Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factor...Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factors.The infection can be acquired by means of oral-oral or fecal-oral transmission,and the pathogen possesses various mechanisms that improve its capacity of mobility,adherence and manipulation of the gastric microenvironment,making possible the colonization of an organ with a highly acidic lumen.In addition,H.pylori presents a large variety of virulence factors that improve its pathogenicity,of which we highlight cytotoxin associated antigen A,vacuolating cytotoxin,duodenal ulcer promoting gene A protein,outer inflammatory protein and gamma-glutamyl transpeptidase.The host immune system,mainly by means of a Th1-polarized response,also plays a crucial role in the infection course.Although most H.pylori-positive individuals remain asymptomatic,the infection predisposes the development of various clinical conditions as peptic ulcers,gastric adenocarcinomas and mucosa-associated lymphoid tissue lymphomas.Invasive and non-invasive diagnostic methods,each of them with their related advantages and limitations,have been applied in H.pylori detection.Moreover,bacterial resistance to antimicrobial therapy is a major challenge in the treatment of this infection,and new therapy alternatives are being tested to improve H.pylori eradication.Last but not least,the development of effective vaccines against H.pylori infection have been the aim of several research studies.展开更多
Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these ar...Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections(alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum-a major contributor to fracture healing- in the femoral neck. In extracapsularfractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients.展开更多
Thermal treatment technologies hold an important niche in the remediation of hydrocarbon- contaminated soils and sediments due to their ability to quickly and reliably meet cleanup standards. However, sustained high t...Thermal treatment technologies hold an important niche in the remediation of hydrocarbon- contaminated soils and sediments due to their ability to quickly and reliably meet cleanup standards. However, sustained high temperature can be energy intensive and can damage soil properties. Despite the broad applicability and prevalence of thermal remediation, little work has been done to improve the environmental compatibility and sustainahility of these technologies. We review several common thermal treatment technologies for hydrocarbon-contaminated soils, assess their potential environmental impacts, and propose frameworks for sustainable and low-impact deployment based on a holistic consideration of energy and water requirements, ecosystem ecology, and soil science. There is no universally appropriate thermal treatment technology. Rather, the appropriate choice depends on the contamination scenario （including the type of hydrocarbons present） and on site-specific considerations such as soil properties, water availability, and the heat sensitivity of contaminated soils. Overall, the convergence of treatment process engineering with soil science, ecosystem ecology, and plant biology research is essential to fill critical knowledge gaps and improve both the removal efficiency and sustainability of thermal technologies.展开更多
BACKGROUND:Hypertriglyceridemia is an unusual cause of acute pancreatitis and sometimes considered to be an epiphenomenon.This study aimed to investigate the clinical and analytical features and the APOE genotypes in ...BACKGROUND:Hypertriglyceridemia is an unusual cause of acute pancreatitis and sometimes considered to be an epiphenomenon.This study aimed to investigate the clinical and analytical features and the APOE genotypes in patients with acute pancreatitis and severe hypertriglyceridemia.METHODS:We undertook a one-year,prospective study of patients with acute pancreatitis whose first laboratory analysis on admission to the emergency department included measurement of serum triglycerides.The APOE genotype was determined and the patients answered an established questionnaire within the first 24 hours concerning their alcohol consumption,the presence of co-morbidities and any medications being taken.The patients’ progression,etiological diagnosis,hospital stay and clinical and radiological severity were all recorded.RESULTS:Hypertriglyceridemia was responsible for 7 of 133 cases of pancreatitis (5%);the remaining cases were of biliary (53%),idiopathic (26%),alcoholic (11%) or other (5%) origin.Compared with these remaining cases,the patients with hypertriglyceridemia were significantly younger,had more relapses,and more often had diabetes mellitus.They usually consumed alcohol or consumed it excessively on the days before admission.Also,the ε4 allele of the APOE gene was more common in this group (P<0.05).CONCLUSION:One of 20 episodes of acute pancreatitis is caused by hypertriglyceridemia and it is linked to genetic (ε4 allele) and comorbid factors such as diabetes and,especially,alcohol consumption.展开更多
AIM:To assess the efficacy and safety of endoscopic papillary large balloon dilation after biliary sphincterotomy for difficult bile duct stones retrieval.METHODS:Retrospective review of consecutive patients submitted...AIM:To assess the efficacy and safety of endoscopic papillary large balloon dilation after biliary sphincterotomy for difficult bile duct stones retrieval.METHODS:Retrospective review of consecutive patients submitted to the technique during 18 mo.The main outcomes considered were:efficacy of the procedure(complete stone clearance;number of sessions;need of lithotripsy) and complications.RESULTS:A total of 30 patients with a mean age of 68 ± 10 years,23 female(77%) and 7 male(23%) were enrolled.In 10 patients,a single stone was found in the common bile duct(33%) and in 20 patients multiple stones(67%) were found.The median diameter of the stones was 17 mm(12-30 mm).Dilations were performed with progressive diameter Through-TheScope balloons(up to 12,15) or 18 mm.Complete retrieval of stones was achieved in a single session in 25 patients(84%) and in two sessions in 4 patients(13%).Failure occurred in 1 case(6%).Mechanical lithotripsywas performed in 6 cases(20%).No severe complications occurred.One patient(3%) had mild-grade post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis.CONCLUSION:Endoscopic balloon dilatation with a large balloon after endoscopic sphincterotomy is a safe and effective technique that could be considered an alternative choice in therapeutic ERCP.展开更多
Impaired gene regulation lies at the heart of many disorders, including developmental diseases and cancer. Furthermore, the molecular pathways that control gene expression are often the target of cellular parasites, s...Impaired gene regulation lies at the heart of many disorders, including developmental diseases and cancer. Furthermore, the molecular pathways that control gene expression are often the target of cellular parasites, such as viruses. Gene expression is controlled through multiple mechanisms that are coordinated to ensure the proper and timely expression of each gene. Many of these mechanisms target the life cycle of the RNA molecule, from transcription to translation. Recently, another layer of regulation at the RNA level involving RNA modifications has gained renewed interest of the scientific community. The discovery that N6-methyladenosine （m6A）, a mod- ification present in mRNAs and long noncoding RNAs, can be removed by the activity of RNA demethylases, launched the field of epitranscriptomics; the study of how RNA function is regulated through the addition or removal of post-transcriptional modifications, similar to strategies used to regulate gene expression at the DNA and protein level. The abundance of RNA post-transcriptional modifications is determined by the activity of writer complexes （methylase） and eraser （RNA demethylase） proteins. Subsequently, the effects of RNA modifications materialize as changes in RNA structure and/or modulation of interactions between the modified RNA and RNA binding proteins or regulatory RNAs. Disruption of these pathways impairs gene expression and cellular function. This review focuses on the links between the RNA modification m6A and its implications in human diseases.展开更多
This study examines the predictability of three major cryptocurrencies—bitcoin,ethereum,and litecoin—and the profitability of trading strategies devised upon machine learning techniques(e.g.,linear models,random for...This study examines the predictability of three major cryptocurrencies—bitcoin,ethereum,and litecoin—and the profitability of trading strategies devised upon machine learning techniques(e.g.,linear models,random forests,and support vector machines).The models are validated in a period characterized by unprecedented turmoil and tested in a period of bear markets,allowing the assessment of whether the predictions are good even when the market direction changes between the validation and test periods.The classification and regression methods use attributes from trading and network activity for the period from August 15,2015 to March 03,2019,with the test sample beginning on April 13,2018.For the test period,five out of 18 individual models have success rates of less than 50%.The trading strategies are built on model assembling.The ensemble assuming that five models produce identical signals(Ensemble 5)achieves the best performance for ethereum and litecoin,with annualized Sharpe ratios of 80.17%and 91.35%and annualized returns(after proportional round-trip trading costs of 0.5%)of 9.62%and 5.73%,respectively.These positive results support the claim that machine learning provides robust techniques for exploring the predictability of cryptocurrencies and for devising profitable trading strategies in these markets,even under adverse market conditions.展开更多
AIM:To evaluate the efficacy and safety of endoscopic sphincterotomy(EST) + endoscopic papillary large balloon dilation(EPLBD)vs isolated EST.METHODS:We conducted a retrospective single center study over two years,fr... AIM:To evaluate the efficacy and safety of endoscopic sphincterotomy(EST) + endoscopic papillary large balloon dilation(EPLBD)vs isolated EST.METHODS:We conducted a retrospective single center study over two years,from February 2010 to January 2012.Patients with large(≥ 10 mm),single or multiple bile duct stones(BDS),submitted to endoscopic retrograde cholangio-pancreatography(ERCP) were included.Patients in Group A underwent papillary large balloon dilation after limited sphincterotomy(EST+EPLBD),using a through-the-scope balloon catheter gradually inflated to 12-18 mm according to the size of the largest stone and the maximal diameter of the distal bile duct on the cholangiogram.Patients in Group B(control group) underwent isolated sphincterotomy.Stones were removed using a retrieval balloon catheter and/or a dormia basket.When necessary,mechanical lithotripsy was performed.Complete clearance of the bile duct was documented with a balloon catheter cholangiogram at the end of the procedure.In case of residual lithiasis,a double pigtail plastic stent was placed and a second ERCP was planned within 4-6 wk.Some patients were sent for extracorporeal lithotripsy prior to subsequent ERCP.Outcomes of EST+EPLBD(Group A) vs isolated EST(Group B) were compared regarding efficacy(complete stone clearance,number of therapeutic sessions,mechanical and/or extracorporeal lithotripsy,biliary stent placement) and safety(frequency,type and grade of complications).Statistical analysis was performed using χ 2 or Fisher’s exact tests for the analysis of categorical parameters and Student’s t test for continuous variables.A P-value of less than 0.05 was considered statistically significant.RESULTS:One hundred and eleven patients were included,68(61.3%) in Group A and 43(38.7%) in Group B.The mean diameter of the stones was similar in the two groups(16.8 ± 4.4 and 16.0 ± 6.7 in Groups A and B,respectively).Forty-eight(70.6%) patients in Group A and 21(48.8%) in Group B had multiple BDS(P = 0.005).Overall,balloon dilation was展开更多
AIM： To determine the clinical, analytical and endoscopic factors related to ischemic colitis （IC） severity. METHODS： A total of 85 patients were enrolled in a retrospective study from January 1996 to May 2004. Th...AIM： To determine the clinical, analytical and endoscopic factors related to ischemic colitis （IC） severity. METHODS： A total of 85 patients were enrolled in a retrospective study from January 1996 to May 2004. There were 53 females and 32 males （age 74.6 ± 9.4 years, range 45-89 years）. The patients were diagnosed as IC. The following variables were analyzed including age, sex, period of time from the appearance of symptoms to admission, medical history, medication, stool frequency, clinical symptoms and signs, blood tests （hemogram and basic biochemical profile）, and endoscopic findings. Patients were divided in mild IC group and severe IC group （surgery and/or death）. Qualitative variables were analyzed using chi-square test and parametric data were analyzed using Student＇s t test （P 〈 0.05）. RESULTS： The mild IC group was consisted of 69 patients （42 females and 27 males, average age 74.7 ± 12.4 years）. The severe IC group was composed of 16 patients （11 females and 5 males, average age of 73.8 ± 12.4 years）. One patient died because of failure of medical treatment （no surgery）, 15 patients underwent surgery （6 after endoscopic diagnosis and 9 after peroperatory diagnosis）. Eight of 85 patients （9.6%） died and the others were followed up as out-patients for 9.6 ± 3.5 mo. Demographic data, medical history, medication and stool frequency were similar in both groups （P 〉 0.05）. Seriously ill patients had less hematochezia than slightly ill patients （37.5% vs 86.9%, P = 0.000）. More tachycardia （45.4% vs 10.1%, P = 0.011） and a higher prevalence of peritonism signs （75% vs 5.7%, P = 0.000） were observed in the severe IC group while the presence and intensity of abdominal pain were similar between two groups. Two patients with severe IC had shock when admitted. Regarding analytical data, more seriously ill patients were found to have anemia and hyponatremia than the mildly ill patients （37.5% vs 10.1%, P = 0.014 and 46.6% vs 14.9%, P = 0.012展开更多
The genus Diaporthe(Phomopsis)includes important plant pathogenic fungi with wide host ranges and geographic distributions.In the present study,phylogenetic species recognition in Diaporthe is re-evaluated using a mul...The genus Diaporthe(Phomopsis)includes important plant pathogenic fungi with wide host ranges and geographic distributions.In the present study,phylogenetic species recognition in Diaporthe is re-evaluated using a multi-locus phylogeny based on a combined data matrix of rDNA ITS,and partial sequences from the translation elongation factor 1-α(EF 1-α),βtubulin(TUB)and calmodulin(CAL)molecular markers.DNA sequences of available extype cultures have been included,providing a multi-locus backbone tree for future studies on Diaporthe.Four utilizable loci were analyzed individually and in combination,and ITS,EF 1-αand multi-locus phylogenetic trees are presented.The phylogenetic tree inferred by combined analysis of four loci provided the best resolution for species as compared to single gene analysis.Notes are provided for nine species previously known in Phomopsis that are transferred to Diaporthe in the present study.The unraveling of cryptic species complexes of Diaporthe based on Genealogical Concordance Phylogenetic Species Recognition(GCPSR)is emphasized.展开更多
Acute respiratory distress syndrome(ARDS) represents a serious problem in critically ill patients and is associated with in-hospital mortality rates of 33%-52%. Recruitment maneuvers(RMs) are a simple, low-cost, feasi...Acute respiratory distress syndrome(ARDS) represents a serious problem in critically ill patients and is associated with in-hospital mortality rates of 33%-52%. Recruitment maneuvers(RMs) are a simple, low-cost, feasible intervention that can be performed at the bedside in patients with ARDS. RMs are characterized by the application of airway pressure to increase transpulmonary pressure transiently. Once non-aerated lung units are reopened, improvements are observed in respiratory system mechanics, alveolar reaeration on computed tomography, and improvements in gas exchange(functional recruitment). However, the reopening process could lead to vascular compression, which can be associated with overinflation, and gas exchange may not improve as expected(anatomical recruitment). The purpose of this review was to discuss the effects of different RM strategies- sustained inflation, intermittent sighs, and stepwise increases of positive end-expiratory pressure(PEEP) and/or airway inspiratory pressure- on the following parameters: hemodynamics, oxygenation, barotrauma episodes, and lung recruitability through physiological variables and imaging techniques. RMs and PEEP titration are interdependent events for the success of ventilatory management. PEEP should be adjusted on the basis of respiratory system mechanics and oxygenation. Recent systematic reviews and meta-analyses suggest that RMs are associated with lower mortality in patients with ARDS. However, the optimal RM method(i.e., that providing the best balance of benefit and harm) and the effects of RMs on clinical outcome are still under discussion, and further evidence is needed.展开更多
In patients with an acute ST-segment elevation myocardial infarction, timely myocardial reperfusion using primary percutaneous coronary intervention is the most effective therapy for limiting myocardial infarct size, ...In patients with an acute ST-segment elevation myocardial infarction, timely myocardial reperfusion using primary percutaneous coronary intervention is the most effective therapy for limiting myocardial infarct size, preserving left-ventricular systolic function and reducing the onset of heart failure. Within minutes after the restoration of blood flow, however, reperfusion itself results in additional damage, also known as myocardial ischemia-reperfusion injury. An improved understanding of the pathophysiological mechanisms underlying reperfusion injury has resulted in the identification ofseveral promising pharmacological(cyclosporin-A, exenatide, glucose-insulin-potassium, atrial natriuretic peptide, adenosine, abciximab, erythropoietin, metoprolol and melatonin) therapeutic strategies for reducing the severity of myocardial reperfusion injury. Many of these agents have shown promise in initial proofof-principle clinical studies. In this article, we review the pathophysiology underlying myocardial reperfusion injury and highlight the potential pharmacological interventions which could be used in the future to prevent reperfusion injury and improve clinical outcomes in patients with coronary heart disease.展开更多
Pestalotiopsis is a taxonomically confused,pathogenic and chemically creative genus requiring a critical reexamination using a multi-gene phylogeny based on ex-type and ex-epitype cultures.In this study 40 isolates of...Pestalotiopsis is a taxonomically confused,pathogenic and chemically creative genus requiring a critical reexamination using a multi-gene phylogeny based on ex-type and ex-epitype cultures.In this study 40 isolates of Pestalotiopsis,comprised of 28 strains collected from living and dead plant material of various host plants from China were studied by means of morphology and analysis of ITS,β–tubulin and tef1 gene sequence data.Based on molecular and morphological data we describe 14 new species(Pestalotiopsis asiatica,P.chinensis,P.chrysea,P.clavata,P.diversiseta,P.ellipsospora,P.inflexa,P.intermedia,P.linearis,P.rosea,P.saprophyta,P.umberspora,P.unicolor and P.verruculosa)and three species are epitypified(P.adusta,P.clavispora and P.foedans).Of the 10 gene regions(ACT,β-tubulin,CAL,GPDH,GS,ITS,LSU,RPB 1,SSU and tef1)utilized to resolve cryptic Pestalotiopsis species,ITS,β–tubulin and tef1 proved to be the better markers.The other gene regions were less useful due to poor success in PCR amplification and/or in their ability to resolve species boundaries.As a single gene tef1 met the requirements for an ideal candidate and functions well for species delimitation due to its better species resolution and PCR success.Althoughβ-tubulin showed fairly good differences among species,a combination of ITS,β-tubulin and tef1 gene data gave the best resolution as compared to single gene analysis.This work provides a backbone tree for 22 ex-type/epitypified species of Pestalotiopsis and can be used in future studies of the genus.展开更多
Three genera,Cochliobolus,Bipolaris and Curvularia form a complex that contains many plant pathogens,mostly on grasses(Poaceae)with a worldwide distribution.The taxonomy of this complex is confusing as frequent nomenc...Three genera,Cochliobolus,Bipolaris and Curvularia form a complex that contains many plant pathogens,mostly on grasses(Poaceae)with a worldwide distribution.The taxonomy of this complex is confusing as frequent nomenclatural changes and refinements have occurred.There is no clear morphological boundary between the asexual genera Bipolaris and Curvularia,and some species show intermediate morphology.We investigated this complex based on a set of ex-type cultures and collections from northern Thailand.Combined gene analysis of rDNA ITS(internal transcribed spacer),GPDH(glyceraldehyde 3-phosphate dehydrogenase),LSU(large subunit)and EF1-α(translation elongation factor 1-α)shows that this generic complex divides into two groups.Bipolaris and Cochliobolus species clustered in Group 1 along with their type species,whereas Curvularia species(including species named as Bipolaris,Cochliobolus and Curvularia)clustered in Group 2,with its generic type.The nomenclatural conflict in this complex is resolved giving priority to the more commonly used established generic names Bipolaris and Curvularia.Modern descriptions of the genera Bipolaris and Curvularia are provided and species resolved in this study are transferred to one of these genera based on their phylogeny.展开更多
In a seed-mediated synthesis, nanocrystal growth is often described by assuming the absence of homogeneous nucleation in the solution. Here we provide new insights into the nucleation and growth mechanisms underlying ...In a seed-mediated synthesis, nanocrystal growth is often described by assuming the absence of homogeneous nucleation in the solution. Here we provide new insights into the nucleation and growth mechanisms underlying the formation of bimetallic nanodendrites that are characterized by a dense array of Pt branches anchored to a Pd nanocrystal core. These nanostructures can be easily prepared by a one-step, seeded growth method that involves the reduction of K2PtCl4 by L-ascorbic acid in the presence of 9-nm truncated octahedral Pd seeds in an aqueous solution. Transmission electron microscopy (TEM) and high-resolution TEM analyses revealed that both homogeneous and heterogeneous nucleation of Pt occurred at the very early stages of the synthesis and the Pt branches grew through oriented attachment of small Pt particles that had been formed via homogeneous nucleation. These new findings contradict the generally accepted mechanism for seeded growth that only involves heterogeneous nucleation and simple growth via atomic addition. We have also investigated the electrocatalytic properties of the Pd-Pt nanodendrites for the oxygen reduction and formic acid oxidation reactions by conducting a comparative study with foam-like Pt nanostructures prepared in the absence of Pd seeds under otherwise identical conditions.展开更多
Recent discovery of PYR/PYL/RCAR-type abscisic acid （ABA） receptors has become one of most significant advances in plant science in the past decade. In mammals, endosomal sorting acts as an important pathway to down...Recent discovery of PYR/PYL/RCAR-type abscisic acid （ABA） receptors has become one of most significant advances in plant science in the past decade. In mammals, endosomal sorting acts as an important pathway to downregulate different types of receptors, but its role in plant hormone signaling is poorly understood. Here, we report that an ubiquitin E2-1ike protein, VPS23A, which is a key component of ESCRT-I, negatively regulates ABA signaling. VPS23A has epistatic relationship with PYR/PYL/RCAR-type ABA receptors and disruption of VPS23A enhanced the activity of key kinase OST1 in the ABA signaling pathway under ABA treatment. Moreover, VPS23A interacts with PYR1/PYLs and K63-1inked diubiquitin, and PYL4 possesses K63-1inked ubiquitinated modification in vivo. Further analysis revealed that VPS23A affects the subcellular localization of PYR 1 and the stability of PYL4. Taken together, our results suggest that VPS23A affects PYR1/ PYL4 via vacuole-mediated degradation, providing an advanced understanding of both the turnover of ABA receptors and ESCRTs in plant hormone signaling.展开更多
文摘Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factors.The infection can be acquired by means of oral-oral or fecal-oral transmission,and the pathogen possesses various mechanisms that improve its capacity of mobility,adherence and manipulation of the gastric microenvironment,making possible the colonization of an organ with a highly acidic lumen.In addition,H.pylori presents a large variety of virulence factors that improve its pathogenicity,of which we highlight cytotoxin associated antigen A,vacuolating cytotoxin,duodenal ulcer promoting gene A protein,outer inflammatory protein and gamma-glutamyl transpeptidase.The host immune system,mainly by means of a Th1-polarized response,also plays a crucial role in the infection course.Although most H.pylori-positive individuals remain asymptomatic,the infection predisposes the development of various clinical conditions as peptic ulcers,gastric adenocarcinomas and mucosa-associated lymphoid tissue lymphomas.Invasive and non-invasive diagnostic methods,each of them with their related advantages and limitations,have been applied in H.pylori detection.Moreover,bacterial resistance to antimicrobial therapy is a major challenge in the treatment of this infection,and new therapy alternatives are being tested to improve H.pylori eradication.Last but not least,the development of effective vaccines against H.pylori infection have been the aim of several research studies.
文摘Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections(alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum-a major contributor to fracture healing- in the femoral neck. In extracapsularfractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients.
基金supported by Chevron Corporationsupport of NSF EAR 0949337
文摘Thermal treatment technologies hold an important niche in the remediation of hydrocarbon- contaminated soils and sediments due to their ability to quickly and reliably meet cleanup standards. However, sustained high temperature can be energy intensive and can damage soil properties. Despite the broad applicability and prevalence of thermal remediation, little work has been done to improve the environmental compatibility and sustainahility of these technologies. We review several common thermal treatment technologies for hydrocarbon-contaminated soils, assess their potential environmental impacts, and propose frameworks for sustainable and low-impact deployment based on a holistic consideration of energy and water requirements, ecosystem ecology, and soil science. There is no universally appropriate thermal treatment technology. Rather, the appropriate choice depends on the contamination scenario （including the type of hydrocarbons present） and on site-specific considerations such as soil properties, water availability, and the heat sensitivity of contaminated soils. Overall, the convergence of treatment process engineering with soil science, ecosystem ecology, and plant biology research is essential to fill critical knowledge gaps and improve both the removal efficiency and sustainability of thermal technologies.
基金supported by a grant from Grupos de Investigacion y Desarrollo Tecnologico de la Junta de Andalucía(Grupo consolidado CTS-159)
文摘BACKGROUND:Hypertriglyceridemia is an unusual cause of acute pancreatitis and sometimes considered to be an epiphenomenon.This study aimed to investigate the clinical and analytical features and the APOE genotypes in patients with acute pancreatitis and severe hypertriglyceridemia.METHODS:We undertook a one-year,prospective study of patients with acute pancreatitis whose first laboratory analysis on admission to the emergency department included measurement of serum triglycerides.The APOE genotype was determined and the patients answered an established questionnaire within the first 24 hours concerning their alcohol consumption,the presence of co-morbidities and any medications being taken.The patients’ progression,etiological diagnosis,hospital stay and clinical and radiological severity were all recorded.RESULTS:Hypertriglyceridemia was responsible for 7 of 133 cases of pancreatitis (5%);the remaining cases were of biliary (53%),idiopathic (26%),alcoholic (11%) or other (5%) origin.Compared with these remaining cases,the patients with hypertriglyceridemia were significantly younger,had more relapses,and more often had diabetes mellitus.They usually consumed alcohol or consumed it excessively on the days before admission.Also,the ε4 allele of the APOE gene was more common in this group (P<0.05).CONCLUSION:One of 20 episodes of acute pancreatitis is caused by hypertriglyceridemia and it is linked to genetic (ε4 allele) and comorbid factors such as diabetes and,especially,alcohol consumption.
文摘AIM:To assess the efficacy and safety of endoscopic papillary large balloon dilation after biliary sphincterotomy for difficult bile duct stones retrieval.METHODS:Retrospective review of consecutive patients submitted to the technique during 18 mo.The main outcomes considered were:efficacy of the procedure(complete stone clearance;number of sessions;need of lithotripsy) and complications.RESULTS:A total of 30 patients with a mean age of 68 ± 10 years,23 female(77%) and 7 male(23%) were enrolled.In 10 patients,a single stone was found in the common bile duct(33%) and in 20 patients multiple stones(67%) were found.The median diameter of the stones was 17 mm(12-30 mm).Dilations were performed with progressive diameter Through-TheScope balloons(up to 12,15) or 18 mm.Complete retrieval of stones was achieved in a single session in 25 patients(84%) and in two sessions in 4 patients(13%).Failure occurred in 1 case(6%).Mechanical lithotripsywas performed in 6 cases(20%).No severe complications occurred.One patient(3%) had mild-grade post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis.CONCLUSION:Endoscopic balloon dilatation with a large balloon after endoscopic sphincterotomy is a safe and effective technique that could be considered an alternative choice in therapeutic ERCP.
基金supported by the Intramural Research Program of the NIH,National Cancer Institute,Center for Cancer Research,United States of America
文摘Impaired gene regulation lies at the heart of many disorders, including developmental diseases and cancer. Furthermore, the molecular pathways that control gene expression are often the target of cellular parasites, such as viruses. Gene expression is controlled through multiple mechanisms that are coordinated to ensure the proper and timely expression of each gene. Many of these mechanisms target the life cycle of the RNA molecule, from transcription to translation. Recently, another layer of regulation at the RNA level involving RNA modifications has gained renewed interest of the scientific community. The discovery that N6-methyladenosine （m6A）, a mod- ification present in mRNAs and long noncoding RNAs, can be removed by the activity of RNA demethylases, launched the field of epitranscriptomics; the study of how RNA function is regulated through the addition or removal of post-transcriptional modifications, similar to strategies used to regulate gene expression at the DNA and protein level. The abundance of RNA post-transcriptional modifications is determined by the activity of writer complexes （methylase） and eraser （RNA demethylase） proteins. Subsequently, the effects of RNA modifications materialize as changes in RNA structure and/or modulation of interactions between the modified RNA and RNA binding proteins or regulatory RNAs. Disruption of these pathways impairs gene expression and cellular function. This review focuses on the links between the RNA modification m6A and its implications in human diseases.
基金This work has been funded by national funds through FCT-Fundaçao para a Ciência e a Tecnologia,I.P.,Project UIDB/05037/2020.
文摘This study examines the predictability of three major cryptocurrencies—bitcoin,ethereum,and litecoin—and the profitability of trading strategies devised upon machine learning techniques(e.g.,linear models,random forests,and support vector machines).The models are validated in a period characterized by unprecedented turmoil and tested in a period of bear markets,allowing the assessment of whether the predictions are good even when the market direction changes between the validation and test periods.The classification and regression methods use attributes from trading and network activity for the period from August 15,2015 to March 03,2019,with the test sample beginning on April 13,2018.For the test period,five out of 18 individual models have success rates of less than 50%.The trading strategies are built on model assembling.The ensemble assuming that five models produce identical signals(Ensemble 5)achieves the best performance for ethereum and litecoin,with annualized Sharpe ratios of 80.17%and 91.35%and annualized returns(after proportional round-trip trading costs of 0.5%)of 9.62%and 5.73%,respectively.These positive results support the claim that machine learning provides robust techniques for exploring the predictability of cryptocurrencies and for devising profitable trading strategies in these markets,even under adverse market conditions.
文摘 AIM:To evaluate the efficacy and safety of endoscopic sphincterotomy(EST) + endoscopic papillary large balloon dilation(EPLBD)vs isolated EST.METHODS:We conducted a retrospective single center study over two years,from February 2010 to January 2012.Patients with large(≥ 10 mm),single or multiple bile duct stones(BDS),submitted to endoscopic retrograde cholangio-pancreatography(ERCP) were included.Patients in Group A underwent papillary large balloon dilation after limited sphincterotomy(EST+EPLBD),using a through-the-scope balloon catheter gradually inflated to 12-18 mm according to the size of the largest stone and the maximal diameter of the distal bile duct on the cholangiogram.Patients in Group B(control group) underwent isolated sphincterotomy.Stones were removed using a retrieval balloon catheter and/or a dormia basket.When necessary,mechanical lithotripsy was performed.Complete clearance of the bile duct was documented with a balloon catheter cholangiogram at the end of the procedure.In case of residual lithiasis,a double pigtail plastic stent was placed and a second ERCP was planned within 4-6 wk.Some patients were sent for extracorporeal lithotripsy prior to subsequent ERCP.Outcomes of EST+EPLBD(Group A) vs isolated EST(Group B) were compared regarding efficacy(complete stone clearance,number of therapeutic sessions,mechanical and/or extracorporeal lithotripsy,biliary stent placement) and safety(frequency,type and grade of complications).Statistical analysis was performed using χ 2 or Fisher’s exact tests for the analysis of categorical parameters and Student’s t test for continuous variables.A P-value of less than 0.05 was considered statistically significant.RESULTS:One hundred and eleven patients were included,68(61.3%) in Group A and 43(38.7%) in Group B.The mean diameter of the stones was similar in the two groups(16.8 ± 4.4 and 16.0 ± 6.7 in Groups A and B,respectively).Forty-eight(70.6%) patients in Group A and 21(48.8%) in Group B had multiple BDS(P = 0.005).Overall,balloon dilation was
基金Supported by a grant from the Instituto de Salud Carlos III (03/02)
文摘AIM： To determine the clinical, analytical and endoscopic factors related to ischemic colitis （IC） severity. METHODS： A total of 85 patients were enrolled in a retrospective study from January 1996 to May 2004. There were 53 females and 32 males （age 74.6 ± 9.4 years, range 45-89 years）. The patients were diagnosed as IC. The following variables were analyzed including age, sex, period of time from the appearance of symptoms to admission, medical history, medication, stool frequency, clinical symptoms and signs, blood tests （hemogram and basic biochemical profile）, and endoscopic findings. Patients were divided in mild IC group and severe IC group （surgery and/or death）. Qualitative variables were analyzed using chi-square test and parametric data were analyzed using Student＇s t test （P 〈 0.05）. RESULTS： The mild IC group was consisted of 69 patients （42 females and 27 males, average age 74.7 ± 12.4 years）. The severe IC group was composed of 16 patients （11 females and 5 males, average age of 73.8 ± 12.4 years）. One patient died because of failure of medical treatment （no surgery）, 15 patients underwent surgery （6 after endoscopic diagnosis and 9 after peroperatory diagnosis）. Eight of 85 patients （9.6%） died and the others were followed up as out-patients for 9.6 ± 3.5 mo. Demographic data, medical history, medication and stool frequency were similar in both groups （P 〉 0.05）. Seriously ill patients had less hematochezia than slightly ill patients （37.5% vs 86.9%, P = 0.000）. More tachycardia （45.4% vs 10.1%, P = 0.011） and a higher prevalence of peritonism signs （75% vs 5.7%, P = 0.000） were observed in the severe IC group while the presence and intensity of abdominal pain were similar between two groups. Two patients with severe IC had shock when admitted. Regarding analytical data, more seriously ill patients were found to have anemia and hyponatremia than the mildly ill patients （37.5% vs 10.1%, P = 0.014 and 46.6% vs 14.9%, P = 0.012
基金supported by the State Key Laboratory of Mycology,Institute of Microbiology by grant NFSC Y2JJ011002Thailand Research fund BRG 52800002.
文摘The genus Diaporthe(Phomopsis)includes important plant pathogenic fungi with wide host ranges and geographic distributions.In the present study,phylogenetic species recognition in Diaporthe is re-evaluated using a multi-locus phylogeny based on a combined data matrix of rDNA ITS,and partial sequences from the translation elongation factor 1-α(EF 1-α),βtubulin(TUB)and calmodulin(CAL)molecular markers.DNA sequences of available extype cultures have been included,providing a multi-locus backbone tree for future studies on Diaporthe.Four utilizable loci were analyzed individually and in combination,and ITS,EF 1-αand multi-locus phylogenetic trees are presented.The phylogenetic tree inferred by combined analysis of four loci provided the best resolution for species as compared to single gene analysis.Notes are provided for nine species previously known in Phomopsis that are transferred to Diaporthe in the present study.The unraveling of cryptic species complexes of Diaporthe based on Genealogical Concordance Phylogenetic Species Recognition(GCPSR)is emphasized.
基金Supported by Brazilian Council for Scientific and Technological Development(CNPq),Carlos Chagas Filho Rio de Janeiro State Research Foundation(FAPERJ),Department of Science and Technology(DECIT)/Brazilian Ministry of HealthCoordination for the Improvement of Higher Level Personnel(CAPES)
文摘Acute respiratory distress syndrome(ARDS) represents a serious problem in critically ill patients and is associated with in-hospital mortality rates of 33%-52%. Recruitment maneuvers(RMs) are a simple, low-cost, feasible intervention that can be performed at the bedside in patients with ARDS. RMs are characterized by the application of airway pressure to increase transpulmonary pressure transiently. Once non-aerated lung units are reopened, improvements are observed in respiratory system mechanics, alveolar reaeration on computed tomography, and improvements in gas exchange(functional recruitment). However, the reopening process could lead to vascular compression, which can be associated with overinflation, and gas exchange may not improve as expected(anatomical recruitment). The purpose of this review was to discuss the effects of different RM strategies- sustained inflation, intermittent sighs, and stepwise increases of positive end-expiratory pressure(PEEP) and/or airway inspiratory pressure- on the following parameters: hemodynamics, oxygenation, barotrauma episodes, and lung recruitability through physiological variables and imaging techniques. RMs and PEEP titration are interdependent events for the success of ventilatory management. PEEP should be adjusted on the basis of respiratory system mechanics and oxygenation. Recent systematic reviews and meta-analyses suggest that RMs are associated with lower mortality in patients with ARDS. However, the optimal RM method(i.e., that providing the best balance of benefit and harm) and the effects of RMs on clinical outcome are still under discussion, and further evidence is needed.
基金Supported by Framework of one research project of the Spanish Society of Cardiology for Clinical Research in Cardiology 2012
文摘In patients with an acute ST-segment elevation myocardial infarction, timely myocardial reperfusion using primary percutaneous coronary intervention is the most effective therapy for limiting myocardial infarct size, preserving left-ventricular systolic function and reducing the onset of heart failure. Within minutes after the restoration of blood flow, however, reperfusion itself results in additional damage, also known as myocardial ischemia-reperfusion injury. An improved understanding of the pathophysiological mechanisms underlying reperfusion injury has resulted in the identification ofseveral promising pharmacological(cyclosporin-A, exenatide, glucose-insulin-potassium, atrial natriuretic peptide, adenosine, abciximab, erythropoietin, metoprolol and melatonin) therapeutic strategies for reducing the severity of myocardial reperfusion injury. Many of these agents have shown promise in initial proofof-principle clinical studies. In this article, we review the pathophysiology underlying myocardial reperfusion injury and highlight the potential pharmacological interventions which could be used in the future to prevent reperfusion injury and improve clinical outcomes in patients with coronary heart disease.
基金We thank Thailand Research Fund(grant:BRG5280002)The National Research Council of Thailand(grant for Pestalotiopsis No:55201020008)+4 种基金Mae Fah Luang University(grant for Pestalotiopsis No:55101020004)The National Natural Science Foundation of China(grant:30930005)the Knowledge Innovation Program of the Chinese Academy of Sciences(grant:KSCX2-YW-Z0935)Mushroom Research Foundation,Chiang Mai,ThailandState Key Laboratory of Mycology,Institute of Microbiology,Chinese Academy of Sciences,Beijing,China and the King Saud University for supporting this research.
文摘Pestalotiopsis is a taxonomically confused,pathogenic and chemically creative genus requiring a critical reexamination using a multi-gene phylogeny based on ex-type and ex-epitype cultures.In this study 40 isolates of Pestalotiopsis,comprised of 28 strains collected from living and dead plant material of various host plants from China were studied by means of morphology and analysis of ITS,β–tubulin and tef1 gene sequence data.Based on molecular and morphological data we describe 14 new species(Pestalotiopsis asiatica,P.chinensis,P.chrysea,P.clavata,P.diversiseta,P.ellipsospora,P.inflexa,P.intermedia,P.linearis,P.rosea,P.saprophyta,P.umberspora,P.unicolor and P.verruculosa)and three species are epitypified(P.adusta,P.clavispora and P.foedans).Of the 10 gene regions(ACT,β-tubulin,CAL,GPDH,GS,ITS,LSU,RPB 1,SSU and tef1)utilized to resolve cryptic Pestalotiopsis species,ITS,β–tubulin and tef1 proved to be the better markers.The other gene regions were less useful due to poor success in PCR amplification and/or in their ability to resolve species boundaries.As a single gene tef1 met the requirements for an ideal candidate and functions well for species delimitation due to its better species resolution and PCR success.Althoughβ-tubulin showed fairly good differences among species,a combination of ITS,β-tubulin and tef1 gene data gave the best resolution as compared to single gene analysis.This work provides a backbone tree for 22 ex-type/epitypified species of Pestalotiopsis and can be used in future studies of the genus.
基金funded by China NSFC(31110103906)CAS(KSCX2-YW-Z-1026)Thailand Research Fund BRG528002.
文摘Three genera,Cochliobolus,Bipolaris and Curvularia form a complex that contains many plant pathogens,mostly on grasses(Poaceae)with a worldwide distribution.The taxonomy of this complex is confusing as frequent nomenclatural changes and refinements have occurred.There is no clear morphological boundary between the asexual genera Bipolaris and Curvularia,and some species show intermediate morphology.We investigated this complex based on a set of ex-type cultures and collections from northern Thailand.Combined gene analysis of rDNA ITS(internal transcribed spacer),GPDH(glyceraldehyde 3-phosphate dehydrogenase),LSU(large subunit)and EF1-α(translation elongation factor 1-α)shows that this generic complex divides into two groups.Bipolaris and Cochliobolus species clustered in Group 1 along with their type species,whereas Curvularia species(including species named as Bipolaris,Cochliobolus and Curvularia)clustered in Group 2,with its generic type.The nomenclatural conflict in this complex is resolved giving priority to the more commonly used established generic names Bipolaris and Curvularia.Modern descriptions of the genera Bipolaris and Curvularia are provided and species resolved in this study are transferred to one of these genera based on their phylogeny.
基金This work was supported in part by the National Science Foundation(NSF)(No.DMR-0804088)startup funds from Washington University in St.Louis.T.Y.was also partially supported by the National Research Foundation of Korea Grant funded by the Korean Government(No.NRF-2009-352-D00160)+1 种基金Pedro Henrique Cury Camargo(P.H.C.C.)was also partially supported by the Fulbright Program and the Brazilian Ministry of Education(CAPES).Part of the work was performed at the Nano Research Facility(NRF),a member of the National Nanotechnology Infrastructure Network(NNIN),which is supported by the National Science Foundation under award No.ECS-0335765NRF is part of the School of Engineering and Applied Science at Washington University in St.Louis.
文摘In a seed-mediated synthesis, nanocrystal growth is often described by assuming the absence of homogeneous nucleation in the solution. Here we provide new insights into the nucleation and growth mechanisms underlying the formation of bimetallic nanodendrites that are characterized by a dense array of Pt branches anchored to a Pd nanocrystal core. These nanostructures can be easily prepared by a one-step, seeded growth method that involves the reduction of K2PtCl4 by L-ascorbic acid in the presence of 9-nm truncated octahedral Pd seeds in an aqueous solution. Transmission electron microscopy (TEM) and high-resolution TEM analyses revealed that both homogeneous and heterogeneous nucleation of Pt occurred at the very early stages of the synthesis and the Pt branches grew through oriented attachment of small Pt particles that had been formed via homogeneous nucleation. These new findings contradict the generally accepted mechanism for seeded growth that only involves heterogeneous nucleation and simple growth via atomic addition. We have also investigated the electrocatalytic properties of the Pd-Pt nanodendrites for the oxygen reduction and formic acid oxidation reactions by conducting a comparative study with foam-like Pt nanostructures prepared in the absence of Pd seeds under otherwise identical conditions.
文摘Recent discovery of PYR/PYL/RCAR-type abscisic acid （ABA） receptors has become one of most significant advances in plant science in the past decade. In mammals, endosomal sorting acts as an important pathway to downregulate different types of receptors, but its role in plant hormone signaling is poorly understood. Here, we report that an ubiquitin E2-1ike protein, VPS23A, which is a key component of ESCRT-I, negatively regulates ABA signaling. VPS23A has epistatic relationship with PYR/PYL/RCAR-type ABA receptors and disruption of VPS23A enhanced the activity of key kinase OST1 in the ABA signaling pathway under ABA treatment. Moreover, VPS23A interacts with PYR1/PYLs and K63-1inked diubiquitin, and PYL4 possesses K63-1inked ubiquitinated modification in vivo. Further analysis revealed that VPS23A affects the subcellular localization of PYR 1 and the stability of PYL4. Taken together, our results suggest that VPS23A affects PYR1/ PYL4 via vacuole-mediated degradation, providing an advanced understanding of both the turnover of ABA receptors and ESCRTs in plant hormone signaling.
