Valenzueladickerson5202

OBJECTIVES Esophageal variceal bleeding can be fatal in patients with liver cirrhosis. The aim of this study was to investigate the relationship between gastroesophageal flap valve (GEFV) and esophageal variceal bleeding. METHODS Subjects were cirrhotic patients with endoscopically diagnosed esophageal varices treated at our hospital between 2005 and 2019, excluding those with F3 form and red color (RC) signs at first endoscopy. Sixty-five patients with normal GEFV (Hill grade I or II) and 42 with abnormal GEFV (Hill grade III or IV) were enrolled. Propensity score matching eliminated the baseline differences, resulting in a sample size of 30 patients per cohort. The primary endpoint was esophageal variceal bleeding, and the secondary endpoint was variceal bleeding or appearance of RC sign. We analyzed the cumulative incidences and predictors of each endpoint. RESULTS The 3-, 5-, and 10-year cumulative incidence of the primary endpoint was all 3.4% in the normal GEFV group, and 19.0%, 24.6% and 34.0% in the abnormal GEFV group, respectively (log-rank P = 0.011) . Cumulative incidence of the secondary endpoint was 13.8%, 33.1% and 39.2% in the normal GEFV group, and 42.2%, 54.6% and 84.9% in the abnormal GEFV group, respectively (log-rank P = 0.001). In multivariate Cox regression analyses, hazard ratios of abnormal GEFV of the primary and secondary endpoints were 12.79 (95% confidence interval 1.331-122.8) and 3.600 (1.653-7.840), respectively. CONCLUSIONS Abnormal GEFV was an independent risk factor for esophageal variceal bleeding and appearance of RC sign. This article is protected by copyright. All rights reserved.OBJECTIVES This study compared the safety and efficacy of peroral endoscopic myotomy for esophageal motility disorders between octogenarians and non-octogenarians. METHODS This retrospective observational study recruited 321 patients (28 octogenarians and 293 non-octogenarians) who underwent peroral endoscopic myotomy from two institutions. Clinical success (postoperative Eckardt score≤3), technical success (completion of gastric and esophageal myotomy), and perioperative adverse events were compared between octogenarians and non-octogenarians. Perioperative adverse events were classified into major and minor adverse events based on the International Peroral Endoscopic Myotomy Survey criteria and were subdivided into technical and non-technical adverse events according to the presence of a direct causal relationship with the procedure. RESULTS There were no significant differences in the rates of clinical success 1-year after treatment (100% vs. 97.3%, p=0.64) and technical success (100% vs. 99.7%, p=0.91) between octogenarians and non-octogenarians. Octogenarians had a higher incidence of perioperative adverse events (28.6% vs. 10.2%, p=0.00097), particularly major adverse events (25.0% vs. 3.0%, p less then 0.0001). There were no significant differences in the incidence of minor adverse events (7.1% vs. 7.9%, p=0.67). Although there was no difference in the incidence of technical adverse events (10.7% vs. 9.2%, p=0.74), octogenarians had a significantly higher incidence of non-technical adverse events (17.9% vs. 1.0%, p=0.0002). CONCLUSIONS There were no significant differences in short-term clinical success and technical success between octogenarians and non-octogenarians. However, octogenarians showed a significantly higher incidence of perioperative adverse events, particularly in major adverse events and non-technical adverse events. Peroral endoscopic myotomy for octogenarians should be carefully applied. This article is protected by copyright. All rights reserved.Phosphoenolpyruvate carboxylase (PEPC) is the second major carbon-fixing enzyme in photoautotrophic organisms. PEPC is required for the synthesis of amino acids of the glutamate and aspartate family by replenishing the TCA cycle. Furthermore, in cyanobacteria, PEPC, together with malate dehydrogenase and malic enzyme, forms a metabolic shunt for the synthesis of pyruvate from PEP. During this process, CO2 is first fixed and later released again. Due to its central metabolic position, it is crucial to fully understand the regulation of PEPC. Here, we identify PEPC from the cyanobacterium Synechocystis sp. PCC 6803 (PEPC) as a novel interaction partner for the global signal transduction protein PII . In addition to an extensive characterization of PEPC, we demonstrate specific PII -PEPC complex formation and its enzymatic consequences. PEPC activity is tuned by the metabolite-sensing properties of PII Whereas in the absence of PII, PEPC is subjected to ATP inhibition, it is activated beyond its basal activity in the presence of PII . Furthermore, PII -PEPC complex formation is inhibited by ADP and PEPC activation by PII -ATP is mitigated in the presence of 2-OG, linking PEPC regulation to the cell's global carbon/nitrogen status. Finally, physiological relevance of the in vitro measurements was proven by metabolomic analyses of Synechocystis wild-type and PII -deficient cells. © 2020 The Authors. Molecular Microbiology published by John Wiley & Sons Ltd.Nitric oxide (NO) is well known to be the secondary in vivo signalling agent, demonstrating various biological functions through regulating ion flux in channels. Considering the crucial role of NO in vivo, herein, a biomimetic NO-regulated nanofluidic sensor has been fabricated through a cyclization reaction strategy. This nanofluidic sensor exhibited a promising NO selectivity, sensitivity and non-interference performance in complex matrices. Thus, such a NO-driven nanosensor will be meaningful for scientific researchers to grasp the in vivo functions of NO. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Despite the significant progress of the enantioselective reaction using chiral catalysts, the enantioselective nucleophilic substitution reaction at the chiral sp 3 -hybridized carbon atom of a racemic electrophile has not been largely explored. Here, we report the enantioconvergent propargylic substitution reaction of racemic propargylic alcohols with thiols using chiral bis-phosphoric acid as the chiral Brønsted acid catalyst. The substitution products were formed in high yields with high enantioselectivities in most cases. The cation-stabilizing effect of the sulfur functional group introduced at the alkynyl terminus is the key to achieving the efficient enantioconvergent process, in which chiral information originating from not only the racemic stereogenic center but also the formed contact ion pair is completely eliminated from the present system. © 2020 WILEY-VCH Verlag GmbH & Co. check details KGaA, Weinheim.Osteoma cutis is the result of osseous metaplasia with mineralization of tumoral, necrobiotic, or otherwise pathological skin tissue. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.The soil adsorption coefficient (Koc ) plays an important role in environmental risk assessment of pesticide registration. Based on this risk assessment, applied and registered pesticides can be allowed in the European Union (EU). Almost one whole year is required to study and obtain the Koc value of a pesticide. Furthermore, acquiring the Koc requires a large cost. It is necessary to efficiently estimate the Koc value in the early stages of pesticide development. In this study, the experimental values of physicochemical properties and molecular descriptors of chemical structures were collected to develop a quantitative structure property relationship (QSPR) model, and the prediction performance of the model was evaluated. More specifically, we compared the accuracies of models based on a gradient boosting decision tree, multiple linear regression, and support vector machine. The experimental results suggest that it is possible to develop a QSPR model with high accuracy using both the molecular descriptors calculated from the structural formula and experimental values of physicochemical properties from open literature and databases. Comparing to the previously established models, we achieved high prediction accuracy, fitness, and robustness by only using freeware. Therefore, our developed QSPR models can be useful for preliminary risk assessment in the early developmental stages of pesticides. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.AIM General movements assessment (GMA), based on Gestalt perception, identifies infants at risk of cerebral palsy. However, the requirement of ample experience to construct the assessor's inner criteria for abnormal movement hampers its widespread clinical use. This study aims to describe details of general movements (GMs) in various body parts and to investigate their association with GMA-Gestalt. METHODS Participants were 24 typically developing infants and 22 very-high-risk infants. GMs were assessed during the writhing (0-8 weeks) and/or fidgety GM-phase (2-5 months) by GMA-Gestalt and a semi-quantification of the duration of simple movements and complex movements in various body parts. RESULTS During both GM-phases, the quality of movement often varied within a single assessment, but the degree of complexity and variation of movements in trunk, arms, and legs were interrelated (ρ=0.32-0.84). Longer durations of complex movements in arms and legs (p less then 0.042) were further associated with a better quality in GMA-Gestalt. Head movement was associated with movements in other body parts only in the writhing phase and not associated with GMA-Gestalt during both GM-phases. CONCLUSION Infants did not show consistently over time and across body parts simple or complex movements. Detailed description of movement characteristics may facilitate the development of computer-based GMA. This article is protected by copyright. All rights reserved.BACKGROUND Tooth wear is a multifactorial condition, leading to the loss of dental hard tissues. Physiological tooth wear is a slow process that normally does not lead to any subjective symptoms. When the condition progresses, it can become pathological, and several signs and symptoms may occur. The Tooth Wear Evaluation System (TWES) was described to implement a systematic diagnostic and management approach. Recently, management guidelines were presented in a European Consensus Statement (ECS) as well. OBJECTIVES To evaluate the TWES in practice and to integrate the principles described in the ECS in order to compose a renewed TWES 2.0 and a new taxonomy. METHODS The TWES and the recommendations of the ECS were used by dental clinicians, in order to test its applicability in practice. RESULTS Agreement was reached that the TWES 2.0 will use a stepwise approach, with a straightforward Tooth Wear Screening part and a more detailed Tooth Wear Status part. Also, the assessment of pathology from the ECS is incorporated in the TWES 2.0 (both classification and taxonomy). CONCLUSIONS In the TWES 2.0 is described that tooth wear is pathological if moderate/severe/extreme tooth wear is present, in combination with one or several described signs and symptoms. Etiology can be assessed by findings that indicate a chemical and/or a mechanical cause. The taxonomy may help to identify situations in which preventive (restorative) interventions in early stages of tooth wear can be indicated. The reliability and validity of the adapted parts must be proven. This article is protected by copyright. All rights reserved.