Serum vitamin D concentrations in rabbits (Oryctolagus cuniculus) are more affected by UVB irradiation of food than irradiation of animals.

Rabbits kept under ultraviolet B (UVB)-irradiation respond with increasing serum vitamin D (25(OH)D) concentrations, but it is unknown whether irradiation of the animals or their feed contributes more. Twenty-four New Zealand White rabbits were divided into three groups for a four-week period: the control group (C) received no UVB-exposure and non-irradiated hay (ergocalciferol (vitamin D2) concentration 2.22 µg/100 g dry matter). The direct exposure group (D) was provided with 12 h of UVB-irradiation daily and fed the same hay as group C in shaded areas to prevent UVB-irradiation thereof. The indirect exposure group (I) did not receive direct UVB-irradiation but was fed hay of the same batch that was exposed to 12 h of UVB-irradiation (vitamin D2 6.06 µg/100 g dry matter). Serum 25(OH)D2, 25(OH)D3, ionised calcium, total calcium, phosphorus, and magnesium concentrations were measured weekly. There was no systematic effect on serum mineral concentrations. The serum 25(OH)D2 concentrations were significantly higher in group I compared to groups C and D from the second week onwards. 25(OH)D3 concentrations increased only in group D, with significant differences to both other groups from the third week onwards, yet at lower magnitudes than the noted increase of 25(OH)D2 in group I. Total 25(OH)D concentrations were highest in group I, intermediate in group D and lowest in group C. Serum total 25(OH)D concentration was more affected by UVB-irradiation of rabbits' feed than by direct irradiation of the animals themselves. If rabbit serum total 25(OH)D concentrations should be managed, diet manipulation rather than animal UVB-exposure appears to be more effective.

Effect of femtosecond laser interaction with human fibroblasts: a preliminary study.

In in vitro methods and cell culture models, femtosecond (fs) laser interaction has been employed to assess its effect on the proliferation and morphology of human skin fibroblasts. We cultured a primary human skin fibroblast cell line on a glass plate, passages 17-23. The cells were irradiated with a 90-fs laser at a wavelength of 800 nm and a repetition rate of 82 MHz. The target received an average power of 320 mW for 5, 20, and 100 s, corresponding to the radiation exposures of 22.6, 90.6, and 452.9 J/cm2, respectively. Using a laser scanning microscopy technique, the photon densities were measured to be 6.4 × 1018, 2.6 × 1019, and 1.3 × 1020 photons/cm2 in a spot area of 0.07 cm2; the recorded spectra were obtained from the laser interaction after 0.00, 1.00, 25.00, and 45.00 h. The cell count and morphological changes showed that the cultured cells were affected by laser irradiation under photon stress; some fibroblasts were killed, while others were injured and survived. We discovered evidence of the formation of several coenzyme compounds, such as flavin (500-600 nm), lipopigments (600-750 nm), and porphyrin (500-700 nm). This study is motivated by the future development of a novel, ultra-short fs laser system and the need to develop a basic in vitro understanding of photon-human cell interaction. The cell proliferation indicated that cells are partly killed or wounded. The exposure of fibroblasts to fs laser fluence up to 450 J/cm2 accelerates cell growth of the viable residual cell.

Effect of high-flow vs. low-flow nasal plus mouthguard oxygen therapy on hypoxaemia during sedation: a multicentre randomised controlled trial.

Whether high-flow vs. low-flow nasal oxygen reduces hypoxaemia for sedation during endoscopic retrograde cholangiopancreatography is currently unknown. In this multicentre trial, 132 patients ASA physical status 3 or higher, BMI > 30 kg.m-2 or with known or suspected obstructive sleep apnoea were randomly allocated to high-flow nasal oxygen up to 60 l.min-1 at 100% FI O2 or low-flow nasal oxygen at 4 l.min-1 . The low-flow nasal oxygen group also received oxygen at 4 l.min-1 through an oxygenating mouthguard, totalling 8 l.min-1 . Primary outcome was hypoxaemia, defined as Sp O2 < 90% regardless of duration. Hypoxaemia occurred in 7.7% (5/65) of patients with high-flow and 9.1% (6/66) with low-flow nasal oxygen (percentage point difference -1.4%, 95%CI -10.9 to 8.0; p = 0.77). Between the groups, there were no significant differences in frequency of hypoxaemic episodes; lowest Sp O2 ; peak transcutaneous carbon dioxide; hypercarbia (transcutaneous carbon dioxide > 2.66 kPa from baseline); requirement of chin lift/jaw thrust; nasopharyngeal airway insertion; bag-mask ventilation; or tracheal intubation. Following adjustment for duration of the procedure, the primary outcome remained non-significant. In high-risk patients undergoing endoscopic retrograde cholangiopancreatography, oxygen therapy with high-flow nasal oxygen did not reduce the rate of hypoxaemia, hypercarbia or the need for airway interventions, compared with combined oral and nasal low-flow oxygen.

Bidirectional reflectance measurement of tungsten samples to assess reflection model in WEST tokamak.

This paper presents the measurement of the bidirectional reflectance distribution function of tungsten (W) samples and the resulting reflection models in the nuclear fusion device WEST (tokamak). For this, an experimental gonio-spectrophotometer was developed to fully characterize the material's optical and thermal-radiative properties of metallic samples with different roughnesses. Ray-tracing photonic simulation was then carried out to predict the photon behavior in a fully metallic environment as a function of reflectance measurement. Low emissivity (0.1 at 4 µm) and highly specular reflectance (fitting with a Gaussian distribution around the specular direction with a small width lower than 10°) are found for W samples. These measurements have been used as input for the photonic simulation, and the resulting synthetic image reproduced the reflection features well on the upper divertor, detected in WEST infrared experimental images.

Is dental general anaesthesia in children an outdated concept? A retrospective analysis.

AIM: The aim of this retrospective study was to determine the prevalence of caries and treatment needs in the collective of patients ?16 years of age, who underwent scheduled dental general anaesthesia (DGA) at the University Clinic of Innsbruck from January 2015 to June 2019, with respect to demographic factors. MATERIALS AND METHODS: A retrospective analysis of children's diagnoses, demographics, and dental treatment under general anaesthesia in Innsbruck, Austria, from 2015 to 2019 was performed. Anonymised demographic data (age; gender; the presence or absence of general disease or disablement; parents' first language (German- (GS) or non-German-speaking (non-GS), reflecting ethnicity; and the number of teeth restored and extracted under DGA were collected from patients' files. Data was analysed by means of descriptive and comparative statistics. RESULTS: The main group consisted of 545 subjects at a median age of 5.3 (IQR 4.4-6.6) years, who had exclusively primary teeth and or first molars that received restorations or were extracted. Of the subjects, 84.4% were classified with uncooperativeness due to dental anxiety and 15.6% with systemic diseases or intellectual and or physical disablement. In this group, 47.9% were GS and 52.1% were non-GS or had GS or non- GS parents. In the total sample, 5 (IQR 3-7) primary teeth were restored and 4 (IQR 4-7) extracted. Subgroup analysis revealed statistically significant differences in the number of extracted primary teeth between children with and without systemic diseases or disablement - 3 (IQR 1-5) versus 4 (IQR 2-7) - and between children of GS and non-GS parents - 4 (IQR 2-6) versus 5 (IQR 3-7.8). Zero (IQR 0-0) first molars were filled and extracted. CONCLUSION: Within the study collective of children in poor oral health, the offspring of non-GS families were overrepresented (compared to their prevalence in the total population) and displayed a higher prevalence of deep caries than those of GS parents. By intensifying and special gearing of prophylactic measures to the non-GS population and promoting the parents' insight into the importance of oral hygiene and regular dental attendance, the demand for scheduled DGA might be greatly reduced. In the small share of children who suffer from severe diseases or disablement and are thus unable to cooperate with home care or dental treatment, DGA will remain the treatment of choice.

Use of Imaging in Children With Witnessed Physical Abuse.

OBJECTIVE: Physicians are occasionally asked to evaluate children who are reported to have been victims of witnessed abuse, but who have no injuries noted on examination. The rate of injury in these patients is presently unknown. This is important because abuse allegations are brought for both altruistic and other reasons. This study compares the use of skeletal survey and neuroimaging in well-appearing and clearly injured children reported to be victims of witnessed child abuse. METHODS: Retrospectively planned secondary analysis of the Examination of Siblings to Recognize Abuse cohort of children referred to a child abuse pediatrician with concerns for physical abuse. Children were selected who presented to a medical provider with a history of witnessed child abuse including shaking. Rates of radiographically evident injuries are noted among children with and without injuries noted on physical examination. RESULTS: Among 2890 children evaluated by a child abuse pediatrician, 90 children (3.1%) presented with a history of witnessed abuse. Among these, 51 children (57%) had injuries noted on physical examination; 9 (29%) of 31 skeletal surveys and 9 (35%) of 26 neuroimaging studies revealed injuries. Of 39 children (43%) with witnessed abuse and normal examination, 3 (10%) of 30 skeletal surveys and 2 (8%) of 25 neuroimaging studies revealed an injury. CONCLUSIONS: A significant minority of children evaluated for allegations of witnessed abuse will have occult injuries identified radiographically. Absence of injury on examination should not deter physicians from obtaining otherwise indicated skeletal surveys and neuroimaging in children reported to have experienced witnessed abuse.

PrEP Eligibility and Interest Among Clinic- and Community-Recruited Young Black Women in Atlanta, Georgia, USA.

BACKGROUND: Atlanta has been identified as an HIV "hot spot" for Black women and ranks 5th in the US with new infections. Yet little is known about PrEP eligibility or interest among young Black women in Atlanta. METHODS: A convenience sample of 1,261 Black women (ages 14-24 years) were recruited from two settings: community venues and sexual health clinics. They provided self-reported sexual behavior data and specimens for laboratory testing for chlamydia (CT) and gonorrhea (GC) infections. For each woman, the number of key self-reported behavioral HIV risk factors was calculated (0-6 factors for the clinic sample, 0-3 factors for the community sample). A single item assessed PrEP interest in the community sample only. RESULTS: Bacterial STI positivity, an indicator for PrEP eligibility, was 20.5% (17.1% CT, 6.3% GC) and 20.9% (18.8% CT, 5.2% GC) for the clinic and community samples, respectively. Of the 144 STI positive women from the clinic sample, 20.1% reported no behavioral risk indicators and 47.2% reported > 2 behavioral indicators. Of the 117 STI positive women from the community sample, 21.4% reported no behavioral risk indicators. 60.7% of the community sample reported they would be likely or very likely to use PrEP if available. CONCLUSION: Young Black women in Atlanta, whether sampled from community or sexual health settings, are at substantial risk for HIV infection and meet several PrEP eligibility criteria. Scaling up PrEP among women in Atlanta could have significant implications for HIV in this high burden region.

Cleaning of first mirrors in ITER by means of radio frequency discharges.

First mirrors of optical diagnostics in ITER are subject to charge exchange fluxes of Be, W, and potentially other elements. This may degrade the optical performance significantly via erosion or deposition. In order to restore reflectivity, cleaning by applying radio frequency (RF) power to the mirror itself and thus creating a discharge in front of the mirror will be used. The plasma generated in front of the mirror surface sputters off deposition, restoring its reflectivity. Although the functionality of such a mirror cleaning technique is proven in laboratory experiments, the technical implementation in ITER revealed obstacles which needs to be overcome: Since the discharge as an RF load in general is not very well matched to the power generator and transmission line, power reflections will occur leading to a thermal load of the cable. Its implementation for ITER requires additional R&D. This includes the design of mirrors as RF electrodes, as well as feeders and matching networks inside the vacuum vessel. Mitigation solutions will be evaluated and discussed. Furthermore, technical obstacles (i.e., cooling water pipes for the mirrors) need to be solved. Since cooling water lines are usually on ground potential at the feed through of the vacuum vessel, a solution to decouple the ground potential from the mirror would be a major simplification. Such a solution will be presented.

Cesarean delivery is not associated with decreased at-birth fracture rates in osteogenesis imperfecta.

PURPOSE: Osteogenesis imperfecta (OI) predisposes to recurrent fractures. Patients with the moderate to severe forms of OI present with antenatal fractures, and the mode of delivery that would be safest for the fetus is not known. METHODS: We conducted systematic analyses of the largest cohort of individuals with OI (n = 540) enrolled to date in the OI Linked Clinical Research Centers. Self-reported at-birth fracture rates were compared among individuals with OI types I, III, and IV. Multivariate analyses utilizing backward-elimination logistic regression model building were performed to assess the effect of multiple covariates, including method of delivery, on fracture-related outcomes. RESULTS: When accounting for other covariates, at-birth fracture rates did not differ based on whether delivery was by vaginal route or by cesarean delivery (CD). Increased birth weight conferred higher risk for fractures irrespective of the delivery method. In utero fracture, maternal history of OI, and breech presentation were strong predictors for choosing CD. CONCLUSION: Our study, the largest to analyze the effect of various factors on at-birth fracture rates in OI, shows that CD is not associated with decreased fracture rate. With the limitation that the fracture data were self-reported in this cohort, these results suggest that CD should be performed only for other maternal or fetal indications, not for the sole purpose of fracture prevention in OI.Genet Med 18 6, 570-576.

Zolpidem test and catatonia.

WHAT IS KNOWN AND OBJECTIVE: There is no consensus regarding treatment of catatonia and the main recent therapeutic progress has been the development of the zolpidem diagnostic and therapeutic test. We report on the use of this test in one of our patients. CASES SUMMARY: Mr. S. suffered from a paranoid schizophrenia. Three episodes of catatonia are described to illustrate the effect of zolpidem in a patient for whom lorazepam was ineffective or inadequate. WHAT IS NEW AND CONCLUSION: Zolpidem with appropriate testing appears to be a credible alternative to electroconvulsive therapy or increased lorazepam dosing and allows continuation of antipsychotic administration.

Validation of reference materials for uranium radiochronometry in the frame of nuclear forensic investigations.

The results of a joint effort by expert nuclear forensic laboratories in the area of age dating of uranium, i.e. the elapsed time since the last chemical purification of the material are presented and discussed. Completely separated uranium materials of known production date were distributed among the laboratories, and the samples were dated according to routine laboratory procedures by the measurement of the (230)Th/(234)U ratio. The measurement results were in good agreement with the known production date showing that the concept for preparing uranium age dating reference material based on complete separation is valid. Detailed knowledge of the laboratory procedures used for uranium age dating allows the identification of possible improvements in the current protocols and the development of improved practice in the future. The availability of age dating reference materials as well as the evolvement of the age dating best-practice protocol will increase the relevance and applicability of age dating as part of the tool-kit available for nuclear forensic investigations.

Consensus conference on best practices in live kidney donation: recommendations to optimize education, access, and care.

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation.

A cross-sectional multicenter study of osteogenesis imperfecta in North America - results from the linked clinical research centers.

Osteogenesis imperfecta (OI) is the most common skeletal dysplasia that predisposes to recurrent fractures and bone deformities. In spite of significant advances in understanding the genetic basis of OI, there have been no large-scale natural history studies. To better understand the natural history and improve the care of patients, a network of Linked Clinical Research Centers (LCRC) was established. Subjects with OI were enrolled in a longitudinal study, and in this report, we present cross-sectional data on the largest cohort of OI subjects (n = 544). OI type III subjects had higher prevalence of dentinogenesis imperfecta, severe scoliosis, and long bone deformities as compared to those with OI types I and IV. Whereas the mean lumbar spine area bone mineral density (LS aBMD) was low across all OI subtypes, those with more severe forms had lower bone mass. Molecular testing may help predict the subtype in type I collagen-related OI. Analysis of such well-collected and unbiased data in OI can not only help answering questions that are relevant to patient care but also foster hypothesis-driven research, especially in the context of 'phenotypic expansion' driven by next-generation sequencing.

Estimating risks of de novo kidney diseases after living kidney donation.

De novo post donation renal diseases, such as glomerulonephritis or diabetic nephropathy, are infrequent and distinct from the loss of GFR at donation that all living kidney donors experience. Medical findings that increase risks of disease (e.g. microscopic hematuria,borderline hemoglobin A1C) often prompt donor refusal by centers. These risk factors are part of more comprehensive risks of low GFR and end-stage renal disease (ESRD) from kidney diseases in the general population that are equally relevant. Such data profile the ages of onset, rates of progression, prevalence and severity of loss of GFR from generically characterized kidney diseases. Kidney diseases typically begin in middle age and take decades to reach ESRD, at a median age of 64. Diabetes produces about half of yearly ESRD and even more lifetime near-ESRD. Such data predict that (1) 10- to 15-year studies will not capture the lifetime risks of post donation ESRD; (2)normal young donors are at demonstrably higher risk than normal older candidates; (3) low-normal predonation GFRs become risk factors for ESRD when kidney diseases arise and (4) donor nephrectomy always increases individual risk. Such population-based risk data apply to all donor candidates and should be used to make acceptance standards and counseling more uniform and defensible.

Inflammation and atrial remodeling after a mountain marathon.

Endurance athletes have an increased risk of atrial fibrillation. We performed a longitudinal study on elite runners of the 2010 Jungfrau Marathon, a Swiss mountain marathon, to determine acute effects of long-distance running on the atrial myocardium. Ten healthy male athletes were included and examined 9 to 1 week prior to the race, immediately after, and 1, 5, and 8 days after the race. Mean age was 34.9 ± 4.2 years, and maximum oxygen consumption was 66.8 ± 5.8 mL/kg*min. Mean race time was 243.9 ± 17.7 min. Electrocardiographic-determined signal-averaged P-wave duration (SAPWD) increased significantly after the race and returned to baseline levels during follow-up (128.7 ± 10.9 vs. 137.6 ± 9.8 vs. 131.5 ± 8.6 ms; P < 0.001). Left and right atrial volumes showed no significant differences over time, and there were no correlations of atrial volumes and SAPWD. Prolongation of the SAPWD was accompanied by a transient increase in levels of high-sensitivity C-reactive protein, proinflammatory cytokines, total leucocytes, neutrophil granulocytes, pro atrial natriuretic peptide and high-sensitivity troponin. In conclusion, marathon running was associated with a transient conduction delay in the atria, acute inflammation and increased atrial wall tension. This may reflect exercise-induced atrial myocardial edema and may contribute to atrial remodeling over time, generating a substrate for atrial arrhythmias.

Functional characterization of Fospeg, and its impact on cell cycle upon PDT of Huh7 hepatocellular carcinoma cell model.

BACKGROUND: Although several treatment options are available for hepatocellular carcinoma (HCC), their application is mostly restricted to early diagnosed cases or includes liver transplantation, which is rarely available due to donor scarcity. The attractiveness of PDT as a cancer treatment does not only come from its minimal invasiveness, but also from the high selectivity due to tumor localization that can be applied. Precise focusing of light on tumor lesions will result in tumor-specific PDT activation. Novel photosensitizers can be applied in such low concentrations that cells not subjected to irradiation remain healthy. The lethal effect and mechanism of death induction of the photosensitizer Fospeg has never been studied on hepatocellular carcinoma. The aim of the present study is to functionally analyze the impact of PDT on Huh-7 HCC cell line, as well as to analyze its impact on cell cycle protein expression. METHODS: Cellular viability, and proliferation assays were conducted via MTT and BrdU assay, respectively. Transfected cell models of Huh7 with different constructs harboring cell cycle genes and downstream reporter luciferase gene were generated. RESULTS: Our results show a statistically significant decrease in both viability and proliferation of Huh-7 cells following PDT, while maintaining Fospeg and laser concentrations far below toxic levels. Proliferative cell cycle genes show a tendency of inhibition, while p53 levels show a significant increase following PDT. CONCLUSION: Fospeg-mediated PDT is a promising strategy for treatment of hepatocellular carcinoma and needs to be further explored in vivo.