Gravesendrachmann2012

Low-moderate physical activity can still be recommended. However, extreme physical activity and hyperventilation during the incubation days and early stages of COVID-19, facilitates early direct penetration of high numbers of virus particles in the lower airways and the alveoli, without impacting on the airway's mucosae covered by neutralizing antibodies. This allows the virus bypassing the efficient immune barrier of the upper airways mucosa in already infected, young and otherwise healthy athletes. In conclusion, whether the virus or the adaptative immune response reach the lungs first, is a crucial factor deciding the fate of the patient. This "quantitative and time-sequence dependent" model has several implications for prevention, diagnosis, and therapy of COVID-19 at all ages. This article is protected by copyright. All rights reserved.The eukaryotic green microalga Tetraselmis suecica is commonly used for aquaculture purposes because of its high stress tolerance and ease of culture in a wide spectrum of environments; they are therefore suitable candidates for biotechnology applications. To date, no data are available regarding chloroplast transformation vectors based on specific endogenous promoters and homologous targeting regions. We report on the identification of Tetraselmis suecica genes encoding the ribulose bisphosphate carboxylase/oxygenase large subunit protein, the photosystem II D1 protein and the ATP synthase CF1-beta subunit protein together with their untranslated regions (5'UTR, 3'UTR). The full-length ORFs of the putative genes with their regulatory sequences were obtained. We were also able to identify the downstream 3' end of the large subunit ribosomal RNA gene (23S) along with the 5S RNA end-to-end with the psbA gene on the complementary strand. The intergenic region between these genes appears to be a good target site for the integration of target proteins. Moreover, we identified a back to back promoter region among the rbcL and atpB genes. To assess the bidirectionality activities of both promoters, a dual reporter vector was constructed for Tetraselmis suecica transformation containing the cat and TurboGFP genes driven by the 5'rbcL/5'atpB divergent promoter. The vector included the 23S-5S and psbA nucleotide sequences as flanking regions. These flanking regions provided suitable insertion sites within the chloroplast genome for cassette integration via homologous recombination. Simultaneous expression of the chloramphenicol-resistance conferring gene and the gene coding for TurboGFP driven by 5'rbcL/5'atpB showed a potent natural bidirectional promoter as a reliable genetic tool. This article is protected by copyright. All rights reserved.BACKGROUND/PURPOSE A pathological response of the primary tumor by preoperative therapy is a prognostic factor in various malignancies, and several histologic grading systems have been proposed for pancreatic ductal adenocarcinoma (PDAC). However, the prognostic value remains unclear. We explored the clinical implication of a major pathological response following preoperative therapy in patients with PDAC. METHODS Of 415 patients with resected PDAC, 137 who had undergone preoperative therapy were examined. Cox proportional hazards models were used to determine the predictors of a major pathological response, and survival analyses were performed. RESULTS Twenty patients exhibited a major pathological response (≥90% tumor reduction). Significant associations were observed between a major pathological response and resectability (P = .001), the period of preoperative therapy (P  less then  .001), RECIST best response (P  less then  .001), the tumor size after preoperative therapy (P = .02), and tumor marker recovery (P  less then  .001). Multivariate analysis of progression-free survival (PFS) revealed that both body mass index (≥20 kg/m2 ) (P = .035) and tumor marker recovery (P = .046) were independent prognostic factors. The median survival time (MST) of PFS for a ≥90% pathological response was better than that of a less then 90% response (P = .25); however, the MST for tumor marker recovery was significantly better than that without tumor marker recovery (P = .0054). CONCLUSIONS In our study, a major pathological response was not extracted as a prognostic factor. Rather, tumor marker recovery was a preferable prognostic factor in patients with PDAC who had undergone preoperative therapy. © 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.In a normal cardiac cycle, the trileaflet aortic valve opening is progressive, which correlates with the phasic blood flow. Therefore, we aimed to determine the impact of including an anatomically accurate reconstructed trileaflet aortic valve within a fluid-structure interaction (FSI) simulation model and determine the cyclical hemodynamic forces imposed on the thoracic aortic walls from aortic valve opening to closure. A pediatric patient with a normal trileaflet valve was recruited. Using the Cardiac Magnetic Resonance Data (CMR), a 3D model of the aortic valve and thoracic aorta was reconstructed. FSI simulations were employed to assess the tissue stress during a cardiac cycle as the result of changes in the valve opening. The blood flow was simulated as a mixture of blood plasma and red blood cells to account for non-Newtonian effects. The computation was validated with phase-contrast CMR. Windkessel boundary conditions were employed to ensure physiological pressures during the cardiac cycle. The leaflets' dynamic motion during the cardiac cycle was defined with an analytic grid velocity function. At the beginning of the valve opening a thin jet is developing. From mid-open towards full opening the stress level increases where the jet impinges the convex wall. At peak systole two counter-rotating Dean-like vortex cores manifest in the ascending aorta, which correlates with increased integrated mean stress levels. GS-9973 chemical structure An accurate trileaflet aortic valve is needed for capturing of both primary and secondary flow features that impact the forces on the thoracic aorta wall. Omitting the aortic valve underestimates the biomechanical response. © 2020 John Wiley & Sons, Ltd.