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Introduction: Spinal muscular atrophy (SMA) is a complex neuromuscular disorder, it is the most usual autosomal recessively inherited lethal neuromuscular disease in pediatrics, it presents a defective alteration in the survival motor neuron 1 (SMN1) gene. Spinal muscular atrophy clinically shows progressive weakness of skeletal and respiratory muscles. In recent years, drugs with encouraging results from phase II and III clinical trials have been presented. Objective: to detail current information related to spinal muscular atrophy, clinical features, classification, natural history, genetics, diagnosis, complications and treatment of the disease. Methodology: a total of 40 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 31 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: spinal muscular atrophy, Spinal Muscular Atrophy, spinal muscular atrophy and spinal muscular atrophy. Results: About 95 % of the occurrences of spinal muscular atrophy are generated by homozygous deletions. Individuals with 5q mutation make up 95% of cases of spinal muscular atrophy and the remaining 5% are generated by mutations in 5q1-5. Targeted treatments may prevent or delay the progression of some symptoms of spinal muscular atrophy. Conclusions: Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by muscle atrophy and weakness resulting from irreversible loss and progressive degeneration of the brainstem nuclei and anterior horn cells in the spinal cord (lower motor neurons). Clinically it presents with symmetrical proximal limb weakness that also impacts the axial muscles, intercostal and bulbar musculature and is progressive, and the classification protocol is important in genetics, as well as providing prognostic and clinical information. The natural history of the disease is variable and complicated. It is made by demonstrating a history of proximal muscle weakness, motor difficulties or regression, diminished or absent deep tendon reflexes. Among the most frequent complications in unsupported individuals are those previously mentioned such as poor weight gain with growth retardation, scoliosis, restrictive lung disease, joint contractures and sleep difficulties. In terms of treatment, several different compounds have been investigated in recent years, focused on increasing muscle strength and function. Proactive supportive treatment involving a multidisciplinary team is paramount to decrease the severity of symptoms. KEY WORDS: muscle atrophy, spine, spinal, spinal cord, motor neuron.

Introduction: Mirizzis syndrome, named after the Argentine surgeon Pablo Luis Mirizzi who first reported the syndrome in 1948, when he showed a history of a patient who presented a calculus of considerable size impacted in the infundibulum of the gallbladder, which generated jaundice due to extrinsic compression of the common bile duct. We speak of Mirizzi syndrome when there is an impaction of a calculus in the infundibulum of the gallbladder or the cystic duct that crushes the common hepatic duct, weakening it and forming a cholecystocholedochal fistula. Objective: to detail the current information related to Mirizzi syndrome, description, etiology, epidemiology, pathophysiology, classification, histopathology, presentation, diagnosis, treatment, prognosis and complications. Methodology: a total of 45 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 33 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: Mirizzi Syndrome, obstruction, common bile duct, gallstone, hepatic duct. Results: Mirizzi syndrome is relatively infrequent, occurring in only 0.1% of patients with gallstones with findings in 0.7% to 25% of patients who have undergone cholecystectomy. Between 5% to 28% of individuals with Mirizzi syndrome had gallbladder cancer following cholecystectomy. The modification of the anatomy and the cholecystocoledocian fistula increase the risk of damage to the biliary tract in the surgical act of cholecystectomy. Regarding classification type I was present in 40% of cases, type II, type III and type IV in 20% each. Conclusions: Mirizzi syndrome, also called extrinsic biliary compression syndrome, is an infrequent complication of chronic cholecystitis and cholelithiasis secondary to obliteration of the cystic duct or gallbladder infundibulum (Hartmanns pouch) generated due to the impact of one or more calculi. The impacted stone plus the inflammatory response produces the obstruction of the external biliary tract, with which the mucosa will erode and form a cholecystohepatic or cholecystocoledocian fistula. The risk of presenting gallbladder cancer increases with Mirizzi syndrome. The most common presentation is obstructive jaundice and right upper quadrant pain accompanied by epigastric pain, dark urine, nausea, tachycardia, vomiting, anorexia, fever and chills. The beginning of the diagnosis should be made with the usual tests for cholecystitis.Right upper quadrant abdominal ultrasound is currently the first-line study for the diagnosis of gallstones and acute cholecystitis. If a gallstone in the common bile duct is suspected by ultrasound, magnetic resonance cholangiopancreatography should be performed. This is followed by endoscopic retrograde cholangiopancreatography (ERCP) performed by a trained gastroenterologist. Conventionally the treatment of Mirizzi syndrome is surgical. Cholecystectomy is the first-line treatment; in case of fistula, open cholecystectomy with bilioenteric anastomosis, possibly with a Roux-en-Y is effective. In individuals without fistula, the prognosis is usually positive. In elderly patients with multiple comorbidities and high risk of surgical complications, non-surgical methods should be considered to minimize the morbidity associated with surgery. KEY WORDS: Mirizzi, syndrome, obstruction, duct, calculus, common bile duct, hepatic.

Purpose Endovascular treatment of spinal AVMs is limited by low complete cure rates. Transarterial extensive treatment with liquid embolics carries the risk of clinically relevant ischemic complications. We report two cases of symptomatic spinal AVMs treated by a transvenous approach with retrograde pressure cooker technique. Methods In two selected cases, transvenous navigation aimed at retrograde pressure cooker embolization. Results Retrograde venous navigation was possible with two parallel microcatheters, and the pressure cooker technique with ethylenvinylalcohol-polymer was applicable in both cases. One AVM was occluded completely, and one subtotally due to a second draining vein. No clinical complications occurred. Conclusion A transvenous approach for embolization with liquid embolics may offer advantages in treating certain spinal AVMs.

El nuevo coronavirus del síndrome respiratorio agudo severo (SARS-CoV-2), es la causa de una enfermedad de rápida propagación, que afecta a miles de personas en todo el mundo. Estudios previos han caracterizado la deglución en pacientes críticos hospitalizados que requieren intubación y ventilación mecánica invasiva. En este estudio se analizó las características deglutorias de pacientes críticos extubados con y sin diagnóstico de COVID-19. Se llevó a cabo un estudio de análisis mediante la revisión sistematica de la literatura, obteniendo como resultado, que la deglución post extubación en pacientes criticos con y sin diagnóstico de covid-19, el 22% padecieron de COVID-19 quienes estuvieron significativamente más días intubados que aquellos sin la patología, inmediatamente posterior a la extubación orotraqueal, más del 99% presentó disfagia. No hubo diferencia significativa, ni asociación significativa en el grado de severidad de la disfagia entre sujetos con y sin COVID-19. De tal forma se concluye que es necesaria la incorporación del fonoaudiólogo dentro de los equipos de Unidades de Pacientes Críticos para el manejo de los pacientes con COVID-19 y disfagia. Además, se recomienda continuar con más estudios en el área.

The present study investigated the unpaid overtime experienced by BPO rank-and-file employees and its effect on their career growth, well-being, and labor earnings. How unpaid overtime affects the morale and productivity of employees, and how responsive the organization's policies are to their needs. The researchers have used a phenomenological approach to achieve the study's objectives of identifying the causes and effects of the pressing issues of unpaid overtime experienced by workers. Additionally, the researchers used key informant interviews and focus group discussions in gathering the data among the participants by using an unstructured interview questionnaire to collect information and responses based on their experience with the guide questions. As such, the study found that unpaid overtime detrimentally affects the overall productivity and morale of the employees concerning their work quality in performing their job; unpaid overtime has no direct correlation with career growth; however, it has significantly affected their labor earnings and affects the well-being of the employee, numerous labor violations have been discussed and identified including miscalculation of overtime pay or salary disputes, intimidation from superior to work forcefully with overtime, and decreasing the original incentives to be received to what has been agreed upon and compromised the interest of the employees in rendering unpaid overtime work.

To evaluate the neurovascular bundle preservation grades during robotic-assisted radical prostatectomy and compared to the trifecta combined outcome (oncologic control, continence, and sexual function) twelve months after the surgery.Cohort of patients who underwent nerve-sparing robotic-assisted radical prostatectomy had the neurovascular bundle preservation retrospectively graded from 0 to 8 according to the Hopkins subjective visual classification. Patients then were divided into two groups, according to the median of nerve-sparing grading: those with score six or high and those with score less than six. Main outcome was the trifecta combined outcome and secondary outcomes was the individual trifecta criteria (prospective analysis). A secondary analysis with groups divided according to pre-operatory SHIM score was made.One hundred robotic-assisted nerve-sparing radical prostatectomy were performed, of which 83 were included. There were 53 patients with grading greater than or equal to six (group 1) and 30 patients less than six (group 2). 66.6% patients (35/53) in group 1 had a trifecta combined outcome of compared to 33.3% (10/30) in group 2 (p = 0.017). Individually, the erectile function was higher in group 1 (73.6%) compared to group 2 (46.7%) (p = 0.014). Both the results of the combined endpoint trifecta and erection were also maintained in the group with preoperative SHIM ≥ 17.The grading of preservation of the neurovascular bundle in radical prostatectomy is related to a better combined trifecta outcome one year after surgery.

Objetivo. Analizar el rol de los factores socioeconómicos y culturales en la vulnerabilidad a la obesidad en madres y sus hijos menores de dos años, en localidades del Sur de Morelos, México. Material y métodos. Se realizó trabajo de campo y observación no participativa. Durante 2019, se aplicaron 17 entrevistas semiestructuradas a una submuestra de una cohorte. Los datos fueron ordenados y analizados con apoyo del software Atlas-Ti v. 7, usando 18 códigos libres. Resultados. Factores sociales como los ingresos del hogar y los roles de género, combinados con la influencia de la parentela y las creencias sobre la preferencia de la niñez por productos ultraprocesados, predisponen la disponibilidad de bebidas y alimentos calóricos que generan vulnerabilidad a la obesidad durante la infancia temprana. La actividad eco­nómica de las madres, la participación de los padres y evitar influencia de parientes puede predisponer una mejor calidad de los alimentos y mayor actividad física. Conclusiones. La baja disponibilidad de alimentos saludables, los riesgos de inseguridad alimentaria y los factores familiares y culturales, que se presentan en contextos de vulnerabilidad económica y social, incrementan la vulnerabilidad del binomio madre-hijo a la obesidad.

Introduction: Depression is a global health problem that has been increasing in recent years, but it is still underdiagnosed and it’s not taken seriously enough. For this reason, it is vital for health workers to know their correct diagnosis and treatment to prevent patients from reaching their worst outcome, which is suicide. Objective: To examine how these patients have been approached and managed, and the effectiveness of both pharmacological and non-pharmacological therapies, based on review articles from the last five years. Methodology: a total of 43 original and review articles, collected from the Cochrane Library, PubMed and Google Scholar databases, were searched for the term Depression. The documents were found in Spanish and English. Some articles were excluded due to lack of updated information and lack of relevance for our literature review. Results: there is a fundamental pillar for the treatment of depression, based on psychological therapies (primary and fundamental element), pharmacotherapy and, as a last line, electroconvulsive therapy. The drugs generally used are serotonin reuptake inhibitors and serotonin and noradrenaline reuptake inhibitors. There are other therapies such as acupuncture, music therapy, which have shown some benefit. Conclusions: throughout this time, it has been determined that current diagnostic modalities have made it possible to diagnose early and a greater number of people suffering from depression, starting with psychotherapy, and administering antidepressant drugs in the absence of response to psychotherapy. KEY WORDS: depression, dysthymia, psychotherapy, Serotonin Uptake Inhibitors, Serotonin and Norepinephrine Reuptake Inhibitors.

Este artículo está con base en una visión universitaria de cómo edificar una planta de generación eléctrica por biogás, para esto se planea utilizar un tipo de programación llamada programación por estructuración de datos, el cual recogerá los datos suficientes para conformar una central a biogás en cualquier parte de todo el mundo solo usando datos del área simples y disponibles, esto reducirá la época de planificación y pondrá un mejor enfoque al proyectista de la central a biogás. Esto se lo ejecuta por el cariño que poseemos por el medio ambiente y la recuperación de ríos y fauna silvestre, nuestro objetivo es que existan facilidades gubernamentales en generar plantas de biogás para intentar la basura y desperdicios.

Vitamin C is a substance that has been the subject of debate over the years because of its numerous documented uses. Benefits have been shown in some cases, from use as prevention and shortening the duration of colds to reviewing vitamin C and its effects on diseases such as cancer. Therefore, vitamin C has been studied to evaluate the different mechanisms of action of vitamin C in relation to cancer; even vitamin C has been used as monotherapy or in combination with chemotherapy to demonstrate or eliminate its role in cancer. The aim of this review is to show whether the effects of vitamin C are effective and whether it makes sense to use it as monotherapy or in combination with chemotherapy; and even more to confirm or deny its positive effect in cancer.

Fibroblasts can be reprogrammed into cardiovascular progenitor cells (CPCs) using transgenic approaches, although the underlying mechanism remains unclear. We determined whether activation of endogenous genes such as Gata4, Nkx2.5, and Tbx5 can rapidly establish autoregulatory loops and initiate CPC generation in adult extracardiac fibroblasts using a CRISPR activation system. The induced fibroblasts (>80%) showed phenotypic changes as indicated by an Nkx2.5 cardiac enhancer reporter. The progenitor characteristics were confirmed by colony formation and expression of cardiovascular genes. Cardiac sphere induction segregated the early and late reprogrammed cells that can generate functional cardiomyocytes and vascular cells in vitro. Therefore, they were termed CRISPR-induced CPCs (ciCPCs). Transcriptomic analysis showed that cell cycle and heart development pathways were important to accelerate CPC formation during the early reprogramming stage. The CRISPR system opened the silenced chromatin locus, thereby allowing transcriptional factors to access their own promoters and eventually forming a positive feedback loop. The regenerative potential of ciCPCs was assessed after implantation in mouse myocardial infarction models. The engrafted ciCPCs differentiated into cardiovascular cells in vivo but also significantly improved contractile function and scar formation. In conclusion, multiplex gene activation was sufficient to drive CPC reprogramming, providing a new cell source for regenerative therapeutics.

The industrialization models of ECLAC, developed during the 1950s, 1960s and 1970s, and those of Ecuador, implemented by the 21st-century socialist government, are similar in their attempt to industrialize through the substitution of imports and government expenditure. In both cases, the economic policies focused on a closed economy, with high tariff barriers, and a strong role of the state as the main actor in the economy. The article uses a comparative method of analysiswhich emphasizes the outcomes of both of the periods studied. The results show that the models applied brought the same problems; imbalance in external trade and rising public debt. An alternative premise is suggested, that the models applied are the main causes of the debt crisis in the 1980s and the increasing public debt in the government of Rafael Correa.

Objectives: to evaluate feeding practices in the first year of life and their association with the development of overweight and obesity in children in Mexico. Methods: the association between overweight and obesity with different feeding practices were evaluated. The data was processed using the statistical package Stata version 14 using logistic regression models. Results: 396 children were evaluated; the prevalence of overweight and obesity was 6% and 7.7% presented a possible risk of overweight. 6.9% had exclusive breastfeeding in the first 6 months of life and 71.7% were fed infant formula. The variables significantly associated with the development of overweight and obesity in the first year of life were the age of the child (p =0.043, RR=0.57), the introduction of fluids in the first three days of life (p=0.02, RR=2.90), consumption of foods with a high sugar content (p =0.01, RR=0.25), consumption of milk other than breast (p =0.02, RR3.25) and egg consumption (p =0.05; RR=0.28). Conclusions: our results show that it is essential to attend complementary feeding practices and reinforce exclusive breastfeeding in the first year of life, as measures to prevent overweight and obesity to improve health in childhood. Resumen Objetivos: evaluar las prácticas de lactancia y alimentación en el primer año de vida y su asociación con desarrollo del sobrepeso y obesidad de niños en México. Métodos: estudio transversal, analítico, y explicativo, se evaluó la asociación entre sobrepeso y obesidad con las distintas prácticas de alimentación en menores de un año de edad. Resultados: se evaluaron 396 menores, la prevalencia de sobrepeso y obesidad fue de 6% y 7.7% presentaba posible riesgo de sobrepeso. El 6.9% tuvo lactancia materna exclusiva en los primeros 6 meses de vida; 71.7% fueron alimentados con fórmula infantil. Las variables asociadas significativamente con el desarrollo de sobrepeso y obesidad en el primer año de vida fueron: la edad del menor (p =0.043; RR=0.57), introducción de líquidos en los tres primeros días de vida (p=0.02; RR=2.90), consumo de alimentos con alto contenido de azúcar (p = 0.01; RR=0.25), consumo de leches distintas al pecho (p = 0.02; RR=3.25) y consumo de huevo (p =0.05; RR=0.28). Conclusiones: nuestros resultados muestran que es fundamental atender las prácticas de alimentación complementaria y reforzar la lactancia materna exclusiva en el primer año de vida, como medidas de prevención del sobrepeso y obesidad para mejorar la salud en la infancia.

Introduction Dysregulated activity of matrix metalloproteinases (MMPs) drives a variety of pathophysiological conditions. Non-invasive imaging of MMP activity in vivo promises diagnostic and prognostic value. However, current targeting strategies by small molecules are typically limited with respect to the bioavailability of the labeled MMP binders in vivo. To this end, we here introduce and compare three chemical modifications of a recently developed barbiturate-based radiotracer with respect to bioavailability and potential to image MMP activity in vivo. Methods Barbiturate-based MMP inhibitors with an identical targeting unit but varying hydrophilicity were synthesized, labeled with technetium-99m, and evaluated in vitro and in vivo. Biodistribution and radiotracer elimination were determined in C57/BL6 mice by serial SPECT imaging. MMP activity was imaged in a MMP-positive subcutaneous xenograft model of human K1 papillary thyroid tumors. In vivo data were validated by scintillation counting, autoradiography, and MMP immunohistochemistry. Results We prepared three new 99mTc‐labeled MMP inhibitors, bearing either a glycine ([99mTc]MEA39), lysine ([99mTc]MEA61), or the ligand HYNIC with the ionic co-ligand TPPTS ([99mTc]MEA223) yielding gradually increasing hydrophilicity. [99mTc]MEA39 and [99mTc]MEA61 were rapidly eliminated via hepatobiliary pathways. In contrast, [99mTc]MEA223 showed delayed in vivo clearance and primary renal elimination. In a thyroid tumor xenograft model, only [99mTc]MEA223 exhibited a high tumor-to-blood ratio that could easily be delineated in SPECT images. Conclusion Introduction of HYNIC/TPPTS into the barbiturate lead structure ([99mTc]MEA223) results in delayed renal elimination and allows non-invasive MMP imaging with high signal-to-noise ratios in a papillary thyroid tumor xenograft model.

Background : Joint replacement surgery as a treatment for complex proximal humeral fractures is an established option, especially in the elderly. In light of the increased attention to reverse total shoulder arthroplasty (rTSA), this study has analyzed the outcomes of patients with primary reverse arthroplasty and after secondary reverse arthroplasty for failed osteosynthesis. Methods : We retrospectively reviewed 57 patients with an average age of 76 years (min. 55; max. 94; SD 7) from 2010 and 2015 who underwent primary rTSA (30) and secondary rTSA after the failure of plate osteosynthesis (27) after proximal humeral fractures. The functional outcome of the operated shoulder was evaluated by clinical scores (Constant-Score, ASES, DASH and Oxford), range of motion (RoM), pain and activity level. Results : Primary rTSA had a significantly better functional outcome, mean-follow-up 37.3 months, measured by Constant-Score (57.13 vs 45.78 points; p= .015) compared to secondary RTSA, mean follow-up 42.1 months. A significantly better active abduction (p = .002), forward flexion (p = .003) and internal rotation (p = .037) was observed in the primary rTSA group, especially in the follow-up > 35 months. Conclusion : Reverse shoulder arthroplasty is an effective treatment for proximal humeral fractures as primary or revision surgery. The reliable clinical outcome especially in the follow-up to 40 months after primary reverse arthroplasty may suggest to prefer rTSA for complex humeral fractures in the elderly.

Heat is the world's largest energy end use, accounting for almost half of global final energy consumption in 2021 (IEA, 2021). Heat is utilized in various applications across a broad range of industries, including refining, chemicals, pulp and paper, textile manufacturing, district heating systems, buildings, etc. Large scale, low-temperature heat pumps are a well-established technology and are currently able to achieve temperature levels of up to 100°C. In recent years, demonstration projects involving Siemens Energy and other original equipment manufacturers (OEMs) have shown that temperatures up to 150°C and 4 bar are within reach using modern high-temperature heat pumps. Further progress has been made to extend this range up to 270°C and pressure levels up to 60 barA using subsequent steam compression. Such configurations recently became bid ready in the marketplace. This paper provides an underlying description of modern electric heat pump technology and will show how it can be used as a low-carbon alternative to traditional heating methods, such as oil- or gas-fired boilers. Several real-world applications will be presented, including one concept at a large integrated chemical complex in Europe, where a high-temperature heat pump and steam compressor are combined to achieve a temperature of 240°C at 19 barA with a coefficient of performance (COP) of 3.

Continuous loss of cardiomyocytes (CMs) is one of the fundamental characteristics of many heart diseases, which eventually can lead to heart failure. Due to the limited proliferation ability of human adult CMs, treatment efficacy has been limited in terms of fully repairing damaged hearts. It has been shown that cell lineage conversion can be achieved by using cell reprogramming approaches, including human induced pluripotent stem cells (hiPSCs), providing a promising therapeutic for regenerative heart medicine. Recent studies using advanced cellular reprogramming-based techniques have also contributed some new strategies for regenerative heart repair. In this review, hiPSC-derived cell therapeutic methods are introduced, and the clinical setting challenges (maturation, engraftment, immune response, scalability, and tumorigenicity), with potential solutions, are discussed. Inspired by the iPSC reprogramming, the approaches of direct cell lineage conversion are merging, such as induced cardiomyocyte-like cells (iCMs) and induced cardiac progenitor cells (iCPCs) derived from fibroblasts, without induction of pluripotency. The studies of cellular and molecular pathways also reveal that epigenetic resetting is the essential mechanism of reprogramming and lineage conversion. Therefore, CRISPR techniques that can be repurposed for genomic or epigenetic editing become attractive approaches for cellular reprogramming. In addition, viral and non-viral delivery strategies that are utilized to achieve CM reprogramming will be introduced, and the therapeutic effects of iCMs or iCPCs on myocardial infarction will be compared. After the improvement of reprogramming efficiency by developing new techniques, reprogrammed iCPCs or iCMs will provide an alternative to hiPSC-based approaches for regenerative heart therapies, heart disease modeling, and new drug screening.

Zusammenfassung Hintergrund Die präoperative Prothesenplanung ist der Goldstandard bei der Implantation einer elektiven Knietotalendoprothese. In dieser Studie führen wir eine retrospektive Analyse zweier verschiedener Kalibrationsmarker durch. Methoden Die präoperative Implantatplanung mittels MediCad wurde in 231 Fällen durchgeführt. Wir verglichen in 2 Gruppen die Treffsicherheit einer Kalibration mittels Kugelmarker gegen eine mithilfe des KingMark-Systems durchgeführte Kalibrierung, indem die präoperativ geplanten Größen mit den tatsächlich implantierten Größen verglichen wurden. Resultate Insgesamt zeigte sich in 60,4% (n = 140) der Fälle kein kombiniertes femorotibiales Match, sprich mindestens eines der geplanten Implantate wich in seiner Größe von der Planung ab. In 39,4% (n = 91) zeigte sich eine treffende Vorhersage der Implantatgrößen in der Messung sowohl femoral als auch tibial. Gruppe 1 zeigte eine statistisch signifikant bessere Vorhersage der Implantatgröße für das kombinierte femorotibiale Match der Implantatgrößen sowie für die femorale Größe allein. Schlussfolgerung Auf Basis unserer Studie sollte das KingMark-Kalibrierungssystem gegenüber standardisierten Kugelmarkern bevorzugt werden. Insgesamt liefern beide Systeme jedoch keine zufriedenstellende Vorhersage der tatsächlichen Prothesengröße.

La lucha contra la infección, y sus implicaciones nocivas para la salud de los seres humanos, es una de las tareas más antiguas del cirujano. Como es bien sabido, las infecciones quirúrgicas pueden dividirse, en aquellas que el cirujano opera, aquellas que constituyen el objeto de la intervención quirúrgica, y las que el cirujano produce, a raíz de la actividad o procedimientos quirúrgicos. Entre las primeras destacan las infecciones intraabdominales, como la peritonitis terciaria, la apendicitis aguda, la diverticulitis, la colecistitis aguda o las debidas a perforación de una víscera hueca. Las infecciones graves de las partes blandas y pared abdominal constituyen un grupo importante de la patología quirúrgica infecciosa en el que son protagonistas patógenos específicos. En realidad, la gran mayoría de las infecciones en cirugía digestiva están causadas por microorganismos del tracto digestivo o por bacterias exógenas procedentes del personal sanitario o del medio ambiente, asociados a una menor capacidad de defensa del huésped frente a la agresión quirúrgica. La otra parte importante de las infecciones en cirugía están relacionadas con la incisión quirúrgica, infección de la herida quirúrgica o dehiscencias anastomóticas. Son estas últimas las que el cirujano provoca en el paciente.

In this article, we analyzed the optical images from high-speed video recordings and the time-correlated waveforms of the current, the electric field, and the magnetic field from four negative upward lightning which struck the Peissenberg Tower, Germany. Two of them were self-initiated ones and two of them were other-triggered ones. From the illumination in the video images, leader activity could clearly be detected during the occurrence of the first of the other-triggered lightning. In contrast, no illumination by leader activity could be found during the occurrence of the second other-triggered lightning and the time period of 2.5 s before. In addition, the current pulses superimposing the initial continuous current/continuing current were examined differing between those which developed in luminous or nonluminous branches. From the total of 26 current pulses which developed in nonluminous branches, 25 (96%) of them had a 10–90%-rise time less than 4 μs, and 23 (88%) of them had a 10–90%-rise time even less than 2 μs. Because the current waveforms resemble those of weak return stroke, we assume that the current pulses indeed represent the leader/return stroke mode of charge transfer to ground. The return strokes were extremely weak, with an arithmetic mean of 2.59 kA (GM: 2.08 kA) for the current peak. On the other hand, from the total of 74 current pulses which developed in already luminous branches, none of them had a 10–90%-rise time less than 4.4 μs. The arithmetic mean is 29.8 μs and the geometric mean is 20.5 μs. Due to the relatively long rise time, we assume that these current pulses represent the M-component mode of charge transfer to ground.

BackgroundNumerous questions regarding procedural details of distal stroke thrombectomy remain unanswered. This study assesses the effect of anesthetic strategies on procedural, clinical and safety outcomes following thrombectomy for distal medium vessel occlusions (DMVOs).MethodsPatients with isolated DMVO stroke from the TOPMOST registry were analyzed with regard to anesthetic strategies (ie, conscious sedation (CS), local (LA) or general anesthesia (GA)). Occlusions were in the P2/P3 or A2–A4 segments of the posterior and anterior cerebral arteries (PCA and ACA), respectively. The primary endpoint was the rate of complete reperfusion (modified Thrombolysis in Cerebral Infarction score 3) and the secondary endpoint was the rate of modified Rankin Scale score 0–1. Safety endpoints were the occurrence of symptomatic intracranial hemorrhage and mortality.ResultsOverall, 233 patients were included. The median age was 75 years (range 64–82), 50.6% (n=118) were female, and the baseline National Institutes of Health Stroke Scale score was 8 (IQR 4–12). DMVOs were in the PCA in 59.7% (n=139) and in the ACA in 40.3% (n=94). Thrombectomy was performed under LA±CS (51.1%, n=119) and GA (48.9%, n=114). Complete reperfusion was reached in 73.9% (n=88) and 71.9% (n=82) in the LA±CS and GA groups, respectively (P=0.729). In subgroup analysis, thrombectomy for ACA DMVO favored GA over LA±CS (aOR 3.07, 95% CI 1.24 to 7.57, P=0.015). Rates of secondary and safety outcomes were similar in the LA±CS and GA groups.ConclusionLA±CS compared with GA resulted in similar reperfusion rates after thrombectomy for DMVO stroke of the ACA and PCA. GA may facilitate achieving complete reperfusion in DMVO stroke of the ACA. Safety and functional long-term outcomes were comparable in both groups.

This study looks at the lives of children after accessing education, the assistance provided, and the efficiency of education at the heart of the classroom. This study aims to answer the following questions about street children: (i) How can they go to school and learn despite the challenges of being street children?; (ii) What programs are available to help them?; (iii) To what extent can these programs be provided to children?; and (iv) When taking to the streets. This study used a qualitative method by conducting interviews with five children aged 10-15 years who came from the city of Tacurong, the Philippines. Some street children continue their education despite all their limitations, some other children take to the streets to find additional money with the knowledge of their parents, and the amount of money they bring home is barely enough or only sufficient, and some programs reach those who are less able. In short, street children are aware of the importance of learning, they have dreams and many are trying to achieve them in any way they can - even if it means risking their lives to beg for alms on the streets. Since this study proves how important education is for these children, this study provides a better scope for us to look at children that are roaming the streets to achieve their dreams and programs.

When a lightning strikes a high object, the current flows along the object and produces in this way a field component additional to the field radiated from the lightning channel. This additional field component enhances the field compared to lightning to flat ground. In this article, the field enhancement is analyzed for lightning striking the Peissenberg Tower, Germany. The analysis is based on investigations of the far field at distances from 10 to 1000 km. In the computer simulations, the return stroke process is taken into account with the transmission line (TL)-model and the tower is modelled with the computer program CONCEPT II based on the method of moments. In a first step, the pure effect of the tower is analyzed. In this case, the ground is taken into account as perfectly conducting plane. In the next step, the effect of the field propagation is added by introducing an attenuation function based on the solution of Sommerfeld and a far-field approximation of Norton. For fast rising return stroke currents and relatively near distances between 10 and 30 km, the field enhancement may exceed 100%. The field enhancement decreases strongly with decreasing soil conductivity ( σ ) and increasing distance ( s ), while the influence of the permittivity ( ϵ ) is rather small. At a distance of more than 100 km the field enhancement is typically in the range of some tens of percent. This result agrees well with the data of the European lightning location system EUCLID. From EUCLID an average field enhancement of about 20% is reported for lightning striking the Peissenberg Tower.

International audience; Background and purpose: Spinal arteriovenous fistulas are challenging to cure by endovascular means, with a risk of incomplete occlusion or delayed recurrence. The authors report herein their preliminary experience using the pressure cooker technique for the embolization of spinal arteriovenous fistulas.Materials and methods: Fifteen patients (8 men; mean age, 60.3 years) underwent an endovascular treatment of a spinal arteriovenous fistula (12 dural spinal arteriovenous fistulas and 3 epidural spinal arteriovenous fistulas) in 2 different institutions using the pressure cooker technique. Two microcatheters could be navigated in the segmental artery in all patients using 2 guiding catheters. A proximal plug was achieved with highly concentrated cyanoacrylate ± coils. The liquid embolic agent injected to cure the fistula was diluted cyanoacrylate (n = 11) or ethylene-vinyl alcohol (n = 4). Technical and clinical complications were systematically recorded. Clinical and angiographic outcomes were systematically evaluated at follow-up.Results: One (6.7%) procedure-related complication was recorded, which consisted of a transient radicular deficit, related to nerve root ischemia. Clinical improvement was observed in 10/14 (71%) patients for whom clinical follow-up was available. Complete spinal arteriovenous fistula occlusion on a follow-up angiography was observed in 11/12 patients (91.7%) for whom angiographic follow-up was available. One patient (8.3%) presented with a delayed recurrence at 29 months.Conclusions: The pressure cooker technique is feasible, with either glue or ethylene-vinyl alcohol, for the embolization of spinal arteriovenous fistulas. Our results suggest the safety and effectiveness of this technique.

BackgroundSelf-expanding stents are increasingly being deployed for stent-assisted coiling or flow diversion of intracranial aneurysms. Complications related to stent misbehavior may arise, however, including lack of expansion, device displacement, or parent vessel thrombosis. We present our experience of various stent removal techniques (stentectomy) with a focus on technical and clinical outcomes.MethodsStentectomy was attempted either with a single device, including the Alligator, Microsnare, or Solitaire, or by combining a Microsnare with a second device. Dual techniques included in this report are the Snare-over-Stentretriever technique we developed using a Microsnare and a Solitaire, and the previously described Loop-and-Snare technique using a Microsnare and a microwire. The technical success and complication rate, as well as the clinical outcome using the mRS were analyzed.ResultsForty-seven stentectomies were attempted in 36 patients treated for 37 aneurysms. Forty-two devices (89.3%) were successfully retrieved. Single-device stentectomy was successful in 34% of cases, compared with 74% with dual-device techniques. Of the 20 patients with a thrombosed parent or efferent vessel, 17 were successfully recanalized using stentectomy. All successful stentectomy patients made a clinically uneventful recovery, except one with a minor postoperative stroke (mRS 1 at discharge). Failed stentectomy was associated with major ischemic stroke in two patients and death in one patient. There were no stentectomy-related vessel perforations or dissections.ConclusionWhile various single devices can be used to safely retrieve dysfunctional intracranial self-expandable stents, dual-device techniques are more than twice as effective, according to our experience.

The goal of this research is to create a "safety device for a person with GPS tracking location" that will allow police to track offenders using the safety device with GPS tracking by sending real-time SMS alerts and GPS tracking to the nearest police station. Depending on the user's response, the device can prevent crimes before they happen. The study is most suited for people who stroll or commute to unpleasant locations. The study requires users to have an active mobile service load to optimize the device's capability. It involves a host server that receives and processes user-initiated complaints. The "Safety Device for Persons with GPS Tracking Location" was made with the Arduino Nano and includes the following functionalities: SMS alert, realtime position direct to the authorities, and GPS tracking location. It has two options. The first is the "push button," where when you press the button it will send a message to the nearby police station, and the second is the keyword "FIND." The police will send a text message to the device if the holder of the device has a serious problem and can no longer press the button. The device will automatically send the exact location of the victim and it will be notified to the police.

OBJECTIVEThe endovascular treatment of complex bifurcation aneurysms possessing a neck that incorporates multiple side branches remains a surgical challenge. Double-stent–assisted coiling techniques, such as those with stents in an X and Y configuration, enable the endovascular treatment of wide-necked complex intracranial bifurcation aneurysms. However, the intraluminal struts at the intersection point in X- and Y-stents are not amenable to endothelialization, which may lead to thromboembolic complications. Stenting in the T configuration is a relatively new double-stent coiling technique. T-stenting differs from X- or Y-stenting in that there are no overlapping or intersecting stent segments. Promising short-term results of T-stent–assisted coiling were recently reported. However, the long-term results have not yet been demonstrated. This retrospective study investigated the long-term angiographic and clinical results in patients with wide-necked complex intracranial bifurcation aneurysms treated with T-stent–assisted coiling.METHODSA retrospective review was performed to identify patients with wide-necked complex intracranial bifurcation aneurysms treated with T-stent–assisted coiling at 4 institutions. The technical success and the initial and follow-up clinical and angiographic outcomes were assessed. Aneurysm filling status was assessed according to the Raymond classification. Periprocedural and delayed complications were reviewed. The neurological status of the patients was evaluated using the modified Rankin Scale (mRS).RESULTSOne hundred two aneurysms in 102 patients (54 females), whose mean age was 57.9 ± 13.0 years, were included in the study. T-stenting was performed successfully in all patients. Immediate postprocedural angiography revealed complete occlusion in 83.3% of patients. Periprocedural complications developed in 13.7%, resulting in permanent morbidity in 1.9% and death in 1%. Eighty patients (78.4%) had at least one follow-up DSA examination performed at 6 months or later following the endovascular procedure. The mean duration of angiographic follow-up was 30.0 ± 16.3 months. The last follow-up examinations showed complete occlusion in 90.0% of patients. During the follow-up period, only 1 patient (1.3%) required retreatment. Delayed thromboembolic complications were observed in 4 patients (3.9%) without permanent morbidity. The mRS scores of all patients at the last clinical follow-up were between 0 and 2.CONCLUSIONSThe short-term angiographic findings showed that T-stent–assisted coiling is a feasible and effective endovascular method to treat wide-necked complex bifurcation aneurysms. The long-term angiographic follow-up results suggest that T-stent–assisted coiling provides a durable treatment for wide-necked complex bifurcation aneurysms with favorable clinical outcomes, demonstrating the long-term safety of T-stent–assisted coiling.

Joint replacement surgery as a treatment for glenohumeral arthritis with glenoid bone loss is challenging. The aim of this study is to offer an anatomical orientation for glenoid reconstruction. In this study, we measured size, inclination and version of the glenoid surface, as well as the distance between the articular line of the glenoid, base of the coracoid process, and acromion using computer tomographic (CT) imaging of 131 study participants aged 19–88 years in the period of 2010–2013. We measured a mean distance of 6.5 ± 0.2 mm from the glenoid articular line to the base of the coracoid process in the transverse CT plane. Body height has shown no significant impact on the glenoid morphology. We observed significant differences between males and females: The glenoid appeared to be located 5.2 ± 0.9 mm higher and the humeral head was 4.5 ± 0.7 mm larger in male subjects compared with females (r = .699; p

Purpose To compare outcomes of patient who underwent surgery using perfluorooctane (PFO; C8F18; Ala Octa) with those who underwent surgery with perfluorodecalin (F-Decalin). Design Retrospective, consecutive, comparative, interventional case series. Methods A total of 48 eyes that underwent vitrectomy with PFO were compared to 29 eyes that underwent vitrectomy with perfluorodecalin. Two experienced surgeons performed vitrectomies at the Geneva University Eye Clinic. Visual acuity before, at 8 and 24 weeks after surgery, was documented, and spectral domain optical coherence tomography (SD-OCT) images were analyzed for abnormalities. Results Two patients experienced severe retinal toxicity, including 1 with severe vision loss. However, no statistical differences in VA were observed between the PFO and perfluorodecalin patients. Analysis of SD-OCT images showed differences in occurrence of several abnormalities, for example, inner segment-outer segment alterations were found in 60.4% of eyes treated with PFO and in 10.3% of perfluorodecalin-treated eyes; retinal atrophic areas were found in 41.7% of PFO and in none of the perfluorodecalin eyes; inner limiting membrane contraction was found in 58.4% of PFO and in none of perfluorodecalin eyes; inner retina cystic alterations were found in 58.3% of PFO eyes and 17.2% of perfluorodecalin eyes; outer retina cystic alterations were found in 39.6% of PFO eyes and 13.8% of perfluorodecalin eyes; retinal holes were found in 14.6% of PFO eyes and in none of the perfluorodecalin eyes; and outer retinal inclusions were found in 20.8% of PFO eyes and in 3.45% of perfluorodecalin eyes. Conclusions Perfluorooctane caused significantly more toxic damage than perfluorodecalin. Special consideration should be given to develop a central European Union (EU) control agency for medical devices and to reevaluate safety procedures currently accepted by the EU and International Organization for Standardization for intraocular surgery.

BackgroundSubstantial clinical evidence supporting the benefit of mechanical thrombectomy (MT) for distal occlusions within the posterior circulation is still missing. This study aims to investigate the procedural feasibility and safety of MT for isolated occlusions of the posterior cerebral artery.MethodsWe retrospectively reviewed patients from three stroke centers with acute ischemic stroke attributed to isolated posterior cerebral artery occlusion (IPCAOs) who underwent MT between January 2014 and December 2019. Procedural and safety assessment included successful recanalization rates (defined as Thrombolysis in Cerebral Infarction Scale (TICI) ≥2b), number of MT attempts and first-pass effect (TICI 3), intracranial hemorrhage (ICH), mortality, and intervention-related serious adverse events. Treatment effects were evaluated by the rate of early neurological improvement (ENI) and early functional outcome was assessed with the modified Rankin Scale (mRS) at discharge. A systematic literature review was conducted to identify and summarize previous reports on MT for IPCAOs.ResultsForty-three patients with IPCAOs located in the P1 (55.8%, 24/43), P2 (37.2%, 16/43), and P3 segment (7%, 3/43) were analyzed. The overall rate of successful recanalization (TICI ≥2b) was 86% (37/43), including a first pass-effect of 48.8% (21/43) leading to TICI 3. sICH occurred in 7% (3/43) and there were two cases with iatrogenic vessel dissection and one perforation. ENI was observed in 59% (23/39) and excellent functional outcome (mRS ≤1) in 46.2% (18/39) of patients who were discharged. The in-hospital mortality rate was 9.3% (4/43).ConclusionOur study suggests the technical feasibility and safety of thrombectomy for IPCAOs. Further studies are needed to investigate safety and long-term functional outcomes with posterior circulation stroke-adjusted outcome assessment.

Small‐molecule probes for the in vitro imaging of KCa3.1 channel‐expressing cells were developed. Senicapoc, showing high affinity and selectivity for the KCa3.1 channels, was chosen as the targeting component. BODIPY dyes 15–20 were synthesized and connected by a CuI‐catalyzed azide–alkyne [3+2]cycloaddition with propargyl ether senicapoc derivative 8, yielding fluorescently labeled ligands 21–26. The dimethylpyrrole‐based imaging probes 25 and 26 allow staining of KCa3.1 channels in NSCLC cells. The specificity was shown by removing the punctate staining pattern by pre‐incubation with senicapoc. The density of KCa3.1 channels detected with 25 and by immunostaining was identical. The punctate structure of the labeled channels could also be observed in living cells. Molecular modeling showed binding of the senicapoc‐targeting component towards the binding site within the ion channel and orientation of the linker with the dye along the inner surface of the ion channel., Imaging channels: Small‐molecule probes for the in vitro imaging of KCa3.1 channel‐expressing cells were designed and developed. Using senicapoc as the targeting component, the BODIPY‐labeled probes could selectively stain the channels in living cells and the channel punctate structure could be observed.

In this paper, we present current pulses from upward lightning, which have been measured since 2011 at the new top structure of the Peissenberg Tower, Germany. The study comprises 38 negative and two positive flashes, which contained 199 current pulses. About 49 of them were return stroke current pulses, 133 of them were current pulses, which superimposed the initial continuous current (ICC-pulses), and 17 of them were M-component current pulses, which superimposed the continuing current of a preceding return stroke. The current pulses are used to evaluate the performance of the European lightning location system EUCLID. Fifty one (25.6%) out of the 199 current pulses were detected by EUCLID, 40 (81.6%) return stroke current pulses, and 11 (8.5%) ICC-pulses or M-component current pulses. The peak currents ranged from 0.1 to 40.8 kA. Two groups of current pulses could be identified. The first group is related to branches of nearby downward lightning which got in contact with the tower. Therefore, EUCLID reported much higher peak currents (more than 100%) compared to the peak currents measured at the Peissenberg Tower. The first group comprises the total of nine current pulses (six ICC-pulses, three return stroke current pulses). The second group of current pulses is related to upward lightning initiated from the top of the tower. The peak current inferred from EUCLID deviates much less from peak current measured at the Peissenberg Tower. The peak current was overestimated by about 20% by EUCLID. The second group comprises the total of 42 current pulses (4 ICC-pulses, 1 M-component current pulses, and 37 return stroke current pulses). The peak currents ranged from 3.1 to 40.8 kA, the geometric mean (GM) was 9.4 kA. About 30% of these events were misclassified as intra-cloud pulses by EUCLID. The GM of the location error was 161 m for all events, and 132 m considering only the return stroke current pulses.

BackgroundNeonatal stroke remains a rare condition that has not yet been assessed in the field of endovascular treatment.CaseWe present the first case report of a successful mechanical thrombectomy in a newborn with a basilar occlusion the treatment was 14 hours after birth. Complete reperfusion of the basilar artery was achieved after the two thrombectomy maneuvers with stent retrievers. Imaging follow-up proved patency of the target vessel and at day 30, the patient showed no neurologic deficits.ConclusionsMechanical thrombectomy appears to be technically feasible and can be an individual option in selected cases to treat stroke in neonates with proven persistent proximal cerebral artery occlusion.

The growth of the aquaculture sector leads to a demand for sustainable feed ingredients. Prebiotics are potential sustainable feed ingredients that can promote the improved performance of aquaculture species without the use of antimicrobials. This study investigated the potential of Azolla pinnata as a candidate prebiotic source. Prebiotic characteristics and dietary effect of commercial diet (CD) with varying pulverised azolla (PA) inclusion was evaluated. Results showed that PA (9.40% moisture) constitutes around 16.1% ash, 22.3% crude fibre, 20.9% crude protein, 1.7% crude fat and 29.6% nitrogen-free extract. Crude xylan and cellulose content of PA were 13.7% and 12.6% dry matter (DM) respectively. Growth of Lactobacillus rhamnosus in PA-supplemented MRS broth remarkably improved after 4 to 6 hours of incubation. Feeding trials results revealed that PA inclusion had no adverse effect on average survival of milkfish fingerlings, albeit significant improvement (p < 0.01) was noted in group fed with 2% PA-replaced CD in terms of the total weight gain (119.9%), specific growth rate (2.62% day–1) and feed efficiency (79.9%). The present study demonstrated the prebiotic activity of PA, as well as its potential use as dietary feed component for improved growth and feed efficiency of cultured milkfish.

A tsunami is a long-period sea wave caused by an earthquake, submarine landslide, or other disturbance such as meteor impact. A 7.1-magnitude earthquake on November 15, 1994 caused a tsunami that hit the coastal areas of Batangas, Quezon, and Mindoro in the Philippines, resulting to 78 deaths. In this study, the 1994 Mindoro tsunami was numerically simulated by modelling of the initial water surface generated by the ground rupture and propagating the tsunami wave towards the coastal areas. Based on the simulations, the generated tsunami wave has a height not exceeding 1.5 m above mean sea level and caused water runup heights in the coast of Calapan, Mindoro reaching 2.6 m. The results of the numerical simulation locally agree with the post-disaster measurements of Imamura et al. (1995) for the coast of Calapan, Mindoro, but the maximum runup levels recorded in the nearby Baco Islands were not obtained with acceptable accuracy. Further calibration of the numerical model is underway to improve the performance of the model.

Background: History starts from where we are now ‐ it is not just things that happened a long time ago. The global pandemic began in 2019. It has changed the lives of people with learning disabilities. We began our project during the first lockdown in April 2020. We came together to set up a website to collect stories and support and learn from each other about how to survive and keep strong. Storytelling is very important because it helps us understand what is going on. It is also a way to capture the history of people with learning disabilities at a very difficult time. We know that thousands of people with learning disabilities became ill and died in the flu epidemic of 1918. But nobody recorded their stories in their own words. We want to make sure this does not happen again, so we created an archive to help us remember. Methods: The project was managed with an advisory group of people with and without learning disabilities who met monthly to monitor the collection and analysis of stories on the site. A site audit was performed regularly to determine the themes in the stories and who had submitted. The article describes the progress of the project, the stories we have shared, and the challenges we have faced. Conclusions: We discuss how people with learning disabilities have been presented in the media and our views about the way we are not heard, or always shown as vulnerable victims. We have found many sad stories, but also positive ones about people being creative and supportive. We look forward to the future and share our ideas about how society could be different and more inclusive. Being part of this project has given us confidence to know we are not alone, and shown us how we can help with the recovery.

Bioorthogonal covalent labeling with self-labeling enzymes like SNAP-tag bears a high potential for specific targeting of cells for imaging

Laguna de Bay is one of the country’s major lakes, providing a third of the fish consumed by Metro Manila’s 16 million residents. It also provides support for agriculture, industry, and hydropower generation, as well as providing a welcome respite for many Filipinos. However, because of the lake’s importance, it is threatened by a variety of issues, including pollution. Heavy metals such as mercury and lead are present in high concentrations in the lake. And these heavy metals may persist in fish, water, air and the human body. As a result, an adsorption technique for heavy metal removal in an aqueous solution was investigated. As an adsorbent, the produced chitosan from crustacean waste shells was employed. The study’s parameters were contact time, adsorbent quantity, and pH. Results showed that 0.5 g of chitosan has a higher absorption rate of 99% in 500 mg/L solutions compared to 1.0 g of chitosan with an adsorption rate of 98%. In terms of contact time, 60 minutes showed almost 100% adsorption rate while 120 minutes was 98%. With increasing pH, the amount of metal adsorption rises. This developed chitosan from crustacean waste shells indicates high capacity as adsorbent materials for heavy metals. As a result, it appears to be a viable material for water treatment.

Aims: Human embryonic stem cell derived-cardiovascular progenitor cells (hESC-CVPCs) are a promising cell source for cardiac repair, while the underlying mechanisms need to be elucidated. We recently observed cardioprotective effects of human pluripotent stem cell (hPSC)-CVPCs in infarcted nonhuman primates, but their effects on inflammation during early phase of myocardial infarction (MI) and the contribution of such effect to the cardioprotection are unclear. Results: Injection of hESC-CVPCs into acutely infarcted myocardium significantly ameliorated the functional worsening and scar formation, concomitantly with reduced inflammatory reactions and cardiomyocyte apoptosis as well as increased vascularization. Moreover, hESC-CVPCs modulated cardiac macrophages toward a reparative phenotype in the infarcted hearts, and such modulation was further confirmed in vitro using human cardiovascular progenitor cell (hCVPC)-conditioned medium (hCVPC-CdM) and highly contained interleukin (IL)-4/IL-13. Furthermore, signal transducer and activator of transcription 6 (STAT6) was activated in hCVPC-CdM- and IL-4/IL-13-treated macrophages in vitro and in hESC-CVPC-implanted MI hearts, resulting in the polarization of macrophages toward a reparative phenotype in the post-MI hearts. However, hESC-CVPC-mediated modulation on macrophages and cardioprotection were abolished in STAT6-deficient MI mice. Innovation: This is the first report about the immunoregulatory role played by hESC-CVPCs in the macrophage polarization in the infarcted hearts, its importance for the infarct repair, and the underlying signaling pathway. The findings provide new insight into the mechanism of microenvironmental regulation of stem cell-based therapy during acute MI. Conclusions: Implantion of hESC-CVPCs during the early phase of MI promotes infarct repair via the modulation of macrophage polarization through secreted cytokine-mediated STAT6 activation. The findings suggest a therapeutic potential by modulating macrophage polarization during acute phase of MI.

In this paper, we present the currents, which have been measured since 2008 at the new top structure of the Peissenberg Tower, Germany, and the associated electric fields in a distance of about 180 m from the tower. The study comprises 17 negative lightning, which contained 44 subsequent return strokes, 108 initial continuous current (ICC)-pulses, and 26 M-components. The analysis, based on the current waveform, revealed three different types for both the M-component current and the ICC-pulse. The impulsive current of type 1 has a more or less symmetrical wave shape. For this type, the electric field occurred on average 15.7 μs prior to the current pulse. The impulsive current of type 2 has a bipolar wave shape with current reversal. The impulsive current of type 3 has a wave shape, which exhibits a fast rise to peak and a much longer decay to low current values. For all types of impulsive currents (return strokes, ICC-pulses, and M-components), the electric field exhibits a first field change (Δ E 1) followed by a second field change (Δ E 2) of opposite polarity. For the ICC-pulses and M-component currents of types 1 and 3, the first field change (Δ E 1) has typically an initial slow-rising section, which is followed by a fast-rising section. The transition point was time-correlated with the onset of the current. The transition point was at about Δ E 1/3 for type 1 and at about Δ E 1/2 for type 3. For type 2, the onset of the current pulse occurred during the second field change (Δ E 2) of opposite polarity. Similar to type 1 and 3 pulses, the slow-rising electric field changed into a fast-rising electric field. The transition point for type 2 pulse was at about Δ E 2/3. From the 44 subsequent return strokes, 8 of them contained one negative M-component of type 1. In that case, the M-component current was extremely strong. The arithmetic mean (AM) was 8.5 kA (GM: 5.4 kA) for the peak current and 747.8 mC (GM: 614.0 mC) for the transferred charge. The return stroke was also very strong, with an AM of 16.7 kA for the peak current (GM: 15.0 kA). In comparison, the AM was 10.4 kA (GM: 8.3 kA) considering all subsequent return strokes.

Phenantrena merupakan polutan organik yang termasuk dalam kelompok senyawa polisiklik aromatik hidrokarbon (PAH) dengan toksisitas tinggi, persisten, mutagenik dan karsinogenik. Karena itu diperlukan metode yang efisien, mudah dan ramah lingkungan untuk penyisihan senyawa polutan tersebut. Dalam penelitian ini telah dilakukan sintesis silika yang difungsionalisasikan dengan difenilamin (DPA) untuk mengadsorpsi phenantrena. Karakterisasi silika-DPA dilakukan dengan menggunakan SEM dan FTIR. Optimasi adsorpsi dilakukan berdasarkan pengaruh massa adsorben, waktu ekstraksi, pH dan konsentrasi phenantrena. Hasil karakterisasi SEM menunjukkan terbentuknya Si-DPA dengan adanya perubahan morfologi pada permukaan silica dan adanya serapan spesifik gugus aromatic dan ikatan C-N pada spectrum FTIR. Hasil optimasi adsorpsi diperoleh pada massa adsorben 4 mg, pH 3, waktu kontak 90 menit, dan konsentrasi larutan standar phenantrena 15,88 ppm. Adsoprsi PAH menggunakan silica sekam padi yang difungsionalisasi DPA telah berhasil dilakukan. doi: http://dx.doi.org/10.23960/aec.v4.i1.2019.p51-64

Dysregulated activity of matrix metalloproteinases (MMPs) drives a variety of pathophysiological conditions. Non-invasive imaging of MMP activity in vivo promises diagnostic and prognostic value. However, current targeting strategies by small molecules are typically limited with respect to the bioavailability of the labeled MMP binders in vivo. To this end, we here introduce and compare three chemical modifications of a recently developed barbiturate-based radiotracer with respect to bioavailability and potential to image MMP activity in vivo.Barbiturate-based MMP inhibitors with an identical targeting unit but varying hydrophilicity were synthesized, labeled with technetium-99m, and evaluated in vitro and in vivo. Biodistribution and radiotracer elimination were determined in C57/BL6 mice by serial SPECT imaging. MMP activity was imaged in a MMP-positive subcutaneous xenograft model of human K1 papillary thyroid tumors. In vivo data were validated by scintillation counting, autoradiography, and MMP immunohistochemistry.We prepared three newIntroduction of HYNIC/TPPTS into the barbiturate lead structure ([