Hopkinswinther5488

Therefore, explorations with whole genome sequencing will be the next step.

Hysterectomy is one of the most common surgical procedures. Same-day discharge (SDD) is increasingly utilized for minimally invasive hysterectomies, but its uptake varies across healthcare systems and surgical specialties. An evidence-based initiative was developed to aid in the incorporation of SDD into the practice of minimally invasive hysterectomy (MIH) in the UPMC Health System. The objective of this study was to identify trends of SDD utilization across various gynecologic specialties at UPMC, as well as evaluate the impact of SDD on length of stay (LOS) and complications after the implementation of SDD initiative.

We retrospectively identified 5554 patients who underwent MIH between 2014 and 2017 and were eligible for SDD, as determined by physicians and authorized by patients' insurance plans. Multivariable logistic regression models evaluated the trend of SDD utilization among four specialty types (general gynecologists, urogynecologists, specialized minimally invasive surgeons, and oncologists) needed to explore same-day discharge process to improve patient outcomes, patient satisfaction, and value of care.

Same-day discharge uptake increased over years and was associated with lower odds of complications and decreased length of stay. More studies are needed to explore same-day discharge process to improve patient outcomes, patient satisfaction, and value of care.

Routine omentectomy is generally not performed in patients with endometrial cancer unless there is evidence of gross omental metastases. The aim of the current study was to evaluate the role of omentectomy in the staging of clinical stage I high-grade endometrial carcinoma and its impact on overall survival.

Patients in the National Cancer Database who presented between 2010 and 2015 with clinical stage I serous, clear cell, carcinosarcoma, or grade 3 endometrioid carcinoma and underwent hysterectomy with lymphadenectomy were selected. Patients who did and did not receive an omentectomy were identified and clinico-pathological characteristics were compared. Overall survival was evaluated for patients diagnosed between 2010 and 2014 who had at least one month of follow-up following generation of Kaplan-Meier curves and comparison with the log-rank test. A Cox model was constructed to control for confounders.

A total of 9097 patients were identified, and 36.3% underwent an omentectomy. Patients who underwent omentectomy were more likely to be managed in academic institutions (50% vs. 44%, p<0.001). They were also more likely to have an open surgery (48.2% vs. 27.2%, p<0.001) and receive adjuvant chemotherapy (54.7% vs. 38.2%, p<0.001). There was no difference in overall survival between patients who did and did not undergo omentectomy, p=0.61; the 3-year OS rates were 82.3% and 82.2%, respectively. After controlling for confounders, the performance of an omentectomy was not associated with better survival (hazard ratio [HR] 0.94, 95% confidence intervals [CI] 0.84, 1.05).

Routine omentectomy may not be associated with a survival benefit for patients with clinical stage I high-grade endometrial carcinoma.

Routine omentectomy may not be associated with a survival benefit for patients with clinical stage I high-grade endometrial carcinoma.Pediatric MLL-rearranged acute myeloid leukemia (AML) has a generally unfavorable outcome, primarily due to relapse and drug resistance. To overcome these difficulties, new therapeutic agents are urgently needed. Yet, implementing novel drugs for clinical use is a time-consuming, laborious, costly and high-risk process. Therefore, we applied a drug-repositioning strategy by screening drug libraries, comprised of >4000 compounds that are mostly FDA-approved, in a high-throughput format on primary MLL-rearranged AML cells. Here we identified pyrvinium pamoate (pyrvinium) as a novel candidate drug effective against MLL-rearranged AML, eliminating all cell viability at less then 1000 nM. Additional screening of identified drug hits on non-leukemic bone marrow samples, resulted in a decrease in cell viability of ∼50% at 1000 nM pyrvinium, suggesting a therapeutic window for targeting leukemic cells specifically. Validation of pyrvinium on an extensive panel of AML cell lines and primary AML samples showed comparable viabilities as the drug screen data, with pyrvinium achieving IC50 values of less then 80 nM in these samples. Remarkably, pyrvinium also induced cell toxicity in primary MLL-AF10+ AML cells, an MLL-rearrangement associated with a poor outcome. While pyrvinium is able to inhibit the Wnt pathway in other diseases, this unlikely explains the efficacy we observed as β-catenin was not expressed in the AML cells tested. Rather, we show that pyrvinium co-localized with the mitochondrial stain in cells, and hence may act by inhibiting mitochondrial respiration. Overall, this study shows that pyrvinium is highly effective against MLL-rearranged AML in vitro, and therefore represents a novel potential candidate for further studies in MLL-rearranged AML.Circulating cancer cells (CTCs) can serve as a non-invasive liquid biopsy and provide opportunities for early cancer diagnosis and evaluation. However, the value of CTCs for diagnosis or prognosis of small pulmonary nodules (SPNs) is unclear. Fifty-three patients diagnosed with SPNs with a diameter less than 30 mm by CT examination were enrolled in the study. The CTC numbers, CT examination features, serum tumor marker concentrations, and histopathological characteristics were analyzed. Centromere probe 8 (CEP8) was used as a marker for CTC identification. The CTC numbers were significantly different in patients with malignant and benign SPNs and with early (0/Ⅰa) and advanced (Ⅰb/Ⅱ/Ⅲ) lung cancer stages. ROC analysis showed that the CTC numbers was effective on malignant SNP diagnosis. The combined use of CTCs and the density features of the nodules determined by CT further improved the overall screening, the diagnostic effectiveness for malignant SNPs, and determination of the pTNM (≤Ia vs.>Ia) stage. The CT morphology revealed that large, single, and solid SPNs were associated with significant CTC numbers and the CTC numbers were correlated with malignant histopathology. Using CEP8 as a marker resulted in detection of more CTC numbers in 22 patient samples triple stained for CEP8, EpCAM, and CKs. The CTCs determined by CEP8-positive staining could serve as potential screening and diagnostic markers for malignant SPNs.Motivated from increasing demands of non-contact optical temperature sensing, the Yb3+-Er3+ and Eu3+ doped NaY9Si6O26 (NYS) oxide phosphors were designed by high-temperature solid-state reaction method. The phase purity of the as-prepared samples was checked from XRD patterns. For the upconversion luminescence in NYSYb3+,Er3+, the optimal Er3+ doping content was determined to be 1 mol%, and the characteristic emission peaks of Er3+ were observed in the region of 500-700 nm. In Eu3+ activated NYS phosphors, it has been found that the emissions originating in 5D1 and 5D0 levels demonstrate different change tendencies in intensity with Eu3+ doping concentration. By studying the temperature-dependent luminescent spectra, it was indicated that the emissions intensities from different excited states of Er3+ change differently with temperature. Two kinds of fluorescence intensity ratio (FIR) strategies were used in NYS10%Yb3+,1%Er3+, containing thermally-coupled levels and non-thermally-coupled levels. In the NYS3%Eu3+ phosphor, it was found that the FIR for 577 and 536 nm emissions follows a linear relation with temperature. The high sensitivities in the present phosphors indicate the potential application in optical temperature sensing.In this work, the protective effect of baicalein on DNA oxidative damage and its possible protection mechanisms were investigated. 2-thiobarbituric acid (TBA) colorimetry and agarose gel electrophoresis study found that baicalein protected the deoxyribose residue and double-stranded backbone of DNA from the damage of hydroxyl radicals. Antioxidant analysis results showed that baicalein has excellent radicals scavenging effects and Fe2+ chelating ability, which might be the mechanism of baicalein protecting DNA. DNA binding studies indicated that baicalein bound to the minor groove of DNA with moderate binding affinity (K = (7.35 ± 0.91) × 103 M-1). Hydrogen bonding and van der Waals forces played a major role in driving the binding process. Molecular docking further confirmed the experimental results. This binding could stabilize DNA double helix structure, thereby protecting DNA from oxidative damage. This study may provide theoretical basis for designing new functional foods of baicalein for DNA damage protection.A sensitive and accurate spectrofluorimetric method was proposed for the determination of Sacubitril calcium and Valsartan simultaneously in binary mixture. The method was established on measuring the native fluorescence of Sacubitril calcium and Valsartan upon excitation at 240 nm in acetonitrile. The emission of Sacubitril calcium was measured at 615 nm. For the determination Valsartan a first derivative ratio method was employed to eliminate any spectral interference. (L)-Dehydroascorbic The ratio emission spectra were achieved by dividing the emission spectra of various concentrations of Valsartan by the emission spectrum of Sacubitril calcium (100 ng/ml) then the first derivative of the obtained ratio emission spectra was recorded using the proper smoothing factor. The amplitude at 354.9 nm on the first derivative ratio emission spectrum was used to calculate the concentrations of Valsartan in presence of Sacubitril calcium. The method was linear over the concentration range 100-1000 ng/ml for both Sacubitril calcium and Valsartan. The mean accuracy values were found to be 99.32 ± 0.62 and 99.30 ± 0.70 for Sacubitril calcium and Valsartan, respectively. Statistical comparison between results obtained by the proposed method and a reported method for this drugs showed no significant difference. This developed method was used for the quantitative determination of Sacubitril calcium and Valsartan in both pure and pharmaceutical dosage form.Accumulating evidence indicates that incorporating youth development (YD) principles, strategies, and supports into an organization promotes positive adult and youth outcomes. However, few validated measures assess this type of capacity. The YMCA commissioned a study to validate its Capacity Assessment for Youth Development Programming (Y-CAP), which examines the organizational infrastructure required to implement YD programs and processes in seven areas. Survey development was an iterative process informed by existing frameworks, instruments, and pilot testing of items. The Y-CAP was reviewed and revised three times prior to this study, with a final round of revisions made at the start of the validation phase as a result of thorough content, survey methodology, and psychometrics reviews. The revised Y-CAP was completed by 123 YMCA implementation teams. Rasch analyses were used to determine the extent to which validity evidence supports the use and interpretation of the Y-CAP scores. Convergent validity was assessed by comparing Y-CAP scales to the Algorhythm staff survey for youth-serving organizations, and focus groups informed the consequential validity of the Y-CAP.