Central tolerance shapes the neutralizing B cell repertoire against a persisting virus in its natural host

Viral mimicry of host cell structures has been postulated to curtail the B cell receptor (BCR) repertoire against persisting viruses through tolerance mechanisms. This concept awaits, however, experimental testing in a setting of natural virus-host relationship. We engineered mouse models expressing a monoclonal BCR specific for the envelope glycoprotein of lymphocytic choriomeningitis virus (LCMV), a naturally persisting mouse pathogen. When the heavy chain of the LCMV-neutralizing antibody KL25 was paired with its unmutated ancestor light chain, most B cells underwent receptor editing, a behavior reminiscent of autoreactive clones. In contrast, monoclonal B cells expressing the same heavy chain in conjunction with the hypermutated KL25 light chain did not undergo receptor editing but exhibited low levels of surface IgM, suggesting that light chain hypermutation had lessened KL25 autoreactivity. Upon viral challenge, these IgMlow cells were not anergic but up-regulated IgM, participated in germinal center reactions, produced antiviral antibodies, and underwent immunoglobulin class switch as well as further affinity maturation. These studies on a persisting virus in its natural host species suggest that central tolerance mechanisms prune the protective antiviral B cell repertoire.

Effects of cardiac rehabilitation on obese hypertensive patients: A controlled trial

INTRODUCTION

The relationship between obesity and hypertension is clearly known and cardiac rehabilitation (CR) is shown as an effective treatment method in both obese and hypertensive patients. The aim of this study is to reveal the effect of CR on obese hypertensive patients by comparing them with non-obese hypertensive patients.

METHODS

Eighty eligible, volunteer participants with hypertension (SBP ≥140mmHg and/or DBP ≥90mmHg) were enrolled in this study. The patients were divided into 2 groups according to their BMI values: obese (BMI ≥30kg/m2) hypertensive patients and non-obese (BMI <30kg/m2) hypertensive patients. The CR program, in which aerobic exercise training was the main part, was performed on the patients. At the end of the 10-week CR program, the resting SBP and DBP values were measured.

RESULTS

A total of 74 patients (37 obese and 37 non-obese) completed the study. After CR significant improvements were achieved in all evaluated parameters compared to pre-CR values. When the amounts of changes before and after CR were compared, the decrease in SBP was found to be significantly higher in obese patients compared to non-obese patients (p=.003). Higher BMI was associated with more reduction in SBP (r=0.287, p=0.013).

CONCLUSIONS

Exercise-based CR effectively reduced SBP in obese and non-obese hypertensive patients. However, it was more effective in obese patients compared to non-obese patients.

Optical Properties in a ZnS/CdS/ZnS Core/Shell/Shell Spherical Quantum Dot: Electric and Magnetic Field and Donor Impurity Effects

A theoretical analysis of optical properties in a ZnS/CdS/ZnS core/shell/shell spherical quantum dot was carried out within the effective mass approximation. The corresponding Schrödinger equation was solved using the finite element method via the 2D axis-symmetric module of COMSOL-Multiphysics software. Calculations included variations of internal dot radius, the application of electric and magnetic fields (both oriented along z-direction), as well as the presence of on-center donor impurity. Reported optical properties are the absorption and relative refractive index change coefficients. These quantities are related to transitions between the ground and first excited states, with linearly polarized incident radiation along the z-axis. It is found that transition energy decreases with the growth of internal radius, thus causing the red-shift of resonant peaks. The same happens when the external magnetic field increases. When the strength of applied electric field is increased, the opposite effect is observed, since there is a blue-shift of resonances. However, dipole matrix moments decrease drastically with the increase of the electric field, leading to a reduction in amplitude of optical responses. At the moment impurity effects are activated, a decrease in the value of the energies is noted, significantly affecting the ground state, which is more evident for small internal radius. This is reflected in an increase in transition energies.

The Prevalence of Biphalangealism for Each Toe in the Turkish Population: An Epidemiologic Study

BACKGROUND

Biphalangealism has been evaluated in many studies and has been shown as a common variant. Its frequency varies according to the populations. This epidemiological study aimed to determine the prevalence of biphalangealism for each toe in the Turkish population and compare it with other populations.

METHODS

The local hospital radiological database was searched for all consecutive foot radiographs, obtained between 2014 and 2018. Anteroposterior (AP) and oblique radiographs obtained to evaluate trauma or foot pathologies were included. Two-phalangeal toes according to radiographical views were defined as biphalangeal and other three-phalangeal toes were defined as normal.

RESULTS

A total of 2,881 radiographs of 2,710 adult patients met the incusion criteria. There were 1,558 (57.5%) female and 1,152 (42.5%) male patients. The cases were unilateral in 2,539 patients and bilateral in 171 patients. The overall prevalence of biphalangeal third toe was 0.29%, fourth toe was 1.29%, and fifth toe was 23.3%.

CONCLUSIONS

The presence of pedal biphalangealism is a common variant and its frequency varies according to the populations. The exact cause is still unclear. Further studies are required to assess the clinical impact of biphalangealism.

Pulsed magnetic field treatment ameliorates the progression of peripheral neuropathy by modulating the neuronal oxidative stress, apoptosis and angiogenesis in a rat model of experimental diabetes

OBJECTIVE

The present study aimed to investigate the possible anti-neuropathic effects of daily pulsed magnetic field treatments (PMF) in streptozotocin (60 mg/kg) induced 4 weeks diabetic (type-1) wistar rats (6-8 months).

MATERIALS AND METHODS

Body mass, blood glucose and thermal and mechanical sensations were evaluated during the PMF or sham-PMF in diabetic or non-diabetic rats (n = 7/group). After the measurements of motor nerve conduction velocities (MNCV), the levels of several biomarkers for oxidative stress, apoptosis and angiogenesis in spinal cord and sciatic nerve were measured.

RESULTS

PMF for 4 weeks significantly recovered the MCNV (96.9% and 63.9%) and almost fully (100%) restored to the latency and threshold. PMF also significantly suppressed the diabetes induced enhances in biochemical markers of both neuronal tissues.

CONCLUSIONS

Findings suggested that PMF might prevent the development of functional abnormalities in diabetic rats due to its anti-oxidative, anti-apoptotic and anti-angiogenic actions in neuronal tissues.

Epidemiology and impact of frailty in patients with atrial fibrillation in Europe

BACKGROUND

Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent.

OBJECTIVES

We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients.

METHODS

A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined.

RESULTS

Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty.

CONCLUSIONS

In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.

Cerebrovascular radiological features of COVID-19 positive patients

OBJECTIVE

To investigate acute cerebrovascular diseases (stroke and intracranial hemorrhage) by cranial radiologic examinations of patients infected with coronavirus disease 2019 (COVID-19) and with neurological signs.

PATIENTS AND METHODS

Between March 2020 and May 2021, patients who were admitted to the Emergency Department and had a positive reverse transcription-polymerase chain reaction (RT-PCR) test and underwent Multidetector Computed Tomography (MDCT) and/or Magnetic Resonance Images (MRI), and/or diffusion MRI due to neurological findings were included in the study.

RESULTS

The study reviewed a total of 925 patients, including 404 (43.67%) female and 521 (56.32%) male patients. The distribution of imaging methods was as follows: 805 (71%) patients had cranial MDCT, 71 (6.35%) patients had MRI, and 241 (21.57%) patients had diffusion MRI. Of the total 925 patients, 128 (13.8%) patients were detected with cerebrovascular diseases, 92 (9.9%) patients were detected with ischemic or hemorrhagic stroke, 37 (4%) patients were detected with intraparenchymal hemorrhage, 10 (1.1%) patients were detected with subarachnoid hemorrhage, and four (0.43%) patients were detected with subdural hemorrhage. There was no statistically significant difference in the incidence of subdural, subarachnoid, parenchymal hemorrhage, and stroke in terms of gender. While there was a significant difference in stroke according to age, there was no statistically significant difference in subdural, subarachnoid, and parenchymal hemorrhagic. Three (0.32%) patients were diagnosed with acute disseminated encephalomyelitis (ADEM)'s-like demyelinating lesions.

CONCLUSIONS

Cerebrovascular diseases, which may cause severe disability and even threaten the patient's life, should be kept in mind, especially in COVID-19 patients who present with neurological symptoms.

Contrasting Modes of New World Arenavirus Neutralization by Immunization-Elicited Monoclonal Antibodies

Transmission of the New World hemorrhagic fever arenaviruses Junín virus (JUNV) and Machupo virus (MACV) to humans is facilitated, in part, by the interaction between the arenavirus GP1 glycoprotein and the human transferrin receptor 1 (hTfR1). We utilize a mouse model of live-attenuated immunization with envelope exchange viruses to isolate neutralizing monoclonal antibodies (NAbs) specific to JUNV GP1 and MACV GP1. Structures of two NAbs, termed JUN1 and MAC1, demonstrate that they neutralize through disruption of hTfR1 recognition. JUN1 utilizes a binding mode common to all characterized infection- and vaccine-elicited JUNV-specific NAbs, which involves mimicking hTfR1 binding through the insertion of a tyrosine into the receptor-binding site. In contrast, MAC1 undergoes a tyrosine-mediated mode of antigen recognition distinct from that used by the reported anti-JUNV NAbs and the only other characterized anti-MACV NAb. These data reveal the varied modes of GP1-specific recognition among New World arenaviruses by the antibody-mediated immune response. IMPORTANCE The GP1 subcomponent of the New World arenavirus GP is a primary target of the neutralizing antibody response, which has been shown to be effective in the prevention and treatment of infection. Here, we characterize the structural basis of the antibody-mediated immune response that arises from immunization of mice against Junín virus and Machupo virus, two rodent-borne zoonotic New World arenaviruses. We isolate a panel of GP1-specific monoclonal antibodies that recognize overlapping epitopes and exhibit neutralizing behavior, in vitro. Structural characterization of two of these antibodies indicates that antibody recognition likely interferes with GP1-mediated recognition of the transferrin receptor 1. These data provide molecular-level detail for a key region of vulnerability on the New World arenavirus surface and a blueprint for therapeutic antibody development.

Antibody bivalency improves antiviral efficacy by inhibiting virion release independently of Fc gamma receptors

Across the animal kingdom, multivalency discriminates antibodies from all other immunoglobulin superfamily members. The evolutionary forces conserving multivalency above other structural hallmarks of antibodies remain, however, incompletely defined. Here, we engineer monovalent either Fc-competent or -deficient antibody formats to investigate mechanisms of protection of neutralizing antibodies (nAbs) and non-neutralizing antibodies (nnAbs) in virus-infected mice. Antibody bivalency enables the tethering of virions to the infected cell surface, inhibits the release of virions in cell culture, and suppresses viral loads in vivo independently of Fc gamma receptor (FcγR) interactions. In return, monovalent antibody formats either do not inhibit virion release and fail to protect in vivo or their protective efficacy is largely FcγR dependent. Protection in mice correlates with virus-release-inhibiting activity of nAb and nnAb rather than with their neutralizing capacity. These observations provide mechanistic insights into the evolutionary conservation of antibody bivalency and help refining correlates of nnAb protection for vaccine development.

No association of anti-osteoporosis drugs with COVID-19-related outcomes in women: a nationwide cohort study

This study was performed to evaluate whether the use of drugs in the treatment of osteoporosis in women is associated with COVID-19 outcomes. The results showed that the risk of hospitalization, intensive care unit admission, and mortality was not altered in individuals taking anti-osteoporosis drugs, suggesting no safety issues during a COVID-19 infection.

INTRODUCTION

Whether patients with COVID-19 receiving anti-osteoporosis drugs have lower risk of worse outcomes has not been reported yet. The aim of this study was to evaluate the association of anti-osteoporosis drug use with COVID-19 outcomes in women.

METHODS

Data obtained from a nationwide, multicenter, retrospective cohort of patients diagnosed with COVID-19 from March 11th to May 30th, 2020 was retrieved from the Turkish Ministry of Health Database. Women 50 years or older with confirmed COVID-19 who were receiving anti-osteoporosis drugs were compared with a 1:1 propensity score-matched COVID-19 positive women who were not receiving these drugs. The primary outcomes were hospitalization, ICU (intensive care unit) admission, and mortality.

RESULTS

A total of 1997 women on anti-osteoporosis drugs and 1997 control patients were analyzed. In the treatment group, 1787 (89.5%) women were receiving bisphosphonates, 197 (9.9%) denosumab, and 17 (0.9%) teriparatide for the last 12 months. Hospitalization and mortality rates were similar between the treatment and control groups. ICU admission rate was lower in the treatment group (23.0% vs 27.0%, p = 0.013). However, multivariate analysis showed that anti-osteoporosis drug use was not an independent associate of any outcome. Hospitalization, ICU admission, and mortality rates were similar among bisphosphonate, denosumab, or teriparatide users.

CONCLUSION

Results of this nationwide study showed that preexisting use of anti-osteoporosis drugs in women did not alter the COVID-19-related risk of hospitalization, ICU admission, and mortality. These results do not suggest discontinuation of these drugs during a COVID-19 infection.

A tissue-bioengineering strategy for modeling rare human kidney diseases in vivo

The lack of animal models for some human diseases precludes our understanding of disease mechanisms and our ability to test prospective therapies in vivo. Generation of kidney organoids from Tuberous Sclerosis Complex (TSC) patient-derived-hiPSCs allows us to recapitulate a rare kidney tumor called angiomyolipoma (AML). Organoids derived from TSC2-/- hiPSCs but not from isogenic TSC2+/- or TSC2+/+ hiPSCs share a common transcriptional signature and a myomelanocytic cell phenotype with kidney AMLs, and develop epithelial cysts, replicating two major TSC-associated kidney lesions driven by genetic mechanisms that cannot be consistently recapitulated with transgenic mice. Transplantation of multiple TSC2-/- renal organoids into the kidneys of immunodeficient rats allows us to model AML in vivo for the study of tumor mechanisms, and to test the efficacy of rapamycin-loaded nanoparticles as an approach to rapidly ablate AMLs. Collectively, our experimental approaches represent an innovative and scalable tissue-bioengineering strategy for modeling rare kidney disease in vivo.

Cadmium-Free and Efficient Type-II InP/ZnO/ZnS Quantum Dots and Their Application for LEDs

It is a generally accepted perspective that type-II nanocrystal quantum dots (QDs) have low quantum yield due to the separation of the electron and hole wavefunctions. Recently, high quantum yield levels were reported for cadmium-based type-II QDs. Hence, the quest for finding non-toxic and efficient type-II QDs is continuing. Herein, we demonstrate environmentally benign type-II InP/ZnO/ZnS core/shell/shell QDs that reach a high quantum yield of ∼91%. For this, ZnO layer was grown on core InP QDs by thermal decomposition, which was followed by a ZnS layer via successive ionic layer adsorption. The small-angle X-ray scattering shows that spherical InP core and InP/ZnO core/shell QDs turn into elliptical particles with the growth of the ZnS shell. To conserve the quantum efficiency of QDs in device architectures, InP/ZnO/ZnS QDs were integrated in the liquid state on blue light-emitting diodes (LEDs) as down-converters that led to an external quantum efficiency of 9.4% and a power conversion efficiency of 6.8%, respectively, which is the most efficient QD-LED using type-II QDs. This study pointed out that cadmium-free type-II QDs can reach high efficiency levels, which can stimulate novel forms of devices and nanomaterials for bioimaging, display, and lighting.

Recombinant human thyrotropin versus thyroid hormone withdrawal in differentiated thyroid carcinoma follow-up: a single center experience

INTRODUCTION

Our goal was to evaluate and compare the diagnostic utility of thyroid hormone withdrawal (THW) and recombinant thyroid-stimulating hormone (rhTSH) methods in detecting recurrence/persistence (R/PD) of differentiated thyroid carcinoma (DTC).

METHODS

The study included 413 patients with DTC who underwent total thyroidectomy and had remnant ablation. DxWBS, s-Tg levels, R/PD were evaluated retrospectively. A s-Tg level≥2 ng/mL was considered as "positive s-Tg".

RESULTS

DxWBS and s-Tg levels were evaluated with rhTSH in 116 and THW in 297 subjects, respectively. The sensitivity and specificity of "positive s-Tg" for R/PD in THW group were 77.3% and 92.7%, with 90.3% accuracy, respectively. The sensitivity and specificity of "positive s-Tg" for R/PD in rhTSH group were 58.8% and 100% with 93.9 % accuracy, respectively. An uptake outside thyroid bed at WBS showed a sensitivity of 17.1%, specificity of 100% for R/PD with 89.4% accuracy in THW group. An uptake outside thyroid bed at WBS showed a sensitivity of 7.7%, specificity of 100% for R/PD with 88.8% accuracy in rhTSH group.

CONCLUSION

Method of TSH stimulation did not influence the reliability of DxWBS. The "positive s-Tg level" had a higher sensitivity with THW when compared to rhTSH in detecting R/PD.

Headache service quality evaluation: implementation of quality indicators in primary care in Europe

BACKGROUND

Lifting The Burden (LTB) and European Headache Federation (EHF) have developed a set of headache service quality indicators, successfully tested in specialist headache centres. Their intended application includes all levels of care. Here we assess their implementation in primary care.

METHODS

We included 28 primary-care clinics in Germany (4), Turkey (4), Latvia (5) and Portugal (15). To implement the indicators, we interviewed 111 doctors, 92 nurses and medical assistants, 70 secretaries, 27 service managers and 493 patients, using the questionnaires developed by LTB and EHF. In addition, we evaluated 675 patients' records. Enquiries were in nine domains: diagnosis, individualized management, referral pathways, patient education and reassurance, convenience and comfort, patient satisfaction, equity and efficiency of headache care, outcome assessment and safety.

RESULTS

The principal finding was that Implementation proved feasible and practical in primary care. In the process, we identified significant quality deficits. Almost everywhere, histories of headache, especially temporal profiles, were captured and/or assessed inaccurately. A substantial proportion (20%) of patients received non-specific ICD codes such as R51 ("headache") rather than specific headache diagnoses. Headache-related disability and quality of life were not part of routine clinical enquiry. Headache diaries and calendars were not in use. Waiting times were long (e.g., about 60 min in Germany). Nevertheless, most patients (> 85%) expressed satisfaction with their care. Almost all the participating clinics provided equitable and easy access to treatment, and follow-up for most headache patients, without unnecessary barriers.

CONCLUSIONS

The study demonstrated that headache service quality indicators can be used in primary care, proving both practical and fit for purpose. It also uncovered quality deficits leading to suboptimal treatment, often due to a lack of knowledge among the general practitioners. There were failures of process also. These findings signal the need for additional training in headache diagnosis and management in primary care, where most headache patients are necessarily treated. More generally, they underline the importance of headache service quality evaluation in primary care, not only to identify-quality failings but also to guide improvements. This study also demonstrated that patients' satisfaction is not, on its own, a good indicator of service quality.

Timing of laparoscopic cholecystectomy in acute cholecystitis

Background

Timing of laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) is still debated.

Aims

The aim of this study was to investigate the effect of timing on operative results; from the first appearance of symptoms to the operation.

Methods

The study included 57 sequential patients operated laparoscopically for AC. Patients operated within the first 3 days of admission (Group 1), those operated between 4^th and 7^th days (Group 2) and those operated after 7^th day (Group 3) were evaluated and compared with respect to demographics, time from admission to operation, duration of operation, adhesion score, complications, conversion rates, duration of hospital stay, morbidity and mortality rates, bile culture results, and histopathological evaluation.

Results

A total of 63% of the patients were female and 21 (37%) were male. The mean age was 48 years (range, 21-74). There was no significant difference among the groups with respect to demographics (P > 0.05, for each). The duration of operation was significantly shorter in Group 1 than both Groups 2 and 3 (P < 0.05 and P < 0.001, respectively). Duration of operation was also significantly shorter in Group 2 than Group 3 (P < 0.001). Group 1 had significantly fewer adhesions compared to Group 2 and Group 3 (P < 0.05 and P < 0.001, respectively), and no significant difference was found between Group 2 and Group 3 (P > 0.05). Duration of hospital stay was significantly shorter in Group 1 compared to Group 2 and Group 3 (P < 0.001) and also was significantly shorter in Group 2 than Group 3 (P < 0.05). Group 1 had significantly lower rate of culture proliferation than Group 3 (P < 0.001), whereas no significant differences were evident in other inter-group analyses (P > 0.05, for each).

Conclusion

LC can safely be performed within 7 days of admission in cases of AC.

Quantum dot and electron acceptor nano-heterojunction for photo-induced capacitive charge-transfer

Capacitive charge transfer at the electrode/electrolyte interface is a biocompatible mechanism for the stimulation of neurons. Although quantum dots showed their potential for photostimulation device architectures, dominant photoelectrochemical charge transfer combined with heavy-metal content in such architectures hinders their safe use. In this study, we demonstrate heavy-metal-free quantum dot-based nano-heterojunction devices that generate capacitive photoresponse. For that, we formed a novel form of nano-heterojunctions using type-II InP/ZnO/ZnS core/shell/shell quantum dot as the donor and a fullerene derivative of PCBM as the electron acceptor. The reduced electron–hole wavefunction overlap of 0.52 due to type-II band alignment of the quantum dot and the passivation of the trap states indicated by the high photoluminescence quantum yield of 70% led to the domination of photoinduced capacitive charge transfer at an optimum donor–acceptor ratio. This study paves the way toward safe and efficient nanoengineered quantum dot-based next-generation photostimulation devices.

Cation exchange mediated synthesis of bright Au@ZnTe core-shell nanocrystals

The synthesis of heterostructured core-shell nanocrystals has attracted significant attention due to their wide range of applications in energy, medicine and environment. To further extend the possible nanostructures, non-epitaxial growth is introduced to form heterostructures with large lattice mismatches, which cannot be achieved by classical epitaxial growth techniques. Here, we report the synthetic procedure of Au@ZnTe core-shell nanostructures by cation exchange reaction for the first time. For that, bimetallic Au@Ag heterostructures were synthesized by using PDDA as stabilizer and shape-controller. Then, by addition of Te and Zn precursors in a step-wise reaction, the zinc and silver cation exchange was performed and Au@ZnTe nanocrystals were obtained. Structural and optical characterization confirmed the formation of the Au@ZnTe nanocrystals. The optimization of the synthesis led to the bright nanocrystals with a photoluminescence quantum yield up to 27%. The non-toxic, versatile synthetic route, and bright emission of the synthesized Au@ZnTe nanocrystals offer significant potential for future bio-imaging and optoelectronic applications.

Determination of hypertension disease using chirp z-transform and statistical features of optimal band-pass filtered short-time photoplethysmography signals

Hypertension is the condition where the normal blood pressure is high. This situation is manifested by the high pressure of the blood in the vein towards the vessel wall. Hypertension mostly affects the brain, kidneys, eyes, arteries and heart. Therefore, the diagnosis of this common disease is important. It may take days, weeks or even months for diagnosis. Often a device, called a blood pressure holter, is connected to the person for 24 or 48 h and the person's blood pressure is recorded at certain intervals. Diagnosis can be made by the specialist physician considering these results. In recent years, various physiological measurement techniques have been used to accelerate this time-consuming diagnostic phase and intelligent models have been proposed. One of these techniques is photopletesmography (PPG). In this study, a model for the detection of hypertension disease in individuals was proposed using chirp z-transform and statistical features (total band power, autoregressive model parameters, standard deviation of signal's derivative and zero crossing rate) of optimal band-pass filtered short-time PPG signals. The proposed method was successfully applied to 657 PPG trials, which each of them had only 2.1 s signal length and achieved a classification accuracy rate of 77.52% on the test data. The results showed that the diagnosis of hypertension can be performed effectively by chirp z-transform and statistical features and support vector machine classifier using optimal frequency range of 1.4-6 Hz.

Magnetic Field Exposure Modulates the Anti-Inflammatory Efficiency of Minocycline in Rats with Peripheral Acute Inflammation

BACKGROUND AND OBJECTIVE

Microglial activation in spinal cord is key contributor and its inhibition by Minocycline (MCN) can result in anti-inflammatory actions. Effect of pulsed magnetic field (PMF) in living system is a very complex process and many biological and cellular processes can play key roles. In this study aimed to reveal the roles of PMF exposure on anti-inflammatory potentials of MCN treatment by evaluating the inflammatory profiles of either inflamed site or spinal cord.

METHODS

In this study, we investigated the anti-inflammatory effects of PMF, MCN or their combination treatments in rats with carrageenan (CG)-induced peripheral inflammation by examining the cardinal signs, hyperalgesia, allodynia, edema and fever. The levels of various inflammation markers (tumor necrosis factor-α), interleukin (IL)-1β, IL-6, IL-17, IL-4, IL-10, C-C motif chemokine ligand3 (CCL3), C-X-C motif chemokine ligand1 and myeloperoxidase were also measured in paw and spinal cord tissues.

RESULTS

CG induced inflammation caused edema, fever, and hypersensitivities. MNC or PMF treatments ameliorated these responses by suppressing pro-inflammatory markers in both inflamed paw and spinal cord. Although anti-hypersensitive, anti-edematous and anti-pyretic actions of MCN or PMF, in combined treatments PMF exposure decreased the anti-hyperalgesic and anti-allodynic actions of MCN treatment. These may be associated with decreases in IL-4 and IL-10 levels and an increase in CCL3 level of spinal cord tissues.

CONCLUSION

Present findings support that MCN or PMF has anti-inflammatory properties duo to the down-regulating central microglial and/or peripheral inflammatory markers. Our data showed here, for the first time, PMF exposure may suppress the anti-hypersensitive actions of MCN by modulating microglia function/phenotype and microglial markers.

Multiparametric Prostate Magnetic Resonance Imaging before Radical Prostatectomy: Can IT Predict Histopathology?

PURPOSE

We aimed to investigate the histopathological correlation of the suspected prostate malignancy detected in multiparametric prostate magnetic resonance imaging (mpMRI).

MATERIALS AND METHODS

The data of 93 patients underwent radical prostatectomy and had preoperative mpMRI were examined. Age and pre-operative Prostate-Specific Antigen value were retrospectively collected from patient files. The pathology specimens were examined again and post-operative ISUP grade group, other pathological findings (seminal vesicle invasion, lymph node involvement and extraprostatic extension), pre-operative mpMRI were re-examined and PIRADS score, extracapsular extension, seminal vesicle invasion, neurovascular bundle invasion, lymph node involvement and ADC values were recorded.

RESULTS

151 (92,07%) of 164 lesions detected in mpMRI were histopathologically correlated. 80% of patients with seminal vesicle invasion (P < 0.001), 28.8% of patients with extracapsular extension (P < 0.052) and 42.9% of patients with lymph node involvement (P = .001) in mpMRI were histopathologically correlated. A significant relationship was found between PIRADS scores and ISUP grade groups (P < 0.001). There was a negative correlation between ADC values and ISUP grade groups (P < 0.001).

CONCLUSION

Our study showed that the lesions detected by mpMRI showed a high histopathological correlation.

Prostaglandin E2 Reverses the Effects of DNA Methyltransferase Inhibitor and TGFB1 on the Conversion of Naive T Cells to iTregs

Naturally occurring regulatory T cells (nTregs) are produced under thymic (tTregs) or peripherally induced (pTregs) conditions in vivo. On the other hand, Tregs generated from naive T cells in vitro under some circumstances, such as treatment with transforming growth factor-β (TGFB), are called induced Tregs (iTregs). Tregs are especially characterized by FOXP3 expression, which is mainly controlled by DNA methylation. nTregs play important roles in the suppression of immune response and self-tolerance. The prostaglandin E2 (PGE2) pathway was reported to contribute to regulatory functions of tumor-infiltrating nTregs. In this study, we examined whether PGE2 contributes to the formation of iTregs treated with TGFB1 and 5-aza-2'-deoxycytidine (5-aza-dC), which is a DNA methyltransferase inhibitor. We found that the protein and gene expression levels of FOXP3 and IL-10 were increased in 5-aza-dC and TGFB1-treated T cells in vitro. However, the addition of PGE2 to these cells reversed these increments significantly. In CFSE-based cell suppression assays, we demonstrated that PGE2 decreased the suppressive functions of 5-aza-dC and TGFB1-treated T cells.

Effects of immune cell-targeted treatments result from the suppression of neuronal oxidative stress and inflammation in experimental diabetic rats

In this study, we hypothesized that reduction of immune cell activation as well as their oxidant or inflammatory mediators with minocycline (MCN), liposome-encapsulated clodronate (LEC), or anti-Ly6G treatments can be neuroprotective approaches in diabetic neuropathy. MCN (40 mg/kg) for reduction of microglial activation, LEC (25 mg/kg) for of macrophage inhibition, or anti-Ly6G (150 μg/kg) for neutrophil suppression injected to streptozotocin (STZ)-induced diabetic rats twice, 3 days, and 1 week (half dose) after STZ. Animal mass and blood glucose levels were measured; thermal and mechanical sensitivities were tested for in pain sensations. The levels of chemokine C-X-C motif ligand 1 (CXCL1), CXCL8, and C-C motif ligand 2 (CCL2), CCL3, and total oxidant status (TOS) and total antioxidant status (TAS) were measured in the spinal cord and sciatic nerve tissues of rats. LEC significantly reduced the glucose level of diabetic rats compared with drug control. However, MCN or anti-LY6G did not change the glucose level. While diabetic rats showed a marked decrease in both thermal and mechanical sensations, all treatments alleviated these abnormal sensations. The levels of chemokines and oxidative stress parameters increased in diabetic rats. All drug treatments significantly decreased the CCL2, CXCL1, and CXCL8 levels of spinal cord tissues and ameliorated the neuronal oxidative stress compared with control treatments. Present findings suggest that the neuroprotective actions of MCN, LEC, or anti-Ly6G treatments may be due to the modulation of neuronal oxidative stress and/or inflammatory mediators of immune cells in diabetic rats with neuropathy.

Antiinflammatory properties of antiLy6G antibody disappear during magnetic field exposure in rats with carrageenan induced acute paw inflammation

Antiinflammatory properties of pulsed magnetic field (PMF) treatments or administration of antiLy6G antibody have been previously reported. In this study, we hypothesized that, the combination of PMF treatments and antiLy6G administration may synergistically potentiate their antiinflammatory actions. The effects of the combination of PMF treatments and antiLy6G administration were investigated by examining the inflammatory signs, histopathological properties of the inflamed site, and measuring the macrophage inflammatory protein-1 alpha (MIP-1α/CCL3) and myeloperoxidase (MPO) levels of inflamed paw tissues in rats with carrageenan-induced acute paw inflammation. In this present study, PMF treatments alone or administration of antiLy6G alone ameliorated the acute inflammation. However, their combination exacerbated the inflammatory signs, hyperalgesia, allodynia, edema and fever, and aggravated the inflammatory conditions by excessive infiltration of inflammatory cells to the inflamed site. These opposing effects of the combined treatments may correlate with enhanced levels of MIP-1α and MPO in inflamed paws. Present results indicated that the combination of the PMF treatments and antiLy6G administration may not provide additional benefits and may actually cause an aggravation of the acute inflammatory process. Findings may also suggest that during neutrophil or immune cell-targeted treatments for inflammatory states, magnetic field exposure may cause unexpected negative consequences.

Predictive Factors of Ureterorenoscopy Outcomes in Proximal Ureteral Stones: A Multicenter Study of Aegean Study Group of the Society of Urological Surgery

INTRODUCTION

We aimed to evaluate the predictive factors in a holistic manner for ureterorenoscopy (URS) outcomes in proximal ureteral stones by a multicenter study.

MATERIALS AND METHODS

The data of patients who underwent URS for proximal ureteral stones between the years 2015 and 2018 in eight centers were recorded retrospectively. Patients were divided into two groups according to URS success: Group 1 consisted of patients with successful URS, and Group 2 consisted of patients with unsuccessful URS. The two groups were compared in terms of risk factors, stone, and clinical characteristics of patients.

RESULTS

A total of 638 patients were included in the study. Group 1 consisted of 527 (82.6%) patients, and Group 2 consisted of 111 (17.4%) patients. In multivariate logistic analysis, the key risk factors for URS success was found to be age (OR = 0.980, 95% [CI] = 0.963-0.996, p = 0.018), stone area (OR = 0.993, 95% [CI] = 0.989-0.997, p = 0.002), and operation time (OR = 0.981, 95% [CI] = 0.968-0.994, p = 0.005).

CONCLUSIONS

To make the treatment decision of proximal ureteral stones, it is necessary to examine several parameters including available equipment, stone, and patient characteristics. Physicians should keep these risk factors in mind in the decision of treatment options.

Bone mineral density and serum osteocalcin levels in patients with gout

Objective: The objective of the study is to evaluate the relation of gout with osteoporosis and serum osteocalcin (OC) levels. Material and methods: Seventy-five patients diagnosed with gout and 55 controls were included in the study. Comorbid conditions and drugs associated with osteoporosis were excluded. The T and Z scores from lumbar spine (L2-L4) and femur (neck, ward, trochanter, total) were determined by dual-energy X-ray absorptiometry (DXA). OC levels were measured by enzyme-linked immunosorbent assay. Results: Osteoporosis according to T scores of lumbar vertebrae L2-L4 was found to be significantly higher in patients with gout compared to the control group (p = 0.02). Lumbar spine T-score was -1.6 in gout group and -1.0 in controls. OC level was 7.9 ng/mL in the gout group and 18.9 ng/mL in the control group. There was a significant difference (p < 0.001). In addition, mean OC level was 12.4 ± 6.9 ng/mL in the patients diagnosed with osteoporosis and 17.2 ± 10.6 ng/mL in the patients that were classified as normal and a significant difference was established between the two groups (p = 0.03). A significant negative correlation was found between OC level and body mass index, age, and age at first attack. Similarly, femoral T-score established a negative correlation with parathyroid hormone, age, age at first attack, and allopurinol dose. Conclusion: Serum OC level can be a useful marker in the assessment of bone turnover and clinicians should keep osteoporosis in mind in gout patients.

Effects of Daily and Intermittent Intake of New Zealand Blackcurrant Extract on Cardiovascular Responses During Moderate Intensity Exercise in Males (P23-011-19)

Objectives

Seven-day intake of anthocyanin-rich New Zealand blackcurrant extract affected exercise-induced cardiovascular responses by vasodilation. It is not known whether daily intake of NZBC extract is required for effectiveness. Effects of daily and intermittent NZBC extract intake on cardiovascular responses were examined during brisk walking.

Methods

Fifteen healthy men (mean ± SD age: 24 ± 6 yr, body mass: 79 ± 16 kg, height: 178 ± 6 cm, BMI: 24.7 ± 4.3 kg·m−2, IPAQ score: 4534 ± 1576 MET·week−1) volunteered. Resting metabolic equivalent (1-MET) was measured using Douglas bags (1-MET: 3.97 ± 0.66 ml·kg−1·min−1) and an incremental walking test to determine the relationship between walking speed and MET. A randomised, cross-over (14-day washout) experimental design was used for baseline, 14-day intermittent (14I, every other day), and 14-day continuous (14C, daily) intake. Participants consumed 2 capsules of NZBC extract (600 mg and containing 210 mg of anthocyanins, CurraNZ™ Health Currancy Ltd., Surrey, UK) with breakfast. On the morning of testing, the final 2 capsules were ingested 2-hr before the 30-min brisk walk at 4 (n = 3) or 5 (n = 12) METs (walking speed: 5.68 ± 0.67 km·hr−1). Cardiovascular responses were measured at 7–10, 17–20 and 27–30 min during the walk by Portapres Model 2, averaged and analysed (ANOVA and post-hoc t-tests).

Results

There were no changes in heart rate (e.g., baseline: 102 ± 18 beats·min-1), systolic blood pressure (e.g., baseline: 158 ± 18 mm Hg) and ejection time (e.g., baseline: 0.28 ± 0.03 s). Cardiac output (baseline: 11.7 ± 2.0, 14I: 12.5 ± 2.0, 14C: 12.7 ± 2.1 L·min-1, P = 0.009) and stroke volume (baseline: 114 ± 13, 14I: 123 ± 17, 14C: 126 ± 21 mL·min-1, P = 0.004) were higher, and total peripheral resistance (baseline 0.51 ± 0.11, 14I: 0.45 ± 0.09, 14C: 0.44 ± 0.12 mmHg·L-1·min-1, P = 0.001), diastolic blood pressure (baseline: 71 ± 9, 14I: 66 ± 9, 14C: 63 ± 11 mm Hg, P < 0.001) and mean arterial pressure (baseline 93 ± 10, 14I: 88 ± 9, 14C: 87 ± 11 mm Hg P = 0.006) were lower for 14I and 14C intake.

Conclusions

Daily intake of anthocyanin-rich NZBC extract is not required to obtain beneficial cardiovascular responses during walking.

Funding Sources

Health Currancy (UK) Ltd and CurraNZ (NZ) Ltd provided supplements and support for conference attendance with Blackcurrant New Zealand Inc. (NZ).

Femoral head subchondral impaction on CT: what does it mean in patients with acetabular fracture?

OBJECTIVE

To evaluate the prevalence of isolated femoral head impactions associated with acetabular fractures and to assess whether impactions may be predictive of the development of delayed major complications requiring total hip arthroplasty.

MATERIALS AND METHODS

A total of 128 consecutive adult patients with acetabular fracture and no femoral head fracture were included. Admission CTs were re-interpreted for the presence of hip dislocation and femoral head impactions. Radiological and clinical reports were reviewed in patients in whom conservative management of the femoral head was attempted, to determine if total hip arthroplasty was eventually required over a 48-month follow-up period. Univariate and multivariate analyses were performed to assess whether impaction is an independent predictor of failure of conservative management.

RESULTS

Impaction was found in 40% of all patients (51 out of 128), in 58% of those with dislocation (19 out of 33), and in 34% of those without dislocation (32 out of 95; p < 0.05). One hundred and five patients underwent conservative management of the femoral head; 12.5% of them (13 out of 105) eventually required total hip arthroplasty. An impaction was present in 77% of the latter (10 out of 13) and in 33% of patients with successful conservative management (30 out of 92; p = 0.0042). At multivariate analysis, impaction and dislocation were significantly and independently associated with a higher risk for delayed total hip arthroplasty (odds ratio of 4.8 and 4.0 respectively).

CONCLUSION

Femoral head impactions are frequently seen on CT of patients with acetabular fractures; they are independent predictive factors for the need for delayed total hip arthroplasty. They should be systematically mentioned in the CT report.

Intake Duration Effects of New Zealand Blackcurrant Extract on Cardiovascular Responses During Moderate Intensity Exercise in Males (P23-015-19)

Objectives

New Zealand blackcurrant (NZBC) is an anthocyanin-rich berry with potential effects on cardiovascular health (e.g., 7-day NZBC extract lowered total peripheral resistance at rest). We examined effects of 7- and 14-day intake of NZBC extract on cardiovascular responses during moderate intensity exercise.

Methods

Fifteen healthy men (mean ± SD, age: 24 ± 6 yr, body mass: 79 ± 16 kg, height: 178 ± 6 cm, BMI: 24.7 ± 4.3 kg·m−2, IPAQ score: 4534 ± 1576 MET·week−1) volunteered. Resting metabolic equivalent (1-MET) was measured using Douglas bags (1-MET: 3.97 ± 0.66 ml·kg−1·min−1) with an incremental walking test to determine the relationship between walking speed and MET. A randomised, cross-over experimental design was used for baseline, 7-day and 14-day intake. Participants consumed 2 capsules of NZBC extract (600 mg and containing 210 mg of anthocyanins, CurraNZ™ Health Currancy Ltd., UK) with breakfast with a 14-day washout. On the morning of testing, the final 2 capsules were ingested 2-hr before the 30-min walk at 4 (n = 3) or 5 (n = 12) METs (speed: 5.68 ± 0.67 km·hr−1). Cardiovascular responses were measured at 7–10, 17–20 and 27–30 min during the walk (Portapres Model 2), averaged and analysed (ANOVA and post-hoc t-tests).

Results

Intake duration had no effect on heart rate (e.g., baseline: 102 ± 18 beats·min−1), systolic blood pressure (e.g., baseline 158 ± 18 mm Hg) and ejection time (e.g., baseline: 0.28 ± 0.03 s). Cardiac output (baseline: 11.7 ± 2.0, 7-day: 12.7 ± 2.5, 14-day: 12.7 ± 2.1 L·min−1, P = 0.012) and stroke volume (baseline: 114 ± 13, 7-day: 123 ± 22, 14-day: 126 ± 21 mL·min−1, P = 0.017) were increased, and total peripheral resistance (baseline: 0.51 ± 0.11, 7-day: 0.46 ± 0.17, 14-day: 0.44 ± 0.12 mmHg·L−1·min−1, P = 0.018) and diastolic blood pressure (baseline 71 ± 9, 7-day: 66 ± 10, 14-day: 63 ± 11 mm Hg, P = 0.002) were lower for 7- and 14-day intake. Only 14-day intake resulted in lower mean arterial pressure (baseline: 93 ± 10, 7-day: 89 ± 9, 14-day: 87 ± 11 mm Hg, P = 0.034).

Conclusions

Beneficial effects of anthocyanin-rich NZBC extract intake on cardiovascular responses during moderate intensity exercise do not require long-duration intake.

Funding Sources

Health Currancy (UK) Ltd and CurraNZ (NZ) Ltd provided supplements and support for conference attendance with Blackcurrant New Zealand Inc. (NZ).

Impact of previous SWL on ureterorenoscopy outcomes and optimal timing for ureterorenoscopy after SWL failure in proximal ureteral stones

PURPOSE

We aimed to evaluate the impact of previous unsuccessful shock wave lithotripsy (SWL) therapy on ureterorenoscopy (URS) outcomes in proximal ureteral stones and to define whether there is any optimal timing for safe URS after SWL.

METHODS

The patients who underwent URS for proximal ureteral stones between the years 2015 and 2018 in eight centers were included. Patients were divided into two groups according to previous SWL history; group 1 consisted of patients without SWL before URS for the stone [SWL (-)] and group 2 consisted of patients with a previous SWL for the stone [SWL (+)]. Demographics, operation outcomes and stone characteristics were compared between these two groups. Regarding the complication and success rates, optimal timing for URS after SWL for the stone was calculated with receiver operator characteristics curve analysis.

RESULTS

Totally 638 patients were included (group 1: 466 patients and group 2: 172 patients). The operation and hospitalization times, rate of ureteral stenting and complications were significantly higher in group 2. Stone free status was similar between the groups. Optimal timing for URS after SWL was calculated as 16.5 days (AUC = 0.657, p = 0.012) with a sensitivity of 68% and specificity of 72%, regarding the complication rates. Complication rates were significantly higher in patients who were operated before 16.5 days (27.7% vs 6.5%, p < 0.001).

CONCLUSIONS

The optimal timing; 2-3 weeks delay of the URS procedure after unsuccessful SWL may decrease complication rates according to our results.

A monolithic fluid-structure interaction framework applied to red blood cells

A parallel fully coupled (monolithic) fluid-structure interaction (FSI) algorithm has been applied to the deformation of red blood cells (RBCs) in capillaries, where cell deformability has significant effects on blood rheology. In the present FSI algorithm, fluid domain is discretized using the side-centered unstructured finite volume method based on the Arbitrary Lagrangian-Eulerian (ALE) formulation; meanwhile, solid domain is discretized with the classical Galerkin finite element formulation for the Saint Venant-Kirchhoff material in a Lagrangian frame. In addition, the compatible kinematic boundary condition is enforced at the fluid-solid interface in order to conserve the mass of cytoplasmic fluid within the red cell at machine precision. In order to solve the resulting large-scale algebraic linear systems in a fully coupled manner, a new matrix factorization is introduced similar to that of the projection method, and the parallel algebraic multigrid solver BoomerAMG is used for the scaled discrete Laplacian provided by the HYPRE library, which we access through the PETSc library. Three important physical parameters for the blood flow are simulated and analyzed: (1) the effect of capillary diameter, (2) the effect of red cell membrane thickness, and (3) the effect of red cell spacing (hematocrit). The numerical calculations initially indicate a shape deformation in which biconcave discoid shape changes to a parachute-like shape. Furthermore, the parachute-like cell shape in small capillaries undergoes a cupcake-shaped buckling instability, which has not been observed in the literature. The instability forms thin riblike features, and the red cell deformation is not axisymmetric but three-dimensional.

The diagnostic value of the serum irisin level in patients with acute pericarditis and acute myopericarditis

OBJECTIVE

This preliminary study aims to examine a change in the blood levels of irisin in patients with acute pericarditis (AP) and acute myopericarditis (AMP) and examine the diagnostic value of the serum irisin level in AP and AMP.

METHODS

10 patients, who applied to the emergency service and cardiology clinic with chest pain and who were diagnosed with AP and 5 patients, who were diagnosed with AMP as a result of routine examinations, were included in the study. The basal laboratory parameters, echocardiography findings and serum irisin levels of the patients and during check one month later were examined.

RESULTS

While the basal irisin levels were found to be significantly low in the AMP group and high during the check (6.6 ± 1.58, 8.19 ± 1.43, respectively), no statistically significant difference was determined (p = 0.23). It was observed that the basal and control irisin levels did not vary significantly in the AP group (8.03 ± 1.6, 8.19 ± 1.43, respectively) (p = 0.84).

CONCLUSION

In this preliminary study, the basal irisin levels were found to be significantly low in the AMP group, while there was no statistically significant difference between the basal irisin levels and control irisin levels in the AP and AMP groups (Tab. 5, Ref. 17).

Effective Neural Photostimulation Using Indium-Based Type-II Quantum Dots

Light-induced stimulation of neurons via photoactive surfaces offers rich opportunities for the development of therapeutic methods and high-resolution retinal prosthetic devices. Quantum dots serve as an attractive building block for such surfaces, as they can be easily functionalized to match the biocompatibility and charge transport requirements of cell stimulation. Although indium-based colloidal quantum dots with type-I band alignment have attracted significant attention as a nontoxic alternative to cadmium-based ones, little attention has been paid to their photovoltaic potential as type-II heterostructures. Herein, we demonstrate type-II indium phosphide/zinc oxide core/shell quantum dots that are incorporated into a photoelectrode structure for neural photostimulation. This induces a hyperpolarizing bioelectrical current that triggers the firing of a single neural cell at 4 μW mm^-2, 26-fold lower than the ocular safety limit for continuous exposure to visible light. These findings show that nanomaterials can induce a biocompatible and effective biological junction and can introduce a route in the use of quantum dots in photoelectrode architectures for artificial retinal prostheses.

Recurrence quantification analysis of resting state EEG signals in autism spectrum disorder - a systematic methodological exploration of technical and demographic confounders in the search for biomarkers

BACKGROUND

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a worldwide prevalence of 1-2%. In low-resource environments, in particular, early identification and diagnosis is a significant challenge. Therefore, there is a great demand for 'language-free, culturally fair' low-cost screening tools for ASD that do not require highly trained professionals. Electroencephalography (EEG) has seen growing interest as an investigational tool for biomarker development in ASD and neurodevelopmental disorders. One of the key challenges is the identification of appropriate multivariate, next-generation analytical methodologies that can characterise the complex, nonlinear dynamics of neural networks in the brain, mindful of technical and demographic confounders that may influence biomarker findings. The aim of this study was to evaluate the robustness of recurrence quantification analysis (RQA) as a potential biomarker for ASD using a systematic methodological exploration of a range of potential technical and demographic confounders.

METHODS

RQA feature extraction was performed on continuous 5-second segments of resting state EEG (rsEEG) data and linear and nonlinear classifiers were tested. Data analysis progressed from a full sample of 16 ASD and 46 typically developing (TD) individuals (age 0-18 years, 4802 EEG segments), to a subsample of 16 ASD and 19 TD children (age 0-6 years, 1874 segments), to an age-matched sample of 7 ASD and 7 TD children (age 2-6 years, 666 segments) to prevent sample bias and to avoid misinterpretation of the classification results attributable to technical and demographic confounders. A clinical scenario of diagnosing an unseen subject was simulated using a leave-one-subject-out classification approach.

RESULTS

In the age-matched sample, leave-one-subject-out classification with a nonlinear support vector machine classifier showed 92.9% accuracy, 100% sensitivity and 85.7% specificity in differentiating ASD from TD. Age, sex, intellectual ability and the number of training and test segments per group were identified as possible demographic and technical confounders. Consistent repeatability, i.e. the correct identification of all segments per subject, was found to be a challenge.

CONCLUSIONS

RQA of rsEEG was an accurate classifier of ASD in an age-matched sample, suggesting the potential of this approach for global screening in ASD. However, this study also showed experimentally how a range of technical challenges and demographic confounders can skew results, and highlights the importance of probing for these in future studies. We recommend validation of this methodology in a large and well-matched sample of infants and children, preferably in a low- and middle-income setting.

Effect of the shell material and confinement type on the conversion efficiency of core/shell quantum dot nanocrystal solar cells

In this study, the effects of the shell material and confinement type on the conversion efficiency of core/shell quantum dot nanocrystal (QDNC) solar cells have been investigated in detail. For this purpose, the conventional, i.e. original, detailed balance model, developed by Shockley and Queisser to calculate an upper limit for the conversion efficiency of silicon p-n junction solar cells, is modified in a simple and effective way to calculate the conversion efficiency of core/shell QDNC solar cells. Since the existing model relies on the gap energy ([Formula: see text]) of the solar cell, it does not make an estimation about the effect of QDNC materials on the efficiency of the solar cells, and gives the same efficiency values for several QDNC solar cells with the same [Formula: see text]. The proposed modification, however, estimates a conversion efficiency in relation to the material properties and also the confinement type of the QDNCs. The results of the modified model show that, in contrast to the original one, the conversion efficiencies of different QDNC solar cells, even if they have the same [Formula: see text], become different depending upon the confinement type and shell material of the core/shell QDNCs, and this is crucial in the design and fabrication of the new generation solar cells to predict the confinement type and also appropriate QDNC materials for better efficiency.

Giant pubertal prolactinoma: Complete resolution following short term carbegoline treatment

Prolactinomas are the most common pituitary tumors but rarely seen in adolescent males. There is no indication for surgery both in micro- and macro-adenomas unless an urgent treatment is necessary. First line treatment is always medical with dopamine agonists. In this report, we presented a patient with pubertal arrest and giant prolactinoma that disappeared in a short time with cabergoline treatment.

Characterization of host proteins interacting with the lymphocytic choriomeningitis virus L protein

RNA-dependent RNA polymerases (RdRps) play a key role in the life cycle of RNA viruses and impact their immunobiology. The arenavirus lymphocytic choriomeningitis virus (LCMV) strain Clone 13 provides a benchmark model for studying chronic infection. A major genetic determinant for its ability to persist maps to a single amino acid exchange in the viral L protein, which exhibits RdRp activity, yet its functional consequences remain elusive. To unravel the L protein interactions with the host proteome, we engineered infectious L protein-tagged LCMV virions by reverse genetics. A subsequent mass-spectrometric analysis of L protein pulldowns from infected human cells revealed a comprehensive network of interacting host proteins. The obtained LCMV L protein interactome was bioinformatically integrated with known host protein interactors of RdRps from other RNA viruses, emphasizing interconnected modules of human proteins. Functional characterization of selected interactors highlighted proviral (DDX3X) as well as antiviral (NKRF, TRIM21) host factors. To corroborate these findings, we infected Trim21^-/- mice with LCMV and found impaired virus control in chronic infection. These results provide insights into the complex interactions of the arenavirus LCMV and other viral RdRps with the host proteome and contribute to a better molecular understanding of how chronic viruses interact with their host.

RNA-dependent RNA-polymerases (RdRps) play a key role in the life cycle of RNA viruses. They interact with cellular proteins during replication and transcription processes and impact the immunobiology of viral infections. This study characterized the host protein interactome of the RdRp-containing L protein of the prototypic arenavirus lymphocytic choriomeningitis virus (LCMV). Several L protein interactors with proviral and antiviral effects were identified in vitro, and mice lacking the identified L protein interactor TRIM21 exhibited impaired control of chronic LCMV infection. Integration of the L protein interactomes with known RdRp interactomes from other RNA viruses highlighted common and virus-specific strategies to interact with the host proteome, which may indicate novel avenues for antiviral interventions.

Effects of Vitamin D Therapy on Quality of Life in Patients with Fibromyalgia

OBJECTIVE

The role of vitamin D in the etiopathogenesis of fibromyalgia and non-specific musculoskeletal pain is controversial. In our study, we aimed to investigate the effect of vitamin D therapy on quality of life in patients with fibromyalgia.

MATERIALS AND METHODS

Seventy patients diagnosed with fibromyalgia and 65 age- and sex-matched controls were included in the study. Patients were grouped as deficient (<20 ng/mL), inadequate (20-30 ng/mL), and sufficient (>30 ng/mL) according to the levels of vitamin D. Vitamin D replacement was performed for patients with deficiencies and inadequacies. Before and after vitamin D therapy, patients filled in the assessment tools, fibromyalgia impact questionnaire (FIQ), Arizona sexual experience scale (ASEX), Beck depression inventory (BDI), visual analog scale (VAS), and short form-36 (SF-36).

RESULTS

Vitamin D deficiencies and inadequacies were observed in 60% of the patients (n=42). Among patients with low and normal levels of vitamin D, no statistically significant difference was observed in their values. In scales examined after vitamin D replacement therapy, statistically significant differences were observed in the FIQ, BDI, VAS, and SF-36 compared with pre-treatment.

CONCLUSION

Vitamin D deficiency seems to be linked to the pathogenesis of fibromyalgia. Vitamin D supplementation may improve the quality of life in patients with fibromyalgia.

Maintenance of the parturient in the left lateral position after spinal anesthesia with plain levobupivacaine for cesarean section reduces hypotension: a randomized study

PURPOSE OF INVESTIGATION

Hypotension during spinal anesthesia is a main concern in cesarean delivery. The authors hypothesized that keeping parturients in a prolonged left lateral position before turning them to a supine position with left lateral tilt would reduce the incidence of hypotension without jeopardizing the quality of anesthesia.

MATERIALS AND METHODS

Randomized comparative unblinded prospective study. This randomized comparative prospective study was conducted at Gaziantep University Hospital between June and December 2011. Sixty parturients undergoing cesarean section were included. Patients were randomized to two groups: turning to the supine position with left lateral tilt immediately or 15 minutes after subarachnoid injection of 2.5 ml 0.5% plain levobupivacaine in the left lateral position. Loss of pinprick sensation to T6 was accepted as adequate for cesarean section, and surgery proceeded. Characteristics of anesthesia; incidences of hypotension, bradycardia, and other adverse events, and ephedrine use were assessed.

RESULTS

Compared with the supine group, parturients kept in a lateral position for 15 minutes showed marked reductions in the incidence of hypotension (33.3% vs. 83.3%, p < 0.001) and adverse events related to hypotension, such as nausea and vomiting (16.7% vs. 57.3%, p <0.001). In addition, ephedrine consumption per hypotension case was significantly reduced in the lateral group (5.4 ± 4.7 vs. 8.9 ± 5.8 mg; p < 0.00 1).

CONCLUSIONS

Keeping parturients in the lateral position for 15 minutes before turning them to the supine position for cesarean section can provide reliable spinal anesthesia with a lower incidence and severity of hypotension and nausea/vomiting.

Clinical significance of ADAMTS1, ADAMTS5, ADAMTS9 aggrecanases and IL-17A, IL-23, IL-33 cytokines in polycystic ovary syndrome

PURPOSE

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. A disintegrin and metalloproteinase with thrombospondin-like motifs (ADAMTS) are involved in inflammation and fertility. The aim of this investigation was to evaluate the serum levels of ADAMTS1, ADAMTS5, ADAMTS9, IL-17, IL-23, IL-33 and to find out the relationship between these inflammatory cytokines and ADAMTSs in PCOS patients.

METHODS

A case-control study was performed in a training and research hospital. Eighty patients with PCOS and seventy-eight healthy female volunteers were recruited in the present study. Serum ADAMTS and IL levels were determined by a human enzyme-linked immunoassay (ELISA) in all subjects.

RESULTS

The IL-17A, IL-23 and IL-33 levels were significantly higher in the PCOS patients compared to the controls (p < 0.05). We could not find significant difference between the groups in terms of ADAMTS1, ADAMTS5 and ADAMTS9 levels. IL-17A had positive correlations with LDL cholesterol and IL-33 and negative correlations with ADAMTS1, ADAMTS5, and ADAMTS9. IL-33 had positive correlation with LDL cholesterol and IL-17A. In ROC curve analysis, PCOS can be predicted by the use of IL-17A, IL-23 and IL-33 which at a cut-off value of 8.37 pg/mL (44 % sensitivity, 83 % specificity), 26.75 pg/mL (36 % sensitivity, 64 % specificity) and 14.28 pg/mL (83 % sensitivity, 39 % specificity), respectively.

CONCLUSIONS

The results of the study might suggest that ADAMTS and IL molecules have a role in the pathogenesis of the PCOS. Further efforts are needed to establish causality for ADAMTS-IL axis.

Reversal of neurobehavioral social deficits in dystrophic mice using inhibitors of phosphodiesterases PDE5A and PDE9A

Duchenne muscular dystrophy is caused by mutations in the DYSTROPHIN gene. Although primarily associated with muscle wasting, a significant portion of patients (approximately 25%) are also diagnosed with autism spectrum disorder. We describe social behavioral deficits in dystrophin-deficient mice and present evidence of cerebellar deficits in cGMP production. We demonstrate therapeutic potential for selective inhibitors of the cGMP-specific PDE5A and PDE9A enzymes to restore social behaviors in dystrophin-deficient mice.

Thrombolytic treatment in a patient with antiphospholipid syndrome : APS developing renal infarction

Antiphospholipid syndrome (APS), a leading entity in acquired thrombophilia, is characterized by recurrent thrombosis, morbidity in pregnancy and presence of antiphospholipid antibodies (APA). Although the etiopathogenesis is unclear, APA against negatively charged phospholipids and phospholipid-protein complexes are held responsible for the clinical picture. In case of acute thrombosis due to APS, thrombolytic therapy is not a commonly administered treatment option. Here, we present a case with acute thrombosis in the left renal artery showing partial response to thrombolytic therapy.

Effects of lowered dialysate sodium on left ventricle function and brain natriuretic peptide in maintenance of hemodialysis patients

Introduction:

Impaired diastolic flow is characterized by decreased left ventricular (LV) filling diastole, abnormal LV distensibility, or delayed relaxation. B-Type natriuretic peptide (BNP) is an indicator of various cardiovascular diseases and body volume status. The aim of this study was to determine whether the lowering of dialysate sodium (Na) levels is effective on LV systolic and diastolic parameters and BNP in the maintenance of hemodialysis patients.

Materials and Methods:

The study included 49 chronic hemodialysis patients. Left atrium (LA) diameter and LV ejection fraction, LV systolic and diastolic diameter, deceleration time (DT), pulmonary artery pressure (PAP), inferior vena cava diameter (IVCD), early diastolic transmitral flow ( E) and late diastolic transmitral flow ( A) velocities, E/ A ratio, isovolumic relaxation time, peak early diastolic velocity ( E′), late diastolic velocity ( A′) of tissue Doppler mitral annulus, and flow propagation velocity of mitral inflow ( Vp) were measured before and 6 months after hemodialysis with low Na dialysate.

Results:

Six months after low Na hemodialysis, a decrease was observed in echocardiographic parameters such as PAP and IVCD ( p < 0.05, p < 0.001, and p < 0.001, respectively). However, a significant difference was not observed in LA diameter. In LV diastolic measurement of E and A waves, E/ A ratio, DT, Vp, septal E′ and A′, and lateral E′ and A′ exhibited significant improvement by low Na HD. BNP level was significantly reduced ( p < 0.001).

Conclusions:

Lowered dialysate Na concentration improves PAP, IVCD, and LV diastolic properties assessed by mitral inflow filling, tissue Doppler velocity, and mitral inflow velocity propagation.

Esophageal hypermotility: cause or effect?

Nutcracker esophagus (NE), Jackhammer esophagus (JHE), distal esophageal spasm (DES), and hypertensive lower esophageal sphincter (HTLES) are defined by esophageal manometric findings. Some patients with these esophageal motility disorders also have abnormal gastroesophageal reflux. It is unclear to what extent these patients' symptoms are caused by the motility disorder, the acid reflux, or both. The aim of this study was to determine the effectiveness of laparoscopic Nissen fundoplication (LNF) on esophageal motility disorders, gastroesophageal reflux, and patient symptoms. Between 2007 and 2013, we performed high-resolution esophageal manometry on 3400 patients, and 221 patients were found to have a spastic esophageal motility disorder. The medical records of these patients were reviewed to determine the manometric abnormality, presence of gastroesophageal symptoms, and amount of esophageal acid exposure. In those patients that underwent LNF, we compared pre- and postoperative esophageal motility, gastroesophageal symptom severity, and esophageal acid exposure. Of the 221 patients with spastic motility disorders, 77 had NE, 2 had JHE, 30 had DES, and 112 had HTLES. The most frequently reported primary and secondary symptoms among all patients were: heartburn and/or regurgitation, 69.2%; respiratory, 39.8%; dysphagia, 35.7%; and chest pain, 22.6%. Of the 221 patients, 192 underwent 24-hour pH monitoring, and 103 demonstrated abnormal distal esophageal acid exposure. Abnormal 24-hour pH monitoring was detected in 62% of patients with heartburn and regurgitation, 49% of patients with respiratory symptoms, 36.8 % of patients with dysphagia, and 32.6% of patients with chest pain. Sixty-six of the 103 patients with abnormal 24-hour pH monitoring underwent LNF. Thirty-eight (13NE, 2JHE, 6 DES, and 17 HTLES) of these 66 patients had a minimum of 6-month postoperative follow-up that included clinical evaluation, esophageal manometry, and 24-hour pH monitoring. Postoperatively, all 38 patients had normal distal esophageal acid exposure. Of these 38 patients, symptoms resolved in 28 and improved in 10. Of six patients (one with NE, two JHE, and three with HTLES) that underwent postoperative esophageal manometry, five exhibited normal motility. Typical reflux symptoms are common among patients with esophageal hypermotility disorders. Abnormal 24-hour pH monitoring is present in the majority of patients with who report typical reflux symptoms and almost half of patients who report respiratory symptoms. Conversely, the majority of patients who report dysphagia or chest pain have normal distal esophageal acid exposure. Based on a small number of patients in this study, it also appears that motility disorders often improve after LNF. LNF is associated with resolution or improvement in reflux related symptoms and esophageal motility parameters in patients exhibiting abnormal esophageal acid exposure. This suggests that patient symptoms are due to abnormal acid exposure and not the motility disorder.