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8 vs 3.0, P = .08), on postoperative day 1 (1.6 vs 2.4, P = .08) and on the first office visit (0.2 vs 0.1, P = .82) did not have a statistically significant difference. Morphine equivalent opioid requirement for pain control in the postoperative period was 0.8 vs 6.9 mg (P less then .01), respectively. CONCLUSION In a randomized control trial, we showed that patients treated with nonopioid analgesia had similar pain scores to those treated with opioids, with the benefit of having lower opioid exposure in the perioperative period. The fludarabine, high dose cytarabine and G-CSF with or without idarubicin combination regimen, referred to as FLAG+/-Ida, is commonly used as a salvage regimen for relapsed/refractory AML but its use as initial induction therapy has been more limited. The impact of choice of induction regimen on post remission survival remains unclear. We retrospectively analyzed 304 consecutive AML patients, with non-favorable NCCN risk who received initial treatment at our center with either 7 + 3 (n = 86) or FLAG+/-Ida (n = 218). Patients in the FLAG+/-Ida group were more likely to achieve remission after one course of induction (74 % vs 62 %, p less then 0.001) and had a faster time to achieve CR (30 days vs 37.5, p less then 0.001) compared to 7 + 3. The time from diagnosis to transplant was shorter among CR patients after FLAG+/-Ida compared to 7 + 3 (115 vs. 151 days, p less then 0.003). The 3-year post-remission OS and DFS was significantly better for patients receiving FLAG-Ida at 54 % and 49 % compared to 39 % and 32 % for 7 + 3 respectively (P = 0.01). Factors associated with post-remission survival included age at CR1, NCCN risk, induction regimen (FLAG+/-Ida vs 3 + 7 h 0.62, p = 0.01) and receipt of HCT. Our data, with the limitations inherent to a retrospective analysis, shows that achieving CR after FLAG+/-Ida has better post remission survival than 7 + 3. Differentiation, self-renewal and quiescence of Hematopoietic stem cells (HSCs) is tightly regulated in order to protect the HSCs from the strain of constant cell division and depletion of the stem cell pool. The neurotransmitter Neuropeptide Y (NPY) is released from sympathetic nerves in the bone marrow and has been shown to indirectly affect HSC function through effects on bone marrow (BM) multipotent Mesenchymal Stromal Cells (MSCs), osteoblasts (OBs) and macrophages. Although the absence of NPY has been shown to be accompanied by severe BM impairment and delayed engraftment of HSCs, the direct effects of NPY on HSCs have never been assessed. Here, we aimed to explore the effect of NPY on the regulation of HSCs. All NPY receptors Y1, Y2, Y4 and Y5 were found to be highly expressed on most HSCs and mature hematopoietic cell subsets. In culture, in particularly expression of the Y1 receptor was shown to decrease in time. Doses of 300 nM NPY suppressed HSC proliferation in cell cultures, as confirmed by an increase of HSCs in G0 phase and an increase in the gene expression levels of FOXO3, DICER1, SMARCA2 and PDK1, which all have been shown to play an important role in the regulation of cell quiescence. These data support the idea that NPY may have a direct effect on the regulation of HSC fate by modulating cell quiescence. The Amphibian Conservation Action Plan (ACAP), published in 2007, is a formal document of international significance that proposed eleven relevant actions for global amphibian conservation. Action seven of the ACAP document addresses the use of amphibian captive programs as a conservation tool. Appendix material under this action explores the potential use of Genome Resource Banking (biobanking) as an urgently needed tool for these captive programs. ACAP proposed twelve objectives for Genome Resource Banking which exhibit little emphasis on reproduction as a vital underlying science for amphibian Captive Breeding Programs (CBP's). Here we have reassessed the original twelve ACAP objectives for amphibian reproduction and biobanking for CBP's as a contribution to future ACAP review processes. read more We have reviewed recent advances since the original objectives, as well as highlighted weaknesses and strengths for each of these objectives. We make various scientific, policy and economic recommendations based on the current reality and recent advances in relevant science in order to inform future ACAP towards new global objectives. The number of amphibian CBP'S has escalated in recent years and reproductive success is not always easily accomplished. Increases in applied and fundamental research on the natural history and reproductive biology of these species, followed by the appropriate development and application of artificial reproductive technologies (ART's) and the incorporation of genome resource banks (GRB's), may turn CBP's into a more powerful tool for amphibian conservation. BACKGROUND Delayed recognition of decompensation and failure-to-rescue on surgical wards are major sources of preventable harm. This review assimilates and critically evaluates available evidence and identifies opportunities to improve surgical ward safety. DATA SOURCES Fifty-eight articles from Cochrane Library, EMBASE, and PubMed databases were included. CONCLUSIONS Only 15-20% of patients suffering ward arrest survive. In most cases, subtle signs of instability often occur prior to critical illness and arrest, and underlying pathology is reversible. Coarse risk assessments lead to under-triage of high-risk patients to wards, where surveillance for complications depends on time-consuming manual review of health records, infrequent patient assessments, prediction models that lack accuracy and autonomy, and biased, error-prone decision-making. Streaming electronic heath record data, wearable continuous monitors, and recent advances in deep learning and reinforcement learning can promote efficient and accurate risk assessments, earlier recognition of instability, and better decisions regarding diagnosis and treatment of reversible underlying pathology. Insulin resistance (IR) is an important pathological basis of obesity, diabetes and cardiovascular diseases, and emerging evidence demonstrates aerobic exercise as an efficient therapeutical tool in the management of IR and IR-related metabolic disease. Interleukin-4 (IL-4), an important anti-inflammatory cytokine, was recently proved to be involved in regulation of IR, yet the effect of IL-4 on exercise-induced insulin sensitivity and underlying mechanism was less investigated. In this study, using a mouse model of swimming exercise training (60 min/day, 5 days/week for 8 weeks), we found that long-term swimming exercise promoted insulin sensitivity compared with sedentary groups as indexed by the homeostasis model assessment of insulin resistance (HOMA-IR), glucose and insulin tolerance test. Accompanying with increased insulin sensitivity, swimming exercise increased serum IL-4 levels as well as insulin receptor substrate 1 (IRS-1) and protein kinase B (Akt) phosphorylation. Mechanistically, IL-4 treatment increased insulin-stimulated glucose uptake and Akt phosphorylation in skeletal muscle C2C12 cells, and inhibition of IL-4 signaling via ruxolitinib, a Janus kinase (JAK) inhibitor, attenuated IL-4-induced insulin sensitivity. Taken together, our results demonstrated IL-4 as a novel exercise factor contributing to exercise-induced insulin sensitivity, providing a potential therapeutical target of IR and related metabolic disease. To reach a high separation efficiency using Centrifugal Partition Chromatography (CPC), the fluid dynamical behavior of the liquid-liquid two-phase systems must be clearly understood. The fluid dynamics, namely the dispersion, the coalescence, and the stationary phase retention, have a high impact on a separation. Especially the mobile phase dispersion influences the mass transfer during a separation. In this study, the mobile phase dispersion of different aqueous-organic solvent systems was characterized for ascending and descending mode via video analysis. Thereby the influence of the physical properties of the solvent systems, the operating parameters, and the geometry of the chamber inlet was investigated systematically using dimensional analysis. With the help of the dimensionless numbers Ohnesorge number (OhCPC), Eötvös number (EoCPC), and Weber number (WeCPC) the impact of the solvent system, the plant parameters, and the operating parameters on the mobile phase dispersion could be described. Inside the three dimensional area, spanned by the dimensionless numbers, each state of mobile phase dispersion (undispersed, low dispersed, highly dispersed, and atomized) could be allocated to an individual region for both operating modes. Moreover, differences in mobile phase deflection depending on the operating mode and a possible reason for these were described. V.BACKGROUND We aimed to identify key genes and microRNAs (miRNAs) associated with the development of polycystic ovary syndrome (PCOS). METHODS GSE84376 mRNA microarray data (15 PCOS granulosa cells and 13 control granulosa cells) and GSE34526 mRNA microarray data (7 PCOS granulosa cells and 3 control granulosa cells) were downloaded from the Gene Expression Omnibus (GEO) database. First, differentially expressed gene (DEG) analysis, gene set enrichment analysis (GSEA) for differentially expressed mRNAs, and protein-protein interaction (PPI) network analysis were conducted. Next, miRNA-target genes were analyzed and functions predicted, and a competing endogenous RNA (ceRNA) network was constructed. Finally, the relationship between miR-486-5p and PRELID2 was experimentally validated. RESULTS Spleen tyrosine kinase (SYK), major histocompatibility complex, class II, DR alpha (HLA-DRA), and interleukin 10 (IL-10) were important nodes in the PPI network. Interestingly, HLA-DRA was significantly enriched in phagosotitute a breakthrough in studying the pathophysiology of PCOS. This paper puts forward an intelligent method for online voltage stability margin (VSM) assessment based on optimal fuzzy system and feature selection technique, which has excellent performance for large power systems. The proposed VSM estimation method includes three key parts feature extraction and selection part, estimator part and training part. In this method, power system's loading parameters are used as the main input of adaptive neuro-fuzzy inference system (ANFIS) and association rules (AR) technique is used to select the most effective loading parameters. In the training part, we used Harris hawks optimization algorithm (HHOA) to train the ANFIS efficiently. Using the proposed method, the VSM can be monitored online with high precision for both small and large systems and appropriate control measures can be applied if necessary. Knowing the exact amount of VSM and applying precautionary measures can prevent from voltage collapse, heavy financial losses and power supply interruption. The proposed method tested on 39-bus, 118-bus and 300-bus IEEE test system and the MATLAB simulation results demonstrated that the propounded method has much better performance than other recently introduced VSM assessment approaches. Providing a VSM estimation method, which is effective for large power systems, selecting the most informative loading parameters and improving the ANFIS's performance using HHOA are the main contributions of this paper.

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