Single‐cell encapsulation promises the cytoprotection of the encased cells against lethal stressors, reminiscent of the sporulation process in nature. However, the development of a cytocompatible ...method for chemically mimicking the germination process (i.e., shell degradation on‐demand) has been elusive, despite the shell degradation being pivotal for the practical use of functional cells as well as for single cell‐based biology. We report that an artificial shell, composed of tannic acid (TA) and FeIII, on individual Saccharomyces cerevisiae controllably degrades on‐demand, while protecting the yeast from multiple external aggressors, including UV‐C irradiation, lytic enzymes, and silver nanoparticles. Cell division is suppressed by the TA–FeIII shell, but restored fully upon shell degradation. The formation of a TA–FeIII shell would provide a versatile tool for achieving the chemical version of “sporulation and germination”.
Cell shells: A cytoprotective tannic acid/FeIII nanoshell was formed on individual yeast cells. Cell division was halted by formation and restarted by degradation of the nanoshell. The shell protected the cell from lytic enzymes, silver nanoparticles, and UV‐C (λ: 100 to 280 nm) irradiation.
Brachial plexus nerve blocks (BPBs) have analgesic and opioid sparing benefits for upper extremity surgery. Single-injection techniques are limited by the pharmacological duration and therapeutic ...index of local anaesthetics (LAs). Continuous catheter techniques, while effective can present management challenges. Off-label use of perineural dexamethasone as an LA adjuvant has been utilized to prolong single-injection techniques. The objectives of this systematic review and meta-analysis are to assess the contemporary literature and quantify the effects of dexamethasone on BPB.
The authors searched for randomized, placebo-controlled trials that compared BPB performed with LA alone with that performed with LA and perineural dexamethasone. Meta-analysis was performed using a random effects model with subgroup analysis stratified by LA (long vs intermediate). The primary outcome was duration of sensory block or analgesia; the secondary outcomes were motor block duration, opioid consumption, and BPB complications.
Nine trials (801 patients) were included with 393 patients receiving dexamethasone (4–10 mg). Dexamethasone prolonged the analgesic duration for long-acting LA from 730 to 1306 min mean difference 576 min, 95% confidence interval (CI) 522–631 and for intermediate from 168 to 343 min (mean 175, 95% CI 73–277). Motor block was prolonged from 664 to 1102 min (mean 438, 95% CI 89–787). The most recent trial demonstrated equivalent prolongation with perineural or systemic administration of dexamethasone compared with placebo.
Perineural administration of dexamethasone with LA prolongs BPB effects with no observed adverse events. The effects of systemic administration of dexamethasone on BPB must be investigated.
Aims
This study aimed to assess all-cause and cause-specific standardized mortality ratios (SMRs) in patients with systemic lupus erythematosus (SLE).
Methods
We surveyed studies examining all-cause ...and/or cause-specific SMR in patients with SLE compared to the general population using PUBMED, EMBASE and Cochrane databases and manual searches. We performed a meta-analysis of all-cause, sex-specific, ethnicity-specific, and cause-specific SMRs in SLE patients.
Results
Fifteen reports including 26,101 patients with SLE with 4640 deaths met the inclusion criteria. Compared to the general population, all-cause SMR was significantly increased 2.6-fold in patients with SLE (SMR 2.663, 95% CI 2.090–3.393, p < 1.0 × 10−8). Stratification by ethnicity showed that all-cause SMR was 2.721 (95% CI 1.867–3.966, p = 1.9 × 10−6) in Caucasians and 2.587 (95% CI 1.475–4.535, p = 0.001) in Asians. Sex-specific meta-analysis revealed that all-cause SMR was 3.141 (95% CI 2.351–4.198, p < 1.0 × 10−8) for women and 3.516 (95% CI 2.928–4.221, p < 1.0 × 10−8) for men. The risk of mortality was significantly increased for mortality due to renal disease (SMR 4.689, 95% CI 2.357–9.330, p = 1.10 × 10−5), cardiovascular disease (CVD) (SMR 2.253, 95% CI 1.304–3.892, p = 0.004), and infection (SMR 4.980, 95% CI 3.876–6.398, p < 1.0 × 10−8), although there was no significant increase in SMR for mortality due to cancer (SMR 1.163, 95% CI 0.572–2.363, p = 0.676).
Conclusions
Patients with SLE had higher rates of death from all causes, regardless of sex, ethnicity, renal disease, CVD or infection. However, the risk of death due to malignancy was not increased.
Background
There is a lack of information regarding the oncological safety of robotic intersphincteric resection (ISR) with coloanal anastomosis. The objective of this study was to compare the ...long‐term feasibility of robotic compared with laparoscopic ISR.
Methods
Between January 2008 and May 2011, consecutive patients who underwent robotic or laparoscopic ISR with coloanal anastomosis from seven institutions were included. Propensity score analyses were performed to compare outcomes for groups in a 1 : 1 case‐matched cohort. The primary endpoint was 3‐year disease‐free survival.
Results
A total of 334 patients underwent ISR with coloanal anastomosis, of whom 212 matched patients (106 in each group) formed the cohort for analysis. The overall rate of conversion to open surgery was 0·9 per cent in the robotic ISR group and 1·9 per cent in the laparoscopic ISR group. Nine patients (8·5 per cent) in the laparoscopic group and three (2·8 per cent) in the robotic ISR group still had a stoma at last follow‐up (P = 0·075). Total mean hospital costs were significantly higher for robotic ISR (€12 757 versus €9223 for laparoscopic ISR; P = 0·037). Overall 3‐year local recurrence rates were similar in the two groups (6·7 per cent for robotic and 5·7 per cent for laparoscopic resection; P = 0·935). The combined 3‐year disease‐free survival rates were 89·6 (95 per cent c.i. 84·1 to 95·9) and 90·5 (85·4 to 96·6) per cent respectively (P = 0·298).
Conclusion
Robotic ISR with coloanal anastomosis for rectal cancer has reasonable oncological outcomes, but is currently too expensive with no short‐term advantages.
No advantage and too costly
This study provides a detailed literature review and an assessment of results of the research and development work forming the current status of nanofluid technology for heat transfer applications. ...Nanofluid technology is a relatively new field, and as such, the supporting studies are not extensive. Specifically, experimental results were reviewed in this study regarding the enhancement of the thermal conductivity and convective heat transfer of nanofluids relative to conventional heat transfer fluids, and assessments were made as to the state-of-the-art of verified parametric trends and magnitudes. Pertinent parameters of particle volume concentration, particle material, particle size, particle shape, base fluid material, temperature, additive, and acidity were considered individually, and experimental results from multiple research groups were used together when assessing results. To this end, published research results from many studies were recast using a common parameter to facilitate comparisons of data among research groups and to identify thermal property and heat transfer trends. The current state of knowledge is presented as well as areas where the data are presently inconclusive or conflicting. Heat transfer enhancement for available nanofluids is shown to be in the 15-40% range, with a few situations resulting in orders of magnitude enhancement.
We describe the case of a 52-year-old male who presented with two episodes of acute exacerbations (AE) of chronic obstructive pulmonary disease (COPD) during work, while suspending live chickens for ...slaughter. The patient was exposed to high levels of bioaerosols, including endotoxins and microorganisms. Endotoxins can induce bronchoconstriction and airway inflammation, and COPD patients are more vulnerable to airway infections caused by microorganisms inhaled with bioaerosols. This study suggests that a high level of bioaerosols may induce airway infections, resulting in acute exacerbations of COPD.
Characterizing the local internal environment surrounding solid-state spin defects is crucial to harnessing them as nanoscale sensors of external fields. This is especially germane to the case of ...defect ensembles which can exhibit a complex interplay between interactions, internal fields, and lattice strain. Working with the nitrogen-vacancy (NV) center in diamond, we demonstrate that local electric fields dominate the magnetic resonance behavior of NV ensembles at a low magnetic field. We introduce a simple microscopic model that quantitatively captures the observed spectra for samples with NV concentrations spanning more than two orders of magnitude. Motivated by this understanding, we propose and implement a novel method for the nanoscale localization of individual charges within the diamond lattice; our approach relies upon the fact that the charge induces a NV dark state which depends on the electric field orientation.
Background
The feasibility and learning curve of laparoscopic living donor right hepatectomy was assessed.
Methods
Donors who underwent right hepatectomy performed by a single surgeon were reviewed. ...Comparisons between open and laparoscopy regarding operative outcomes, including number of bile duct openings in the graft, were performed using propensity score matching.
Results
From 2014 to 2018, 103 and 96 donors underwent laparoscopic and open living donor right hepatectomy respectively, of whom 64 donors from each group were matched. Mean(s.d.) duration of operation (252·2(41·9) versus 304·4(66·5) min; P < 0·001) and median duration of hospital stay (8 versus 10 days; P = 0·002) were shorter in the laparoscopy group. There was no difference in complication rates of donors (P = 0·298) or recipients (P = 0·394) between the two groups. Total time for laparoscopy decreased linearly (R2 = 0·407, β = –0·914, P = 0·001), with the decrease starting after approximately 50 procedures when cases were divided into four quartiles (2nd versus 3rd quartile, P = 0·001; 3rd versus 4th quartile, P = 0·023). Although grafts with bile duct openings were more abundant in the laparoscopy group (P = 0·022), no difference was found in the last two quartiles (P = 0·207).
Conclusion
Laparoscopic living donor right hepatectomy is feasible and an experience of approximately 50 cases may surpass the learning curve.
Antecedentes
Se evaluó la viabilidad y la curva de aprendizaje de la hepatectomía derecha de donante vivo
Métodos
Se llevó a cabo una revisión de los donantes sometidos a hepatectomía derecha por un único cirujano. Las comparaciones entre el abordaje abierto y laparoscópico con respecto a los resultados operatorios, incluyendo el número of aberturas de los conductos biliares en el injerto se realizó utilizando un análisis de emparejamiento por puntaje de propensión.
Resultados
Desde 2014 a 2018, 96 y 103 donantes fueron sometidos a hepatectomía derecho de donante vivo por cirugía abierta y laparoscópica, respectivamente, de los cuales 64 donantes fueron emparejados para ambos grupos. La media del tiempo operatorio (304,3 ± 66,5 versus 252,2 ± 41,9 minutos, P < 0,001) y la mediana de la estancia hospitalaria fueron más cortas en el grupo de cirugía laparoscópica (10 versus 8 días, P = 0,002). No hubo diferencias entre ambos grupos en las tasas de complicaciones de los donantes (P = 0,298) o receptores (P = 0,394). El tiempo total de la laparoscopia disminuyó linealmente (R2= 0,407, β = ‐0,914, P = 0,001) y esta disminución comenzó a partir aproximadamente de los 50 casos realizados cuando los casos fueron divididos en cuatro cuartiles (segundo a tercero y tercero a cuarto, P = 0,001 y P = 0,023, respectivamente). Aunque los injertos con aperturas de los conductos biliares fueron más numerosos en el grupo laparoscópico (P = 0,022), no se hallaron diferencias en los dos últimos cuartiles (P = 0,207).
Conclusión
La hepatectomía derecha de donante vivo por vía laparoscópica es viable, y una experiencia de aproximadamente 50 casos, puede superar la curva de aprendizaje.
This study analysed the feasibility of laparoscopic living donor right hepatectomy. Propensity score matching was used for comparing preoperative and postoperative outcomes. The learning curve of laparoscopic living donor right hepatectomy was around 50 procedures. IVC, inferior vena cava; RPV, right portal vein; LPV, left portal vein; CBD, common bile duct; HA, hepatic artery; PV, portal vein; GB, gallbladder; RHD, right hepatic duct; CHD, common hepatic duct; RHV right hepatic vein.
Better for donors
Nuclear magnetic resonance spectroscopy is a powerful tool for the structural analysis of organic compounds and biomolecules but typically requires macroscopic sample quantities. We use a sensor, ...which consists of two quantum bits corresponding to an electronic spin and an ancillary nuclear spin, to demonstrate room temperature magnetic resonance detection and spectroscopy of multiple nuclear species within individual ubiquitin proteins attached to the diamond surface. Using quantum logic to improve readout fidelity and a surface-treatment technique to extend the spin coherence time of shallow nitrogen-vacancy centers, we demonstrate magnetic field sensitivity sufficient to detect individual proton spins within 1 second of integration. This gain in sensitivity enables high-confidence detection of individual proteins and allows us to observe spectral features that reveal information about their chemical composition.
PDF
