Enhancement of Non-Linear Deep Learning Model by Adjusting Confounding Variables for Bone Age Estimation in Pediatric Hand X-rays.

In medicine, confounding variables in a generalized linear model are often adjusted; however, these variables have not yet been exploited in a non-linear deep learning model. Sex plays important role in bone age estimation, and non-linear deep learning model reported their performances comparable to human experts. Therefore, we investigate the properties of using confounding variables in a non-linear deep learning model for bone age estimation in pediatric hand X-rays. The RSNA Pediatric Bone Age Challenge (2017) dataset is used to train deep learning models. The RSNA test dataset is used for internal validation, and 227 pediatric hand X-ray images with bone age, chronological age, and sex information from Asan Medical Center (AMC) for external validation. U-Net based autoencoder, U-Net multi-task learning (MTL), and auxiliary-accelerated MTL (AA-MTL) models are chosen. Bone age estimations adjusted by input, output prediction, and without adjusting the confounding variables are compared. Additionally, ablation studies for model size, auxiliary task hierarchy, and multiple tasks are conducted. Correlation and Bland-Altman plots between ground truth and model-predicted bone ages are evaluated. Averaged saliency maps based on image registration are superimposed on representative images according to puberty stage. In the RSNA test dataset, adjusting by input shows the best performances regardless of model size, with mean average errors (MAEs) of 5.740, 5.478, and 5.434 months for the U-Net backbone, U-Net MTL, and AA-MTL models, respectively. However, in the AMC dataset, the AA-MTL model that adjusts the confounding variable by prediction shows the best performance with an MAE of 8.190 months, whereas the other models show the best performances by adjusting the confounding variables by input. Ablation studies of task hierarchy reveal no significant differences in the results of the RSNA dataset. However, predicting the confounding variable in the second encoder layer and estimating bone age in the bottleneck layer shows the best performance in the AMC dataset. Ablations studies of multiple tasks reveal that leveraging confounding variables plays an important role regardless of multiple tasks. To estimate bone age in pediatric X-rays, the clinical setting and balance between model size, task hierarchy, and confounding adjustment method play important roles in performance and generalizability; therefore, proper adjusting methods of confounding variables to train deep learning-based models are required for improved models.

Implementation of Highly Stable Memristive Characteristics in an Organic-Inorganic Hybrid Resistive Switching Layer of Chitosan-Titanium Oxide with Microwave-Assisted Oxidation.

This study proposes a high-performance organic-inorganic hybrid memristor for the development of neuromorphic devices in the memristor-based artificial synapse. The memristor consists of a solid polymer electrolyte (SPE) chitosan layer and a titanium oxide (TiOx) layer grown with a low-thermal-budget, microwave-assisted oxidation. The fabricated Ti/SPE-chitosan/TiOx/Pt-structured memristor exhibited steady bipolar resistive switching (BRS) characteristics and demonstrated excellent endurance in 100-cycle repetition tests. Compared to SPE-chitosan memristors without a TiOx layer, the proposed organic-inorganic hybrid memristor demonstrated a higher dynamic range and a higher response to pre-synaptic stimuli such as short-term plasticity via paired-pulse facilitation. The effect of adding the TiOx layer on the BRS properties was examined, and the results showed that the TiOx layer improved the chemical and electrical superiority of the proposed memristor synaptic device. The proposed SPE-chitosan organic-inorganic hybrid memristor also exhibited a stable spike-timing-dependent plasticity, which closely mimics long-term plasticity. The potentiation and depression behaviors that modulate synaptic weights operated stably via repeated spike cycle tests. Therefore, the proposed SPE-chitosan organic-inorganic hybrid memristor is a promising candidate for the development of neuromorphic devices in memristor-based artificial synapses owing to its excellent stability, high dynamic range, and superior response to pre-synaptic stimuli.

Unexpected Solvent-Dependent Self-Assembly of Alkali Metal Complexes of Calix[6]-mono-crown-4: Dinuclear Bowls, a Pseudo-Capsule, and a One-Dimensional Polymer.

1,4-Bridged calix[6]-mono-crown-4 (H4L) capable of metal binding was employed, and the influence of solvent variations on the formation of alkali metal complexes (1-6) was investigated. In the crystal, the bowl-shaped H4L host contains one water molecule in a good-fit fashion via H-bonds. When the H4L host was reacted with alkali metal hydroxides (M = Na, K, Rb, and Cs) in chloroform/methanol (solvent A), anion-free dinuclear bowl-shaped complexes of type [M2(H2L)] were isolated regardless of the metal ions. In the dinuclear bowl complexes 1-4, two metal ions (M1 and M2) show different binding behaviors: one (M1) locates inside the pocket like an "egg-in-nest", and the other (M2) positions above the M1 interacting with the calix rim. When chloroform/acetonitrile (solvent B) was used in potassium(I) complexation, interestingly, an elegant pseudo-capsule-type quadrunuclear complex 5 was isolated. In 5, two dipotassium(I) bowls in a rim-to-rim arrangement are triply bridged by one water and two acetonitrile molecules like a magic glue. However, in dichloromethane/methanol (solvent C), cesium(I) yielded an infinite product 6 in which dicesium(I) bowls are linked by cation-π interactions, giving rise to a one-dimensional zigzag coordination polymer. Taken collectively, all products share a dinuclear bowl unit, some of which are further extended to the pseudo-capsule or polymeric array, depending on the solvents. The results suggest the solvent variation as a versatile engineering tool and present a perspective on the metallosupramolecules of calix[6]-mono-crowns with monomer, dimer (e.g., pseudo-capsule), and polymer topologies.

Positive Eusocial Impacts on Ants by Taurine Derivatives.

The present study is to investigate potential eusocial effects on ants from treatment of taurine or its derivatives: galactose-taurine (GT) or xylose-taurine (XT). Japanese carpenter ants (Camponotus japonicus) were maintained on taurine-supplemented diets, and their performance was evaluated according to arbitrary eusocial indexes. Four classes of criteria were employed: establishment of residence chambers, survival at severe conditions, cooperative defense index (CDI), and population size. Taurine or its derivatives were administered orally in 0.1 mM sucrose solution. When fed with taurine or taurine derivatives, ants built more chambers than the non-fed control. Among the taurine groups, the XT-fed group showed the highest number of chambers. Differences in survivorship were obvious between the control and taurine-fed groups at the extreme conditions of light exposure and high temperature. More ants survived when fed with taurine or its derivatives. The taurine-supplemented groups took less time to organize a defense form than the control. The XT-fed group showed a high level of CDI which refer to the willingness to participate in defense against a foreign queen. The taurine-fed group sustained higher total numbers of ants. The XT-fed groups showed a 15% increase in the number of workers and an 11% increase in the number of eggs. The taurine-fed ants positively responded according to the eusocial vitality indexes, especially when fed with XT. In summary, these results show that ants respond more like superorganisms when treated with XT among taurine or its two derivatives.

Synergism Between Taurine and Dexamethasone in Anti-inflammatory Response in LPS-Activated Macrophages.

The aim of the present study is to examine the potential effect of dexamethasone (DEX) and taurine (TAU) on endoplasmic reticular stress (ERS) and inflammation. The macrophages were pre-treated with DEX or TAU, and the level of ERS and pro-inflammatory response was evaluated in LPS-activated macrophages. The expression of ERS marker proteins (GRP78 and CHOP) and the pro-inflammatory cytokines (IL-1ß and IL-6) was analyzed by immunoblotting and ELISA of LPS-induced macrophages. At lower concentrations (<50 nM), DEX alone reduced the levels of ERS and pro-inflammatory markers. Similarly, TAU reduced the expression of LPS-induced ERS and pro-inflammatory markers. When treated with a combination of DEX and TAU, however, the macrophages showed even a greater level of reduction in ERS and pro-inflammatory responses. The RT-qPCR data indicate that the reduction of ERS markers is caused by the inhibition of their own transcriptional expression. The significant level of reduction can be interpreted as a strong synergistic effect (p < 0.01). In summary, the results strongly indicate that a single pre-treatment of DEX or TAU may attenuate ERS and inflammation in LPS-induced macrophages at the concentrations tested in this study. Most importantly, concurrent treatment of macrophages by both agents reduced the level of ERS and pro-inflammatory cytokines in a synergistic fashion.

High Light Acclimation Mechanisms Deficient in a PsbS-Knockout Arabidopsis Mutant.

The photosystem II PsbS protein of thylakoid membranes is responsible for regulating the energy-dependent, non-photochemical quenching of excess chlorophyll excited states as a short-term mechanism for protection against high light (HL) stress. However, the role of PsbS protein in long-term HL acclimation processes remains poorly understood. Here we investigate the role of PsbS protein during long-term HL acclimation processes in wild-type (WT) and npq4-1 mutants of Arabidopsis which lack the PsbS protein. During long-term HL illumination, photosystem II photochemical efficiency initially dropped, followed by a recovery of electron transport and photochemical quenching (qL) in WT, but not in npq4-1 mutants. In addition, we observed a reduction in light-harvesting antenna size during HL treatment that ceased after HL treatment in WT, but not in npq4-1 mutants. When plants were adapted to HL, more reactive oxygen species (ROS) were accumulated in npq4-1 mutants compared to WT. Gene expression studies indicated that npq4-1 mutants failed to express genes involved in plastoquinone biosynthesis. These results suggest that the PsbS protein regulates recovery processes such as electron transport and qL during long-term HL acclimation by maintaining plastoquinone biosynthetic gene expression and enhancing ROS homeostasis.

Hemp-Derived Nanovesicles Protect Leaky Gut and Liver Injury in Dextran Sodium Sulfate-Induced Colitis.

Hemp (Cannabis sativa L.) is used for medicinal purposes owing to its anti-inflammatory and antioxidant activities. We evaluated the protective effect of nanovesicles isolated from hemp plant parts (root, seed, hemp sprout, and leaf) in dextran sulfate sodium (DSS)-induced colitis in mice. The particle sizes of root-derived nanovesicles (RNVs), seed-derived nanovesicles (SNVs), hemp sprout-derived nanovesicles (HSNVs), and leaf-derived nanovesicles (LNVs) were within the range of 100-200 nm as measured by nanoparticle tracking analysis. Acute colitis was induced in C57BL/N mice by 5% DSS in water provided for 7 days. RNVs were administered orally once a day, leading to the recovery of both the small intestine and colon lengths. RNVs, SNVs, and HSNVs restored the tight (ZO-1, claudin-4, occludin) and adherent junctions (E-cadherin and α-tubulin) in DSS-induced small intestine and colon injury. Additionally, RNVs markedly reduced NF-κB activation and oxidative stress proteins in DSS-induced small intestine and colon injury. Tight junction protein expression and epithelial cell permeability were elevated in RNV-, SNV-, and HSNV-treated T84 colon cells exposed to 2% DSS. Interestedly, RNVs, SNVs, HSNVs, and LNVs reduced ALT activity and liver regeneration marker proteins in DSS-induced liver injury. These results showed for the first time that hemp-derived nanovesicles (HNVs) exhibited a protective effect on DSS-induced gut leaky and liver injury through the gut-liver axis by inhibiting oxidative stress marker proteins.

Therapeutic effect of steroids on vestibular neuritis: Systematic review and meta-analysis.

OBJECTIVES: The present meta-analysis sought to assess further evidence for the efficacy of steroids in vestibular neuritis (VN). METHODS: The PubMed, EMBASE and Cochrane Library databases were searched through 30 August 2019. The main outcome measure was dizziness handicap inventory (DHI) and secondary outcomes included complete caloric recovery and improvement of canal paresis (CP). The follow-up times were divided into short, mid and long-term. RESULTS: Among 276 records identified, 5 studies (n = 253) were included in the analysis. The therapeutic effect of steroid on VN was confirmed (Hedges' g = 0.172, 95% CI 0.05-0.30, p = .006). Although there was no significant difference between steroids and control in the DHI score (Hedges' g = -0.323, 95% CI -0.533 to -0.113, p < .01), significant effect was seen on complete caloric recovery and improvement in CP (Hedges' g = 0.364, 95% CI 0.18-0.55, p < .0001; Hedges' g = 0.592, 95% CI 0.32-0.59, p < .0001). CONCLUSIONS: The results suggest that corticosteroids have an effect on the results of caloric tests for VN recovery, especially in long-term follow-up. However, in terms of dizziness handicap, we did not find any evidence of positive effect on corticosteroid. More data are required before recommendations can be made regarding management in patients on corticosteroids.

Five Surfactin Isomers Produced during Cheonggukjang Fermentation by Bacillus pumilus HY1 and Their Properties.

The cyclic lipopeptide produced from Bacillus pumilus strain HY1 was isolated from Korean soybean sauce cheonggukjang. The chemical structures of the surfactin isomers were analyzed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and electrospray ionization tandem mass spectrometry (ESI-MS/MS). The five potential surfactin isoforms were detected with protonated masses of m/z 994.7, 1008.7, 1022.7, 1036.7, and 1050.7 and different structures in combination with Na+, K+, and Ca2+ ions. ESI-MS/MS analysis revealed that the isolated surfactin possessed the precise amino acid sequence LLVDLL and hydroxyl fatty acids with 12 to 16 carbons. The surfactin content during cheonggukjang fermentation increased from 0.3 to 51.2 mg/kg over 60 h of fermentation. The mixture of five surfactin isoforms of cheonggukjang inhibited the growth of two cancer cell lines. The growth of both MCF-7 and Caco-2 cells was strongly inhibited with 100 µg/µL of surfactin. This study is the first-time report of five surfactin isomers of Bacillus pumilus strain HY1 during Korean soybean sauce cheonggukjang fermentation, which has cytotoxic properties.

Discrepancies in Hearing Thresholds between Pure-Tone Audiometry and Auditory Steady-State Response in Non-Malingerers.

OBJECTIVES: To evaluate discrepancies between pure-tone audiometry (PTA) and auditory steady state response (ASSR) tests in non-malingerers and investigate brain lesions that may explain the discrepancies, especially in cases where the PTA threshold was worse than the estimated ASSR threshold. DESIGN: PTA, speech audiometry, auditory brainstem response, ASSR, and neuroimaging tests were carried out on individuals selected from 995 cases of hearing impairment. Among these, medical records of 25 subjects (19 males, 6 females; mean age = 46.5 ± 16.0 years) with significant discrepancy between PTA and estimated ASSR thresholds were analyzed retrospectively. To define acceptable levels of discrepancy in PTA and ASSR hearing thresholds, 56 patients (27 males, 29 females; mean age = 53.0 ± 13.6 years) were selected for the control group. Magnetic resonance images, magnetic resonance angiograms, and positron emission tomograms were reviewed to identify any neurologic abnormalities. RESULTS: Pathologic brain lesions were found in 20 cases (80%) in the study group, all of which showed a significant discrepancy in hearing threshold between PTA and ASSR. Temporal lobe lesions were found in 14 cases (70%), frontal lobe lesions in 12 (60%), and thalamic lesions without the frontal or temporal lobe in 2 cases (10%). On repeated PTA and ASSR tests a few months later, the discrepancy between ASSR and behavioral hearing thresholds was reduced or resolved in 6 cases (85.7%). Temporal lobe lesions were found in all 3 cases in which the estimated ASSR threshold worsened with unchanged PTA threshold, and frontal lobe lesions were found in all 3 cases in which the PTA threshold improved but the estimated ASSR threshold was unchanged. No neurological lesions were found in 5 cases (20%) of patients with a discrepancy between ASSR and behavioral hearing thresholds. CONCLUSIONS: Clinicians should not rely exclusively on ASSR, especially in cases of central nervous system including temporal, frontal lobe, or thalamus lesions. If no lesions are found in a neuroimaging study of a patient with a discrepancy between PTA thresholds and estimated ASSR thresholds, further functional studies of the brain may be needed. If clinicians encounter patients with a discrepancy between PTA thresholds and estimated ASSR thresholds, an evaluation of brain lesions and repeat audiologic tests are recommended in lieu of relying solely on ASSR.

A randomized Comparison of laparoscopic LEns defogging using Anti-fog solution, waRm saline, and chlorhexidine solution (CLEAR).

OBJECTIVE: Current literature demonstrates a lack of comparative in vivo studies regarding laparoscopic lens fogging (LLF). This randomized trial aimed to compare 3 popular methods of minimizing or reducing LLF in laparoscopic surgery by heating the lens using warm saline, applying anti-fog solution to the lens, and rubbing the lens with chlorhexidine solution. METHODS: Ninety-six participants underwent randomization to be allocated in control (n = 24), warm saline (n = 24), anti-fog solution (n = 24), and chlorhexidine groups (n = 24). The primary outcome measure was the severity of LLF during the first 3 min after laparoscope insertion into the abdominal cavity. The severity of LLF was rated on a 10-point visual clarity scale ranging from 0 (clearest) to 10 (foggiest). The secondary outcome measures were (1) the severity of LLF during the remaining operative time other than the first 3 min, (2) the number of lens cleansings, and (3) the total time required to clean the lens. RESULTS: Lens fogging during the first 3 min and remaining operative time other than the first 3 min was significantly decreased in the warm saline group compared to that in the other 3 groups (all, P < 0.001). In post hoc analysis, the anti-fog solution group was significantly foggier than the warm saline group, but clearer than the chlorhexidine and control groups. The number of lens cleansings and total time required to clean the lens were significantly lower in the warm saline and anti-fog solution groups than in the chlorhexidine and control groups (all, P < 0.05). CONCLUSION: The use of warm saline leads to significantly fewer fogging events than the use of anti-fog solution or chlorhexidine solution, resulting in an improved continuity of surgery.

Preparing the surgical area for non-shaved ear surgery: a clinical assessment.

OBJECTIVE: To review the clinical experience for non-shaved middle ear/mastoid surgery and evaluate the proper method of preparing the postauricular surgical field. METHODS: This retrospective study reviewed medical records of cases where the non-shaved surgical procedure was carried out for middle ear/mastoid diseases. In all cases, middle ear and mastoid surgery was performed by one otologic surgeon without hair shaving to treat chronic perforation of tympanic membrane, as well as chronic suppurative otitis media, with or without mastoiditis during two years. The prevalence of surgical site infection (SSI) and bacterial culture of the surgical field was assessed just before the skin incision. RESULTS: In this review of 106 cases, the SSI rate was 1.6% for the non-shaved ear surgery. Bacterial colonisation was found on the prepared surgical field in 8.5% of cases and these bacteria was different from true pathogens. SSI of the skin incision occurred in two cases, although no bacterial colonisation of the non-shaved surgical field was found. The surgical exposure of postauricular area was enough to do tympanoplasty or tympanomastoidectomy, even though in cases where a hairline was close to postauricular sulcus. CONCLUSION: This study showed that when preparing the non-shaved ear surgery, the surgeons should not have to worry about skin contamination by hair. We suggest that the non-shaved ear surgery would appear to be preferable for the postauricular approach.

Modulation of Energy Metabolism Is Important for Low-Oxygen Stress Adaptation in Brassicaceae Species.

Low-oxygen stress, mainly caused by soil flooding, is a serious abiotic stress affecting crop productivity worldwide. To understand the mechanisms of low-oxygen stress responses and adaptation of plants, we characterized and compared low-oxygen responses in six species with different accessions of the Brassicaceae family. Based on the growth and survival responses to submergence or low-oxygen condition, these accessions could be divided into three groups: (i) Highly tolerant species (Rorippa islandica and Arabis stelleri); (ii) moderately tolerant species (Arabidopsis thaliana [esk-1, Ler, Ws and Col-0 ecotype]); and (iii) intolerant species (Thlaspi arvense, Thellungiella salsuginea [Shandong and Yukon ecotype], and Thellungiella parvula). Gene expression profiling using Operon Arabidopsis microarray was carried out with RNA from roots of A. thaliana (Col-0), A. stelleri, R. islandica, and T. salsuginea (Shandong) treated with low-oxygen stress (0.1% O2/99.9% N2) for 0, 1, 3, 8, 24, and 72 h. We performed a comparative analysis of the gene expression profiles using the gene set enrichment analysis (GSEA) method. Our comparative analysis suggested that under low-oxygen stress each species distinctively reconfigures the energy metabolic pathways including sucrose-starch metabolism, glycolysis, fermentation and nitrogen metabolism, tricarboxylic acid flow, and fatty acid degradation via beta oxidation and glyoxylate cycle. In A. thaliana, a moderately tolerant species, the dynamical reconfiguration of energy metabolisms occurred in the early time points of low-oxygen treatment, but the energy reconfiguration in the late time points was not as dynamic as in the early time points. Highly tolerant A. stelleri appeared to have high photosynthesis capacity that could produce more O2 and in turn additional ATP energy to cope with energy depletion caused by low-oxygen stress. R. islandica seemed to retain some ATP energy produced by anaerobic energy metabolism during a prolonged period of low-oxygen conditions. Intolerant T. salsuginea did not show significant changes in the expression of genes involved in anaerobic energy metabolisms. These results indicate that plants developed different energy metabolisms to cope with the energy crisis caused by low-oxygen stress.

Plastidial and Mitochondrial Malonyl CoA-ACP Malonyltransferase is Essential for Cell Division and Its Overexpression Increases Storage Oil Content.

Malonyl-acyl carrier protein (ACP) is a key building block for the synthesis of fatty acids, which are important components of cell membranes, storage oils and lipid-signaling molecules. Malonyl CoA-ACP malonyltransferase (MCAMT) catalyzes the production of malonyl-ACP and CoA from malonyl-CoA and ACP. Here, we report that MCAMT plays a critical role in cell division and has the potential to increase the storage oil content in Arabidopsis. The quantitative real-time PCR and MCAMT promoter:GUS analyses showed that MCAMT is predominantly expressed in shoot and root apical meristems, leaf hydathodes and developing embryos. The fluorescent signals of MCAMT:eYFP were observed in both chloroplasts and mitochondria of tobacco leaf protoplasts. In particular, the N-terminal region (amino acid residues 1-30) of MCAMT was required for mitochondrial targeting. The Arabidopsis mcamt-1 and -2 mutants exhibited an embryo-lethal phenotype because of the arrest of embryo development at the globular stage. The transgenic Arabidopsis expressing antisense MCAMT RNA showed growth retardation caused by the defects in cell division. The overexpression of MCAMT driven by the promoter of the senescence-associated 1 (SEN1) gene, which is predominantly expressed in developing seeds, increased the seed yield and storage oil content of Arabidopsis. Taken together, the plastidial and mitochondrial MCAMT is essential for Arabidopsis cell division and is a novel genetic resource useful for enhancing storage oil content in oilseed crops.

Pleiotropic Effects of Taurine on Nematode Model for Down Syndrome.

Taurine is traditionally used to treat Down Syndrome (DS); however, the actual foundation for this treatment is not well understood. DS patients suffer from disturbance of the proteostasis network (PN) due to aberrant calcium signaling, which eventually causes endoplasmic reticulum stress (ERS). Taurine has been suggested to play a role in modulating calcium homeostasis and ERS. This study examined whether taurine affects DS symptoms using C. elegans - a DS model in which calcineurins, Ca2+/calmodulin-dependent protein phosphatase is mutated to null. The DS nematode model has short body length, slow growth, fertility defects, serotonin-resistant egg-laying defects, and faulty thermal sensing. This study focused on whether taurine may ameliorate the severity of DS at the whole-body level, including reduction in ERS. When treated with taurine, DS nematodes appeared to have lower levels of ERS and phenotypes closer to the wild type. DS nematodes also showed improved egg laying efficiency and thermal sensing index comparable to the wild type. Our findings offer a new perspective on the effectiveness of taurine in treating DS and designing therapeutic strategies to lower ERS and restore disrupted PN.

Effects of Taurine on Eusociality of Ants.

The effects of taurine have been characterized primarily in mammals, and insects are not generally used to study taurine. In this study, ants were used to examine the effect of taurine on eusociality. Ants are the principal models for studying eusociality and superorganisms. Japanese carpenter ants (Camponotus japonicus) were fed a taurine-supplemented diet and tested using ant eusocial indexes. Ant farm structures were constructed using transparent PET bottles containing autoclaved soil. Three categories of vital index were used to study the effect of taurine on group activity: creation of formicaries (residence chambers), cooperative defense efforts, and population density (or group size and composition). Control, low-, and high-taurine diets were prepared using three different levels of taurine in sucrose powder: 0, 5, and 20% (g/g), respectively. The cooperative defense efforts against exogenous queen ants were recorded daily. The high-taurine group took less time to complete their defense formation than the other groups. At least 16% more formicaries (chambers) were observed in the taurine-fed groups than in the control. There were evident differences between control and taurine-fed groups in the total numbers of ants and eggs. The taurine-fed group sustained higher total numbers of ants, excluding the queen. Taurine-fed groups showed a significant increase both in the number of workers and eggs. When fed with taurine, ants responded positively on the eusocial vitality indexes. These results show that taurine exerts a positive effect on the eusociality of ants at the level of the superorganism.

Incidence, natural course, and characteristics of postlaparoscopic shoulder pain.

BACKGROUND: To determine the incidence, natural course, and specific characteristics of postlaparoscopic shoulder pain (PLSP). METHODS: The prospective study included 105 patients undergoing laparoscopy for benign gynecologic diseases. The intensity of pain, and the identification of the pain site, was assessed 24- and 48-h after surgery, using a visual analogue scale. The description and intensity of PLSP, its aggravating and relieving factors, and the response to analgesics were assessed over a 1-week period using a self-reported questionnaire. RESULTS: Of 105 patients, 84 (80%) experienced PLSP. PLSP along with wound pain peaked one day after surgery, gradually subsided, and were not reported by the seventh day after surgery. Of the 84 patients experiencing PLSP, 77 (91.7%) had aggravating and relieving factors, which included position change (48.8%) and rest (42.9%), respectively. Analgesics provided significantly less pain relief for PLSP (32.7 ± 32.2%), when compared to relief of wound pain (68.0 ± 16.2%) (P < 0.001). CONCLUSION: PLSP, identified in 80% of our patients, resolved in most patients within the first week after laparoscopy. Since PLSP is less responsive to analgesics, when compared to wound pain, surgeons should pay attention to the prevention of PLSP among patients undergoing laparoscopy.

Usefulness of hemostatic sealants for minimizing ovarian damage during laparoscopic cystectomy for endometriosis.

AIM: We aimed to evaluate the impact of topical hemostatic sealants and bipolar coagulation during laparoscopic ovarian endometriotic cyst resection on ovarian reserve by comparing the rates of decrease in anti-Müllerian hormone (AMH). METHODS: A randomized prospective data collection was made on women aged 19-45 years who planned to have laparoscopic ovarian cystectomy at one of two institutions (n = 80), Kangbuk Samsung Hospital, Seoul, Korea or National Health Insurance Service Ilsan Hospital, Goyang, Korea, from January 2014 to April 2016. Patients were randomly divided into two groups treated with either a topical hemostatic sealant or bipolar coagulation for hemostasis. The hemostatic group was randomized to the FloSeal or TachoSil subgroups. Preoperative and 3-month postoperative AMH levels were checked and the rates of decrease of AMH were compared. All patients enrolled were treated with dienogest (Visanne) for 6-12 months. None were lost to follow-up at postoperative 3 months, but about one-third of the patients had been lost to follow-up by 6-12 months. RESULTS: AMH was significantly decreased in both groups 3 months postoperatively; however, the rate of decrease in the bipolar coagulation group was greater than that in the hemostatic sealant group, 41.9% (interquartile range [IQR], 22.29-65.24) versus 18.1% (IQR, 10.94-29.90), P = 0.007. Between the two hemostatic subgroups, there was no significant difference in AMH decrease rate, 14.95% (IQR, 11.34-21.21) versus 18.1% (IQR 9.76-40.70), P = 0.204. CONCLUSION: Hemostatic sealants may be an alternative to bipolar coagulation for preservation of ovarian reserve after laparoscopic ovarian cystectomy for endometriosis.

Analysis of Taurine's Anti-Down Syndrome Potential in Caenorhabditis elegans.

Down syndrome (DS) patients overexpress human DS critical region gene 1 (hDSCR-1), whose translational product inhibits calcineurin-dependent signaling pathways of genetic transcription. Compared to hDSCR-1, C. elegans rcn-1 has 40% sequence similarity and its proteins share an analogous function with hDSCR-1 in regulating calcineurin. Taurine has had a positive effect on DS patients. According to animal research studies, taurine reduces the expression of MCIP1, a calcineurin inhibitory protein, on C2C12 myotubes and fibroblast in mouse. This study utilizes two C. elegans models for DS: rcn-1 overexpression model, displaying a calcineurin-deficient phenotype, and calcineurin loss-of function mutants. C. elegans larvae were treated with taurine to characterize its effect and mechanism in helping DS patients. RCN-1 expression and behavioral changes were examined in rcn-1 overexpression and calcineurin-deficient models at different concentrations of taurine. When treated with taurine, transgenic worms harboring an rcn-1 reporter (RCN-1::GFP) showed a reduced level of rcn-1 mRNA expression and improved behaviors that were comparable to those in the wild type. These results indicate that taurine exerts a down-regulating effect on the expression of rcn-1 and, consequently, a positive effect on the expression of calcineurins. In summary, taurine may improve the DS symptoms by prompting a positive interaction between RCN-1 and calcineurin. Furthermore, these results suggest that novel mechanisms may regulate interactions among taurine, RCN-1 and calcineurin.

Therapeutic Effect of Exogenous Truncated IK Protein in Inflammatory Arthritis.

Inhibitor K562 (IK) protein was first isolated from the culture medium of K562, a leukemia cell line. It is known to be an inhibitory regulator of interferon-γ-induced major histocompatibility complex class (MHC) II expression. Previously, we found that transgenic (Tg) mice constitutively expressing truncated IK (tIK) showed reduced numbers of pathogenic Th1 and Th17 cells, which are known to be involved in the development of rheumatoid arthritis (RA). Here, we investigated whether exogenous tIK protein has a therapeutic effect in arthritis in disease models and analyzed its mechanism. Exogenous tIK protein was produced in an insect expression system and applied to the collagen antibody-induced arthritis (CAIA) mouse disease model. Injection of tIK protein alleviated the symptoms of arthritis in the CAIA model and reduced Th1 and Th17 cell populations. In addition, treatment of cultured T cells with tIK protein induced expression of A20, a negative regulator of nuclear factor-κB (NFκB)-induced inflammation, and reduced expression of several transcription factors related to T cell activation. We conclude that exogenous tIK protein has the potential to act as a new therapeutic agent for RA patients, because it has a different mode of action to biopharmaceutical agents, such as tumor necrosis factor antagonists, that are currently used to treat RA.