Foghmorse1878

AIM Majority of mediastinal masses in children are malignant. These masses are complex to manage as they have a risk of compression to surrounding structures. Many of these children have to be managed in the intensive care unit (ICU). Hence we sought to evaluate the local epidemiology of malignant mediastinal masses in children and their clinical presentation, and identified factors associated with ICU admission so that at-risk patients may be identified early. METHODS This study is a retrospective review of institutional case records of 56 children below 18 years of age from 2000 to 2015 with a malignant mediastinal mass. We collected data on their presenting symptoms, clinical signs, radiological investigations, treatment and correlated these factors with admission to our ICU. RESULTS Lymphoma was most common diagnosis, comprising 37 children (66.0%). There were 6 patients with neuroblastoma (10.7%), 3 patients with germ-cell tumour (5.4%) and 10 patients with T-cell acute lymphoblastic leukaemia (17.9%). Overall, 21 patients (37.5%) had to be admitted to the ICU. Almost all patients (98.2%) were symptomatic on presentation, of which lymphadenopathy was the most common (69.6%). Factors that are significantly associated with ICU admission are stridor, pericardial effusion and need for pleural drainage. CONCLUSIONS Malignant mediastinal masses in children in our institution range from leukaemias and lymphomas to germ cell tumours and neuroblastomas, of which almost all are symptomatic. These children have a risk of cardiorespiratory collapse and many of them require intensive care. We identified factors that are associated with ICU admission, with the aim of early intervention of at-risk cases. © 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).Most monogenic diabetes is misdiagnosed as either type 1 or type 2 diabetes (T1D/T2D). Few studies have examined the diagnostic challenges from the patients' perspective. This qualitative study aimed to investigate patients' journeys to obtaining a diagnosis of maturity-onset diabetes of the young (MODY) by elucidating the range of factors that can act as barriers and facilitators throughout this process. We recruited participants from the Personalized Diabetes Medicine Program (PDMP) at University of Maryland and used respondent-driven sampling to recruit additional patients. We conducted qualitative phone interviews between October 2016 and June 2017 with nine patients with diagnoses of monogenic diabetes (one HNF4A-MODY, seven GCK-MODY, and one HNF1A-MODY) and one parent of a patient with INS-MODY. Interview data were audio recorded, transcribed, and analyzed both inductively and deductively using thematic content analysis. All patients were female, with a mean age of 35 (range 7-67 years). The amount of time these patients were misdiagnosed ranged from a few months to 41 years. We identified barriers and facilitators in three broad themes (a) patient-related (nature of MODY symptoms, perceived test utility, individual personality); (b) provider-related (provider awareness and knowledge, provider communication); and (c) healthcare system-related (cost of testing, access to knowledgeable providers, patient education, and support resources). The diverse range of barriers and facilitators reiterates the complexity of the MODY diagnostic process. Limited awareness and knowledge of MODY from healthcare professionals and patients themselves account for most diagnostic delays described in this study. Efforts to promote awareness of MODY and expand access to screening and testing may result in quicker diagnosis and ensure the downstream benefits of proper treatment. © 2020 National Society of Genetic Counselors.PURPOSE This systematic review and meta-analysis aims to synthesize evidence relating to the effects of TiO2 nanotubes on osseointegration in animal models. MATERIALS AND METHODS The focused question was Does the preparation of TiO2 nanotubes on the surface of implants enhance osseointegration? Searches were performed for relevant manuscripts up to September 2019 using the PubMed, Embase, Scopus and Google Scholar databases with terms such as "TiO2 nanotubes" in combination with "osseointegration", "osteogenic", "osteogenesis", and "bone regeneration". The titles, abstracts and full texts of the manuscripts were reviewed in accordance with the eligibility criteria. The meta-analysis were then performed to analyze the effects of TiO2 nanotubes in bone-implant contact (BIC) and biomechanical tests. RESULTS Fourteen manuscripts were included for the systematic review and meta-analysis. Eleven studies showed that the results of a histological analysis, micro-CT evaluation and biomechanical tests were significantly higher near TiO2 than titanium. The meta-analysis demonstrating similar results in the BIC and biomechanical tests were obtained. The selected studies also showed the preferable nanotube diameter (70, 80 or 100 nm) to enhance osseointegration in BIC and/or bone area (BA). CONCLUSION TiO2 nanotubes, especially those with large diameters, enhanced osseointegration near titanium implants. Compared to bare nanotubes, TiO2 nanotube composite coatings resulted in higher osteogenic ability. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.2D covalent organic frameworks (COFs) are receiving ongoing attention in semiconductor photocatalysis. Herein, we present a photocatalytic selective chemical transformation by combining sp2 carbon-conjugated porphyrin-based covalent organic framework (Por-sp2 c-COF) photocatalysis with TEMPO catalysis illuminated by 623 nm red light-emitting diodes (LEDs). Highly selective conversion of amines into imines was swiftly afforded in minutes. Specifically, the π-conjugation of porphyrin linker leads to extensive absorption of red light; the sp2 -C=C- double bonds linkage ensures the stability of Por-sp2 c-COF under high concentrations of amine. Most importantly, we found that crystalline framework of Por-sp2 c-COF is pivotal for cooperative photocatalysis with (2,2,6,6-tetramethylpiperidin-1-yl)oxyl (TEMPO). This work foreshadows that the outstanding hallmarks of COFs, particularly crystallinity, could be exploited to address energy and environmental challenges by cooperative photocatalysis. © 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.Mitochondrial dysfunction is the leading cause of reactive oxygen species (ROS) burst and apoptosis in hepatic ischemia/reperfusion (I/R) injury. Ursodeoxycholyl lysophosphatidylethanolamide (UDCA-LPE) is a hepatotargeted agent that exerts hepatoprotective roles by regulating lipid metabolism. Our previous studies have shown that UDCA-LPE improves hepatic I/R injury by inhibiting apoptosis and inflammation. However, the role of UDCA-LPE in lipid metabolism and mitochondrial function in hepatic I/R remains unknown. In the present study, we investigated the role of UDCA-LPE in hepatic I/R by focusing on the interface of phospholipid metabolism and mitochondrial homeostasis. Livers from 28-week-old mice, primary hepatocytes and HepG2 cells were subjected to in vivo and in vitro I/R, respectively. Analyses of oxidative stress, imaging, ATP generation, genetics, and lipidomics showed that I/R was associated with mitochondrial dysfunction and a reduction in phospholipids. UDCA-LPE alleviated mitochondria-dependent oxidative stress and apoptosis and prevented the decrease of phospholipid levels. Our study found that cytosolic phospholipase A2 (cPLA2 ), a phospholipase that is activated during I/R, hydrolyzed mitochondrial membrane phospholipids and led to mitochondria-mediated oxidative stress and apoptosis. UDCA-LPE inhibited the interaction between cPLA2 and mitochondria and reduced phospholipid hydrolysis-mediated injury. UDCA-LPE might regulate the crosstalk between the phospholipid metabolism and the mitochondria, restore mitochondrial function and ameliorate I/R injury. © 2020 The Authors. The FASEB Journal published by Wiley Periodicals, Inc. on behalf of Federation of American Societies for Experimental Biology.During adhesion, cells develop filopodia to facilitate the attachment to the extracellular matrix. The small guanosine triphosphate (GTP)-binding protein, Cdc42, plays a central role in the formation of filopodia. It has been reported that Cdc42 activity is regulated by cholesterol (Chol). We examined Chol distribution in filopodia using Chol-binding domain 4 (D4) fragment of bacterial toxin, perfringolysin O that senses high membrane concentration of Chol. Our results indicate that fluorescent D4 was enriched at the tip of the outer leaflet of filopodia in the initiation phase of cell adhesion. This enrichment was accompanied by a defect of D4 labeling in the inner leaflet. Steady phase adhered cell experiment indicated that both Cdc42 and ATP-binding cassette transporter, ABCA1, were involved in the binding of D4 to the cell surface. Depletion of Chol activated Cdc42. Our results suggest that asymmetric distribution of Chol at the tip of filopodia induces activation of Cdc42, and thus, facilitates filopodia formation. © 2020 Federation of American Societies for Experimental Biology.Blood vessels and nerves travel together to supply most tissues in the body. However, there is a knowledge gap in the mechanisms underlying the direct regulation of angiogenesis by nerves. In the current study, we examined the regulation of angiogenesis by sensory nerves in response to inflammation using the cornea, a normally avascular and densely innervated ocular tissue, as a model. We used desiccating stress as an inflammatory stimulus in vivo and found that sub-basal and epithelial nerve densities in the cornea were reduced in dry eye disease (DED). We established a co-culture system of trigeminal ganglion sensory neurons and vascular endothelial cells (VEC) and found that neurons isolated from mice with DED directly promoted VEC proliferation and tube formation compared with normal controls. In addition, these neurons expressed and secreted higher levels of substance P (SP), a proinflammatory neuropeptide. SP potently promoted VEC activation in vitro and blockade of SP signaling with spantide I, an antagonist of SP receptor Neurokinin-1, significantly reduced corneal neovascularization in vivo. Spantide I and siRNA knockdown of SP abolished the promotion of VEC activation by DED neurons in vitro. Taken together, our data suggested that sensory neurons directly promote angiogenesis via SP signaling in response to inflammation in the cornea. © 2020 Federation of American Societies for Experimental Biology.AIMS His-Purkinje system pacing has been demonstrated as a synchronized ventricular pacing strategy via pacing His-Purkinje system directly, which can decrease the incidence of adverse cardiac structure alteration compared with right ventricular pacing (RVP). The purpose of this meta-analysis was to compare the effects of His-Purkinje system pacing and RVP in patients with bradycardia and cardiac conduction dysfunction. Pidnarulex METHODS PubMed, Embase, Cochrane Library, and Web of Science were systematically searched from the establishment of databases up to 15 December 2019. Studies on long-term clinical outcomes of His-Purkinje system pacing and RVP were included. Chronic paced QRS duration, chronic pacing threshold, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), all-cause mortality, and heart failure hospitalization were collected for meta-analysis. RESULTS A total of 13 studies comprising 2348 patients were included in this meta-analysis.