Time Factors

The feasibility of use and long-term outcomes of vaginal pessaries for the management of pelvic organ prolapse (POP) in older women remains unknown. Our aim was to determine successful fit rates and outcomes among older women seeking care for POP. This was a retrospective cohort study of 304 consecutive women aged 65 years and older with symptomatic POP undergoing a pessary trial at the outpatient urogynecology clinic in Québec, Canada. Women successfully fitted with a pessary were followed, and survival curves were used to ascertain the median time to pessary discontinuation for women aged 65 to 74 years in comparison with women aged 75 years and older. Long-term use was defined as longer than 1 year. Predictors of a successful fitting and long-term discontinuation were ascertained using logistic and Cox regression analyses. Half of the women attempting a pessary trial were aged 75 years and older, and 63 % were fitted successfully regardless of age. Women with a history of hystere...

Study Type – Therapy (outcomes research)
Level of Evidence 2cOBJECTIVETo present a prospective long‐term evaluation of the bone‐anchored male sling (InVanceTM, American Medical Systems, Minnetonka, MN, USA) for patients with moderate to severe stress urinary incontinence (SUI) after prostate surgeryPATIENTS AND METHODSForty‐five patients had a male sling implanted for SUI after prostate surgery. The evaluation before and after surgery included a complete history and physical examination, various questionnaires (American Urological Association Symptom Score, University of California Los Angeles/RAND prostate index), cysto‐urethroscopy, International Continence Society (ICS) 1‐h pad test and a urodynamic study. The follow‐up assessments were at 2, 6 and 12 months after surgery, and yearly thereafter. The success rate was defined as the percentage of patients ‘dry’ and ‘improved’.RESULTSThe median (range) follow‐up was 36 (2–64) months. Twelve patients (27%) had previous adjuvant radio...

The risks and benefits of initiating antiretroviral treatment (ART) at high CD4 cell counts have not been reliably quantified. The Strategic Timing of AntiRetroviral Treatment (START) study is a randomized international clinical trial that compares immediate with deferred initiation of ART for HIV-positive individuals with CD4 cell counts above 500 cells/μL. We describe the demographics, HIV-specific characteristics and medical history of this cohort. Data collected at baseline include demographics, HIV-specific laboratory values, prior medical diagnoses and concomitant medications. Baseline characteristics were compared by geographical region, gender and age. START enrolled 4685 HIV-positive participants from 215 sites in 35 countries. The median age is 36 years [interquartile range (IQR) 29-44 years], 27% are female, and 45% self-identify as white, 30% as black, 14% as Latino/Hispanic, 8% as Asian and 3% as other. The route of HIV acquisition is reported as men who have sex with m...

Left ventricular (LV) and right ventricular pacing site characteristics have been shown to influence response to cardiac resynchronization therapy (CRT). This study aimed to determine the clinical feasibility of image-guided lead delivery using a 3-dimensional navigational model displaying both LV and right ventricular (RV) pacing targets. Serial echocardiographic measures of clinical response and procedural metrics were evaluated. Thirty-one consecutive patients underwent preimplant cardiac MRI with the generation of a 3-dimensional navigational model depicting optimal segmental targets for LV and RV leads. Lead delivery was guided by the model in matched views to intraprocedural fluoroscopy. Blinded assessment of final lead tip location was performed from postprocedural cardiac computed tomography. Clinical and LV remodeling response criteria were assessed at baseline, 3 months, and 6 months using a 6-minute hall walk, quality of life questionnaire, and echocardiography. Mean age ...

Thirty-one cases of acute posterior fossa infarcts are reported . CT evidence of obliterated posterior fossa cisterns and hydrocephalus indicates a grave prognosis due to brainstem compression . Progressive obliteration of posterior fossa cisterns may be used as an indicator f or surgical decompression. Patients with intact posterior fossa cisterns had good recoveries without surgical treatment. CT can be used to diagnose the very early phase of an acute posterior fossa infarct and has prognostic value in predicting the outcome. Acute infarcts involving the pons, medulla oblongata , and ce rebellum are assoc iated with high mortali ty . Early diagnosis is esse ntial [1-4 ], but has been difficult unti l the introduc tion of computed tomography (CT) . We reviewed literature on 'this entity [1-25] and carefully analyzed 3 1 cases seen ove r the past 3 years . CT plays an important role in the diagnostic and prog nosti c impli cati ons of acute posterior fossa infarcts.

Otoacoustic emissions (sound emitted from the ear) allow cochlear function to be probed noninvasively. The emissions evoked by pure tones, known as stimulus-frequency emissions (SFOAEs), have been shown to provide reliable estimates of peripheral frequency tuning in a variety of mammalian and non-mammalian species. Here, we apply the same methodology to explore peripheral auditory function in the largest member of the cat family, the tiger (Panthera tigris). We measured SFOAEs in 9 unique ears of 5 anesthetized tigers. The tigers, housed at the Henry Doorly Zoo (Omaha, NE), were of both sexes and ranged in age from 3 to 10 years. SFOAE phase-gradient delays are significantly longer in tigers-by approximately a factor of two above 2 kHz and even more at lower frequencies-than in domestic cats (Felis catus), a species commonly used in auditory studies. Based on correlations between tuning and delay established in other species, our results imply that cochlear tuning in the tiger is significantly sharper than in domestic cat and appears comparable to that of humans. Furthermore, the SFOAE data indicate that tigers have a larger tonotopic mapping constant (mm/octave) than domestic cats. A larger mapping constant in tiger is consistent both with auditory brainstem response thresholds (that suggest a lower upper frequency limit of hearing for the tiger than domestic cat) and with measurements of basilar-membrane length (about 1.5 times longer in the tiger than domestic cat).

This paper investigates the extent of tiger (Panthera tigris) vocal individuality through both qualitative and quantitative approaches using long distance roars from six individual tigers at Omaha's Henry Doorly Zoo in Omaha, NE. The framework for comparison across individuals includes statistical and discriminant function analysis across whole vocalization measures and statistical pattern classification using a hidden Markov model (HMM) with frame-based spectral features comprised of Greenwood frequency cepstral coefficients. Individual discrimination accuracy is evaluated as a function of spectral model complexity, represented by the number of mixtures in the underlying Gaussian mixture model (GMM), and temporal model complexity, represented by the number of sequential states in the HMM. Results indicate that the temporal pattern of the vocalization is the most significant factor in accurate discrimination. Overall baseline discrimination accuracy for this data set is about 70...

1. Inward currents through single K+ channels in isolated ventricular heart cells of the guinea-pig were recorded using the patch-clamp techhi-que(Hamill, Marty, Neher, Sakmann & Sigworth, 1981). The voltage-dependent gating properties of the channels were examined in the potential range between 0 and -120 mV with 145 mM-KCl on the extracellular side of the membrane patch, i.e. with approximately symmetrical transmembrane K+ concentrations. 2. When voltage pulses from 0 mV to negative test potentials were applied to patches containing several channels, more channels were open at the beginning of the pulses than in the steady state. Averages of many current responses showed inactivation of the mean current in response to the hyperpolarizing voltage pulses. The inactivation was stronger and faster at larger hyperpolarization. 3. The lifetimes of the open and closed states of the channel and the probability of the open state p were estimated from records of the elementary currents at various constant potentials. As indicated by the inactivation of the averaged currents, the value of p was smaller at more negative potentials, approximately 0 15 at -50 mV and 0-02 at -110 mV. This caused a negative slope in the current-voltage relation of the time-averaged current at potentials more negative than -50 mV. 4. The channel openings were grouped in complex bursts. At least three exponentials were needed to fit the frequency histogram of the lifetimes of all closed states (time constants at -50 mV: 1-1 ms, 16 ms and 3-2 s). The lifetimes of the individual openings were exponentially distributed (time constant: 70 ms). 5. The kinetics of the channel were interpreted by two different models involving three states of a channel (closed-closed-open or closed-open-closed). The rate constants and their voltage dependence were estimated for both models. Both models describe the data equally well; the reason for this ambiguity is discussed. 6. The channels are blocked by Cs+ or Ba2+. Cs+ (0.1 mM) caused frequent and short interruptions of the individual channel openings. Ba2+ (0-5 mM) also shortened the openings and in addition decreased the number of openings per burst. t To whom correspondence should be addressed. Same address as B. S. (*) after December 31, 1983. B. SAKMANN AND G. TRUBE 7. The results suggest that the inward-rectifying current IKI in heart ventricular cells is partially inactivated by hyperpolarization. The inactivation could account for part of the time-dependent decrease in the whole-cell current previously ascribed to depletion of K+.

Introduction: Living donor liver transplantation (LDLT) is an alternative to conventional transplantation given its excellent results. The aim of this study is to evaluate long-term outcomes in LDLT recipients. Methods: 100 consecutive THDV recipients from the Hospital Clı ´nic of Barcelona from March 2000 to October 2015 were included. The main indication for transplantation was end-stage liver disease (58%) followed by hepatocellular carcinoma (41%). 95% of grafts consisted of the right liver of the donor and the 5% of the left liver. Results: After a median follow-up of 65.5 months, patient and graft survival at 1, 3, and 5 years was 93%, 80% and 74% and 90%, 76%, and 71%, respectively. The overall re-transplant rate was 9%. The most common long-term complication was biliary stenosis (40%) with an average time of onset of 13.5 AE 12 months, with repeated admissions and an average of 1.9 AE 2 endoscopic procedures and 3.5 AE 3 Radiological procedures per patient. The definitive treatment was radiological dilation in 40% of cases, surgical intervention in 22.5% and re-transplantation in 7.5%. Conclusions: Given the long-term results, LDLT is confirmed as an alternative to conventional transplantation. However, the high rate of late biliary complications involves repeated admissions and invasive treatments that, while not compromising survival, can affect the patient's quality of life.

que el treball titulat "Las complicaciones biliares en el trasplante hepático de donante vivo no afectan a los resultados a largo plazo" ha estat realitzat sota la meva direcció pel llicenciat Santiago Sánchez Cabús, trobant-se en condicions de poder ser presentat com a treball d'investigació de 12 crèdits, dins el programa de doctorat en Cirurgia (curs 2010-2011), a la convocatòria de juny.

Objectives. Our goal was to study a consecutive series of 1000 liver transplants performed in our institution to evaluate the changes over time in donors, recipients, and results. Patients and Methods. With the aim to evaluate differences between transplantation in the first period and the present period, the first consecutive 100 liver transplants performed from June 1988 to June 1990 (first period) were compared with the last consecutive 200 liver transplants performed from January 2001 to June 2003 (second period). Results. Increased donor age, change in donor cerebral death etiology, and increasing numbers of grafts from alternative methods using cadaveric donors were observed in the second period. Piggy-back technique and the biliary anastomosis without a t-tube was also started in the second period. One-year actuarial patient survival was higher in the second period (84% vs 91.3%). The need for retransplantation in the overall series was 95%. One-, 5-, and 10-year actuarial retransplant survival was 67.7%, 51.3%, and 39.4%, respectively. Conclusions. Technical innovations, better understanding of donor and recipient aspects, and global improvements were the reasons for time-related improved results of liver transplantation.

Background. Adult living-donor liver transplantation recipients undergo important hemodynamic changes during the procedure, which in turn have proven to be of the upmost importance when dealing with small grafts, to avoid the so-called ''small-for-size'' syndrome. Methods. Back in 2003, we started a hemodynamic monitoring protocol in adult living-donor liver transplantation recipients, which evaluated the hemodynamic status of the patient 24 hr before, during, and 3 days after transplantation. We analyzed the correlation between the same hemodynamic variables measured in the hemodynamic laboratory and those taken in the operating room. Results. With the exception of cardiac index and indexed systemic vascular resistance, all the other hepatic and systemic hemodynamic parameters measured before and during the intervention, as well as during and after the intervention, showed a lack of correlation. Conclusion. The observed lack of correlation may happen due to many factors, such as the influence of vasoactive and anesthetic drugs, total muscular relaxation, or the presence of an open abdomen. As a result, a direct comparison between hemodynamic values should only be done when measured in the same conditions.

Living donor liver transplantation (LDLT) is an alternative to conventional transplantation given its excellent results. The aim of this study is to evaluate long-term outcomes in LDLT recipients. 100 consecutive THDV recipients from the Hospital Clínic of Barcelona from March 2000 to October 2015 were included. The main indication for transplantation was end-stage liver disease (58%) followed by hepatocellular carcinoma (41%). 95% of grafts consisted of the right liver of the donor and the 5% of the left liver. After a median follow-up of 65.5 months, patient and graft survival at 1, 3, and 5 years was 93%, 80% and 74% and 90%, 76%, and 71%, respectively. The overall re-transplant rate was 9%. The most common long-term complication was biliary stenosis (40%) with an average time of onset of 13.5±12 months, with repeated admissions and an average of 1.9±2 endoscopic procedures and 3.5±3 Radiological procedures per patient. The definitive treatment was radiological dilation in 40% of...

The messenger-RNA (mRNA) expression of selected cytokines and chemokines in primary chicken oviduct epithelial cells (COEC) was determined following in vitro infections with wild-type or type three secretion system (T3SS)-mutant Salmonella enterica serovar Enteritidis (SE) strains. All SE strains examined in this study elicited the expression of proinflammatory immune mediators including inducible nitric oxide synthase (iNOS), CXCLi1 (K60), CXCLi2 (IL-8), CCLi3 (K203), and CCLi4 (MIP-1b). SE also triggered the expression of an anti-inflammatory cytokine, IL-10, but repressed TGF-b3 transcription. Both T3SS-1 (sipA and sipB) and T3SS-2 ( pipB and ssaV ) mutants showed reduced capacity, compared to the wild-type SE, to stimulate iNOS mRNA expression in COEC. T3SS-1 (sipA and sipB) mutants were significantly impaired in their ability to induce the expression of CXCLi1 and CXCLi2. T3SS-2 mutants displayed a wild-type phenotype in terms of modulating the expression of chemokines and cytokines in COEC. The expression of iNOS, but not CXC chemokines, correlated with the number of intracellular bacteria in COEC. Genetic complementation of the sipA mutation restored a wild-type phenotype. Thus, SE induction of CXCLi1 and CXCLi2 was sipA-dependent. These results provide enhanced insights into the complex interplay between local host innate immune system and bacterial virulence factors. RESUMEN. Induccio ´n de la expresio ´n del ARN mensajero de la quimioquina CXC en ce ´lulas epiteliales de oviducto de pollo por Salmonellla enterica Serovar Enteritidis a trave ´s del sistema de secrecio ´n tipo III-1. La expresio ´n de ARN mensajero de citoquinas y qumioquinas selectas fue determinada en cultivos primarios de ce ´lulas epiteliales de oviducto despue ´s de la infeccio ´n in vitro con cepas silvestres y cepas mutantes del sistema de secrecio ´n tipo III (con las siglas en ingle ´s T3SS) de Salmonella enterica serovar Enteritidis (SE). Todas las cepas de SE examinadas en este estudio estimularon la produccio ´n de mediadores inmunes proinflamatorios incluyendo a la enzima o ´xido nitrico sintetasa inducible (con las siglas en ingle ´s iNOS), CXCLi1 (K60), CXCLi2 (IL-8), CCLi3 (K203) y CCLi4 (MIP-1b). Tambie ´n, la SE estimulo ´la expresio ´n de la citoquina antiinflamatoria IL-10, pero reprimio ´la transcripcio ´n de TGF-b3. Ambas bacterias mutantes, T3SS-1 (con genes sipA y sipB) y T3SS-2 (con genes pipB y ssaV ) mostraron una capacidad reducida en comparacio ´n con la cepa silvestre de SE para estimular la expresio ´n de ARN mensajero de la enzima iNOS en las ce ´lulas epiteliales de oviducto de pollo. Las bacterias mutantes T3SS-1 (sipA y sipB) mostraron una capacidad disminuida para inducir la expresio ´n de CXCLi1 y CXCLi2. Los mutantes T3SS-2 mostraron un fenotipo similar al silvestre en te ´rminos de la modulacio ´n de la expresio ´n de quimioquinas y citoquinas en las ce ´lulas epiteliales de oviducto de pollo. So ´lo la expresio ´n de la iNOS y no de otras quimioquinas CXC, estuvo correlacionada con el nu ´mero de bacterias intracelulares en las ce ´lulas epiteliales de oviducto de pollo. La complementacio ´n gene ´tica de la mutacio ´n sipA re-establecio ´el fenotipo silvestre. De esta manera, la induccio ´n por SE de CXCLi1 y CXCLi2 fue dependiente del gen sipA. Estos resultados proporcionan una mayor informacio ´n acerca de las relaciones complejas entre el sistema inmune innato del hospedador y los factores de virulencia bacterianos.

SUMMARYIn contrast to terrestrial animals that function under hypoxic conditions but display the typical exercise response of increasing ventilation and cardiac output, marine mammals exercise under a different form of hypoxic stress. They function for the duration of a dive under progressive asphyxia,which is the combination of increasing hypoxia, hypercapnia and acidosis. Our previous studies on short-duration, shallow divers found marked adaptations in their skeletal muscles, which culminated in enhanced aerobic capacities that are similar to those of atheltic terrestrial mammals. The purpose of the present study was to assess the aerobic capacity of skeletal muscles from long-duration divers. Swimming and non-swimming muscles were collected from adult Weddell seals, Leptonychotes weddelli, and processed for morphometric analysis, enzymology, myoglobin concentrations and fiber-type distribution. The results showed that the skeletal muscles of Weddell seals do not have enhanced ae...

T-cell responses to heat shock proteins (Hsp) have been suggested to play a role not only in inflammatory conditions, but also in various human autoimmune diseases and in the allograft response. Previous data from our group suggested that during the early posttransplantation (post-Tx) period (Ͻ6 months post-Tx), the anti-Hsp60 T-cell repertoires in renal transplant recipients were predominantly proinflammatory. In the later period, they were predominantly regulatory. In agreement with our results, diversification of the T-cell responses toward the carboxy-terminal determinants of Hsp60, related to the resolution of the inflammatory process, was shown in an experimental model of adjuvant arthritis. It has not been clarified whether this diversification is also present in transplantation. In this context, our objective was to analyze cytokine production against autologous Hsp60 peptides from different regions of the protein, using peripheral blood mononuclear cells of 9 renal transplant recipients at 2 timepoints after transplantation: early (Ͻ6 months) and late (Ͼ1 year). IFN␥ production induced by Hsp60 peptides was observed in 71% and 75% of the patients in the early and late post-Tx periods, respectively. Interleukin (IL)-10 production induced by Hsp60 peptides was observed in 28% of the patients in the early period and in 62% in the late period. Interestingly, the production of IL-10 was induced mainly by peptides of the intermediate and the C-terminal regions. This suggests a predominance of autoreactive regulatory anti-Hsp T-cell repertoire in the late post-Tx period, which predominantly recognize peptides from the intermediate and C-terminal regions of the protein.

Aim: This study was an attempt at investigating the variation in growth and morphology of primary avian chondrocyte and neural cell cultures established under standard laboratory conditions. Methods: For establishing chondrocyte cultures, the tibia were dissected from chick embryos that were 12 (E12), 14 (E14) and 15 (E15) days old. For the neural cell culture initiation, the two lobes of the forebrain were dissected from chick embryos that were 4 (E4), 8 (E8) and 12 (E12) days old. The final characterization of the cells was performed by H&E and CFV staining. Results: In the chondrocyte cultures, two forms of morphology were observed which is reversible in process.The primary variation evaluated in chondrocytes cultures was the effect of the media on the state of the cells. Based on whether the cells were cultured in DMEM or MEM, there was a difference in the transformation of the attached cells from the differentiated to de-differentiated forms. The primary variation examined in neuron cultures was the embryonic age of the tissue and the effect that it had on the proliferation and neurite formation of the cells. E8 embryo neural cells cultures result in well-developed cells with neurite formation along with axonal and dendritic outgrowths with highly complex interconnections between them. Conclusion: Ultimately, this study demonstrated the composition of culture media had an effect on the morphological appearance of the chondrocytes, as well as, confirmed that the culture of primary neurons is best performed using cells from an E8 embryo.

BackgroundAnastomotic leaks (AL) are among the most serious complications due to the substantial impact on the quality of life and mortality. Inspite of the advance in diagnostic tools such as laboratory tests and radiological adjuncts, only moderate improvement has been recorded in the rate of detected leaks. The purpose of the research was to assess the perioperative risk factors for AL.MethodsThis study was achieved at MUH and MIH/Egypt within the period between January 2016 and January 2019 for the candidates who underwent bowel anastomosis for small intestinal (except duodenal one) and colorectal pathology. The collected data were analyzed using SPSS of V-26.ResultsThis study included 315 cases, among them, 27 cases (8.57%) developed AL. The percentage of covering stoma was significantly higher in the non-leakage group vs leakage one (24.3% vs 11.1% respectively). lower albumin, operative timing, perforation, and covering stoma were shown as significant risk factors for leakage...

Background: Early and accurate diagnosis of acute myocardial infarction (AMI) remains a clinical challenge. This study evaluates the diagnostic performance of a newly developed highsensitivity cardiac troponin I (hs-cTnI) assay compared to current gold-standard methods in emergency department (ED) patients presenting with chest pain. Methods: A total of 1,250 patients presenting with suspected AMI across three medical centers were prospectively enrolled. Blood samples were collected at 0, 1, and 3 hours after admission and analyzed using both the novel hs-cTnI assay and the standard commercial assay. Clinical outcomes were assessed at 30-day follow-up. Sensitivity, specificity, and time-to-diagnosis were primary endpoints. Results: The novel hs-cTnI assay demonstrated superior sensitivity (98.7%) and negative predictive value (NPV: 99.2%) at 1 hour compared to the standard assay (sensitivity: 92.3%, NPV: 96.1%). The mean time-to-diagnosis was reduced by 45 minutes in the novel assay group. No statistically significant increase in false positives was observed. The assay also showed excellent analytical precision (CV < 5% at the 99th percentile). Conclusion: The novel hs-cTnI assay provides rapid and highly accurate identification of AMI in ED settings, with potential to improve clinical outcomes and reduce unnecessary admissions. Further validation in diverse populations is recommended.

The Venus Flytrap D (Dionaea muscipula) digital twin simulates a 20-year lifespan in a North Carolina wetland environment, capturing subatomic resolution (∼ 10^11 atoms, ∼ 10^8 cells, ∼ 0.1 kg). Built from Arabidopsis thaliana D with ∼ 5% genetic divergence, it models trap closure (0.1 s, 90% success), photosynthesis (0.5 µmol CO2 /s/m 2), and chemical signaling (e.g., jasmonic acid, 0.2 nM). The simulation, completed in 15 minutes on 100 GPUs (1 PFLOP), reveals predation-driven responsiveness (95% accuracy) and environmental adaptation (70% trap functionality under drought).

Background: The discovery of a novel photoreceptor in the retinal ganglion cells with a highest sensitivity of 470-490 nm blue light has led to research on the effects of short-wavelength light in humans. Several studies have explored the efficacy of monochromatic blue or blue-enriched light in the treatment of SAD. In this study, a comparison has been made between the effects of broad-wavelength light without ultraviolet (UV) wavelengths compared to narrow-band blue light in the treatment of sub-syndromal seasonal affective disorder (Sub-SAD). Method: In a 15-day design, 48 participants suffering from Sub-SAD completed 20-minute sessions of light treatment on five consecutive days. 22 participants were given bright white-light treatment (BLT, broad-wavelength light without UV 10 000 lux, irradiance 31.7 Watt/m 2 ) and 26 participants received narrow-band blue light (BLUE, 100 lux, irradiance 1.0 Watt/m 2 ). All participants completed daily and weekly questionnaires concerning mood, activation, sleep quality, sleepiness and energy. Also, mood and energy levels were assessed by means of the SIGH-SAD, the primary outcome measure. Results: On day 15, SIGH-SAD ratings were significantly lower than on day 1 (BLT 54.8 %, effect size 1.7 and BLUE 50.7 %, effect size 1.9). No statistically significant differences were found on the main outcome measures. Light treatment is an effective treatment for Sub-SAD. The use of narrow-band blue-light treatment is equally effective as bright white-light treatment. Trial registration: This study was registered in the Dutch Trial Register (Nederlands Trial Register TC = 4342) (20-12-2013).

A versatile tracking task has been developed to assess the competence of feline subjects in using sensory information to initiate and guide limb movement. In the present study we investigated the response latency and the factors which affect it in order to define temporal constraints on the underlying processing of information. The paradigm makes use of an electromechanical display of the difference between the output of transducers in a manipulandum (controlled by the cat) and a target level (controlled by the experimenter). Because of inertia and friction, a step change in target level required 230 msec to fully shift the display. The animals were trained to match the position of the manipulandum (or the force they applied to it isometrically) to the target level for a food reward. Target perturbations elicited rapid position or force adjustments of appropriate direction and magnitude at short latency. Under isometric conditions, the latency of the response was an inverse function of the extent of display motion and of the peak rate of force change attained during the adjustment. Asymptotic values of the response time, measured from the perturbation to the first change in force applied to the lever, were typically between 50 and 70 msec. Since the motor responses were invariably initiated while the display was still moving, the animals must have used information contained in the derivatives of its motion. In the absence of visual cues, deflection of the vibrissae by the sudden motion of the dispaly provided two of the four animals with sufficient information to initiate and guide their movements without changes in response latency. When vision was allowed, section of the vibrissae produced a persistent increase in response times of 15-20 msec. This difference in latency is compatible with the delays due to retinal transmission. The short time interval elapsing between stimulus and response strongly suggests that the topography and the metrics of the underlying transformations are adjusted by gating and/or biasing processes which precede the stimulus. It is concluded that sensory information can generate purposeful movements through pathways which include only a small number of central relays in series, independently of its modality.

The type strains of Clostridium estertheticum subsp. laramiense and C. estertheticum subsp. estertheticum both utilized glucose and glycogen when growing in meat juice medium and fermented lactate, but ceased growth when glucose was exhausted. The fermentation products from glucose were butyrate, acetate, and formate; those from lactate were 1-butanol, ethanol, butyrate, and formate. Both organisms utilized several amino acids (not containing sulfur) during their cultivation in meat juice medium and did not produce H2S. The optimum and maximum temperatures for growth of C. estertheticum subsp. laramiense were 10°C, and 20 to 22°C, respectively. Those same optimum and maximum temperatures have previously been determined for C. estertheticum subsp. estertheticum. The pH range for growth of the two organisms, 5.5 to 7.5, was also the same. Both organisms were beta-hemolytic and formed subterminal spores. Thus, the organisms did not display the difference in fermentation products, optim...

.-For two months, the fruit production of Didymopanax pachycarpum trees was studied in a remanescent woodlot of subtropical and mesophytic secondary forest at Sáo Paulo State, Brazil. Ten species of birds were observed feeding on the unripe fruits. It is suggested that the potential seed dispersers could act as seed predators of these tree species under food scarcity conditions.

We examined control of the hand's trajectory (direction and shape) and final equilibrium position in horizontal planar arm movements by quantifying transfer of learned visuomotor rotations between two tasks that required aiming the hand to the same spatial targets. In a trajectory-reversal task ("slicing"), the hand reversed direction within the target and returned to the origin. In a positioning task ("reaching"), subjects moved the hand to the target and held it there; cursor feedback was provided only after movement ended to isolate learning of final position from trajectory direction. We asked whether learning acquired in one task would transfer to the other. Transfer would suggest that the hand's entire trajectory, including its endpoint, was controlled using a common spatial plan. Instead we found minimal transfer, suggesting that the brain used different representations of target position to specify the hand's initial trajectory and its final stabilized position. We also observed asymmetrical practice effects on hand trajectory, including systematic curvature of reaches made after rotation training and hypermetria of untrained slice reversals after reach training. These are difficult to explain with a unified control model, but were replicated in computer simulations that specified the hand's initial trajectory and its final equilibrium position. Our results suggest that the brain uses different mechanisms to plan the hand's initial trajectory and final position in point-to-point movements, that it implements these control actions sequentially, and that trajectory planning does not account for specific impedance values to be implemented about the final stabilized posture.

The period of hypoxia is an important priming event for the vascular dysfunction that accompanies reperfusion, with endothelial cells (ECs) and neutrophils (PMNs) playing a central role. We hypothesized that EC Weibel-Palade (WP) body exocytosis during the hypoxic/ischemic period during organ preservation permits brisk PMN recruitment into postischemic tissue, a process further amplified in an oxidant-rich milieu. Exposure of human umbilical vein ECs to a hypoxic environment (pO 2 ഠ 20 torr) stimulated release of von Willebrand factor (vWF), stored in EC WP bodies, as well as increased expression of the WP body-derived PMN adhesion molecule P-selectin at the EC surface. Increased binding of 111 In-labeled PMNs to hypoxic EC monolayers (compared with normoxic controls) was blocked with a blocking antibody to P-selectin, but was not affected by a nonblocking control antibody. Although increased P-selectin expression and vWF release were also noted during reoxygenation, hypoxia alone (even in the presence of antioxidants) was sufficient to increase WP body exocytosis. To determine the relevance of these observations to hypothermic cardiac preservation, during which the pO 2 within the cardiac vasculature declines to similarly low levels, experiments were performed in a rodent (rat and mouse) cardiac preservation/transplantation model. Immunodepletion of recipient PMNs or administration of a blocking anti-Pselectin antibody before transplantation resulted in reduced graft neutrophil infiltration and improved graft survival, compared with identically preserved hearts transplanted into control recipients. To establish the important role of endothelial P-selectin expression on the donor vasculature, murine cardiac transplants were performed using homozygous P-selectin deficient and wild-type control donor hearts flushed free of blood/platelets before preservation/transplantation. P-selectin-null hearts transplanted into wildtype recipients demonstrated a marked (13-fold) reduction in graft neutrophil infiltration and increased graft survival compared with wild-type hearts transplanted into wild-type recipients. To determine whether coronary endothelial WP exocytosis may occur during cardiac preservation in humans, the release of vWF into the coronary sinus (CS) was measured in 32 patients during open heart surgery. CS samples obtained at the start and conclusion of the ischemic period demonstrated an increase in CS vWF antigen (by ELISA) consisting of predominantly high molecular weight multimers (by immunoelectrophoresis). These data suggest that EC WP exocytosis occurs during hypothermic cardiac preservation, priming the vasculature to recruit PMNs rapidly during reperfusion. (

Implantation is a complex sequence of processes between the embryo and endometrium. The surface of embryo and endometrium undergoes a series of changes within a short time, which is considered as “implantation window”. During this time, the endometrium has high ...

Brucellosis is a ubiquitous zoonosis particularly affecting the Mediterranean countries and the Middle East. Its clinical presentation is quite heterogeneous and diagnosis requires a high index of suspicion in patients from endemic areas. The radiological abnormalities of neurobrucellosis are also variable and may mimic other inflammatory, infectious or vascular diseases. We present two cases of neurobrucellosis with varying clinical involvement from south of Morocco. The results of lumbar puncture, magnetic resonance imaging and especially serology have led to the conclusion of neurobrucellosis. Neurobrucellosis is a serious disease whose prognosis depends on the early diagnosis and treatment.

Background: to compare the effect of intracytoplasmic sperm injection (ICSI) and conventional fertilization (IVF) on the development of embryos derived from modified natural cycles, in order to find the most effective fertilization method. Methods: Seventy-two embryos were evaluated, of which 43 resulted from intracytoplasmic sperm injection (ICSI) and 29 from conventional fertilization (IVF). The evaluation was performed according to the KIDScore Day 5 algorithm, but also according to the Gardner and Schoolcraft evaluation system. The quality of each embryo was evaluated and categorized according to their quality on the 5th day of their development, the presence of multiple nuclei at the 2 and 4 cell stage (MN2, MN4 respectively), the direct cleavage of blastomeres (DC) and the reverse cleavage of blastomeres (RC). Additionally the time points of each cellular event was recorded. Results: the fertilization method is independent of the qualitative classification of embryos, the appearance of multiple nuclei, the direct cleavage and the reverse cleavage of blastomeres. The time points of cellular events were similar between the two fertilization methods. Conclusions: No significant difference was observed in the development of ICSI and IVF derived embryos from modified natural cycles. Therefore, neither of the two fertilization methods is considered more appropriate for the embryonic development in modified natural cycles. It is suggested to evaluate both the medical history and the gametes quality of the couple in order to choose the appropriate fertilization method. It is also recommended to use both methods of embryos evaluation in combination.

Osseointegrated implants are widely used in dental rehabilitation. They are particularly valuable if the structures supporting a denture had to be removed because of oral cancer. Additionally, many of these patients undergo radiotherapy, but cancer and radiotherapy are seen as relative contraindications for implant therapy. In the literature, there are few clinical studies documenting successful oral rehabilitation using implants in such patients. The authors report a clinical case in which histologic evidence of osseointegration can be demonstrated in an irradiated and reconstructed mandible. This observation should encourage the extended application of implants in rehabilitation following oral cancer surgery.

Background Except for early T1,2 N0 stages, the prognosis for patients with oral cavity cancer (OCC) is reported to be worse than for carcinoma in other sites of the head and neck (HNC). The aim of this work was to assess disease outcome in OCC following IMRT. Between January 2002 and January 2007, 346 HNC patients have been treated with curative intensity modulated radiation therapy (IMRT) at the Department of Radiation Oncology, University Hospital Zurich. Fifty eight of these (16%) were referred for postoperative (28) or definitive (30) radiation therapy of OCC. 40 of the 58 OCC patients (69%) presented with locally advanced T3/4 or recurred lesions. Doses between 60 and 70 Gy were applied, combined with simultaneous cisplatin based chemotherapy in 78%. Outcome analyses were performed using Kaplan Meier curves. In addition, comparisons were performed between this IMRT OCC cohort and historic in-house cohorts of 33 conventionally irradiated (3DCRT) and 30 surgery only patients tre...

OBJECTIVES: Although there are many reports about risk factors for the development of BP-associated osteonecrosis of the jaws, the role of dental implants as a local risk factor is still discussed, especially in patients with oral BP treatment. Until now, a few case reports and surveys display a possible minor risk in patients with oral BP therapy, whereas the avoidance of implant placement is generally accepted in patients with intravenous BP therapy. PATIENT AND METHODS: In this study, the cases of 14 patients with osteonecrosis of the jaws in association with BP therapy and dental implant placement were analyzed carefully with a detailed literature review. RESULTS: Of 14 patients, nine had underlying malignant disease and five patients had osteoporosis. In ten patients, implants were placed either in the posterior mandible or maxilla; the mean interval between implant insertion and disease onset was 20.9 months. Pain (n12) and signs of infection (n10) were the most common symptoms. Histologically, signs of infection were found in nine of 11 analyzed patients with presence of Actinomyces in six patients. Two patients turned out to have infiltration of underlying malignant disease. CONCLUSIONS: Posteriorly placed implants seem to be of higher risk of development of osteonecrosis of the jaws. Not only the implant placement but also the inserted implant itself seems to be a continuous risk factor. CLINICAL RELEVANCE: The herein elaborated risk factors help dentists plan dental rehabilitation with implants in this high-risk group of patients and indicate careful and regular dental recall.

Introduction: Infections of male urogenital tracts may contribute to male infertility. However, the effects of bacterial presence on sperm quality and fertility are controversial. Objectives: We investigated the occurrence of non-specific bacteria and quality/quantity of semen of infertile and fertile control groups in Nigeria. Subjects and methods: We investigated 162 infertile and 54 fertile men. Spermiogram, culture, bacterial isolation and characterization were conducted. Results: We report 114/162(70.4%) occurrence of bacteria species, 49.4% of such were Gram positive and 21% Gram negative: Staphylococcus aureus (29.6%) and Escherichia coli (10.5%) had the highest occurrence for each group respectively. On semen quality/quantity, we report 14.2% azoospermia, 52.5% oligozoospermia and 33.3% of normozoospermia. The mean sperm concentrations were 10 × 7/ml and 41 × 10 6/ml for oligo and normozoospermia respectively. Majority (52%) of azoospermic group had no bacterial growth. S. aureus was the most implicated among the bacterial positive group. Within the ologozoospermic category, 28% had no bacterial growth, 28% had S. aureus and 11.8% E. coli. The normozoospermic patients had 18.5% no bacteria contamination, 33.3% had S. aureus, 13% had E. coli. From the analysis, the normozoospermic group with bacterial contamination had lower sperm concentrations compared with those without contamination. It was apparent that factors other than bacterial contamination may contribute more to oligozoospermia (compare: "no bacteria" group mean sperm concentration 8.97 × 106/ml, Gram positive bacteria contaminated group 17.74 × 106/ml and Gram negative bacteria * Corresponding author.

Purpose: To study time patterns in bilateral exudative age-related macular degeneration (AMD) and the pattern of drusen before and after the onset of exudative AMD. Material and Methods: Out of 2220 individuals in the Icelandic genetic study of AMD, 151 had bilateral exudative AMD. We searched for previous records in the Icelandic University Retina Unit. For the 65 patients with a fluorescein angiography record of both eyes, we established the time between the onset of disease in each eye. For the 53 patients with colour fundus photographs of the latter eye taken prior to the occurrence of exudative disease, we graded the drusen before and after the onset of exudative AMD in the second eye. Results: The time interval between the onset of exudative AMD in the first and second eyes was 2.5 years (95% CI: 1.8-3.2; n ¼ 65) and the median was 1.8 years. In 82% of cases the second eye was affected within 4 years. Soft drusen in the macula were found in 95% of eyes that later developed exudative disease (n ¼ 53). Soft and hard drusen decreased in number in the central macula following the development of exudative disease. Conclusions: Bilateral exudative AMD develops within a few years in both eyes. Drusen are less visible following the onset of exudative AMD in the second eye.

To date, there has been limited research on manipulation of the estrous cycle in endangered equids. The objectives of this study were to assess the efficacy of using combinations of: (a) oral altrenogest and PGF2α, and (b) injectable altrenogest and PGF2α for manipulation of ovarian activity in Przewalski&#39;s mares. Reproductive cycles were monitored by assessing follicular changes with rectal ultrasound and changes in urinary steroid hormones. In Study 1, five cycling mares were treated with oral altrenogest (n=11 cycles) for 14 days. In Study 2, cycling mares were treated with oral altrenogest for 12 days (n=5 cycles; n=5 mares) or a single injection of biorelease altrenogest (n=10 cycles; n=6 mares). In all study groups, PGF2α was given 2 days before cessation of progestagen treatment. In Study 1, mares responded in six of 11 cycles (54%) where treatment occurred with normal ovarian follicular development post hormone therapy. In Study 2, mares responded in four of five (80%, o...

In 2015, the international community adopted Sustainable Development Goal-3 (SDG-3) on health, which includes a specific target to enhance maternal health among its 13 objectives. [1] 94% of maternal deaths occurred in low-and lower-middle-income countries, with 65% of these deaths concentrated in Africa. [2] Pregnancy-related problems result in the majority of women's fatalities, and most of them are avoidable. Pregnancy-related preventable causes cost the lives of one woman every 2 min in 2020. [1] Antenatal care (ANC) visits are recommended by the World Health Organization (WHO) as an essential approach to support the health of expectant mothers. [3] To ensure a safe pregnancy and healthy baby, the WHO revised its recommendation in 2016 from four to eight ANC visits. [4] Regular and timely ANC improves the use of current medical therapies, immunization against malaria, iron supplementation, dietary therapy, HIV testing and counseling, and treatment for urinary tract infections. [5] However, there was a noticeable decline in the use of prenatal services in low-income, middle-income, and high-income nations following COVID-19. [6] Tshwane district research in South Africa found that low birth weight babies are more likely to be delivered by women who visit the ANC clinic fewer than five times. [7] Due to the efficient implementation of Background and Objectives: Rwanda, a country in Sub-Saharan Africa, is among the most underprivileged nations. Women in Rwanda face significant challenges in achieving good health and well-being. This study aims to explore the impact of various sociodemographic factors on the utilization of antenatal care (ANC) services in Rwanda. Methodology: This study is based on secondary research using data extracted from the Rwanda Demographic Health Survey conducted in 2019-2020. 14,634 women were interviewed, and their data were analyzed using SPSS 24.0. The statistical significance level was set at 5% and a confidence interval of 95% was used in the analysis. Results: The average age of the survey respondents was 29. Over 87% of them visited ANC before their 5 th month of pregnancy, and only a very small percentage (0.04%) had more than six visits. The logistic regression analysis results showed that women aged over 45 years were twice as likely to visit the clinic as women aged 15-30 years (odds ratio (OR): 2.022, 95% confidence interval (CI): 1.241-3.293, P = 0.005). Women who completed primary education were 4.2 times more likely to use ANC clinics than uneducated women (OR: 4.190, 95%CI: 1.230-2.653, P = 0.003). Pregnant women who read the newspaper at least once a week were 1.4 times more likely to visit the clinic than those who did not read the newspaper at all (OR: 1.148, 95%CI: 1.097-2.028, P = 0.014). Conclusions: The utilization of antenatal care ANC services is significantly influenced by sociodemographic factors. Therefore, these elements should be considered when developing strategies to improve antenatal services in Rwanda.

The reconstructive surgery of urothelial defects, such as severe hypospadias is susceptible to complications. The major problem is the lack of suitable grafting materials. Therefore, finding alternative treatments such as reconstruction of urethra using tissue engineering is essential. The aim of this study was to compare the effects of naturally derived acellular human amniotic membrane (hAM) to synthetic poly- l -lactide-co-ε-caprolactone (PLCL) on human urothelial cell (hUC) viability, proliferation and urothelial differentiation level. The viability of cells was evaluated using live/dead staining and the proliferation was studied using WST-1 measurement. Cytokeratin (CK)7/8 and CK19 were used to confirm that the hUCs maintained their phenotype on different biomaterials. On the PLCL, the cell number significantly increased during the culturing period, in contrast to the hAM, where hUC proliferation was the weakest at 7 and 14 days. In addition, the majority of cells were viable a...

Introduction: Fibromyalgia (FM) is a chronic pain condition that causes impaired functional capacity, possibly through the adoption of sedentary behaviour. However, little is known regarding physical activity level and its relationship with physical performance in women with FM. Objectives: To compare physical activity level, assessed using the International Physical Activity Questionnaire (IPAQ), and physical performance, measured using the six-minute walk test (6MWT), in women with and without FM and to examine the possible relationships between physical activity level and physical performance in both groups. Methods: The study included 30 women diagnosed with FM (patients) and 28 healthy women (controls) who answered the IPAQ and performed the 6MWT. Results: Patients and controls self-reported similar physical activity level, considering both the total score and all IPAQ subcomponents (P > 0.05). However, the FM patients had worse physical performance in the 6MWT (patients, 441.8 ± 84.1 m vs. controls, 523.9 ± 80.3 m; P < 0.01). There were no relationships between the distance walked in the 6MWT and the IPAQ variables for the control group. However, the distance walked by patients in the test showed a signifi cant correlation (P < 0.05) with the total score and the subcomponents transport, household activities, and physical activities of moderate intensity in the IPAQ. Conclusions: Women with FM had physical activity levels similar to women without FM but exhibited worse physical performance. This functional impairment may be related to the lifestyle adopted because there was a relationship between physical activity level and physical performance in those patients.