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In the multivariate analysis, factors N, M and mitotic index behaved as independent prognostic factors related to survival. Median disease-free interval in the series was 163.35 months. In cases with loco-regional recurrence, 53% had positive hiliar or mediastinal nodal involvement at the time of the surgery. In the univariate analysis, we observed statistically significant differences in disease-free interval in patients with nodal involvement (P = 0.024) and non-anatomical resections (P = 0.04). Histological characteristics showed no statistically significant differences in disease-free interval.

Lymph node involvement, the development of distant metastasis and mitotic index, more than Ki-67 determination, were shown as independent prognostic factors related to survival of these patients.

Lymph node involvement, the development of distant metastasis and mitotic index, more than Ki-67 determination, were shown as independent prognostic factors related to survival of these patients.

To examine national variation in systemic antibiotic use in long-term care facilities (LTCFs) and identify facility characteristics associated with antibiotic utilization.

This retrospective cohort study included 312 375 residents of 2536 Australian LTCFs between 2011 and 2016. MS4078 LTCFs were categorized as low, medium or high antibiotic use facilities according to tertiles of DDDs of systemic antibiotics dispensed per 1000 resident-days. Multivariable logistic regression estimated the associations between facility characteristics (ownership, size, location, medication quality indicator performance, prevalence of after-hours medical practitioner services) and antibiotic use (low versus high).

LTCFs in the lowest and highest antibiotic use categories received a median of 54.3 (IQR 46.5-60.5) and 106.1 (IQR 95.9-122.3) DDDs/1000 resident-days, respectively. Compared with not-for-profit LTCFs in major cities, government-owned non-metropolitan LTCFs were less likely to experience high antibiotic use [adjusted Ouse provides a basis for targeted stewardship initiatives.The effect of radiofrequency (RF) heating technology at 27 MHz and 8 kW on the quality properties of vacuum-packed nitrite-free sausages was investigated. One of the several advantages of RF heating technology is the use of less time compared to retort heating. RF heating at 125 °C for a holding time of 2 min and retort heating at 121 °C for 7 min reduced Bacillus subtilis to 7 log cfu/g. In addition, the textural properties of the RF-heated sausages were better than those of retort-heated samples. Furthermore, the growth of B. subtilis and general live bacteria at 25 °C were not detected after 42 days of shelf life in the sausages that underwent RF heating at 125 °C with a holding time of 2 min.Indole-3-acetic acid (IAA) produced by intestinal bacteria from tryptophan in dietary proteins is considered to suppress the inflammatory response through aryl hydrocarbon receptor (AhR) activation. However, AhR activation was not involved in the downregulation of tumor necrosis factor α (TNFα) expression induced by IAA in Caco-2 cells. The activation of unidentified IAA receptors might attenuate the inflammatory response to TNFα in colorectal cancer cells.

Ultrasound-guided stellate ganglion block (SGB) is an injection of local anesthetic (8mL of 0.5% ropivacaine) in the neck to temporarily block the cervical sympathetic trunk which controls the body's fight-or-flight response. This outpatient procedure takes less than thirty minutes and is immediately effective. Our goal was to determine if a left-sided stellate ganglion block is effective for treating posttraumatic stress disorder (PTSD) symptoms. While right-sided SGB has been extensively studied, left-sided SGB has not been formally evaluated for this indication.

Our hypothesis was that patients who fail to improve following a right-sided SGB will report significant improvement following a left-sided SGB. A retrospective chart review was conducted for patients who received SGB for PTSD symptoms between August 2019 and March 2020. All procedures were performed at an established musculoskeletal practice by the same anesthesia/pain fellowship-trained physician. Subjects included those who underwent a left-sided SGB (LSGB) only after non-response to a right-sided SGB (RSGB). Non-response was defined as less than 10 points of improvement on a PTSD Checklist (PCL-5).

Out of 205 patients, 20 did not respond to an RSGB and were included in our analysis. Ten of these patients subsequently received an LSGB, and 90% responded favorably (PCL-5 mean improvement = 28.3 points).

Based on our sample of 205 patients receiving SGB for PTSD, we concluded that at least 4.4% did not respond to a right-sided SGB but did have a significant response to a left-sided SGB.

Based on our sample of 205 patients receiving SGB for PTSD, we concluded that at least 4.4% did not respond to a right-sided SGB but did have a significant response to a left-sided SGB.

The Military Health System (MHS) overhauled its previous Electronic Health Records (EHRs) system. The MHS is in need of modernizing its healthcare system to improve patient safety and coordination of care between the MHS and Veterans Affairs. In 2015, the DoD awarded Cerner, Leidos, and Accenture a $4.3 billion EHR contract for a commercialized off-the-shelf system model to be used by more than 146,000 end users. This exploratory case study looked to access socio-technical barriers and facilitators to EHR implementation specifically in the military.

A document review served as the data source implementation plans, evaluation reports, congressional reports, news articles, and relevant peer-reviewed literature. A series of a priori codes were developed, and emergent codes arose out of the thematic analysis process.

There were several constructs that emerged from the analysis, placing emphasis on the uniqueness of EHR implementation in the MHS. The constructs of people, communication, and hardware and techders during health information technology implementation. Although significant health information technology changes may occur only once every few years, having issues during implementation impacts mission success, overall threatening the vital role that the MHS provides to national defense.

Linking microbial community members to their ecological functions is a central goal of environmental microbiology. When assigned taxonomy, amplicon sequences of metabolic marker genes can suggest such links, thereby offering an overview of the phylogenetic structure underpinning particular ecosystem functions. However, inferring microbial taxonomy from metabolic marker gene sequences remains a challenge, particularly for the frequently sequenced nitrogen fixation marker gene, nitrogenase reductase (nifH). Horizontal gene transfer in recent nifH evolutionary history can confound taxonomic inferences drawn from the pairwise identity methods used in existing software. Other methods for inferring taxonomy are not standardized and require manual inspection that is difficult to scale.

We present Phylogenetic Placement for Inferring Taxonomy (PPIT), an R package that infers microbial taxonomy from nifH amplicons using both phylogenetic and sequence identity approaches. After users place query sequences on a refes at https//github.com/bkapili/ppit. Installation includes a vignette that demonstrates package use and reproduces the nifH amplicon analysis discussed here. The raw nifH amplicon sequence data have been deposited in the GenBank, EMBL, and DDBJ databases under BioProject number PRJEB37167.

Supplementary data are available at Bioinformatics online.

Supplementary data are available at Bioinformatics online.From 2012 through 2020, a survey of wheat stem sawfly, Cephus cinctus Norton, was conducted in wheat (Triticum aestivum L.) fields in Eastern Colorado. In 2013, results showed sawfly infestations concentrated in the northern part of the state with only a few highly infested sites, with 38 of the 94 sampled sites having any infestation (five of which had >50% infestation levels). By 2020 sawfly had been found in all eastern counties sampled, and 72 of the 106 sites sampled were found to contain sawfly (11 of which had >50% infestation levels). The spread of this pest across the Colorado wheat-growing region will have lasting economic effects. The information gathered from this and future surveys will inform wheat variety development and aid in management decisions made by growers across the state.

The aim of this study was to use human genetics to investigate the pathogenesis of sick sinus syndrome (SSS) and the role of risk factors in its development.

We performed a genome-wide association study of 6469 SSS cases and 1000187 controls from deCODE genetics, the Copenhagen Hospital Biobank, UK Biobank, and the HUNT study. Variants at six loci associated with SSS, a reported missense variant in MYH6, known atrial fibrillation (AF)/electrocardiogram variants at PITX2, ZFHX3, TTN/CCDC141, and SCN10A and a low-frequency (MAF = 1.1-1.8%) missense variant, p.Gly62Cys in KRT8 encoding the intermediate filament protein keratin 8. A full genotypic model best described the p.Gly62Cys association (P = 1.6 × 10-20), with an odds ratio (OR) of 1.44 for heterozygotes and a disproportionally large OR of 13.99 for homozygotes. All the SSS variants increased the risk of pacemaker implantation. Their association with AF varied and p.Gly62Cys was the only variant not associating with any other arrhythmia or cardiovascular disease. We tested 17 exposure phenotypes in polygenic score (PGS) and Mendelian randomization analyses. Only two associated with the risk of SSS in Mendelian randomization, AF, and lower heart rate, suggesting causality. Powerful PGS analyses provided convincing evidence against causal associations for body mass index, cholesterol, triglycerides, and type 2 diabetes (P > 0.05).

We report the associations of variants at six loci with SSS, including a missense variant in KRT8 that confers high risk in homozygotes and points to a mechanism specific to SSS development. Mendelian randomization supports a causal role for AF in the development of SSS.

We report the associations of variants at six loci with SSS, including a missense variant in KRT8 that confers high risk in homozygotes and points to a mechanism specific to SSS development. Mendelian randomization supports a causal role for AF in the development of SSS.The whitefly, Bemisia tabaci MEAM1 Gennadius causes serious losses to Florida vegetable and ornamental production. In 2019, a maximum dose bioassay was administered to 20 field populations of B. tabaci MEAM1 collected from various economic and weed hosts across south Florida to assess insecticide efficacy. The maximum dose bioassay tests the top labeled rate of the insecticide against B. tabaci adults on treated cotton leaves in a Petri dish over a 72-h period. A susceptible laboratory colony of B. tabaci MEAM1 and a colony of B. tabaci MED were also tested. Survival over 72 h was used to produce an area under the maximum dose curve, which was used to compare insecticide effects on different populations. Overall, imidacloprid demonstrated the poorest efficacy, dinotefuran and flupyradifurone were the most effective, and bifenthrin, cyantraniliprole, and thiamethoxam tended to group together, providing intermediate control. Across populations tested, survival in whitefly adults treated with dinotefuran was 50% lower than whiteflies treated with imidacloprid, about 33% lower than whiteflies treated with thiamethoxam, bifenthrin, and cyantraniliprole, and 10% lower than whiteflies treated with flupyradifurone.