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Airway nitric oxide (NO) deficiency is a hallmark of cystic fibrosis (CF), but the reasons for the reduced NO production in CF airways are unclear. Interleukin (IL)-1 pathway activation plays a role in early CF lung disease and is also involved in the regulation of NO synthase activity. Treatment of CF patients with the CFTR-targeting drug ivacaftor, among other beneficial effects, results in an increase in airway NO levels. In this longitudinal observational trial, we show that ivacaftor therapy leads to a significant reduction in sputum IL-1�� concentration but not in other IL-1- or Th17-associated cytokines. IL-1�� concentrations were closely linked to improvement in pulmonary function, measures of NO metabolism in sputum and exhaled NO. These data therefore suggest a potential interaction between transepithelial chloride conductance, IL-1�� and airway NO production.

Study objective To derive and internally and externally validate machine-learning models to predict emergency ambulance patient door–to–off-stretcher wait times that are applicable to a wide variety of emergency departments. Methods Nine emergency departments provided 3 years (2017 to 2019) of retrospective administrative data from Australia. Descriptive and exploratory analyses were undertaken on the datasets. Statistical and machine-learning models were developed to predict wait times at each site and were internally and externally validated. Results There were 421,894 episodes analyzed, and median site off-load times varied from 13 (interquartile range [IQR], 9 to 20) to 29 (IQR, 16 to 48) minutes. The global site prediction model median absolute errors were 11.7 minutes (95% confidence interval [CI], 11.7 to 11.8) using linear regression and 12.8 minutes (95% CI, 12.7 to 12.9) using elastic net. The individual site model prediction median absolute errors varied from the most accurate at 6.3 minutes (95% CI, 6.2 to 6.4) to the least accurate at 16.1 minutes (95% CI, 15.8 to 16.3). The model technique performance was the same for linear regression, random forests, elastic net, and rolling average. The important variables were the last k-patient average waits, triage category, and patient age. The global model performed at the lower end of the accuracy range compared with models for the individual sites but was within tolerable limits. Conclusion Electronic emergency demographic and flow information can be used to estimate emergency ambulance patient off-stretcher times. Models can be built with reasonable accuracy for multiple hospitals using a small number of point-of-care variables.

As far as we know this is the first report on bulking agent injection into intravesical ectopic ejaculatory orifices reported in the English literature. During a follow-up period of 23 months, the child was free of episodes of epididymo-orchitis. Deflux injection in this rare anomaly of intravesical refluxing ducts had prevented irreversible damage to the testes from recurrent EO. Thus, it may be a better option than vasectomy when antibiotic treatment fails.

An innovative method for the determination of the depletion in research reactor fuel assemblies (FAs) based on gamma transparency was developed, tested, and presented. The basic concept is the assessment of the uranium content from the attenuation of gamma rays passing through the FA, which is placed between a gamma-emitting source and a spectroscopic detector. With increasing depletion, more uranium transforms into fission products, which causes a significant decrease in the gamma-rays attenuation at energies higher than ∼ 116 keV, thus increasing the count rate at the detector. The attenuation from the fuel assembly was compared to that of a fresh (highest known uranium content, most opaque to gamma-rays) and dummy (Aluminum-only; most transparent) fuel assemblies, and subsequently, a logarithmic interpolation to determine the current uranium content was performed. In this study, a low-energy gamma ray of 155 keV (emitted from 188Re) was used, which exhibited significant contrast between the attenuation through the uranium versus its fission products, while obtaining sufficiently high count-rate at the detector at relatively short count durations. The 188Re source was generated prior to the experimental campaign through the 187Re(n, γ ) reaction by irradiation of natural rhenium in IRR1 (Israel Research Reactor 1, 5MW open-pool HEU MTR-type fuel, Soreq Nuclear Research Center, Israel). Five FAs of different irradiation histories previously used in the IRR1 reactor were studied. The determined depletions were found to be in the range of 47%–59%, with absolute uncertainties of 2%–3%. The axial distribution of the depletion along the FAs was determined with high resolution (20 axial points per FA) using the low-energy photons and found to be in good agreement compared to the axial distributions obtained from fission products such as 137Cs. Experimental results of the present study were also compared to results of a different experiment that used the traditional gamma ray spectroscopy technique (i.e., using 137Cs activity) for one of the studied fuel assemblies (FS-5), giving good agreement in both the axial depletion distribution, as well as the whole assembly depletion. Thus, the method described in this paper demonstrates improved accuracy compared to other non-destructive spectroscopy-based methods. Furthermore, we managed to obtain spectroscopic signatures of relatively short-lived fission products such as 140Ba ( T 1 ∕ 2 = 12 . 7 days) from an FA that was irradiated 65 days before the measurement.

Objective To assess the postpubertal outcome of ventral penile curvature repaired in infancy in terms of recurrence and aesthetics. Materials and Methods Postpubertal patients treated for hypospadias and ventral penile curvature in infancy at a tertiary medical center were invited to undergo assessment of the quality of the repair. Findings were compared between patients with a straight penis after skin release and patients who required dorsal plication. Results The cohort included 27 patients of mean age 16.5 years who were reported with straight penis after surgery. Postpubertal curvature was found in 6 of 14 patients (43%) successfully treated by skin release and 10 of 13 patients (77%) who underwent dorsal plication (P = .087). Significant curvature (≥30 degrees) was found in 1 of 14 patients in the skin-release group and 4 of 13 in the dorsal plication group (P = .16). Rates of redo urethroplasty were 2 of 14 (14%) and 5 of 10 (50%), respectively. Patient satisfaction with the appearance of the penis did not differ significantly. Conclusion Ventral penile curvature repaired in infancy often recurs after puberty. The need for dorsal plication has a trend-level association with recurrence of penile curvature in puberty. It might also be related to the degree of postpubertal penile curvature and the need for redo urethroplasty. Procedure type does not affect patient satisfaction with the postpubertal appearance of the penis.

Moringa oleifera Lam. (MO) seedlings, sown at high density on June 2014 and grown under irrigation in Israel, were harvested at 45 d intervals to yield a total biomass of 35 t dry matter (DM) per ha. Based on a preliminary study in glass-silos, fresh harvested MO from the 2nd harvest was mixed with chopped wheat hay and sugar cane molasses at a ratio, of 370:540:90 on DM basis, respectively, and ensiled in 40 pressed bales (700 kg each) wrapped with stretch polyethylene film. This silage was included in the total mixed ration (TMR) of lactating cows at a level of 180 g/kg DM as wheat silage and hay substitute. Performance and digestion experiment was conducted with two groups of 21 milking cows each, fed individually, either the MO TMR or the control ration. Voluntary DM intake of cows, fed the control TMR, tended to be 1.22% higher than that of the MO-fed cows ( p = 0.09). In vivo digestibility of DM, neutral detergent fiber (NDF), cellulose, hemicelluloses and crude protein were higher in the control cows compared with the MO-fed group. Notwithstanding, higher yields of milk and 4% fat corrected milk (FCM) by 1.91% and 4.26%, respectively, were observed in the MO-fed cows. Milk fat content was 2.34% higher and milk protein content 2.28% lower in the MO-fed cows than in their control counterparts. This was reflected in a 2.37% higher energy corrected milk (ECM) yield and 3.27% increase in production efficiency (kg ECM/kg DM intake) of the MO-fed cows compared with the control ones. Milk of the MO-fed cows was also characterized by 20% more anti-oxidative activity than that of the control cows. Body weight gain, however, was similar in both groups. It is therefore suggested to ensile mixture of MO with soy hulls or corn grains as higher digestible solid additive for feeding lactating dairy cows.

Objective To characterize patients who develop late obstruction after subureteral injection of bulking agent for the treatment of pediatric vesicoureteral reflux (VUR). Methods We retrospectively evaluated the medical records of all patients who underwent endoscopic injection for the correction of VUR during 2008-2015 in 2 centers in Israel: Bnai-Zion Medical Center, Haifa, and Schneider Children's Medical Center, Petah Tikva. Nine patients who developed late-onset obstruction were included in the study, and their data were reviewed and analyzed. Results Three boys and 6 girls with mean age of 3 years were included in the study. All patients had moderate-to-high grade VUR. Following injection, all children had a radiographic evidence showing resolution of the reflux. During follow-up, patients were diagnosed with late obstruction in a mean time of 13.4 months. All patients underwent open re-implantation. Conclusion Late-onset obstruction may develop in patients treated with subureteral injection for VUR. Patients with high grade reflux and dilated ureters are at risk of late obstruction. Long-term follow-up with ultrasound is mandatory following endoscopic treatment of VUR.

We assessed the effects of replacing wheat silage and hay with barley silage and hay in total mixed rations (TMRs) on: eating behavior, digestibility, and performance of individually fed high-yielding lactating cows. The barley cultivar Ma’anit and the wheat cultivar Omer were grown by dryland farming (210 mm precipitation) in a commercial field with sandy loam soil. The two cultivars were harvested simultaneously for silage or hay at a similar dry matter (DM) content (35.6%). Barley yields exceeded wheat yields by 19% (5.68 vs. 4.79 t DM/ha, P = 0.01). Two-thirds of each crop's DM yield was chopped and transferred for direct ensiling in polyethylene-wrapped bales, and one-third was wilted in the field for 2 weeks and then pressed into hay bales. The chemical composition and in-vitro DM digestibility of the wheat and barley silages and hays were similar. The two experimental TMRs contained either barley silage (280 g/kg DM) and hay (60 g/kg DM) or similar contents of wheat silage and hay, as the sole source of roughage. High-yielding multiparous Israeli Holstein cows were paired into two experimental groups of 21 cows each and fed either wheat- or barley-based TMR ad libitum for 28 days. DM intake of cows fed the wheat TMR was higher than that of the barley TMR-fed cows (28.0 vs. 27.5 kg/day) due to a faster eating rate (137.9 vs. 132.9 g DM/min) and larger meal size. Energy corrected milk production was similar in the two groups (42.4 and 42.8 kg/day), while milk fat yield was higher in barley-fed cows than wheat-fed cows (1.62 vs. 1.57 kg/day). Daily rumination time of the barley-fed cows was longer (577 vs. 537 min/day) and their rumen pH higher during the day and night (P

In 2018, a measurement campaign took place with participants from Los Alamos National Laboratory (LANL), the Nuclear Research Centre-Negev (NRCN) and Soreq Nuclear Research Center (SNRC) at the Israeli Research Reactor-1 (IRR-1) in which 14 of the reactor’s used fuel assemblies (FAs) with varied amount of depletion were measured with the nondestructive assay instrument Advanced Experimental Fuel Counter (AEFC). Designed for safeguards purposes, the AEFC measures both neutrons emitted from the FA (passive neutrons) and fission neutrons induced by an external neutron source (in this experiment, 252Cf). Signals recorded with the AEFC include total neutron count rates (Singles), time-correlated neutron count rates (Doubles), and total gamma-ray count rates. The 235U content of the FAs was previously assessed by two independent methods: (1) measurement of the transparency of the FA to low-energy gamma rays from an activated rhenium source (rhenium gamma transmission, or the RGT method) and (2) calculation of the ∼ 30-year burnup history of the core using detailed three-dimensional Monte-Carlo core depletion calculations. The results from the FAs that had been measured via the RGT method were used to construct the calibration curves, which translate the AEFC count rates to 235U mass. Then, the calibration was evaluated using AEFC measurements of six additional FAs that were not measured via the RGT method. From the results, it was determined the Doubles calibration curve was more reliable than that of the Singles and follows a simple second-order polynomial fit for the whole range of residual 235U mass content, albeit with larger statistical uncertainty. Detailed uncertainties quantification was conducted for both the AEFC Singles and Doubles. This includes the analysis of statistical uncertainties, calibration uncertainty, and random uncertainties due to the sensitivity of the AEFC to several sources of uncertainty, namely the FA position, FA orientation, interrogation source position, and ambient pool temperature. An overall total uncertainty of 6 g of 235U is estimated for the Singles and Doubles, which is mainly due to calibration uncertainty (for the Singles) and statistical uncertainty (for the Doubles), and which constitutes 3%–6% of the 235U total mass in the FAs, depending on their level of depletion.