Background
The risk for occult neck nodal metastasis in carcinoma of the parotid gland is inconclusive. Therefore, addressing a negative neck prophylactically and the extent to do so remain ...controversial. This systematic review aimed to determine the rate of occult nodal metastasis for each neck level, and consequently, to elucidate the proper extent of elective neck dissection (END).
Methods
A meta-analysis of all studies that included patients with a diagnosis of parotid malignancies who underwent an END was performed. The risk for occult nodal metastasis was calculated for each neck level separately.
Results
The search strategy identified 124 papers from January 1980 to December 2019 in the various databases. Nine retrospective studies (
n
=548) met the inclusion criteria. The risk for occult neck nodal metastasis ranged from 0.0 to 9.43% with a random-effect model of 2.2% for level 1 (
n
=459), from 3.4 to 28.38% with a random-effect model of 16.51% for level 2 (
n
=548), from 0.0 to 21.63% with a random-effect model of 4.23% for level 3 (
n
=518), from 0.0 to 17.02% with a fixed-effect model of 0.39% for level 4 (
n
=310), and from 0.0 to 11.63% with a fixed-effect model of 1.7% for level 5 (
n
=417).
Conclusion
The rate of occult neck nodal metastasis in parotid malignancies is low, with neck level 2 the most commonly involved. The results of this meta-analysis prevented the authors from substantiating the appropriate extent of an END in parotid cancer.
Recommendations for moderate alcohol consumption remain controversial, particularly in type 2 diabetes mellitus (T2DM). Long-term randomized, controlled trials (RCTs) are lacking.
To assess ...cardiometabolic effects of initiating moderate alcohol intake in persons with T2DM and whether the type of wine matters.
2-year RCT (CASCADE CArdiovaSCulAr Diabetes & Ethanol trial). (ClinicalTrials.gov: NCT00784433).
Ben-Gurion University of the Negev-Soroka Medical Center and Nuclear Research Center Negev, Israel.
Alcohol-abstaining adults with well-controlled T2DM.
Patients were randomly assigned to 150 mL of mineral water, white wine, or red wine with dinner for 2 years. Wines and mineral water were provided. All groups followed a Mediterranean diet without caloric restriction.
Primary outcomes were lipid and glycemic control profiles. Genetic measurements were done, and patients were followed for blood pressure, liver biomarkers, medication use, symptoms, and quality of life.
Of the 224 patients who were randomly assigned, 94% had follow-up data at 1 year and 87% at 2 years. In addition to the changes in the water group (Mediterranean diet only), red wine significantly increased high-density lipoprotein cholesterol (HDL-C) level by 0.05 mmol/L (2.0 mg/dL) (95% CI, 0.04 to 0.06 mmol/L 1.6 to 2.2 mg/dL; P < 0.001) and apolipoprotein(a)1 level by 0.03 g/L (CI, 0.01 to 0.06 g/L; P = 0.05) and decreased the total cholesterol-HDL-C ratio by 0.27 (CI, -0.52 to -0.01; P = 0.039). Only slow ethanol metabolizers (alcohol dehydrogenase alleles ADH1B*1 carriers) significantly benefited from the effect of both wines on glycemic control (fasting plasma glucose, homeostatic model assessment of insulin resistance, and hemoglobin A1c) compared with fast ethanol metabolizers (persons homozygous for ADH1B*2). Across the 3 groups, no material differences were identified in blood pressure, adiposity, liver function, drug therapy, symptoms, or quality of life, except that sleep quality improved in both wine groups compared with the water group (P = 0.040). Overall, compared with the changes in the water group, red wine further reduced the number of components of the metabolic syndrome by 0.34 (CI, -0.68 to -0.001; P = 0.049).
Participants were not blinded to treatment allocation.
This long-term RCT suggests that initiating moderate wine intake, especially red wine, among well-controlled diabetics as part of a healthy diet is apparently safe and modestly decreases cardiometabolic risk. The genetic interactions suggest that ethanol plays an important role in glucose metabolism, and red wine's effects also involve nonalcoholic constituents.
European Foundation for the Study of Diabetes.
The redox chemistry of Ce
DOTA
in carbonate solutions was studied using electrochemistry and radiolysis techniques (continuous radiolysis and pulse radiolysis). Spectroscopic measurements point out ...that the species present in the solutions at high bicarbonate concentrations are Ce
DOTA(CO
)
(or less plausible Ce
DOTA(HCO
)
) with the carbonate (bicarbonate) anion as the ninth ligand versus Ce
DOTA(H
O)
present in the absence of bicarbonate. Electrochemical results show a relatively low increase in the thermodynamic stabilization of the redox couple Ce
in the presence of carbonate versus its aqueous analogue. Ce
DOTA(CO
)
and Ce
DOTA(H
O), prepared electrochemically, decompose photolytically. However, kept in the dark, both are relatively long lived; Ce
DOTA(H
O), though, is orders of magnitude kinetically more stable (a considerably longer half-life). Thus, one concludes that the carbonate species have a different mechanism of decomposition depending also on the presence of dioxygen after its preparation (in deaerated/aerated solutions). The Ce
DOTA(CO
)
species is produced radiolytically by oxidation of the trivalent species by CO
with a rate constant, measured using pulse radiolysis, of 3.3 × 10
M
s
. This rate constant is at least 1 order of magnitude smaller than most of the rate constants so far reported for the reaction of CO
with transition metal/lanthanide (cerium)/actinide complexes. This result together with the bulkiness of the reactants might suggest an
electron transfer rather than the
one so far proposed. The lifetime of the tetravalent cerium species obtained radiolytically in the presence of carbonate is shorter than the electrochemical one, suggesting a different conformer involved.
Epithelial ovarian cancer (EOC) is usually discovered after extensive metastasis have developed in the peritoneal cavity. The ovarian surface is exposed to peritoneal fluid pressures and shear forces ...due to the continuous peristaltic motions of the gastro-intestinal system, creating a mechanical micro-environment for the cells. An in vitro experimental model was developed to expose EOC cells to steady fluid flow induced wall shear stresses (WSS). The EOC cells were cultured from OVCAR-3 cell line on denuded amniotic membranes in special wells. Wall shear stresses of 0.5, 1.0 and 1.5 dyne/cm(2) were applied on the surface of the cells under conditions that mimic the physiological environment, followed by fluorescent stains of actin and β-tubulin fibers. The cytoskeleton response to WSS included cell elongation, stress fibers formation and generation of microtubules. More cytoskeletal components were produced by the cells and arranged in a denser and more organized structure within the cytoplasm. This suggests that WSS may have a significant role in the mechanical regulation of EOC peritoneal spreading.
Background
Chordoma is a rare bony malignancy known to have a high rate of local recurrence after surgery. The best treatment paradigm is still being evaluated. We report our experience and review ...the literature. We emphasize on the difference between endoscopic and open craniotomy in regard to the anatomical compartment harboring the tumor, the limitations of the approaches and the rate of surgical resection.
Method
We retrospectively collected all patients with skull-base chordomas operated on between 2004 and 2014. Detailed radiological description of the compartments being occupied by the tumor and the degree of surgical resection is discussed.
Results
Eighteen patients were operated on in our facility for skull-base chordoma. Seventeen endoscopic surgeries were done in 15 patients, and 7 craniotomies were done in 5 patients. The mean age was 48.9 years (±19.8 years). When reviewing the anatomical compartments, we found that the most common were the upper clivus (95.6%) and lower clivus (58.3%), left cavernous sinus (66.7%) and petrous apex (∼60%). Most of the patients had intradural tumor involvement (70.8%). In all craniotomy cases, there was residual tumor in multiple compartments. In the endoscopic cases, the most difficult compartments for total resection were the lower clivus, and lateral extensions to the petrous apex or cavernous sinus.
Conclusions
Our experience shows that the endoscopic approach is a good option for midline tumors without significant lateral extension. In cases with very lateral or lower extensions, additional approaches should be added trying to achieve complete resection.
The limited regenerative capacity of the injured myocardium leads to remodeling and often heart failure. Novel therapeutic approaches are essential. Induced pluripotent stem cells (iPSC) ...differentiated into cardiomyocytes are a potential future therapeutics. We hypothesized that organ-specific reprogramed fibroblasts may serve an advantageous source for future cardiomyocytes. Moreover, exosomes secreted from those cells may have a beneficial effect on cardiac differentiation and/or function. We compared RNA from different sources of human iPSC using chip gene expression. Protein expression was evaluated as well as exosome micro-RNA levels and their impact on embryoid bodies (EBs) differentiation. Statistical analysis identified 51 genes that were altered (
≤ 0.05), and confirmed in the protein level, cardiac fibroblasts-iPSCs (CF-iPSCs) vs. dermal fibroblasts-iPSCs (DF-iPSCs). Several miRs were altered especially miR22, a key regulator of cardiac hypertrophy and remodeling. Lower expression of miR22 in CF-iPSCs vs. DF-iPSCs was observed. EBs treated with these exosomes exhibited more beating EBs
= 0.05. vs. control. We identify CF-iPSC and its exosomes as a potential source for cardiac recovery induction. The decrease in miR22 level points out that our CF-iPSC-exosomes are naïve of congestive heart cell memory, making them a potential biological source for future therapy for the injured heart.
Carbon nanotube (CNT) nanopaper (NP) reinforced thermoplastic polyurethane (TPU) multi-functional thin nanocomposites were fabricated by novel ultrasonic infiltration method and dip soaking without ...using any organic solvent. Uniform resin infiltration with high loading CNT (26 wt %) was achieved in the nanocomposites. The resin infiltration time was reduced to 4 s in the ultrasonic method which greatly favored full scale production. Besides multi wall carbon nanotube (MWNT) NP, hybrid NP with 10% single wall carbon nanotube (SWNT) was used to improve the nanocomposite's mechanical and electromagnetic interference (EMI) shielding properties. The 10% SWNT NP TPU nanocomposite exhibited 2170% increase in tensile strength, and 7170% increase in Young's modulus compared to pure TPU, and reached a strain at break of 296%. Due to the high electrical conductivity and aspect ratio of SWNT, the thin hybrid NP nanocomposite (100 μm thick) demonstrated high and stable EMI shielding effectiveness (35 dB) after large deformation (100% strain extension). As coating application, the NP nanocomposites obtained 45 times improvement in sand erosion resistance, compared to glass fiber epoxy composite substrate. Micro injection molding was conducted using the NP TPU nanocomposite as raw material which indicated good process flexibility. The NP demonstrated to be a good platform to fabricate multi-functional TPU nanocomposites, with potential applications in wind energy, aerospace and automotive industries, etc.
Let $G$ be an $n$-vertex oriented graph. Let $t(G)$ (respectively $i(G)$) be the probability that a random set of $3$ vertices of $G$ spans a transitive triangle (respectively an independent set). We ...prove that $t(G) + i(G) \geq \frac{1}{9}-o_n(1)$. Our proof uses the method of flag algebras that we supplement with several steps that make it more easily comprehensible. We also prove a stability result and an exact result. Namely, we describe an extremal construction, prove that it is essentially unique, and prove that if $H$ is sufficiently far from that construction, then $t(H) + i(H)$ is significantly larger than $\frac{1}{9}$.
We go to greater technical detail than is usually done in papers that rely on flag algebras. Our hope is that as a result this text can serve others as a useful introduction to this powerful and beautiful method.
The mechanism of reaction of DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) with ·CH3, CH3O2· and ·OH radicals were studied. The radicals were formed in situ radiolytically. The ...methyl radicals react orders of magnitude slower with DOTA and with MIII(DOTA)- than the hydroxyl radicals. The various final products were identified and mechanisms for their formation are proposed. CH3O2· radicals do not react, or react too slowly to be observed, with DOTA and with MIII(DOTA)- as long as the central cation is not oxidized by the peroxyl radical. The results imply that synthesis of the MIII(DOTA)-(MIII = radioisotope) complexes in a water-organic solvent (ethanol or 2-propanol or acetonitrile) mixture is not only kinetically desired but the so formed complex also decreases the radiolytic decomposition of DOTA.
Display omitted
•The mechanisms of the reactions of Hydroxyl, Methyl and Peroxyl radicals with DOTA are reported.•The implications to the synthesis of MIIIDOTA, ( MIII = Radioactive isotope) are discussed.
The immunogenicity of two-dose severe acute respiratory syndrome coronavirus 2 vaccine is lower among heart transplant (HTx) recipients, compared with the general population. Our aim was to assess ...the immunogenicity of a third-dose vaccine in HTx recipients.
This is a prospective cohort study of HTx recipients who received a third dose of the BNT162b2 vaccine. Immunogenicity was assessed by serum levels of anti-spike immunoglobulin G (S-IgG), taken at baseline and 14-28 days after the third dose. Titres above 50 U/ml were interpreted positive.
We Included 42 HTx recipients at a median age of 65 years interquartile range (IQR) 58-70. At baseline, the median of 27 days (IQR 13-42) before the third dose and the median titre of the whole group was 18 U/ml (IQR 4-130). Only 14 patients (33%) were S-IgG seropositive. After the third dose, the proportion of seropositive patients increased significantly to 57% (P = 0.05) and the median titre increased significantly to 633 U/ml (IQR 7-6104, P < 0.0001). Younger age at HTx (OR per 1-year decrease 1.07, P = 0.05), low tacrolimus serum level (OR per 1-unit decrease 2.28, P = 0.02), mammalian target of rapamycin use (OR 13.3, P = 0.003), lack of oral steroids use (OR 4.17, P = 0.04) and lack of calcineurin inhibitor use (71% of responders vs 100% non-responders received calcineurin inhibitors, P = 0.01) were predictors of seropositive result after the third dose. However, no significant association was detected following adjustment for baseline S-IgG titre.
Third-dose booster of BNT162b2 vaccine significantly increased immunogenicity among HTx recipients who previously received a two-dose vaccine.
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