Exceptionally Rare Isolated Thyroidal Metastasis of Pulmonary Carcinosarcoma: A Tale of 18F-FDG-positive Thyroid Nodule.

Pulmonary carcinosarcomas (PCS) are uncommon and aggressive malignant tumors with epithelial and mesenchymal components and have a worse prognosis than other non-small-cell lung cancers. Metastases of non-thyroidal malignancies to the thyroid are rare. We reported a unique case of isolated thyroidal metastasis of PCS and discussed 18F-fluorodeoxyglucose (18F-FDG) positivity in incidentally found thyroid nodules on 18F-FDG positron emission tomography scan.

Impact of xylan on field productivity and wood saccharification properties in aspen.

Xylan that comprises roughly 25% of hardwood biomass is undesirable in biorefinery applications involving saccharification and fermentation. Efforts to reduce xylan levels have therefore been made in many species, usually resulting in improved saccharification. However, such modified plants have not yet been tested under field conditions. Here we evaluate the field performance of transgenic hybrid aspen lines with reduced xylan levels and assess their usefulness as short-rotation feedstocks for biorefineries. Three types of transgenic lines were tested in four-year field tests with RNAi constructs targeting either Populus GT43 clades B and C (GT43BC) corresponding to Arabidopsis clades IRX9 and IRX14, respectively, involved in xylan backbone biosynthesis, GATL1.1 corresponding to AtGALT1 involved in xylan reducing end sequence biosynthesis, or ASPR1 encoding an atypical aspartate protease. Their productivity, wood quality traits, and saccharification efficiency were analyzed. The only lines differing significantly from the wild type with respect to growth and biotic stress resistance were the ASPR1 lines, whose stems were roughly 10% shorter and narrower and leaves showed increased arthropod damage. GT43BC lines exhibited no growth advantage in the field despite their superior growth in greenhouse experiments. Wood from the ASPR1 and GT43BC lines had slightly reduced density due to thinner cell walls and, in the case of ASPR1, larger cell diameters. The xylan was less extractable by alkali but more hydrolysable by acid, had increased glucuronosylation, and its content was reduced in all three types of transgenic lines. The hemicellulose size distribution in the GALT1.1 and ASPR1 lines was skewed towards higher molecular mass compared to the wild type. These results provide experimental evidence that GATL1.1 functions in xylan biosynthesis and suggest that ASPR1 may regulate this process. In saccharification without pretreatment, lines of all three constructs provided 8-11% higher average glucose yields than wild-type plants. In saccharification with acid pretreatment, the GT43BC construct provided a 10% yield increase on average. The best transgenic lines of each construct are thus predicted to modestly outperform the wild type in terms of glucose yields per hectare. The field evaluation of transgenic xylan-reduced aspen represents an important step towards more productive feedstocks for biorefineries.

A Rare Case of Post-pubertal Pure Yolk-sac Tumour Incidentally Diagnosed after Surgical Intervention for Fournier's Gangrene.

The testicular tumour is the most common solid malignancy in males between the ages of 15 and 35 years. Testicular tumours most commonly present with a painless testicular mass. Fournier's gangrene is necrotising fasciitis of the genital, perineal, and perianal region characterized by the microvascular thrombosis and skin necrosis, and is most commonly seen in elderly males with the comorbid conditions. To the best of our knowledge, there is no published case of testicular tumour presenting as Fournier's gangrene. Herein, we report a case of a young adult male, otherwise healthy, who presented to the emergency room with Fournier's gangrene and was found to have a metastatic post-pubertal pure yolk-sac tumour of the testis which is extremely rare in the adults. Key Words: Fournier's gangrene, Yolk sac tumour, Testicular neoplasm.

Cell Wall Acetylation in Hybrid Aspen Affects Field Performance, Foliar Phenolic Composition and Resistance to Biological Stress Factors in a Construct-Dependent Fashion.

The production of biofuels and "green" chemicals from the lignocellulose of fast-growing hardwood species is hampered by extensive acetylation of xylan. Different strategies have been implemented to reduce xylan acetylation, resulting in transgenic plants that show good growth in the greenhouse, improved saccharification and fermentation, but the field performance of such plants has not yet been reported. The aim of this study was to evaluate the impact of reduced acetylation on field productivity and identify the best strategies for decreasing acetylation. Growth and biological stress data were evaluated for 18 hybrid aspen lines with 10-20% reductions in the cell wall acetyl content from a five year field experiment in Southern Sweden. The reduction in acetyl content was achieved either by suppressing the process of acetylation in the Golgi by reducing expression of REDUCED WALL ACETYLATION (RWA) genes, or by post-synthetic acetyl removal by fungal acetyl xylan esterases (AXEs) from two different families, CE1 and CE5, targeting them to cell walls. Transgene expression was regulated by either a constitutive promoter (35S) or a wood-specific promoter (WP). For the majority of transgenic lines, growth was either similar to that in WT and transgenic control (WP:GUS) plants, or slightly reduced. The slight reduction was observed in the AXE-expressing lines regulated by the 35S promoter, not those with the WP promoter which limits expression to cells developing secondary walls. Expressing AXEs regulated by the 35S promoter resulted in increased foliar arthropod chewing, and altered condensed tannins and salicinoid phenolic glucosides (SPGs) profiles. Greater growth inhibition was observed in the case of CE5 than with CE1 AXE, and it was associated with increased foliar necrosis and distinct SPG profiles, suggesting that CE5 AXE could be recognized by the pathogen-associated molecular pattern system. For each of three different constructs, there was a line with dwarfism and growth abnormalities, suggesting random genetic/epigenetic changes. This high frequency of dwarfism (17%) is suggestive of a link between acetyl metabolism and chromatin function. These data represent the first evaluation of acetyl-reduced plants from the field, indicating some possible pitfalls, and identifying the best strategies, when developing highly productive acetyl-reduced feedstocks.

Determinants of Needle Stick Injuries Among Healthcare Providers at a Tehran University Hospital in 2016: A Descriptive Report.

BACKGROUND: Needle Stick Injuries (NSIs) are the most common occupational injuries among HCWs. The aim of this study was to explore the prevalence and distribution of determinants for such injuries in a university hospital in Tehran, Iran, in 2016. METHODS: We conducted a descriptive cross-sectional study in Ziaeian Hospital, a teaching hospital of Tehran University. The medical records of 55 Health Care Workers (HCWs) who experienced NSIs in 2016, were extracted from the hospital registry and analyzed using SPSS version 22. RESULTS: Available data of 55 HCWs with a history of NSIs were extracted from the hospital registry. The highest number of NSIs belonged to registered nurses (34.6%), licensed practical nurses (14.5%) and medical doctors (12.7%), respectively. The majority of the NSIs occurred in the morning shift (50.9%) followed by night shift (36.4%) and evening shift (12.7%). Most of the NSIs occurred in the emergency department (38.1%) and operating room (18.2%). The healthcare workers reported fatigue as the most common reason for being injured by needles (67.4%). All the HCWs were trained and familiarized with the safety and risk control measures after needle stick exposures in the hospital. DISCUSSION: The present study described the determinants of NSIs among HCWs in a university hospital. The fatigue and working overload were the main reasons for NSIs. The results of this study could be used to address the shortcoming in the guidelines and protocols to ensure the sustainable safety measures that could reduce the occurrence of the NSIs in hospitals in Iran.

PECTIN ACETYLESTERASE9 Affects the Transcriptome and Metabolome and Delays Aphid Feeding.

The plant cell wall plays an important role in damage-associated molecular pattern-induced resistance to pathogens and herbivorous insects. Our current understanding of cell wall-mediated resistance is largely based on the degree of pectin methylesterification. However, little is known about the role of pectin acetylesterification in plant immunity. This study describes how one pectin-modifying enzyme, PECTIN ACETYLESTERASE 9 (PAE9), affects the Arabidopsis (Arabidopsis thaliana) transcriptome, secondary metabolome, and aphid performance. Electro-penetration graphs showed that Myzus persicae aphids established phloem feeding earlier on pae9 mutants. Whole-genome transcriptome analysis revealed a set of 56 differentially expressed genes (DEGs) between uninfested pae9-2 mutants and wild-type plants. The majority of the DEGs were enriched for biotic stress responses and down-regulated in the pae9-2 mutant, including PAD3 and IGMT2, involved in camalexin and indole glucosinolate biosynthesis, respectively. Relative quantification of more than 100 secondary metabolites revealed decreased levels of several compounds, including camalexin and oxylipins, in two independent pae9 mutants. In addition, absolute quantification of phytohormones showed that jasmonic acid (JA), jasmonoyl-Ile, salicylic acid, abscisic acid, and indole-3-acetic acid were compromised due to PAE9 loss of function. After aphid infestation, however, pae9 mutants increased their levels of camalexin, glucosinolates, and JA, and no long-term effects were observed on aphid fitness. Overall, these data show that PAE9 is required for constitutive up-regulation of defense-related compounds, but that it is not required for aphid-induced defenses. The signatures of phenolic antioxidants, phytoprostanes, and oxidative stress-related transcripts indicate that the processes underlying PAE9 activity involve oxidation-reduction reactions.

Burnout Among Nursing Staff in Ziaeian Hospital.

INTRODUCTION: Occupational burnout among nurses is a major factor affecting the quality of nursing care. Assessing the prevalence of burnout and its related factors is necessary for discouraging the development of burnout. AIM: The aim of this study is determining the burnout among nurses of Ziaeian Hospital, which has not done before. METHODS: In this cross-sectional study, all the nursing staff (287 people) was included after filling the informed consent. Occupational burnout was detected using the Maslach occupational burnout inventory tool. Data were analyzed by SPSS software and the significance threshold was set at p < 0.05. RESULTS: Most of the subjects were female, married, had a bachelor's degree, worked as a nurse, and had less than 5 years of work experience. The mean score of emotional exhaustion was 29.25 ± 12.64, personal performance was 37.31 ± 7.9, and depersonalization was 14.7 ± 5.1. Altogether, 75% of the population had severe emotional exhaustion and depersonalization and mild personal dysfunction. The severity of emotional exhaustion, depersonalization and individual performance impairment weregreater in staff with higher degree. Job position also affected the intensity of emotional exhaustion and depersonalization. Additionally, there was a significant association between marital status and depersonalization. CONCLUSION: Nurses of Ziaeean Hospital have severe emotional exhaustion and depolarization; and mild personal function impairment. The findings of this research are a guide for the next steps to solve burnout in this hospital.

Double-Blind Randomized Clinical Trial of the Efficacy of Venlafaxine Versus Citalopram in the Treatment of the Acute Phase of Major Depressive Disorder.

BACKGROUND: There are many antidepressant medications with different side-effects and efficacy profiles. OBJECTIVES: In this study, we compared the efficacy of citalopram and venlafaxine in major depression, which has not yet been studied in Iran. PATIENTS AND METHODS: In this double-blind, randomized controlled trial study, 39 patients aged 18-54 year old with major depressive disorder were randomly allocated into two groups in Yazd City, Iran, between March 2011 and December 2012. A total of 16 patients were treated with velafaxine and 23 patients were treated with citalopram for 8 weeks. Hamilton Depression Rating Scale (HDRS) questionnaire was used for monitoring depression severity. Data were analyzed by SPSS version 20.0 software using Mann Whitney U test and chi-square statistical tests. RESULTS: The HDRS scores were decreased significantly in each group after 8 weeks of treatment (P = 0.001). However, there was no significant difference considering the score of HDRS (P = 0.110). Ten patients in the venlafaxine group and two patients in the citalopram group stopped using medication, all due to nausea or vomiting, or both, and the rate of these two side-effects was significantly higher in the venlafaxine group (P = 0.010). CONCLUSIONS: The efficacy of venlafaxine and citalopram are almost the same, but compliance for the use of medication, such as nausea and vomiting, in patients using venlafaxine is much higher than the citalopram group. Therefore, this implies that citalopram could be a safer antidepressant for patients suffering from major depression.

Correlation of Blood Gas Parameters with Central Venous Pressure in Patients with Septic Shock; a Pilot Study.

OBJECTIVE: To determine the correlation between blood gas parameters and central venous pressure (CVP) in patients suffering from septic shock. METHODS: Forty adult patients with diagnosis of septic shock who were admitted to the emergency department (ED) of Shohadaye Tajrish Hospital affiliated with Shahid Beheshti University of Medical Sciences, and met inclusion and exclusion criteria were enrolled. For all patients, sampling was done for venous blood gas analysis, serum sodium and chlorine levels. At the time of sampling; blood pressure, pulse rate and CVP were recorded. Correlation between blood gas parameters and hemodynamic indices were. RESULTS: A significant direct correlation between CVP with anion gap (AG) and inversely with base deficit (BD) and bicarbonate. CVP also showed a relative correlation with pH, whereas it was not correlated with BD/ AG ratio and serum chlorine level. There was no significant association between CVP and clinical parameters including shock index (SI) and mean arterial pressure (MAP). CONCLUSION: It seems that some of non invasive blood gas parameters could be served as alternative to invasive measures such as CVP in treatment planning of patients referred to an ED with septic shock.

The effects of bupropion on negative symptoms in schizophrenia.

This study was designed determine the efficacy of bupropion versus placebo in subjects with negative symptoms of schizophrenia. A convenience sample of 40 patients of both genders aged 18-60 years who were living in psychiatric care centers were randomly treated with bupropion (started with 75 mg twice a day; increased to 100 mg thrice daily) or placebo. The diagnosis of schizophrenia was confirmed by a psychiatrist based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. Before and after the intervention, severity of negative symptoms was determined using a reliable and valid Persian version of Scales for the Assessment of Negative Symptoms (SANS). Comparison of post-treatment total SANS score and subscale scores between bupropion treated patients and placebo group demonstrated no significant difference. Moreover, comparison of pre- treatment and post-treatment total SANS score and subscales within 2 groups revealed that nor bupropion neither placebo improved the severity of negative symptoms significantly. Present study demonstrated that bupropion has no significant effect on SANS score of patients with severe negative symptoms. However, further studies with larger sample size are recommended to achieve more accurate results.

The influence of a behavior modification interventional program on body mass index in obese adolescents.

BACKGROUND/PURPOSE: The prevalence of obesity and overweight among children and adolescents is increasing rapidly. The present research was performed to determine the influence of a ''behavior modification'' program on body mass index (BMI) in obese public high school students in Iran. METHODS: In this study, 152 adolescence and their parents were selected from 12 high schools of Khorram Abad from 2004 to 2006, and they were randomly assigned to either the intervention or the control groups. The "behavior modification" interventional program consisted of nutritional education, modifying dietary habits, teaching exercise programs, teaching nutritional facts to the parents, and performing exercises 3 days a week. The height and weight as well as waist, hip, and wrist circumferences of the participants were measured before and after implementing the interventional program. BMI and waist to hip ratio (WHR) were calculated. The adolescents and parents completed a nutrition knowledge questionnaire. Adolescents also completed the Beck's Depression Questionnaire. RESULTS: Adolescent's mean weight, BMI, and waist and hip circumferences decreased significantly after implementing the interventional program, in the intervention group (p≤0.001). In addition, the students' and parents' nutrition knowledge increased in the intervention group after implementing the interventional program (p<0.046). The symptoms of depression decreased and the frequency of students without symptoms of depression increased in the case group, but it did not reveal a statistically significant difference between case and control groups. CONCLUSION: The ''behavior modification'' interventional program is effective in reducing BMI in obese students, and therefore, school principals and planners can play an important role in controlling obesity by implementing this program via the students, their parents, and the school staff.

NKX2-5 regulates the expression of beta-catenin and GATA4 in ventricular myocytes.

BACKGROUND: The molecular pathway that controls cardiogenesis is temporally and spatially regulated by master transcriptional regulators such as NKX2-5, Isl1, MEF2C, GATA4, and beta-catenin. The interplay between these factors and their downstream targets are not completely understood. Here, we studied regulation of beta-catenin and GATA4 by NKX2-5 in human fetal cardiac myocytes. METHODOLOGY/PRINCIPAL FINDINGS: Using antisense inhibition we disrupted the expression of NKX2-5 and studied changes in expression of cardiac-associated genes. Down-regulation of NKX2-5 resulted in increased beta-catenin while GATA4 was decreased. We demonstrated that this regulation was conferred by binding of NKX2-5 to specific elements (NKEs) in the promoter region of the beta-catenin and GATA4 genes. Using promoter-luciferase reporter assay combined with mutational analysis of the NKEs we demonstrated that the identified NKX2-5 binding sites were essential for the suppression of beta-catenin, and upregulation of GATA4 by NKX2-5. CONCLUSIONS: This study suggests that NKX2-5 modulates the beta-catenin and GATA4 transcriptional activities in developing human cardiac myocytes.