoing planned left-sided open heart valve surgery.

Development of the Young Disability Questionnaire (spine) for children with spinal pain: field testing in Danish school children.

The objective of this study was to finalise the development of the Young Disability Questionnaire (YDQ-spine) to measure the consequences of neck, midback and low back pain, relevant for schoolchildren aged 9-12 years.

APDR Healthcare Disparities Curriculum Pilot: Helping Trainees Meet More Than a Milestone.

In order to help program directors satisfy the Accreditation Council for Graduate Medical Education common program requirement for health care disparities (HCD) education, a comprehensive web-based curriculum on HCDs in Radiology was developed. The curriculum was designed to educate trainees about existing HCDs, stimulate discussion, and spur research about HCDs in radiology. The curriculum was piloted to assess its educational value and feasibility.

Natriuretic Response to Acetazolamide in Patients With Acute Heart Failure and Volume Overload.

Acetazolamide facilitates decongestion in acute decompensated heart failure (ADHF).

Nursing students' views on trauma-informed pediatric nursing care and family-centered care.

We studied the views of nursing students on family-centered care (FCC) and their knowledge, opinions, self-rated competence, current practice, and perceived implementation barriers with regard to trauma-informed pediatric nursing care.

Problematic media use and psychological adaptation in children in the COVID-19 pandemic: A descriptive cross-sectional study.

This study was conducted to determine the problematic media use and psychological adaptation levels of children.

Nurse views of obstacles encountered by nurses in Saudi Arabia during the provision of psychiatric care.

Nursing staff within the mental health sector are major actors in delivering healthcare. They face considerable obstacles that may hinder the provision of high-quality care to patients with mental health challenges.

What is Obesity?: Definition as a Disease, with Implications for Care.

Advances in the understanding of weight regulation provide the framework for the recognition of obesity as a chronic disease. Lifestyle approaches are foundational in the prevention of obesity and should be continued while weight management interventions, including antiobesity medications and metabolic-bariatric procedures, are offered to eligible patients. Clinical challenges remain, however, including overcoming obesity stigma and bias within the medical community toward medical and surgical approaches, ensuring insurance coverage for obesity management (including medications and surgery), and promoting policies that reverse the upward worldwide trend in obesity and adiposity complications in populations.

Health Complications of Obesity: 224 Obesity-Associated Comorbidities from a Mechanistic Perspective.

Obesity is associated with a wide range of comorbidities that transverse multiple specialties in clinical medicine. The development of these comorbidities is driven by various mechanistic changes including chronic inflammation and oxidative stress, increased growth-promoting adipokines, insulin resistance, endothelial dysfunction, direct loading and infiltrative effect of adiposity, heightened activities of the renin-angiotensin-aldosterone system and sympathetic nervous system, impaired immunity, altered sex hormones, altered brain structure, elevated cortisol levels, and increased uric acid production, among others. Some of the comorbidities might develop secondary to one or more other comorbidities. Considering the obesity-associated comorbidities in the context of the mechanistic changes is helpful in understanding these conditions and in guiding treatment and future research.

The Effect of Obesity on Gastrointestinal Disease.

Obesity exerts both direct and indirect effects on gastrointestinal function. From physical effects of central adiposity on intragastric pressure resulting in higher incidence of reflux to dyslipidemia and effects on gallstone disease, the gastrointestinal manifestations of obesity are wide-ranging. Of particular emphasis is the identification and management of non-alcoholic fatty liver disease including non-invasive assessment and lifestyle and pharmacologic interventions for patients with non-alcoholic steatohepatitis. Additional focus is on the impact of obesity and western diet on intestinal disorders and colorectal cancer. Bariatric interventions involving the gastrointestinal tract are also discussed.

Developing Effective Strategies for Obesity Prevention.

Nutrition policies can work with clinical treatments to address the obesity epidemic. The United States has passed beverage taxes at the local level and calorie labeling mandates at the federal level to encourage healthier consumption. Nutritional changes to federal nutrition programs have been either implemented or suggested; evidence shows that the changes that have been implemented have resulted in improvements in diet quality and are cost-effective in decreasing the increase in obesity prevalence. A comprehensive policy agenda that addresses risk of obesity on multiple levels of the food supply will have meaningful long-term effects on obesity prevalence.

Vitamin D testing in children and adolescents in Victoria, Australia: are testing practices in line with global recommendations?

To describe changing primary care ordering of serum 25-hydroxyvitamin D (25OHD) tests in Australian children.

Structural diversification of fungal natural products by oxidative enzymes.

Ascomycota and basidiomycota fungi are prolific producers of biologically active natural products. Fungal natural products exhibit remarkable structural diversity and complexity, which are generated by the enzymes involved in their biosynthesis. After the formation of core skeletons, oxidative enzymes play a critical role in converting them into mature natural products. Besides simple oxidations, more complex transformations, such as multiple oxidations by single enzymes, oxidative cyclization, and skeletal rearrangement, are often observed. Those oxidative enzymes are of significant interest for the identification of new enzyme chemistry and have the potential to be biocatalysts for the synthesis of complex molecules. This review presents selected examples of unique oxidative transformations that have been found in the biosynthesis of fungal natural products. The development of strategies for refactoring the fungal biosynthetic pathways with an efficient genome-editing method is also introduced.

Technical performance and diagnostic yield of motorised spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn's disease: a randomised controlled, open-label study (the MOTOR-CD trial).

Recent studies have shown that motorised spiral enteroscopy (MSE) enables deeper and total small bowel evaluation compared with single-balloon enteroscopy (SBE) in suspected Crohn's disease (CD) when analysed per procedure. However, no randomised controlled study has compared bidirectional MSE with bidirectional SBE in suspected CD.

Cypermethrin toxicity in the environment: analytical insight into detection methods and microbial degradation pathways.

The unrestricted utilization of xenobiotic compounds has sparked widespread concern by the world's growing population. A synthetic pyrethroid called cypermethrin (CP) is commonly utilized as an insecticide in horticulture, agriculture, and pest control. The high toxicity levels of accumulated CP have prompted environmental concerns; it damages soil fertility, and an ecosystem of essential bacteria, and causes allergic reactions and tremors in humans by affecting their nervous systems. The damage caused by CP to groundwater, food, and health makes it imperative that new effective and sustainable alternatives are investigated. Microbial degradation has been established as a reliable technique for mineralizing CP into less toxic chemicals. Among the many enzymes produced by bacteria, carboxylesterase enzymes are determined to be the most efficient in the CP breakdown process. High-performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS) have been reported as the best methods for determining CP and its metabolized products, with detection limits as low as ppb from diverse environmental samples. The current study describes the ecotoxicological impact of CP and innovative analytical techniques for their detection. The newly isolated CP-degrading bacterial strains have been evaluated in order to develop an efficient bioremediation strategy. The proposed pathways and the associated critical enzymes in the bacterial mineralization of CP have also been highlighted. Additionally, the strategic action to control CP toxicity has been discussed.

Intracardiac Thrombosis and Systemic Embolism in a Patient with Cardiac Amyloidosis in Sinus Rhythm.

Intracardiac thrombosis formation in patients in sinus rhythm is a rare phenomenon. An 84-year-old woman was admitted because of worsening dyspnea on exertion. An electrocardiogram showed sinus rhythm, left atrial overload, marked left axis deviation, low voltage, and poor r-wave progression in leads V1-4. An echocardiogram showed relatively preserved left ventricular ejection fraction with minimal wall thickening. Her serum level of B-type natriuretic peptide (931 pg/mL) was markedly elevated and a diagnosis of worsening heart failure was made. During the course of treatment for heart failure, she was complicated by acute abdominal aortic thromboembolism together with left atrial thrombus. An emergency abdominal aortic thrombectomy was followed by the removal of a left atrial thrombus 2 days later. Left ventricular biopsy performed during the surgery revealed amyloid deposits in the myocardial interstitium. Immunohistochemical study confirmed the diagnosis of transthyretin cardiac amyloidosis. It is postulated that the risk of intracardiac thrombosis and systemic embolism is increased even in sinus rhythm in patients with cardiac amyloidosis.

Prognostic Value of Postoperative Platelet to Mean Platelet Volume Ratio for In-hospital Mortality in Type A Acute Aortic Dissection Patients.

Surgical treatment is the most effective method to improve the prognosis of type A acute aortic dissection (TAAAD) patients. Thus, this investigation aimed to evaluate the value of postoperative platelet to mean platelet volume ratio (PMR) in predicting in-hospital mortality in postoperative TAAAD patients and to compare it with preoperative PMR.A retrospective study (171 postoperative patients) was conducted in the hospital from January 2017 to December 2019. Clinical (age, gender, and outcome of the patients' in-hospital mortality), preoperative PMR, and postoperative laboratory results were gathered. The area under the receiver operating characteristic curve (AUC) and logistic regression were employed.Preoperative and postoperative PMR levels were higher in the survivors than in the nonsurvivors (13.44 ± 7.15 versus 9.15 ± 4.05, P = 0.002; 12.02 ± 6.79 versus 6.85 ± 2.42, P < 0.001; respectively). Multivariate logistic regression indicated that postoperative PMR was an independent factor even adjusted with different variables. Moreover, postoperative PMR had the highest area under the receiver operating characteristic curve (AUC) (AUC: 0.778, 95% CI: 0.708-0.838, P < 0.001), with the best prognostic accuracy, followed by preoperative PMR (AUC: 0.721, 95% CI: 0.648-0.787, P < 0.001). The best cutoff value for postoperative PMR was 9.9206, with a high sensitivity (90.3%) and specificity (55.7%).Postoperative PMR should serve as an independent index to predict in-hospital mortality in TAAAD patients. In addition, postoperative PMR are superior to preoperative PMR to recognize high-risk patients.

Impact of mental disorders during education on work participation: a register-based longitudinal study on young adults with 10 years follow-up.

Mental disorders are a leading cause of disability and a major threat to work participation in young adults. This register-based longitudinal study aims to investigate the influence of mental disorders on entering and exiting paid employment among young graduates and to explore differences across socioeconomic groups.

Intensive care unit admission is not necessary after venous sinus stenting.

Venous sinus stenting (VSS) has emerged as a safe and effective treatment option for idiopathic intracranial hypertension. Many physicians routinely admit patients to the intensive care unit (ICU) for close monitoring, but little data exists on whether this is necessary.

Early venous filling after mechanical thrombectomy in acute ischemic stroke due to large vessel occlusion in anterior circulation.

The significance of early venous filling (EVF) after mechanical thrombectomy (MT) in acute ischemic stroke (AIS) is not fully understood. In this study, we aimed to investigate the impact of EVF after MT.

Regional Disparities in Transvenous Lead Extraction for Cardiac Implantable Electronic Device Infection in Japan　- A Descriptive Study Using the National Database Open Data.

Because the penetration of transvenous lead extraction (TLE) for cardiac implantable electronic device (CIED) infection has not been investigated in Japan, we conducted a population-based, retrospective, descriptive study to evaluate regional disparities in the use of TLE for CIED infection and the potential undertreatment of CIED infection using a nationwide insurance claims database.Methods and Results: Patients who underwent CIED implantation or generator exchange and TLE between April 2018 and March 2020 were identified. Moreover, the penetration ratio of TLE for CIED infection in each prefecture was estimated. CIED implantation and TLE were most prevalent in the age categories of 80-89 years (40.3%) and 80-89 years (36.9%), respectively. There was no correlation between the number of CIED implantations and that of TLE (rho=-0.087, 95% confidence interval -0.374 to 0.211, P=0.56). The median penetration ratio was 0.00 (interquartile range 0.00-1.29). Of the 47 prefectures, 6, comprising Okinawa, Miyagi, Okayama, Fukuoka, Tokyo, and Osaka, showed a penetration ratio ≥2.00.

Impact of Octacalcium Phosphate/Gelatin (OCP/Gel) Composite on Bone Repair in Refractory Bone Defects.

In clinical settings, bone grafting is frequently used to treat bone defects. Therefore, the development of bone graft substitutes with superior bone formation ability is expected, instead of autogenous bone grafting. Octacalcium phosphate (OCP) has been developed as a bone graft substitute, and preclinical studies using OCP have reported superior bone formation ability compared with β-tricalcium phosphate. Furthermore, OCP has been used in composite forms with natural polymers such as collagen and gelatin to improve the usability of OCP, and OCP/collagen composite forms have been clinically applied in the dental field because of their excellent usability and osteogenic potential. This review describes the development and preclinical results of OCP and OCP/gelatin (OCP/Gel) composites and prospects for future applications in orthopedics. The development of bone graft substitutes that achieve a high degree of biodegradability and strength will be needed for the clinical application of OCP composites in orthopedics in the future.

Cumulative Cigarette Consumption is Associated with Cardio-Ankle Vascular Index (CAVI) Mediated by Abdominal Obesity Assessed by A Body Shape Index (ABSI): A Cross-Sectional Study.

To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness.

Ustekinumab Decreases Circulating Th17 Cells in Ulcerative Colitis.

Objective T helper (Th) cells play a central role in the pathogenesis of ulcerative colitis (UC). The present study analyzed the changes in circulating T cells by administration of ustekinumab (UST), an interleukin-12/23p40 antibody. Methods CD4 T cells were isolated from peripheral blood at 0 and 8 weeks after UST treatment, and we analyzed the proportion of CD4 T cells by flow cytometry. Clinical information and laboratory data were obtained at 0, 8, and 16 weeks. Patients We evaluated 13 patients with UC who received UST for the induction of remission between July 2020 and August 2021. Results The median partial Mayo score improved from 4 (1-7) to 0 (0-6) (p<0.001) with UST. Among serological parameters, albumin concentrations, C-reactive protein concentrations, the sedimentation rate, and leucine-rich alpha 2 glycoprotein concentrations showed significant improvement with UST. A flow cytometric analysis of circulating CD4 T cells showed that the percentage of Th17 cells was significantly decreased by UST treatment in all patients (1.85% to 0.98%, p<0.0001). Th1 cells were significantly increased by UST treatment (9.52% to 10.4%, p<0.05), but Th2 and regulatory T cells were not significantly different. The high-Th17 subgroup had a significantly better partial Mayo score than the low-Th17 subgroup at 16 weeks after UST treatment (0 vs. 1, p=0.028). Conclusion Treatment with UST decreases circulating Th17 cells, suggesting that this change may be related to the anti-inflammatory effect of UC.

Diagnostic dilemma of syncope: Esophageal hiatal hernia and high-risk bundle-branch block.

We herein report a complicated case of recurrent syncope accompanying bundle branch block and hiatal hernia of the esophagus. An 83-year-old woman presented with syncope. Echocardiography visualized the left atrium compressed by an esophageal hiatal hernia, which had potential to decrease the cardiac output. Although she underwent esophageal repair surgery, two months after the surgery, she presented to the emergency department again with complaints of syncope. At the return visit, her face was pale and her pulse rate was 30 beats per minute. Electrocardiography showed complete atrioventricular block. On reviewing the patient's previous electrocardiography findings, we found a record of trifascicular block. This case illustrates the importance of predicting atrioventricular blocks in patients with high-risk bundle-branch blocks. Keeping in mind high-risk bundle-branch blocks will help clinicians avoid anchoring bias due to a striking image masquerading as the true diagnosis.

Zinc Supplementation and an Improved Quality of Life in Patients with Autoimmune Hepatitis.

Background and Aims Patients with autoimmune hepatitis (AIH) reportedly have an impaired quality of life (QOL), mainly due to depression, even during remission. In addition, hypozincaemia has been demonstrated in patients with chronic liver disease, including AIH, and is known to be related to depression. Corticosteroids are known to cause mental instability. We therefore investigated the longitudinal association between zinc supplementation and changes in the mental status among AIH patients treated with corticosteroids. Patients and Methods This study enrolled 26 patients with serological remission of AIH routinely treated at our facility after excluding 15 patients who either discontinued polaprezinc (150 mg/day) within 24 months or interrupted treatment. Two questionnaires, the Chronic Liver Disease Questionnaire (CLDQ) and SF-36, were adopted to evaluate the QOL before and after zinc supplementation. Results Serum zinc levels were significantly elevated after zinc supplementation (P <0.0001). The CLDQ worry subscale significantly improved after zinc supplementation (P = 0.017), but none of the SF-36 subscales was affected. Multivariate analyses demonstrated that daily prednisolone dosing was inversely related to both the CLDQ worry domain score (P = 0.036) and the SF-36 mental health component (P = 0.031). There was a significant negative correlation between the changes in the daily steroid dose and the CLDQ worry domain scores before and after zinc supplementation (P = 0.006). No serious adverse events occurred during the observation period. Conclusions Zinc supplementation safely and efficiently improved mental impairment, possibly caused by continuous treatment with corticosteroids, in patients with AIH.

[A case of Lambert-Eaton myasthenic syndrome with exacerbation of respiratory failure triggered by acute myocardial infarction].

The patient, a 58-year-old man, experienced weakness of the proximal muscles in both lower extremities, and Lambert-Eaton myasthenic syndrome and small cell carcinoma of unknown primary origin were diagnosed. He received symptomatic treatment for myasthenia and radiochemotherapy for small cell carcinoma; once this regimen, the myasthenic symptoms improved. However, acute myocardial infarction occurred, after which type II respiratory failure developed, and the patient required ventilator management with tracheal intubation. Acute-phase treatment, such as plasma exchange, intravenous immune globulin therapy, and methylprednisolone pulse therapy, and intensification of symptomatic treatment allowed for extubation, and eventually the patient was able to walk independently. According to electrophysiological examination, compound muscle action potentials were larger at discharge than at the time of exacerbation.

[Steroid pulse therapy was effective against anti-muscle-specific kinase antibody-positive myasthenia gravis crisis: a case report].

A 50-year-old woman experienced cardiopulmonary arrest. Although the arrest lasted for 4 min, she could not be withdrawn from the mechanical ventilator because of low tidal volume, despite being awake and alert after admission. The results of the anti-acetylcholine receptor antibody and repetitive nerve stimulation tests were negative, and the anti-muscle-specific kinase antibody levels revealed myasthenia gravis. We recommended therapeutic plasma exchange; however, the patient refused the treatment as she did not want to use blood products. Consequently, we initially attempted steroid pulse therapy, which enabled the patient to be withdrawn from the mechanical ventilator. Thus, steroid pulse therapy was beneficial for the crisis associated with the anti-muscle-specific kinase antibody in the absence of therapeutic plasma exchange.

Preoperative Computed Tomography of the Right Gastroepiploic Artery for Coronary Artery Bypass Grafting.

Grafting the right gastroepiploic artery (GEA) to the right coronary artery (RCA) is effective, but preoperative evaluation of arterial conduit availability has not been established. By comparing the midterm graft results, we aimed to assess the efficacy of preoperative evaluation of the GEA using computed tomography (CT).Methods and Results: We retrospectively examined patients who underwent isolated coronary artery bypass grafting surgery between April 2010 and December 2020, and those whose GEA was grafted to the RCA were selected: 55 patients were included in the study analysis. Postoperative evaluations were performed during the early phase, 1 year postoperatively, and at follow-up evaluations. The outer diameter of the proximal GEA was compared with the midterm graft patency grade on CT and patients were classified as Functional (Grade A) or Dysfunctional (Grades O or B). The proximal GEA outer diameters were significantly different between the Functional and Dysfunctional groups (P<0.001). Furthermore, multivariate Cox regression analysis revealed that this diameter was an independent predictor of graft functionality (P<0.001). Patients with outer proximal diameters larger than the cutoff value had superior graft results at 3 years postoperatively. The rate of freedom from a dysfunctional graft at 3 years postoperatively was 95.5% and 45.5% for the Larger and Smaller diameter subgroups, respectively (P<0.001).

Fast-Spiking Interneurons of the Premotor Cortex Contribute to Initiation and Execution of Spontaneous Actions.

Planning and execution of voluntary movement depend on the contribution of distinct classes of neurons in primary motor and premotor areas. However, timing and pattern of activation of GABAergic cells during specific motor behaviors remain only partly understood. Here, we directly compared the response properties of putative pyramidal neurons (PNs) and GABAergic fast-spiking neurons (FSNs) during spontaneous licking and forelimb movements in male mice. Recordings centered on the face/mouth motor field of the anterolateral motor cortex (ALM) revealed that FSNs fire longer than PNs and earlier for licking, but not for forelimb movements. Computational analysis revealed that FSNs carry vastly more information than PNs about the onset of movement. While PNs differently modulate their discharge during distinct motor acts, most FSNs respond with a stereotyped increase in firing rate. Accordingly, the informational redundancy was greater among FSNs than PNs. Finally, optogenetic silencing of a subset of FSNs reduced spontaneous licking movement. These data suggest that a global rise of inhibition contributes to the initiation and execution of spontaneous motor actions.

Connecting Connectomes to Physiology.

With the advent of volumetric EM techniques, large connectomic datasets are being created, providing neuroscience researchers with knowledge about the full connectivity of neural circuits under study. This allows for numerical simulation of detailed, biophysical models of each neuron participating in the circuit. However, these models typically include a large number of parameters, and insight into which of these are essential for circuit function is not readily obtained. Here, we review two mathematical strategies for gaining insight into connectomics data: linear dynamical systems analysis and matrix reordering techniques. Such analytical treatment can allow us to make predictions about time constants of information processing and functional subunits in large networks.

Association of Physical Activity and Parkinson Disease in Women: Long-term Follow-up of the E3N Cohort Study.

Previous cohort studies reported that a single measure of physical activity (PA) assessed at baseline was associated with lower Parkinson disease (PD) incidence, but a meta-analysis suggested that this association was restricted to men. Because of the long prodromal phase of the disease, reverse causation could not be excluded as a potential explanation. Our objective was to study the association between time-varying PA and PD in women using lagged analyses to address the potential for reverse causation and to compare PA trajectories in patients before diagnosis and matched controls.

The effect of longitudinal sleep monitoring on clinician agreement in obstructive sleep apnea diagnosis: The ELSA study.

There is strong evidence for clinically relevant night-to-night variability of respiratory events in patients with suspected obstructive sleep apnea. Sleep experts retrospectively evaluated diagnostic data in 56 patients with suspected obstructive sleep apnea. Experts were blinded to the fact that they were diagnosing the same case twice, once based on a short report of a single in-laboratory respiratory polygraphy and once with the additional information of 14 nights of pulse oximetry at home. All experts (n = 22) were highly qualified, 13 experts (59.1%) treated > 100 patients with suspected obstructive sleep apnea per year. In 12 patients, the apnea-hypopnea index in the respiratory polygraphy was < 5 per hr, but the mean oxygen desaturation index of 14 nights of pulse oximetry was ≥ 5 per hr. The additional information of 14 nights of pulse oximetry helped to diagnose obstructive sleep apnea with a 70% consensus in two of those patients (16.7% [95% confidence interval: 4.7/44.8]). In eight patients, experts could not agree to a 70% consensus regarding continuous positive airway pressure therapy recommendation after respiratory polygraphy. The additional information of multiple-night testing led to a consensus in three of those cases (37.5% [95% confidence interval: 14/69]). Change of obstructive sleep apnea diagnosis and continuous positive airway pressure recommendation was significantly negatively associated with the number of treated obstructive sleep apnea patients > 100 per year compared with 0-29 patients per year (Coef. [95% confidence interval] -0.63 [-1.22/-0.04] and -0.61 [-1.07/-0.15], respectively). Experts found already a high level of consensus regarding obstructive sleep apnea diagnosis, severity and continuous positive airway pressure recommendation after a single respiratory polygraphy. However, longitudinal sleep monitoring could help increase consensus in selected patients with diagnostic uncertainty.

When elective egg freezers become egg donors: practical and ethical issues.

Many people hope that the unused and unwanted eggs frozen by women for self-use could be applied to reduce the shortage of donor eggs. However, several practical (additional screening and counselling) and ethical (informed consent and reimbursement) issues may dampen this hope. This paper also considers the question of whether elective egg freezers who want to donate their eggs should be reimbursed for the costs they have met for the IVF cycle and storage. It is argued that a partial reimbursement for the collection (hormonal stimulation and retrieval) is morally acceptable because it is limited to proven expenses (and does not violate the altruism rule) and because the recipients should contribute to the costs of a scheme from which they are benefiting. The storage fee should be paid by the egg freezer herself and no reward for effort, time and inconvenience should be given. This compromise benefits both donors and recipients.

Oral anticancer agents as generators of relevant pharmacokinetic interactions.

The goal of this paper is to review the impact of marketed oral anticancer agents on the pharmacokinetics of co-administered medications in humans focusing on clinically relevant interactions.

Meningococcal ACWY conjugate vaccine immunogenicity and safety in adolescents with juvenile idiopathic arthritis and inflammatory bowel disease: A prospective observational cohort study.

Immunogenicity to meningococcal serogroup ACWY (MenACWY) conjugate vaccine has not been studied in immunocompromised minors with juvenile idiopathic arthritis (JIA) or inflammatory bowel disease (IBD). We determined immunogenicity of a MenACWY-TT vaccine in JIA and IBD patients at adolescent age and compared results to data from aged-matched healthy controls (HCs).

The patient experience with localized upper tract urothelial cancer.

To understand the experiences of patients with low-grade upper tract urothelial carcinoma via in-depth interviews covering the diagnosis, treatment, and follow-up.

m6A Modification Mediates Exosomal LINC00657 to Trigger Breast Cancer Progression Via Inducing Macrophage M2 Polarization.

Exosome-mediated transfer of long noncoding RNAs (lncRNAs) is critical for the cell-cell crosstalk in the tumor microenvironment. Nevertheless, the role of breast cancer (BC) cell-derived exosomal lncRNA in macrophage polarization during the development of BC remains unclear.

Depth of anaesthesia monitoring: time to reject the index?

Depth of anaesthesia monitors can fail to detect consciousness under anaesthesia, primarily because they rely on the frontal EEG, which does not arise from a neural correlate of consciousness. A study published in a previous issue of the British Journal of Anaesthesia showed that indices produced by the different commercial monitors can give highly discordant results when analysing changes in the frontal EEG. Anaesthetists could benefit from routinely assessing the raw EEG and its spectrogram, rather than relying solely on an index produced by a depth of anaesthesia monitor.

The efficacy of various Enoxaparin dosing regimens in general surgery patients: A systematic review.

Patients undergoing surgical procedures are at an increased risk of venous thromboembolism events. A fixed Enoxaparin dosing regimen is the standard of care for chemoprophylaxis in most institutions; however, breakthrough venous thromboembolism events are still reported. We aimed to systematically review the literature to determine the ability of various Enoxaparin dosing regimens to achieve adequate prophylactic anti-Xa levels for venous thromboembolism prevention in hospitalized general surgery patients. Additionally, we aimed to assess the correlation between subprophylactic anti-Xa levels and the development of clinically significant venous thromboembolism events.

E2F target score is associated with cell proliferation and survival of patients with hepatocellular carcinoma.

E2F target genes are essential for the cell cycle. A score that quantifies its activity is expected to reflect the aggressiveness and prognosis of hepatocellular carcinoma.

Impact of Hepatitis B virus infection on postoperative complications and length of stay in elderly patients with hip fracture: A retrospective cohort study.

Osteoporosis and subsequent fractures are common in the chronic hepatitis B (CHB) population, especially in the elderly. This study investigated the effects of hepatitis B virus (HBV) infection on postoperative outcomes following hip fracture surgery.

The role of CDK4/6 inhibitors in older and younger patients with breast cancer: A systematic review and meta-analysis.

Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have an extremely important impact on the treatment of hormone-sensitive breast cancer (BC) and have radically changed the first-line treatment for metastatic disease with increased rates of treatment response, overall survival (OS), and progression-free survival (PFS). We performed a pooled analysis of randomized trials to validate or refute the hypothesis that there is a significant survival benefit of adding anti-CDK4/6 inhibitors to standard endocrine therapy (ET) in older patients with advanced BC.

Use of Technology to Improve the Adherence to Surgical Safety Checklists in the Operating Room.

Although checklists can improve safety in the operating room (OR), compliance with their use is variable. Use of a forcing function, a principle of human factors engineering, has not been reported earlier as a method of increasing checklist use. The authors conducted this study to determine the feasibility and effects of introducing a forcing function on OR surgical safety checklist implementation and adherence.

New Techniques in Iatrogenic Coronary Artery Perforation Management Including Umbrella Technique, Case Report.

This case report presents a patient with iatrogenic coronary artery perforation during coronary angioplasty, complicated with a life-threatening cardiac tamponade. Tamponade decompression was achieved via timely pericardiocentesis with direct autotransfusion. The coronary artery perforation itself was initially closed by using the umbrella technique, which involves distal vessel occlusion with angioplasty balloon fragments. To control further blood extravasation into the pericardial sac, the perforation site was injected with thrombin, ensuring the leak closure. If performed with caution, these relatively rarely used, management techniques are effective in dealing with percutaneous coronary intervention complications.

Laparoscopic distal pancreatectomy is more cost-effective than open resection: results from a Swedish randomized controlled trial.

Laparoscopic distal pancreatectomy is being implemented worldwide. The aim of this study was to perform a cost-effectiveness analysis from a health care perspective.

Changes in Computed-Tomography-Derived Segmental Left Ventricular Longitudinal Strain After Transcatheter Aortic Valve Implantation.

Patients with severe aortic stenosis (AS) may show left ventricular (LV) apical longitudinal strain sparing. Transcatheter aortic valve implantation (TAVI) improves LV systolic function in patients with severe AS. However, the changes in regional longitudinal strain after TAVI have not been extensively evaluated. This study aimed to characterize the effect of the pressure overload relief after TAVI on LV apical longitudinal strain sparing. A total of 156 patients (mean age 80 ± 7 years, 53% men) with severe AS who underwent computed tomography before and within 1 year after TAVI (mean time to follow-up 50 ± 30 days) were included. LV global and segmental longitudinal strain were assessed using feature tracking computed tomography. LV apical longitudinal strain sparing was evaluated as the ratio between the apical and midbasal longitudinal strain and was defined as an LV apical to midbasal longitudinal strain ratio >1. LV apical longitudinal strain remained stable after TAVI (from 19.5 ± 7.2% to 18.7 ± 7.7%, p = 0.20), whereas LV midbasal longitudinal strain showed a significant increase (from 12.9 ± 4.2% to 14.2 ± 4.0%, p ≤0.001). Before TAVI, 88% of the patients presented with LV apical strain ratio >1% and 19% presented with an LV apical strain ratio >2. After TAVI, these percentages significantly decreased to 77% and 5% (p = 0.009, p ≤0.001), respectively. In conclusion, LV apical sparing of strain is a relatively common finding in patients with severe AS who underwent TAVI and its prevalence decreases after the afterload relief after TAVI.

Enough vs. More: Neuropsychological testing is more useful than genetic testing in the baseline evaluation of Parkinson disease.

In conclusion, baseline neuropsychological testing provides a vast amount of unique cognitive, psychiatric, behavioral, and psychosocial information that is useful to individuals with PD, care partners, and treatment team providers. As a baseline examination, it provides opportunities for comparison purposes in the future, a prediction of risk assessment and future treatment needs, and at the time of evaluation for clinical treatment to improve quality of life. Such information is not captured by genetic testing, although the ideal path moving forward would be to perform both neuropsychological testing and genetic testing at baseline.

Sensitivity and specificity in affective and social learning in adolescence.

Adolescence is a period of heightened affective and social sensitivity. In this review we address how this increased sensitivity influences associative learning. Based on recent evidence from human and rodent studies, as well as advances in computational biology, we suggest that, compared to other age groups, adolescents show features of heightened Pavlovian learning but tend to perform worse than adults at instrumental learning. Because Pavlovian learning does not involve decision-making, whereas instrumental learning does, we propose that these developmental differences might be due to heightened sensitivity to rewards and threats in adolescence, coupled with a lower specificity of responding. We discuss the implications of these findings for adolescent mental health and education.

The use of coronary artery calcium scoring in young adults.

Although overall atherosclerotic cardiovascular disease (ASCVD) incidence has been declining in the United States, there is evidence that the incidence of ASCVD events in young adults is increasing. The early initiation of preventive therapies could result in a greater number of life-years saved, and therefore determining the appropriate way to identify high-risk young adults is becoming increasingly important. The coronary artery calcium (CAC) score, an established marker of coronary artery atherosclerosis, can improve discrimination for ASCVD risk beyond established risk prediction tools. Based on abundant evidence, the American College of Cardiology/American Heart Association (ACC/AHA) guidelines currently recommend an approach of using CAC scores as a tool for risk assessment and decision-making regarding drug therapy for primary prevention in middle-aged individuals. However, CAC scoring is not recommended for universal screening in young adults, where its yield and utility for altering clinical decisions are limited. Recent studies have demonstrated the nonnegligible prevalence of CAC and its strong association with ASCVD in young adults, suggesting its potential to reclassify risk and improve selection of young adults most likely to benefit from early preventive therapies. Although convincing clinical trials have not been performed in this population yet, CAC scores should be used selectively in young adults whose ASCVD risk may be sufficiently high to warrant a CAC score assessment. This review summarizes the evidence available regarding CAC scoring in young adults, and discusses an appropriate future role of CAC scores in preventing ASCVD in this population.

[Exploration and expectation of magnetic resonance imaging in the evaluation of prostate cancer].

With the progress of imaging technology, magnetic resonance imaging (MRI) has become the preferred imaging method for prostate cancer due to its excellent soft tissue resolution and the capability of multiparametric and multi-planar imaging. This paper briefly describes the current application and research progress of MRI in the preoperative qualitative diagnosis, staging assessment and postoperative recurrence monitoring of prostate cancer. The purpose is to deepen the understanding of clinicians and radiologists on the value of MRI in prostate cancer, and to promote the exploration of MRI in the management of prostate cancer.

Construction of Five Tryptophan Isomers and Application of the Isomers to Solid-Phase Total Syntheses of Lysocin E Derivatives.

Tryptophan (Trp) plays a unique role in peptides and proteins as its indole ring possesses an electron-rich character and an N1-H hydrogen-bond donor. Because of its non-rotationally symmetric structure, synthetic alterations of the orientation of the indole ring would modulate the intrinsic structures and functions of peptides and proteins. Here we developed synthetic routes to the five Trp isomers in which the C3-substitution of the indole ring was changed to the C2/4/5/6/7-substitutions, and applied the five monomers to Fmoc-based solid-phase peptide synthesis. Specifically, the five monomers were prepared via Negishi cross-coupling reactions of C2/4/5/6/7-iodoindoles. To demonstrate the applicability of the monomers to the solid-phase synthesis, the five Trp isomers of macrocyclic antibiotic lysocin E were selected as target molecules and synthesized through peptide elongation, on-resin macrocyclization, and global deprotection. The Trp isomers displayed markedly weaker antibacterial activity than the parent natural product, revealing the biological importance of the precise three-dimensional shape of the original Trp residue of lysocin E. The present methods for the preparation and application of these five Trp isomers provide a new strategy for analyzing and modifying the specific functions of numerous Trp-containing peptides and proteins beyond this study.

Seasonality of sporotrichosis in Brazil: A modelled analysis of the epidemic in São Paulo, 2011-2020.

Sporotrichosis is an endemic subcutaneous mycosis classically caused by the Sporothrix schenckii species complex. Recently, sporotrichosis has emerged in Brazil as a cat-transmitted epidemic caused by a new species, Sporothrix brasiliensis.

Prevalence of gastrointestinal malignancy in non-anemic iron deficiency and significance for endoscopic screening: A Western Australian multicenter cohort study.

There is a paucity of evidence regarding non-anemic iron deficiency as a predictor for colorectal cancer and therefore the indication for endoscopic evaluation. This study explores the rates of malignancy in adults with iron deficiency with and without anemia.

The thioesterase APT1 is a bidirectional-adjustment redox sensor.

The adjustment of cellular redox homeostasis is essential in when responding to environmental perturbations, and the mechanism by which cells distinguish between normal and oxidized states through sensors is also important. In this study, we found that acyl-protein thioesterase 1 (APT1) is a redox sensor. Under normal physiological conditions, APT1 exists as a monomer through S-glutathionylation at C20, C22 and C37, which inhibits its enzymatic activity. Under oxidative conditions, APT1 senses the oxidative signal and is tetramerized, which makes it functional. Tetrameric APT1 depalmitoylates S-acetylated NAC (NACsa), and NACsa relocates to the nucleus, increases the cellular glutathione/oxidized glutathione (GSH/GSSG) ratio through the upregulation of glyoxalase I expression, and resists oxidative stress. When oxidative stress is alleviated, APT1 is found in monomeric form. Here, we describe a mechanism through which APT1 mediates a fine-tuned and balanced intracellular redox system in plant defence responses to biotic and abiotic stresses and provide insights into the design of stress-resistant crops.

Electrically tunable solid-state metasurfaces realized by flash localized heating.

Electrically programmed metasurfaces provide large modulation depth, high modulation rate, and solid-state component, breaking the limitations of existing modulation methods.

A randomized clinical trial assessing the effect of automated medication-targeted alerts on acute kidney injury outcomes.

Acute kidney injury is common among hospitalized individuals, particularly those exposed to certain medications, and is associated with substantial morbidity and mortality. In a pragmatic, open-label, National Institutes of Health-funded, parallel group randomized controlled trial (clinicaltrials.gov NCT02771977), we investigate whether an automated clinical decision support system affects discontinuation rates of potentially nephrotoxic medications and improves outcomes in patients with AKI. Participants included 5060 hospitalized adults with AKI and an active order for any of three classes of medications of interest: non-steroidal anti-inflammatory drugs, renin-angiotensin-aldosterone system inhibitors, or proton pump inhibitors. Within 24 hours of randomization, a medication of interest was discontinued in 61.1% of the alert group versus 55.9% of the usual care group (relative risk 1.08, 1.04 - 1.14, p = 0.0003). The primary outcome - a composite of progression of acute kidney injury, dialysis, or death within 14 days - occurred in 585 (23.1%) of individuals in the alert group and 639 (25.3%) of patients in the usual care group (RR 0.92, 0.83 - 1.01, p = 0.09). Trial Registration Clinicaltrials.gov NCT02771977.

The experience of Anxiety for people with Parkinson's disease.

Anxiety is a common non-motor symptom of Parkinson's disease (PD) associated with increased disability and reduced quality of life. However, anxiety is poorly understood, underdiagnosed, and undertreated. To date, little research has explored how anxiety is experienced by patients themselves. This study explored the experience of anxiety for people with Parkinson's (PWP) to inform future research and interventions. Semi-structured interviews with 22 PWP (aged 43-80, 50% female) were conducted and analysed using inductive thematic analysis. Four main themes were extracted: conceptualising anxiety; anxiety and the body; anxiety and social identity; and coping with anxiety. Sub-themes revealed inconsistent perceptions: anxiety was in body and mind, part of disease and human nature, part of self-identity and a threat to it. The symptoms described were diverse. Many perceived their anxiety as more incapacitating than motor symptoms or capable of amplifying them, and described that anxiety restricted their lifestyle. All perceived anxiety as connected to PD, and ultimately persistent: dominant aspirations were coping and acceptance rather than cures, with medications strongly resisted. Findings highlight the complexity and high importance of anxiety for PWP. Implications for therapeutic approaches are discussed.

Effect of cetrimonium carrier micelles on bacterial membranes and extracellular DNA, an in silico study.

Microorganisms do not live as dispersed single cells but rather they form aggregates with extracellular polymeric substances at interfaces. Biofilms are considered efficient life forms because they shield bacteria from biocides and collect dilute nutrients. This is a big concern in industry since the microorganisms can colonize a wide range of surfaces, accelerating material deterioration, colonizing medical devices, contaminating ultrapure drinking water, increasing energy costs and creating focus of infection. Conventional biocides that target a specific component of the bacteria are not effective in the presence of biofilms. Efficient biofilm inhibitors are based on a multitarget approach interacting with the bacteria and the biofilm matrix. Their rationale design requires a thorough understanding of inhibitory mechanisms that are still largely lacking today. Herein we uncover via molecular modelling the inhibition mechanism of cetrimonium 4-OH cinnamate (CTA-4OHcinn). Simulations show that CTA-4OH micelles can disrupt symmetric and asymmetric bilayers, representative of inner and outer bacterial membranes, following three stages: adsorption, assimilation, and defect formation. The main driving force for micellar attack is electrostatic interactions. In addition to disrupting the bilayers, the micelles work as carriers facilitating the trapping of 4OH cinnamate anions within the bilayer upper leaflet and overcoming electrostatic repulsion. The micelles also interact with extracellular DNA (e-DNA), which is one of the main components of biofilms. It is observed that CTA-4OHcinn forms spherical micelles on the DNA backbone; which hinders their ability to pack. This is demonstrated by modelling the DNA along the hbb histone-like protein, showing that in the presence of CTA-4OHcinn, DNA does not pack properly around hbb. The abilities of CTA-4OHcinn to cause cell death through membrane disruption and to disperse a mature, multi-species biofilm are also confirmed experimentally.

Higher-order epistasis shapes natural variation in germ stem cell niche activity.

To study how natural allelic variation explains quantitative developmental system variation, we characterized natural differences in germ stem cell niche activity, measured as progenitor zone (PZ) size, between two Caenorhabditis elegans isolates. Linkage mapping yielded candidate loci on chromosomes II and V, and we found that the isolate with a smaller PZ size harbours a 148 bp promoter deletion in the Notch ligand, lag-2/Delta, a central signal promoting germ stem cell fate. As predicted, introducing this deletion into the isolate with a large PZ resulted in a smaller PZ size. Unexpectedly, restoring the deleted ancestral sequence in the isolate with a smaller PZ did not increase-but instead further reduced-PZ size. These seemingly contradictory phenotypic effects are explained by epistatic interactions between the lag-2/Delta promoter, the chromosome II locus, and additional background loci. These results provide first insights into the quantitative genetic architecture regulating an animal stem cell system.

Stability of silicon-tin alloyed nanocrystals with high tin concentration synthesized by femtosecond laser plasma in liquid media.

Nanocrystals have a great potential for future materials with tunable bandgap, due to their optical properties that are related with the material used, their sizes and their surface termination. Here, we concentrate on the silicon-tin alloy for photovoltaic applications due to their bandgap, lower than bulk Si, and also the possibility to activate direct band to band transition for high tin concentration. We synthesized silicon-tin alloy nanocrystals (SiSn-NCs) with diameter of about 2-3 nm by confined plasma technique employing a femtosecond laser irradiation on amorphous silicon-tin substrate submerged in liquid media. The tin concentration is estimated to be [Formula: see text], being the highest Sn concentration for SiSn-NCs reported so far. Our SiSn-NCs have a well-defined zinc-blend structure and, contrary to pure tin NCs, also an excellent thermal stability comparable to highly stable silicon NCs. We demonstrate by means of high resolution synchrotron XRD analysis (SPring 8) that the SiSn-NCs remain stable from room temperature up to [Formula: see text] with a relatively small expansion of the crystal lattice. The high thermal stability observed experimentally is rationalized by means of first-principle calculations.

High-affinity peptides developed against calprotectin and their application as synthetic ligands in diagnostic assays.

Common inflammatory disorders such as ulcerative colitis and Crohn's disease are non-invasively diagnosed or monitored by the biomarker calprotectin. However, current quantitative tests for calprotectin are antibody-based and vary depending on the type of antibody and assay used. Additionally, the binding epitopes of applied antibodies are not characterized by structures and for most antibodies it is unclear if they detect calprotectin dimer, tetramer, or both. Herein, we develop calprotectin ligands based on peptides, that offer advantages such as homogenous chemical composition, heat-stability, site-directed immobilization, and chemical synthesis at high purity and at low cost. By screening a 100-billion peptide phage display library against calprotectin, we identified a high-affinity peptide (K

Measurement-induced collective vibrational quantum coherence under spontaneous Raman scattering in a liquid.

Spontaneous vibrational Raman scattering is a ubiquitous form of light-matter interaction whose description necessitates quantization of the electromagnetic field. It is usually considered as an incoherent process because the scattered field lacks any predictable phase relationship with the incoming field. When probing an ensemble of molecules, the question therefore arises: What quantum state should be used to describe the molecular ensemble following spontaneous Stokes scattering? We experimentally address this question by measuring time-resolved Stokes-anti-Stokes two-photon coincidences on a molecular liquid consisting of several sub-ensembles with slightly different vibrational frequencies. When spontaneously scattered Stokes photons and subsequent anti-Stokes photons are detected into a single spatiotemporal mode, the observed dynamics is inconsistent with a statistical mixture of individually excited molecules. Instead, we show that the data are reproduced if Stokes-anti-Stokes correlations are mediated by a collective vibrational quantum, i.e. a coherent superposition of all molecules interacting with light. Our results demonstrate that the degree of coherence in the vibrational state of the liquid is not an intrinsic property of the material system, but rather depends on the optical excitation and detection geometry.

Face-to-face more important than digital communication for mental health during the pandemic.

During the lockdowns associated with the COVID-19 pandemic, many people tried to compensate for limited face-to-face interaction by increasing digital communication. Results of a four-week experience sampling study in the German-speaking countries (N = 411 participants; k = 9791 daily questionnaires) suggest, however, that digital communication was far less relevant for lockdown mental health than face-to-face communication. Digital text-based communication (e.g., e-mail, WhatsApp, SMS) nevertheless was meaningfully associated with mental health, and both face-to-face and digital text communication were more predictive of mental health than either physical or outdoor activity. Our results underscore the importance of face-to-face communication for mental health. Our results also suggest that videoconferencing was only negligibly associated with mental health, despite providing more visual and audible cues than digital text communication.

Peripheral retinal vessel whitening in patients with diabetes mellitus.

This study aimed to identify retinal vessel whitening outside the standard Early Treatment Diabetic Retinopathy Study (ETDRS) fields and to correlate the findings with vision and severity of diabetic retinopathy. Patients with diabetes mellitus who were seen in the retinal clinic to assess diabetic retinopathy status were included. Retinal vessel whitening was identified using ultra-widefield imaging. Four hundred and forty-five eyes of 260 patients were included. Thirty-five eyes in 24 patients (7.9%) were noted to have peripheral retinal vessel whitening. Thirty-one eyes with peripheral retinal vessel whitening did not have vessel whitening within the standard 7 ETDRS fields (p < 0.001). The proportion of whitening increased as DR severity increased, from 4.0% for patients with no DR (OR 0.249) to 33.3% for those with severe NPDR and PDR (OR 6.430 and 7.232, respectively). In addition, patients with peripheral retinal vessel whitening had worse visual acuity (logMAR = 0.34) compared to those without (logMAR = 0.15) (p < 0.001). In conclusion, we found an association between peripheral retinal vessel whitening in diabetic patients which correlated with diabetic retinopathy severity. Additionally, we found an association between vessel whitening and reduced vision, suggesting that vessel whitening identified using ultra-widefield imaging may be a prognostic indicator of vision in diabetic retinopathy.

Responses of pyramidal cell somata and apical dendrites in mouse visual cortex over multiple days.

The apical dendrites of pyramidal neurons in sensory cortex receive primarily top-down signals from associative and motor regions, while cell bodies and nearby dendrites are heavily targeted by locally recurrent or bottom-up inputs from the sensory periphery. Based on these differences, a number of theories in computational neuroscience postulate a unique role for apical dendrites in learning. However, due to technical challenges in data collection, little data is available for comparing the responses of apical dendrites to cell bodies over multiple days. Here we present a dataset collected through the Allen Institute Mindscope's OpenScope program that addresses this need. This dataset comprises high-quality two-photon calcium imaging from the apical dendrites and the cell bodies of visual cortical pyramidal neurons, acquired over multiple days in awake, behaving mice that were presented with visual stimuli. Many of the cell bodies and dendrite segments were tracked over days, enabling analyses of how their responses change over time. This dataset allows neuroscientists to explore the differences between apical and somatic processing and plasticity.

The cancer-testis lncRNA LINC01977 promotes HCC progression by interacting with RBM39 to prevent Notch2 ubiquitination.

Cancer-testis genes are involved in the occurrence and development of cancer, but the role of cancer-testis-associated lncRNAs (CT-lncRNAs) in hepatocellular carcinoma (HCC) remains to be explored. Here, we discovered a novel CT-lncRNA, LINC01977, based on the Genotype-Tissue Expression (GTEx) and The Cancer Genome Atlas (TCGA) databases. LINC01977 was exclusively expressed in testes and highly expressed in HCC. High LINC01977 levels correlated with poorer overall survival (OS) in individuals with HCC. Functional assays showed that LINC01977 promoted HCC growth and metastasis in vitro and in vivo. Mechanistically, LINC01977 directly bound to RBM39 to promote the further entry of Notch2 into the nucleus, thereby preventing the ubiquitination and degradation of Notch2. Furthermore, the RNA binding protein IGF2BP2, one of the m

Genetic predictors of cultural values variation between societies.

Associations between the STin2 and 5-HTTLPR polymorphisms within the serotonin transporter gene, SLC6A4, and culture across societies were examined. Based on an analysis of 75 primary studies (28,726 individuals), STin2 allelic frequencies were found to vary widely across countries, ranging from 26% in Germany to 85% in Singapore. Across 53 countries, and after controlling for all major environmental influences of culture, STin2 and 5-HTTLPR were found to explain 23.6% unique variance in monumentalism but none in individualism. Our findings evidence a significant role of genetics in predicting cross-societal cultural values variation, and potentially speak to the need for and importance of incorporating both nature and nurture in theories of cultural values variation across societies.

Research on tire crack detection using image deep learning method.

Driving can understand the importance of tire tread depth and air pressure, but most people are unaware of the safety risks of tire oxidation. Drivers must maintain vehicle tire quality to ensure performance, efficiency, and safety. In this study, a deep learning tire defect detection method was designed. This paper improves the traditional ShuffleNet and proposes an improved ShuffleNet method for tire image detection. The research results are compared with the five methods of GoogLeNet, traditional ShuffleNet, VGGNet, ResNet and improved ShuffleNet through tire database verification. The experiment found that the detection rate of tire debris defects was 94.7%. Tire defects can be effectively detected, which proves the robustness and effectiveness of the improved ShuffleNet, enabling drivers and tire manufacturers to save labor costs and greatly reduce tire defect detection time.

Heterosis patterns and sources of self-compatibility, cross-compatibility and key nut traits within single and double hybrid crosses of kola [Cola nitida (Vent) Schott and Endl.].

Sexual incompatibility among kola genotypes accounted for over 50% yield loss. Compatible and high yielding varieties are in demand to develop commercial orchards. The objective of this study was to assess self-compatibility and cross-compatibility of kola (C. nitida) genotypes within self, single and double hybrid crosses and to determine heterosis pattern in the resulting hybrids for sexual compatibility and key nut yield and quality traits. Crosses among kola genotypes from three field gene banks (JX1, GX1, MX2) and one advanced germplasm (Bunso progeny) in Ghana were evaluated along their parents for sexual compatibility, nut yield and nut quality. Data were collected on pod set, pseudo-pod set, pod weight, number of nuts per pod, nut weight, brix, potential alcohol and nut firmness. Significant (P < 0.001) differential pod set was observed within Bunso progeny, JX1, GX1 and MX2 crosses; while pseudo-pod set differed only within JX1 and MX2 crosses (P < 0.001). Very large prevalence of mid-parent, heterobeltiosis, and economic heterosis was observed for sexual compatibility, outturn and brix for the single and double hybrid crosses. Heterosis was prominent among the double hybrid crosses as compared to the single hybrid crosses suggesting that recurrent selection of compatible varieties from advanced generations could result in genetic gain in kola improvement. The top five crosses with best heterosis for sexual compatibility and an appreciable positive heterosis for outturn and brix were B1/11 × B1/71 × B1/157 × B1/149, B1/11 × B1/71 × B1/296 × B1/177, GX1/46 × GX1/33 × B1/212 × B1/236, JX1/90 × JX1/51 and JX1/51 × JX1/36. These materials could serve as sources of beneficial alleles for improving Ghanaian kola hybrids and populations for yield and sexual compatibility.

All boreal forest successional stages needed to maintain the full suite of soil biodiversity, community composition, and function following wildfire.

Wildfire is a natural disturbance in boreal forest systems that has been predicted to increase in frequency, intensity, and extent due to climate change. Most studies tend to assess the recovery of one component of the community at a time but here we use DNA metabarcoding to simultaneously monitor soil bacteria, fungi, and arthropods along an 85-year chronosequence following wildfire in jack pine-dominated ecosites. We describe soil successional and community assembly processes to better inform sustainable forest management practices. Soil taxa showed different recovery trajectories following wildfire. Bacteria shared a large core community across stand development stages (~ 95-97% of their unique sequences) and appeared to recover relatively quickly by crown closure. By comparison fungi and arthropods shared smaller core communities (64-77% and 68-69%, respectively) and each stage appeared to support unique biodiversity. We show the importance of maintaining a mosaic ecosystem that represents each stand development stage to maintain the full suite of biodiversity in soils following wildfire, especially for fungi and arthropods. These results will provide a useful baseline for comparison when assessing the effects of human disturbance such as harvest or for assessing the effects of more frequent wildfire events due to climate change.

An enzyme-free technique enables the isolation of a large number of adipose-derived stem cells at the bedside.

Adipose tissue derived stromal cells (ADSCs) play a crucial role in research and applications of regenerative medicine because they can be rapidly isolated in high quantities. Nonetheless, their purity, pluripotency, differentiation capacity, and stem cell marker expression might vary greatly depending on technique and tools used for extraction and harvesting. There are two methods described in the literature for isolating regenerative cells from adipose tissue. The first technique is enzymatic digestion, which utilizes many enzymes to remove stem cells from the tissue they reside in. The second method involves separating the concentrated adipose tissue using non-enzymatic, mechanical separation methods. ADSCs are isolated from the stromal-vascular fraction (SVF) of processed lipoaspirate, which is the lipoaspirate's aqueous portion. The purpose of this work was to evaluate a unique device 'microlyzer' for generating SVF from adipose tissue using a mechanical technique that required minimal intervention. The Microlyzer was examined using tissue samples from ten different patients. The cells that were retrieved were characterized in terms of their cell survival, phenotype, proliferation capacity, and differentiation potential. The number of progenitor cells extracted only from the microlyzed tissue was in comparable amount to the number of progenitor cells acquired by the gold standard enzymatic approach. The cells that were collected from each group exhibit similar levels of viability as well as proliferation rates. In addition, the differentiation potentials of the cells derived from the microlyzed tissue were investigated, and it was discovered that cells isolated through microlyzer entered the differentiation pathways more quickly and displayed a greater level of marker gene expression than cells isolated by enzymatic methods. These findings suggest that microlyzer, particularly in regeneration investigations, will allow quick and high rate cell separation at the bedside.

Structural and functional analyses of the echinomycin resistance conferring protein Ecm16 from Streptomyces lasalocidi.

Echinomycin is a natural product DNA bisintercalator antibiotic. The echinomycin biosynthetic gene cluster in Streptomyces lasalocidi includes a gene encoding the self-resistance protein Ecm16. Here, we present the 2.0 Å resolution crystal structure of Ecm16 bound to adenosine diphosphate. The structure of Ecm16 closely resembles that of UvrA, the DNA damage sensor component of the prokaryotic nucleotide excision repair system, but Ecm16 lacks the UvrB-binding domain and its associated zinc-binding module found in UvrA. Mutagenesis study revealed that the insertion domain of Ecm16 is required for DNA binding. Furthermore, the specific amino acid sequence of the insertion domain allows Ecm16 to distinguish echinomycin-bound DNA from normal DNA and link substrate binding to ATP hydrolysis activity. Expression of ecm16 in the heterologous host Brevibacillus choshinensis conferred resistance against echinomycin and other quinomycin antibiotics, including thiocoraline, quinaldopeptin, and sandramycin. Our study provides new insight into how the producers of DNA bisintercalator antibiotics fend off the toxic compounds that they produce.

Clinical relevance of MYC/BCL2 expression and cell of origin in patients with diffuse large b-cell lymphoma treated with autologous transplant.

Dual expression of MYC and BCL2 proteins (double-expressor lymphoma [DEL]) as well as cell of origin (COO) are important prognostic factors in patients with diffuse large B-cell lymphoma (DLBCL) after conventional chemotherapy. We studied the prognostic impact of DEL and COO in patients with relapsed DLBCL treated with autologous stem cell transplant (ASCT). Three-hundred and three patients with stored tissue samples were identified. Classification was successful in 267 patients: 161 (60%) were DEL/non-double hit (DHL), 98 (37%) were non-DEL/non-DHL, and 8 (3%) were DEL/DHL. Compared to non-DEL/non-DHL, DEL/DHL had worse overall survival while DEL/non-DHL did not significantly differ in overall survival. On multivariable analysis, DEL/DHL, age >60 years, and >2 prior therapies, but not COO, were important prognostic factors for overall survival. When we explored the interaction of COO and BCL2 expression, patients with germinal center B-cell (GCB)/BCL2 (+) had inferior progression-free survival (PFS) compared to GCB/BCL2 (-) patients (HR, 4.97; P = 0.027). We conclude that the DEL/non-DHL and non-DEL/non-DHL subtypes of DLBCL have similar survival after ASCT. The negative impact of GCB/BCL2 (+) on PFS warrants future trials targeting BCL2 after ASCT. The inferior outcomes in DEL/DHL need to be verified in a larger number of patients.

NT-proBNP as a surrogate for unknown heart failure and its predictive power for peripheral artery disease outcome and phenotype.

Patients with peripheral artery disease (PAD) are at high risk of excess mortality despite major improvements in multimodal pharmacotherapy for cardiovascular disease. However, little is known about co-prevalences and implications for the combination of heart failure (HF) and PAD. Thus, NT-proBNP as a suggested surrogate for HF was evaluated in symptomatic PAD regarding long-term mortality. After approval by the institutional ethics committee a total of 1028 patients with PAD, both with intermittent claudication or critical limb ischemia were included after admission for endovascular repair and were followed up for a median of 4.6 years. Survival information was obtained from central death database queries. During the observation period a total of 336 patients died (calculated annual death rate of 7.1%). NT-proBNP (per one standard deviation increase) was highly associated with outcome in the general cohort in crude (HR 1.86, 95%CI 1.73-2.01) and multivariable-adjusted Cox-regression analyses with all-cause mortality (HR 1.71, 95%CI 1.56-1.89) and CV mortality (HR 1.86, 95% CI 1.55-2.15). Similar HR's were found in patients with previously documented HF (HR 1.90, 95% CI 1.54-2.38) and without (HR 1.88, 95%CI 1.72-2.05). NT-proBNP levels were independently associated with below-the-knee lesions or multisite target lesions (OR 1.14, 95% CI 1.01-1.30). Our data indicate that increasing NT-proBNP levels are independently associated with long-term mortality in symptomatic PAD patients irrespective of a previously documented HF diagnosis. HF might thus be highly underreported in PAD, especially in patients with the need for below-the-knee revascularization.

Research on spatial and temporal differences of carbon emissions and influencing factors in eight economic regions of China based on LMDI model.

With the gradual increase of international willingness to reach the carbon peak and carbon neutrality, this paper decomposes the influencing factors of China's carbon emission changes from 2008 to 2019 using the Logarithmic Mean Divisia Index model (LMDI), and analyzes the contribution amount and rate of each influencing factor. The results found that: for the whole country, the cumulative growth of carbon emissions during the study period is about 416,484.47 (10

Urban structure reinforces attitudes towards tsunami evacuation.

Evacuation is a critical life-saving action, especially in devastating natural hazards such as near-field tsunamis. However, the development of effective evacuation measures remains challenging to the extent that a successful example has been referred to as a 'miracle'. Here we show that urban structures have the potential to reinforce attitudes towards evacuation and significantly influence the success of tsunami evacuation. Agent-based evacuation simulations revealed that a distinctive root-like urban structure formed in ria coasts reinforces positive evacuation attitudes by effectively gathering evacuation flows and leads to higher evacuation rates compared to typical grid-like urban structures, which can explain the regional differences in the number of casualties in the 2011 Tohoku tsunami. Although a grid-like structure reinforces negative attitudes under low evacuation tendencies, with leading evacuees, its dense feature helps to propagate positive attitudes and drastically improve evacuation tendencies. These findings pave the way for making successful evacuation inevitable through harmonised urban and evacuation plannings.

Real time object detection using LiDAR and camera fusion for autonomous driving.

Autonomous driving has been widely applied in commercial and industrial applications, along with the upgrade of environmental awareness systems. Tasks such as path planning, trajectory tracking, and obstacle avoidance are strongly dependent on the ability to perform real-time object detection and position regression. Among the most commonly used sensors, camera provides dense semantic information but lacks accurate distance information to the target, while LiDAR provides accurate depth information but with sparse resolution. In this paper, a LiDAR-camera-based fusion algorithm is proposed to improve the above-mentioned trade-off problems by constructing a Siamese network for object detection. Raw point clouds are converted to camera planes to obtain a 2D depth image. By designing a cross feature fusion block to connect the depth and RGB processing branches, the feature-layer fusion strategy is applied to integrate multi-modality data. The proposed fusion algorithm is evaluated on the KITTI dataset. Experimental results demonstrate that our algorithm has superior performance and real-time efficiency. Remarkably, it outperforms other state-of-the-art algorithms at the most important moderate level and achieves excellent performance at the easy and hard levels.

Probing midbrain dopamine function in pediatric obsessive-compulsive disorder via neuromelanin-sensitive magnetic resonance imaging.

Obsessive-compulsive disorder (OCD) is an impairing psychiatric condition, which often onsets in childhood. Growing research highlights dopaminergic alterations in adult OCD, yet pediatric studies are limited by methodological constraints. This is the first study to utilize neuromelanin-sensitive MRI as a proxy for dopaminergic function among children with OCD. N = 135 youth (6-14-year-olds) completed high-resolution neuromelanin-sensitive MRI across two sites; n = 64 had an OCD diagnosis. N = 47 children with OCD completed a second scan after cognitive-behavioral therapy. Voxel-wise analyses identified that neuromelanin-MRI signal was higher among children with OCD compared to those without (483 voxels, permutation-corrected p = 0.018). Effects were significant within both the substania nigra pars compacta (p = 0.004, Cohen's d = 0.51) and ventral tegmental area (p = 0.006, d = 0.50). Follow-up analyses indicated that more severe lifetime symptoms (t = -2.72, p = 0.009) and longer illness duration (t = -2.22, p = 0.03) related to lower neuromelanin-MRI signal. Despite significant symptom reduction with therapy (p < 0.001, d = 1.44), neither baseline nor change in neuromelanin-MRI signal associated with symptom improvement. Current results provide the first demonstration of the utility of neuromelanin-MRI in pediatric psychiatry, specifically highlighting in vivo evidence for midbrain dopamine alterations in treatment-seeking youth with OCD. Neuromelanin-MRI likely indexes accumulating alterations over time, herein, implicating dopamine hyperactivity in OCD. Given evidence of increased neuromelanin signal in pediatric OCD but negative association with symptom severity, additional work is needed to parse potential longitudinal or compensatory mechanisms. Future studies should explore the utility of neuromelanin-MRI biomarkers to identify early risk prior to onset, parse OCD subtypes or symptom heterogeneity, and explore prediction of pharmacotherapy response.

Nonlinear and machine learning analyses on high-density EEG data of math experts and novices.

Current trend in neurosciences is to use naturalistic stimuli, such as cinema, class-room biology or video gaming, aiming to understand the brain functions during ecologically valid conditions. Naturalistic stimuli recruit complex and overlapping cognitive, emotional and sensory brain processes. Brain oscillations form underlying mechanisms for such processes, and further, these processes can be modified by expertise. Human cortical functions are often analyzed with linear methods despite brain as a biological system is highly nonlinear. This study applies a relatively robust nonlinear method, Higuchi fractal dimension (HFD), to classify cortical functions of math experts and novices when they solve long and complex math demonstrations in an EEG laboratory. Brain imaging data, which is collected over a long time span during naturalistic stimuli, enables the application of data-driven analyses. Therefore, we also explore the neural signature of math expertise with machine learning algorithms. There is a need for novel methodologies in analyzing naturalistic data because formulation of theories of the brain functions in the real world based on reductionist and simplified study designs is both challenging and questionable. Data-driven intelligent approaches may be helpful in developing and testing new theories on complex brain functions. Our results clarify the different neural signature, analyzed by HFD, of math experts and novices during complex math and suggest machine learning as a promising data-driven approach to understand the brain processes in expertise and mathematical cognition.

Impact of vitamin D in children with chronic tonsillitis (immunohistochemical study of CD68 polarisation and proinflammatory cytokines estimation).

Inflammatory processes are increasingly attributed to macrophage polarization. Proinflammatory macrophages promote T helper (Th) 1 response, tissue repair, and Th2 responses. Detection of macrophages in tissue sections is facilitated by CD68. Our study is focused on the expression of CD68 and the estimation of proinflammatory cytokines in children's patients with chronic tonsillitis secondary to vitamin D supplementation. This hospital-based Randomized prospective case-control study was conducted on 80 children with chronic tonsillitis associated with vitamin D deficiency where (40 received vitamin D 50,000 IU weekly for 3-6 months and 40 received 5 ml distilled water as placebo). The serum 25-hydroxyvitamin D [25(OH)D] was measured using an Enzyme-linked immunosorbent assay on all included children. Different histological and immunohistochemical studies for the detection of CD68 were done. There was a significantly lower serum level of 25(OH)D in the placebo group versus the vitamin D group (P < 0.001). The levels of pro-inflammatory cytokines, TNFα, and IL-2 significantly increased in the placebo group as compared to the vitamin D group (P < 0.001). The increased level of IL-4 and IL-10 in the placebo group as compared to the vitamin D group was insignificant (P = 0.32, 0.82) respectively. Vitamin D supplementation alleviated the deleterious effect of chronic tonsillitis on the histological structure of the tonsil. Tonsillar tissues of the children in the control and vitamin D groups demonstrated a highly statistically significantly lower number of CD68 immunoexpressing cells compared with those in the placebo group (P < 0.001). Low vitamin D may play a role in chronic tonsillitis. Vitamin D supplementation could help reduce the occurrence of chronic tonsillitis in susceptible children.

Effects of folic acid supplementation in pregnant mice on glucose metabolism disorders in male offspring induced by lipopolysaccharide exposure during pregnancy.

The DOHaD theory suggests that adverse environmental factors in early life may lead to the development of metabolic diseases including diabetes and hypertension in adult offspring through epigenetic mechanisms such as DNA methylation. Folic acid (FA) is an important methyl donor in vivo and participates in DNA replication and methylation. The preliminary experimental results of our group demonstrated that lipopolysaccharide (LPS, 50 µg/kg/d) exposure during pregnancy could lead to glucose metabolism disorders in male offspring, but not female offspring; however, the effect of folic acid supplementation on glucose metabolism disorders in male offspring induced by LPS exposure remains unclear. Therefore, in this study, pregnant mice were exposed to LPS on gestational day (GD) 15-17 and were given three doses of FA supplementation (2 mg/kg, 5 mg/kg, or 40 mg/kg) from mating to lactation to explore its effect on glucose metabolism in male offspring and the potential mechanism. This study confirmed that FA supplementation of 5 mg/kg in pregnant mice improved glucose metabolism in LPS-exposed offspring during pregnancy by regulating gene expression.

Monitoring and analysis of ground subsidence in Shanghai based on PS-InSAR and SBAS-InSAR technologies.

Shanghai is susceptible to land subsidence due to its unique geological environment and frequent human activities. Traditional leveling techniques are not sufficient for monitoring large areas of land subsidence due to the time-consuming, labor-intensive, and expensive nature of the process. Furthermore, the results of conventional methods may not be timely, rendering them ineffective for monitoring purposes. Interferometric Synthetic Aperture Radar (InSAR) technology is a widely used method for monitoring ground subsidence due to its low cost, high efficiency, and ability to cover large areas. To monitor the surface sink condition of Shanghai over the past 2 years, monitoring data were obtained through the technical processing of 24 images from Sentinel-1A data covering Shanghai from 2019 to 2020 using the Persistent Scatterer (PS-InSAR) and Small Baseline Subset (SBAS-InSAR) technique. The ground subsidence (GS) results were extracted via PS and SBAS interferometry processing, while Shuttle Radar Topography Mission data were used to correct the residual phase. According to PS and SBAS methods, the maximum ground subsidence in the study area reached 99.8 mm and 47.2 mm, respectively. The subsidence rate and the accumulated amount of subsidence derived from the monitoring results revealed the urban area in Shanghai to be principally characterized by uneven GS, with multiple settlement funnels being found to be distributed across the main urban area. Moreover, when compared with the historical subsidence data, geological data, and urban construction distribution data, the individual settlement funnels were observed to correspond to those data concerning the historical surface settlement funnel in Shanghai. By randomly selecting GS time-series data regarding three feature points, it was determined that the morphological variables of the GS remained largely consistent at all time points and that their change trends exhibited a high degree of consistency, which verified the reliability of the PS-InSAR and SBAS-InSAR monitoring method. The results can provide data support for decision making in terms of geological disaster prevention and control in Shanghai.

A Systematic Review and Meta-Analysis of the Clinical Efficacy and Patients' Satisfaction of Micro-focused Ultrasound (MFU) Treatment for Facial Rejuvenation and Tightening.

Micro-focused ultrasound (MFU) is commonly used to improve facial relaxation and wrinkles. The objective of this study was to determine the efficacy of MFU for facial rejuvenation and patients' satisfaction with the treatment.

Comparative appraisal of mono and hybrid nanofluid flows comprising carbon nanotubes over a three-dimensional surface impacted by Cattaneo-Christov heat flux.

Carbon nanotubes (CNTs) are nanoscale tubes made of carbon atoms with unique mechanical, electrical, and thermal properties. They have a variety of promising applications in electronics, energy storage, and composite materials and are found as single-wall carbon nanotubes (SWCNTs) and double-wall carbon nanotubes (DWCNTs). Considering such alluring attributes of nanotubes, the motive of the presented flow model is to compare the thermal performance of magnetohydrodynamic (MHD) mono (SWCNTs)/Ethylene glycol) and hybrid (DWCNTs- SWCNTs/Ethylene glycol) nanofluids over a bidirectional stretching surface. The thermal efficiency of the proposed model is gauged while considering the effects of Cattaneo-Christov heat flux with prescribed heat flux (PHF) and prescribed surface temperature (PST). The flow is assisted by the anisotropic slip at the boundary of the surface. The system of partial differential equations (PDEs) is converted into a nonlinear ordinary differential system by the use of similarity transformations and handled using the bvp4c numerical technique. To depict the relationship between the profiles and the parameters, graphs, and tables are illustrated. The significant outcome revealed that the fluid temperature rises in the scenario of both PST and PHF cases. In addition, the heat transfer efficiency of the hybrid nanoliquid is far ahead of the nanofluid flow. The truthfulness of the envisioned model in the limiting scenario is also given.

Ethiopian orthodox fasting is associated with weight reduction and body composition changes among healthy adults: a prospective cohort study.

The Ethiopian Orthodox Christian (EOC) fasts, although adopted for religious purposes, combines aspects of energy restriction, time-restricted feeding, and a vegan dietary pattern, all of which have been independently associated with weight loss and healthier body composition. However, combined effect of these practices as part of EOC fast remains unknown. This longitudinal study design evaluated the effect of EOC fasting on body weight and body composition. Information on socio-demographic characteristics, physical activity level, and fasting regimen followed was captured through an interviewer-administered questionnaire. Weight and body composition measurements were taken before and at the end of major fasting seasons. Body composition parameters were measured by bioelectrical impedance (BIA), Tanita® BC-418®, Japan). Significant changes in body weight and body composition were observed for both fasts. Significant decreases in body weight (14/44 day fast: - 0.45; P = 0.004/- 0.65; P = 0.004), FFM (- 0.82; P = 0.002/- 0.41; P < 0.0001), and trunk fat mass (- 0.68; P < 0.0001/- 0.82; P < 0.0001) were observed after adjusting for covariates including age, sex, and physical activity. The EOC fasting regimen leads to significant reductions of body weight and compositions. Longer fasting duration led to much higher effects in body weight and body composition and may be non-pharmacological strategy in prevention or treatment of chronic diseases.

Trade-offs between diaspore dispersal and dormancy within a spike of the invasive annual grass Aegilops tauschii.

Differences in dispersal and dormancy of heteromorphic diaspores of Aegilos tauschii may increase its flexibility to invade/occupy weedy unpredictable habitats by spreading risk in space and time. In plant species that produce dimorphic seeds, there often is a negative relationship between dispersal and dormancy, with high dispersal-low dormancy in one morph and low dispersal-high dormancy in the other, which may function as a bet-hedging strategy that spreads the risk of survival and ensures reproductive success. However, the relationship between dispersal and dormancy and its ecological consequences in invasive annual grasses that produce heteromorphic diaspores is not well studied. We compared dispersal and dormancy responses of diaspores from the basal (proximal) to the distal position on compound spikes of Aegilops tauschii, an invasive grass with heteromorphic diaspores. Dispersal ability increased and degree of dormancy decreased as diaspore position on a spike increased from basal to distal. There was a significant positive correlation between length of awns and dispersal ability, and awn removal significantly promoted seed germination. Germination was positively correlated with GA concentration and negatively correlated with ABA concentration, and the ABA: GA ratio was high in seeds with low germination/high dormancy. Thus, there was a continuous inverse-linear relationship between diaspore dispersal ability and degree of dormancy. This negative relationship between diaspore dispersal and degree of dormancy at different positions on a spike of Aegilops tauschii may facilitate seedling survival in space and time.

The role of the mitochondrial trans-sulfuration in cerebro-cardio renal dysfunction during trisomy down syndrome.

One in 700 children is born with the down syndrome (DS). In DS, there is an extra copy of X chromosome 21 (trisomy). Interestingly, the chromosome 21 also contains an extra copy of the cystathionine beta synthase (CBS) gene. The CBS activity is known to contribute in mitochondrial sulfur metabolism via trans-sulfuration pathway. We hypothesize that due to an extra copy of the CBS gene there is hyper trans-sulfuration in DS. We believe that understanding the mechanism of hyper trans-sulfuration during DS will be important in improving the quality of DS patients and towards developing new treatment strategies. We know that folic acid "1-carbon" metabolism (FOCM) cycle transfers the "1-carbon" methyl group to DNA (H3K4) via conversion of s-adenosyl methionine (SAM) to s-adenosyl homocysteine (SAH) by DNMTs (the gene writers). The demethylation reaction is carried out by ten-eleven translocation methylcytosine dioxygenases (TETs; the gene erasers) through epigenetics thus turning the genes off/on and opening the chromatin by altering the acetylation/HDAC ratio. The S-adenosyl homocysteine hydrolase (SAHH) hydrolyzes SAH to homocysteine (Hcy) and adenosine. The Hcy is converted to cystathionine, cysteine and hydrogen sulfide (H

Tumour-stroma ratio (TSR) in breast cancer: comparison of scoring core biopsies versus resection specimens.

Tumour-stroma ratio (TSR) is an important prognostic and predictive factor in several tumour types. The aim of this study is to determine whether TSR evaluated in breast cancer core biopsies is representative of the whole tumour.

De novo MCM6 variants in neurodevelopmental disorders: a recognizable phenotype related to zinc binding residues.

The minichromosome maintenance (MCM) complex acts as a DNA helicase during DNA replication, and thereby regulates cell cycle progression and proliferation. In addition, MCM-complex components localize to centrosomes and play an independent role in ciliogenesis. Pathogenic variants in genes coding for MCM components and other DNA replication factors have been linked to growth and developmental disorders as Meier-Gorlin syndrome and Seckel syndrome. Trio exome/genome sequencing identified the same de novo MCM6 missense variant p.(Cys158Tyr) in two unrelated individuals that presented with overlapping phenotypes consisting of intra-uterine growth retardation, short stature, congenital microcephaly, endocrine features, developmental delay and urogenital anomalies. The identified variant affects a zinc binding cysteine in the MCM6 zinc finger signature. This domain, and specifically cysteine residues, are essential for MCM-complex dimerization and the induction of helicase activity, suggesting a deleterious effect of this variant on DNA replication. Fibroblasts derived from the two affected individuals showed defects both in ciliogenesis and cell proliferation. We additionally traced three unrelated individuals with de novo MCM6 variants in the oligonucleotide binding (OB)-fold domain, presenting with variable (neuro)developmental features including autism spectrum disorder, developmental delay, and epilepsy. Taken together, our findings implicate de novo MCM6 variants in neurodevelopmental disorders. The clinical features and functional defects related to the zinc binding residue resemble those observed in syndromes related to other MCM components and DNA replication factors, while de novo OB-fold domain missense variants may be associated with more variable neurodevelopmental phenotypes. These data encourage consideration of MCM6 variants in the diagnostic arsenal of NDD.

The 100 most-cited publications on Peyronie's disease: a bibliometric analysis and visualization study.

This study aimed to summarize the characteristics of the top 100 most-cited publications on Peyronie's disease (PD) research and to analyse past and current research hotspots and trends. The SCI-E database of the Web of Science Core Collection (WoSCC) provided us with the top 100 most-cited publications in PD research, from which we took the following information: general trend of publication, year of publication, nation/region, institution, journal, author, and keywords. VOSviewer (version 1.6.18) and Excel (version 2016) were used for information analysis. Through a standardized search, we ultimately found 1019 papers in the field of PD research, from which we extracted the 100 articles that had received the highest citations. The articles were published between 1949 and 2016. The United States is a major contributor to PD research (n = 67). The University of California, Los Angeles, was the institution with the largest number of articles (n = 11). These articles were published in 16 journals, with the largest number appearing in the Journal of Urology (n = 47). The author with the most articles was Levine LA (n = 9). Gelbard MK's articles had the highest citation frequency (n = 1158). Erectile dysfunction (n = 19) was the keyword with the highest frequency, indicating that PD-related erectile dysfunction was the leading focus of research in this field. Most of the keywords that have appeared in the past decade are related to the clinical treatment of PD. Therefore, we believe that improving patients' erectile function to the greatest extent in clinical treatment is the frontier and hot spot of future research.

Three-dimensional multifrequency magnetic resonance elastography improves preoperative assessment of proliferative hepatocellular carcinoma.

To investigate the viscoelastic signatures of proliferative hepatocellular carcinoma (HCC) using three-dimensional (3D) magnetic resonance elastography (MRE).

3D modelling of surface spreading and underground dam groundwater recharge: Egri Creek Subbasin, Turkey.

This study investigated surface spreading and underground dam recharge methods to replenish groundwater in Turkey's Egri Creek Sub-basin of the Kucuk Menderes River Basin. A three-dimensional numerical model was employed for this purpose. Field and lab data are provided to the model for realistic simulations. Pumping test results were used to determine the aquifer parameters. The laboratory works involved sieve analysis, permeability tests, and porosity and water content prediction. The numerical model's boundary conditions were determined from the geological and hydrogeological characteristics of the study area. Initial conditions were expressed regarding water content and pressure head in the vadose zone. The numerical model was satisfactorily validated by simulating water levels in three different pumping wells in the study area. Seven different scenarios, each having a different pool size, were investigated for the surface spreading recharge method. The results showed that a pool size of 30 × 30 m with a 6-m depth basin was the most optimal choice, raising the groundwater level to about 29.3 m. On the other hand, it was found that an underground dam could raise the levels by an average of 9.5 m, which might not be significant to warrant the construction.

Association of Magnesium Depletion Score with Congestive Heart Failure: Results from the NHANES 2007-2016.

The magnesium depletion score (MDS) is considered a new valuable and reliable predictor of body magnesium status. This study aimed to explore the association between MDS and congestive heart failure (CHF) among US adults. A total of 19,227 eligible participants from the 2007-2016 National Health and Nutrition Examination Survey were enrolled in this study and then divided into three groups according to the level of MDS (none to low: MDS=0-1, middle: MDS=2, high: MDS=3-5). Sample-weighted logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) exploring the independent relationship between MDS and CHF. The estimated prevalence of CHF increased with the increasing level of MDS (none to low: 0.86%, middle: 4.06%, high: 13.52%; P < 0.001). Compared to those in the none-to-low group, participants in the middle and high groups were at significantly higher risk of CHF after adjusting for various covariates (model 3: OR=1.55, 95%CI: 1.05-2.30, P < 0.001; OR=3.20, 95%CI: 2.07-4.96, P < 0.001; respectively). Subgroup analyses indicated that adequate dietary magnesium intake could reduce the risk of CHF in participants who did not meet the recommended dietary allowance (RDA) for magnesium. Besides, there was an interaction between coronary artery disease and MDS on CHF (P for interaction < 0.001). These findings indicated that MDS, a novel indicator estimating magnesium deficiency, is associated with the risk of CHF in non-institutionalized US civilians. Participants whose dietary magnesium intake reaches the RDA might be at lower risk.

Integrated microscale immiscible phase extraction and isothermal amplification for colorimetric detection of Neisseria gonorrhoeae.

Gonorrhea is the second most common sexually transmitted infection (STI) with around 87 million cases worldwide estimated in 2016 by the World Health Organization. With over half of the cases being asymptomatic, potential life-threatening complications and increasing numbers of drug-resistant strains, routine monitoring of prevalence and incidence of infections are key preventive measures. Whilst gold standard qPCR tests have excellent accuracy, they are neither affordable nor accessible in low-resource settings. In this study, we developed a lab-on-a-chip platform based on microscale immiscible filtration to extract, concentrate and purify Neisseria gonorrhoeae DNA with an integrated detection assay based on colorimetric isothermal amplification. The platform was capable of detecting as low as 500 copies/mL from spiked synthetic urine and showed no cross-reactivity when challenged with DNAs from other common STIs. The credit card-size device allows DNA extraction and purification without power or centrifuges, and the detection reaction only needs a low-tech block heater, providing a straightforward and visual positive/negative result within 1 h. These advantages offer great potential for accurate, affordable and accessible monitoring of gonorrhea infection in resource-poor settings.

Comparative efficiency of native and non-native starter culture in the production of bio-silage using composite waste from fish and vegetables.

The efficiency of native and non-native starter cultures in the production of bio-silage using composite waste from fish and vegetables was studied. An ensilage experiment was conducted in a natural way (without starter culture) of composite waste (fish to vegetable at 80 to 20%) to isolate the native fermentative microflora. An Enterococcus faecalis strain isolated from the natural ensilage of composite waste showed higher efficiency over other commercial LAB strains generally used for ensilation. A total of 60 isolates were screened and characterized biochemically from ensilaged composite waste. Among them, 12 proteolytic and lipolytic positive isolates were identified as Enterococcus faecalis, based on a BLAST search of the 16S rRNA gene sequences. Subsequently, composite bio-silage was prepared by inoculating starter cultures with three (3) treatments T1 (native-Enterococcus faecalis), T2 (non-native-Lactobacillus acidophilus), T3 (a mixture of E. faecalis and L. acidophilus) and compared with control (composite bio-silage without starter culture). The highest non-protein nitrogen (0.78 ± 0.01 mg of N /100 g) and degree of hydrolysis (70.00 ± 0.06% of protein/100 g) was seen in the T3 sample, and the lowest (0.67 ± 0.02 mg of N/100 g and 50.40 ± 0.04% of protein/100 g) was seen in the control. At the end of ensilation, the pH fell (5.95-3.88) in conjunction with the formation of lactic acid (0.23-2.05 g of lactic acid/100 g), and the lactic acid bacteria count nearly doubled (log 5.60-10.60). The lipid peroxidation products PV (0.11-0.41 milli equivalent of oxygen/kg of fat) and TBARs (1.64-6.95 mg of malonaldehyde/kg of silage) were changed within a reasonable range in the following pattern Control > T2 > T3 > T1, which led to oxidatively stable products. The findings revealed that native starter culture E. faecalis, which can be employed as a single or in combination with non-native L. acidophilus, performed better in the bio-ensilation process. Additionally, the finished composite bio-silage can be used as a novel, protein-carbohydrate rich feed component to help manage wastes from both sectors.

Impact of the systematic introduction of tomosynthesis on breast biopsies: 10 years of results.

Digital Breast Tomosynthesis (DBT) is a cutting-edge technology introduced in recent years as an in-depth analysis of breast cancer diagnostics. Compared with 2D Full-Field Digital Mammography, DBT has demonstrated greater sensitivity and specificity in detecting breast tumors. This work aims to quantitatively evaluate the impact of the systematic introduction of DBT in terms of Biopsy Rate and Positive Predictive Values for the number of biopsies performed (PPV-3). For this purpose, we collected 69,384 mammograms and 7894 biopsies, of which 6484 were Core Biopsies and 1410 were stereotactic Vacuum-assisted Breast Biopsies (VABBs), performed on female patients afferent to the Breast Unit of the Istituto Tumori "Giovanni Paolo II" of Bari from 2012 to 2021, thus, in the period before, during and after the systematic introduction of DBT. Linear regression analysis was then implemented to investigate how the Biopsy Rate had changed over the 10 year screening. The next step was to focus on VABBs, which were generally performed during in-depth examinations of mammogram detected lesions. Finally, three radiologists from the institute's Breast Unit underwent a comparative study to ascertain their performances in terms of breast cancer detection rates before and after the introduction of DBT. As a result, it was demonstrated that both the overall Biopsy Rate and the VABBs Biopsy Rate significantly decreased following the introduction of DBT, with the diagnosis of an equal number of tumors. Besides, no statistically significant differences were observed among the three operators evaluated. In conclusion, this work highlights how the systematic introduction of DBT has significantly impacted the breast cancer diagnostic procedure, by improving the diagnostic quality and thereby reducing needless biopsies, resulting in a consequent reduction in costs.