Atrial fibrillation is highly prevalent, and affected patients are at an increased risk of a number of complications, including heart failure and thrombo‐embolism. Over the past years, there has been ...increasing interest in the role of inflammatory processes in atrial fibrillation, from the first occurrence of the arrhythmia to dreaded complications such as strokes or peripheral emboli. As the standard drug combination which aims at rate control and anticoagulation only offers partial protection against complications, newer agents are needed to optimize treatment. In this paper, we review recent knowledge regarding the impact of inflammation on the occurrence, recurrence, perpetuation and complications of the arrhythmia, as well as the role of anti‐inflammatory therapies in the treatment for the disease.
Recently, we have identified serum response factor (SRF) as a mediator of clinically relevant androgen receptor (AR) action in prostate cancer (PCa). Genes that rely on SRF for androgen ...responsiveness represent a small fraction of androgen-regulated genes, but distinguish benign from malignant prostate, correlate with aggressive disease, and are associated with biochemical recurrence. Thus, understanding the mechanism(s) by which SRF conveys androgen regulation to its target genes may provide novel opportunities to target clinically relevant androgen signaling. Here, we show that the small GTPase ras homolog family member A (RhoA) mediates androgen-responsiveness of more than half of SRF target genes. Interference with expression of RhoA, activity of the RhoA effector Rho-associated coiled-coil containing protein kinase 1 (ROCK), and actin polymerization necessary for nuclear translocation of the SRF cofactor megakaryocytic acute leukemia (MAL) prevented full androgen regulation of SRF target genes. Androgen treatment induced RhoA activation, increased the nuclear content of MAL, and led to MAL recruitment to the promoter of the SRF target gene FHL2. In clinical specimens RhoA expression was higher in PCa cells than benign prostate cells, and elevated RhoA expression levels were associated with aggressive disease features and decreased disease-free survival after radical prostatectomy. Overexpression of RhoA markedly increased the androgen-responsiveness of select SRF target genes, in a manner that depends on its GTPase activity. The use of isogenic cell lines and a xenograft model that mimics the transition from androgen-stimulated to castration-recurrent PCa indicated that RhoA levels are not altered during disease progression, suggesting that RhoA expression levels in the primary tumor determine disease aggressiveness. Androgen-responsiveness of SRF target genes in castration-recurrent PCa cells continued to rely on AR, RhoA, SRF, and MAL and the presence of intact SRF binding sites. Silencing of RhoA, use of Rho-associated coiled-coil containing protein kinase 1 inhibitors, or an inhibitor of SRF-MAL interaction attenuated (androgen-regulated) cell viability and blunted PCa cell migration. Taken together, these studies demonstrate that the RhoA signaling axis mediates clinically relevant AR action in PCa.
AIMSThe aims of this article are to provide an overview of the technique of phalloplasty by radial forearm free flap in the context of female-to-male gender reassignment surgery, with a specific ...focus on surgical technical details and the prevention of postoperative complications. METHODSIn the light of our 30 years of experience in caring for female-to-male transgender individuals and conducting a critical review of the literature, we exhaustively present our technique of radial forearm free flap phalloplasty in female-to-male gender reassignment surgery. RESULTSThe technique of radial forearm free flap phalloplasty, utilizing a one-stage approach for neourethral and neophallus construction based on the "tube within a tube" principle, not only achieves an aesthetically pleasing appearance of the neophallus resembling a normal penis with tactile and erogenous sensitivities but also yields a functional neourethra and satisfactory penile rigidity using implants for standing voiding and sexual intercourse. This intricate surgical procedure demands not only meticulous execution of all surgical maneuvers but also high-level postoperative care. Despite refinements in technique over recent decades, aesthetic sequelae at the donor site of the flap remain subject to criticism, and postoperative complications, particularly of vascular and urological nature, remain significant. CONCLUSIONFuture optimization of the surgical technique for this procedure will be imperative to minimize postoperative complications and establish a true technical "gold standard" for phalloplasty in female-to-male transgender individuals.
The research done in the bakery industry worldwide and in special in the Romanian market had their goals on the production and technological process, focusing on the end result products. Bakery ...industry focused on profits changed and developed their products according to the market need and preferences and very few traditional businesses know how to make the profits continuing the distribution routes and using the old bread recipes. During this study we aim to go through an experimental process in order to observe the influence that different cost factors have on the end result such as performance and profits. A questionnaire was designed to answer questions regarding the existent technology in the bakery industry, transportation vehicles, clients, turnover, invoice overdue, and the structure of the production, costs with workers, transport, maintenance, marketing and raw materials. The questionnaire will be applied only in the North West area of Romania to all the bakery companies that have over 5 employees and deliver bread products to business customers using predefine routs. In a future stage, it would be of a great interest to apply a similar questionnaire in different parts of Europe for further studies in this industry, where management has a deficiency in scientific research and managers have to take decision based most of the time only on their own experience.
The surface quality study of the cutting processes is a very current and complex subject, which approached in variously specialized researches. This paper is a continuation of our previous research. ...The primary objective of this paper is to track the evolution of the surface roughness measured longitudinally on the feed motion direction in the end-milling process of an aluminum alloy used in the aerospace industry. The active experiment is the research method used to achieve the proposed objective. The cutting regime adapted to carrying out the necessary experiments supposes a constant cutting speed, while the cutting depth varies with different values. Obtaining the experimental data did possibly using the roughness tester as a measuring device. The obtained measurements were used to determine the surface quality evolution in the various situations of the cutting regimes resulting from the combination of the process parameters considered in the analysis. The experimental study is very complex and carried in an industrial organization that focuses on the aerospace industry. Through this original research that was carried out in the smallest details, a series of comparative graphs of the surface roughness evolution performed under the cutting depth variation, which led to a package of conclusions to have taken into consideration.
To determine blood viscosity in adult comatose patients treated with mild therapeutic hypothermia after cardiac arrest and to assess the relation between blood viscosity, cerebral blood flow, and ...cerebral oxygen extraction.
Observational study.
Tertiary care university hospital.
Ten comatose patients with return of spontaneous circulation after out-of-hospital cardiac arrest.
Treatment with mild therapeutic hypothermia for 24 hours followed by passive rewarming to normothermia.
Median viscosity at shear rate 50/s was 5.27 mPa · s (4.29-5.91 mPa · s) at admission; it remained relatively stable during the first 12 hours and decreased significantly to 3.00 mPa · s (2.72-3.58 mPa · s) at 72 hours (p < 0.001). Median mean flow velocity in the middle cerebral artery was low (27.0 cm/s 23.8-30.5 cm/s) at admission and significantly increased to 63.0 cm/s (51.0-80.0 cm/s) at 72 hours. Median jugular bulb saturation at the start of the study was 61.5% (55.5-75.3%) and significantly increased to 73.0% (69.0-81.0%) at 72 hours. Median hematocrit was 0.41 L/L (0.36-0.44 L/L) at admission and subsequently decreased significantly to 0.32 L/L (0.27-0.35 L/L) at 72 hours. Median C-reactive protein concentration was low at admission (2.5 mg/L 2.5-6.5 mg/L) and increased to 101 mg/L (65-113.3 mg/L) in the following hours. Median fibrinogen concentration was increased at admission 2,795 mg/L (2,503-3,565 mg/L) and subsequently further increased to 6,195 mg/L (5,843-7,368 mg/L) at 72 hours. There was a significant negative association between blood viscosity and the mean flow velocity in the middle cerebral artery (p = 0.0008).
Changes in blood viscosity in vivo are associated with changes in flow velocity in the middle cerebral artery. High viscosity early after cardiac arrest may reduce cerebral blood flow and may contribute to secondary brain injury. Further studies are needed to determine the optimal viscosity during the different stages of the postcardiac arrest syndrome.
As a part of the cutting process, a researched aspect continuously is surface quality. Based on and using the results of previous research, the present scientific paper addresses the problem of the ...machined surfaces roughness. The cutting process approached in this study is the end-milling one, and the workpiece material used to carry out the study is the aluminum alloy used in the aerospace industry. The adopted cutting regime imply to keep the cutting speed at a constant value while the cutting parameters: cutting depth and feed per tooth vary with different values. The experimental research carried out by the authors in a prestigious industrial company is complicated and complies with the specific methodology. The conclusions stand based on the interpretation of the results obtained from the experiments which were carried out based on the active experimental type. The confirmation of the obtained results was performed using the profiles and images of the microscopic analysis of the machined surface.
In the aerospace industry, the milling of aluminum alloy parts is a machining process with the primary purpose of removing high volumes of material. Aluminum alloys are materials that have relatively ...good machinability, which helps the process because many of the components of the aircraft are of high dimensions. These parts have many pockets more or less deep, and the removal by cutting off about 90% of the initial volume of the workpiece is a matter of consideration. The manufacturing process is protracted and involves long semi-finishing and finishing operations, so it is recommended that any researcher who begins and finishes an experimental study should do it base on a specific experimental plan. Mathematical statistics techniques and methods are used, but also optimization methods that lead to a rational choice of process parameters, process input data and objective functions that need to be improved. This scientific paper presents applied research based on an extremely pertinent active experiment that has led to some practical solutions applied in the aerospace industry worldwide. The dedicated objective function on which the study conducted in this case was the mean arithmetic deviation of the surface profile. The independent variables were chosen by the concrete application of a dispersion analysis applied to the milling process, namely the cutting speed, the cutting depth and the feed per tooth. Interpretation of the results was performed by a graphical evaluation of the normality of the data distribution, by presenting the histogram responses as well as by the dispersion diagrams. It was used for a better correlation a 3D graphical analysis that followed the Ra variation of the mean arithmetic deviation of the machined surface profile under the influence of the cutting parameters and the independent variables respectively. The obtained conclusions led to the validation of the experimental model and the application of the research presented within an aerospace industry organization with important global valences.
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