Here we model SNARE-mediated adhesion kinetics in SNARE-reconstituted GUV-GUV or GUV-supported bilayer experiments. Adhesion involves many SNAREs whose complexation pulls apposing membranes into contact. The contact region is a tightly bound rapidly expanding patch whose growth velocity SNARE proteins are conserved components of the core fusion machinery driving diverse membrane adhesion and fusion processes in the cell. In many cases micron-sized membranes adhere over large areas before fusion. Reconstituted  In cells the controlled delivery of materials packaged by membrane-bound organelles and vesicles is achieved by membrane fusion. SNARE proteins are involved in most intracellular eukaryotic fusion processes trans complex assembly was blocked in PC12 It has been postulated that SNAREs are dual adhesion-fusion agents. Subsequent to bringing membranes into intimate contact, it has been proposed that SNAREs trigger fusion in vitro studies Identifying and quantifying the role played by SNAREs is challenging because the complex cellular fusion machinery involves many components. A substantial body of in vitro mechanisms. Typical measured fusion times greatly exceed the ∼1 ms required for synaptic vesicle fusion in vitro, SNAP25 was not required in vitro fusion events may result from the small sub-population of vesicles rendered inherently unstable by particularly high curvature and SNARE∶lipid ratios SUV studies have contributed significantly to current understanding of SNARE function. Nonetheless questions remain as to the cellular relevance of in vitro studies have used ∼50-nm SUVs, appropriate to processes such as synaptic transmission where 50-nm vesicles fuse with the presynaptic plasma membrane ∼1 ms after Ca2+ stimulation Most giant unilamellar vesicles (GUVs). Studies have begun to realize the potential of SNARE-reconstituted GUVs as model in vitro systems which may reveal mechanisms of adhesion and fusion of micron-scale membrane compartments. Bacia et al To mimic large membrane cellular fusion systems it is natural to turn to In this paper we develop a model of SNARE-mediated adhesion kinetics in controlled SNARE-reconstituted GUV-GUV or GUV-SBL systems. We discuss experiments where such adhesion kinetics could be followed and GUV membrane tension and SNARE surface densities precisely controlled . Surface adhesion by other biosticker systems was observed to progress by growth of tightly bound patches, including GUV-substrate adhesion mobileimmobilized on a substrate. Thus different mathematical models are necessary to describe SNARE adhesion. Mobile complexes may exert 2D osmotic pressure tending to enlarge a patch. De Gennes, Puech, and Brochard-Wyart uniform complex density in the patch they predicted growth velocity v increases as the 3/2 power of receptor and sticker density. In this paper we explicitly calculate SNARE density profiles and show that in fast growing patches the complex density is in fact severely depleted at the boundary. Osmotic pressure and growth rate are thus diminished and a different power law results. Using properties taken from the literature we find typical SNARE systems belong to this fast growth regime.Since SNAREs and their complexes are apparently In our model the origin of adhesion patch growth is that the initial tension-dependent mean membrane separation in the GUV-GUV or GUV-SBL contact zone  normallyin vitro systems.In the Discussion the possible relevance of these results to cellular fusion pathways is addressed. Tight SNARE adhesion is preceded by loose binding by tethering factors. Given typical tether sizes  For simplicity the symmetric case is assumed: both vesicles have equal numbers of SNAREs per unit area in their respective membranes, ct area  .The first SNARE complex assembles at time xes form . The patγ, SNARE diffusivities and the complexation rate constant Our interest is steady state patch growth where the velocity To calculate Patch growth is driven by the 2D osmotic pressure In steady state the outward osmotic pressure is balanced by dissipative drag forces owth see . These dAs fluid is not expected to significantly penetrate the patch, dissipation occurs primarily in a narrow band along its boundary. The coefficient nce  see , yieldinSince a patch grows within contact zone of area ss than   patch grTo obtain the patch velocity For simplicity we assume the two SNARE types have equal diffusivities ties see . Irreverx, and the far field boundary conditions are in effect at x is distance from the boundary, and similarly We seek equations governing the steady state densities. In the region close to the patch boundary densities will change substantially as a function of position. Provided the patch radius is much larger than the size of this region, the situation becomes approximately 1D in the direction orthogonal to the patch boundary, Each of eqs. 5 consists of a convective term proportional to In this subsection we use scaling analysis to solve eqs. 4–7 for the steady state patch velocity The regime boundaries are defined by two critical densitiesNote the intermediate regime exists because we assume SNARE diffusivity exceeds that of the complex  will be presented which confirm the scaling results.Initially both adhering vesicles have uniform SNARE density, Slow regime,regime, . We defiFast regime,regime, . Since tIntermediate regime,regime, . This reIn the following subsection the scaling solutions will be evaluated using realistic parameter values taken from or inferred from the literature, listed in d values of C in eq. 1. We found in vitro values. The range represents a two-decade SNARE density window to test GUV adhesion kinetics. For comparison, in cells the SNARE density presumably depends on organelle or vesicle type. A report of synaptic vesicle composition suggests (i) Micropipette control allows direct regulation of GUV tension over a large range of values, shown in 2/s.Bacia et al report values A key parameter is the diffusivity  a point  the diff a point . It is pgiven overlap of two cognate SNAREs and the SNARE reach The rate constant Patch drag coefficient, . The model of ref. Using the parameter values of in vitro SNARE density range  The universal curve onto which the numerically obtained data collapses is in very close agreement with our earlier scaling predictions, eq. 8. The predicted power laws in each regime are clearly obeyed.Though adhesion is our main concern in this paper, we briefly consider a very simple model of fusion whose results articulate how adhesion and fusion may be coupled. Past theoretical work on fusion has focused mainly on protein-free membranes. Energy barriers to access intermediate high-curvature membrane structures on the pathway to fusion were calculated independently of all others. Only one such event can occur, assuming fusion results in immediate and irreversible conversion of the adhered vesicles into a single vesicle.Here we invoke the simplest imaginable model for SNARE-induced GUV fusion: each SNARE complex in the patch can trigger fusion with a certain probability per unit time, What is the delay before fusion occurs? This depends on the mean fusion time t. For constant velocity Adhesion kinetics analyzed in previous subsections determine the number of SNARE complexes t isAssuming each SNARE complex triggers fusion independently from all others in the mean time This is the product of factors The distribution of fusion times is thusInserting the particular form This distribution of fusion times road see . It follin vitro range Click here for additional data file.Figure S11crit and velocity scaled by v1crit = ε3/2λ3/4v0. (B) As for (A), but for intermediate and fast regimes. Densities and velocities scaled, respectively, by Γ2crit and v2crit = ε-3/2λ3/4v0. Numerical results confirm the asymptotic solutions with relative errors in the velocity peaking at the critical densities (106% in (A) and 54% in (B)) and approaching zero far from the critical densities in each regime.Collapse of scaled SNARE-mediated adhesion data onto a single universal patch growth law. Same as (0.64 MB TIF)Click here for additional data file.


We have utilized the blast cell assay of Buick et al. (1977) to grow and subsequently cytogenetically analyze cultured colony forming cells (CFUs) from patients with acute and chronic myelogenous leukaemia . Cytogenetic analysis of CFUs was successful in 30/36 cases (83%), a success rate similar to direct harvesting techniques. Identical clonal chromosomal abnormalities demonstrated by direct techniques were also observed in CFUs from AML and CML. Removal of T-precursor cells by E-rosetting prior to plating did not eliminate growth of karyotypically normal cells. The combination of morphologic and cytogenetic studies performed clearly established that the assay system supports the growth of leukaemic progenitors. Although both karyotypically normal and abnormal leukaemic colonies grew in this assay, growth of leukaemic colonies was much more likely if the plated cells were karyotypically abnormal (P = 0.010). Leukaemic colony growth was also more frequent if the tritiated thymidine labelling index (LI%) of plated cells was greater than or equal to 5% (P = 0.018). Leukaemic colonies were most likely (P = 0.018) to have been derived from plated cells with both abnormal karyotype and high LI% . Cytogenetic analyses from cultured cells revealed only those karyotypic features found in the uncultured cells . However, in most cases, the greatly enhanced number and quality of mitotic figures allowed for more detailed banding analysis.


In 101 breast cancer patients, measurement of oestrogen receptor status in multiple biopsies across a tumour reveals a highly significant difference in the proportion of patients remaining either disease-free (P less than 0.04) or alive (P less than 0.005), when those with uniformly receptor positive (++) primary tumours are matched with clinically comparable patients whose tumours were homogeneously receptor negative (--). Mean follow-up time was 85 months. The prognostic value of this discriminant is particularly striking in the 53 patients with involved nodes at presentation. Of these, 13 were (++) and seven remain alive of whom six are disease-free, whereas 24 of the 29 (--) patients are dead. These results further suggest that receptor assay on a single homogenate gives less clinical information than do assays on multiple biopsies across the tumour. For patients with involved nodes, clinical management may best be decided after determination of 'macroheterogeneity'.


In a prospective randomised study 68 patients with limited small cell bronchogenic carcinoma were assigned to induction treatment with combined alternating non-cross-resistant chemotherapy plus split course radiotherapy without (NM) or with (M) subsequent maintenance therapy. Induction chemotherapy consisted of cisplatinum and VP16213q. 3 weeks followed by cyclophosphamide, vincristine and methotrexate (CVM)q. 4 weeks. Three courses of this 7-week chemotherapy programme were given. Radiotherapy to the primary lesion of 25 Gy in 13 fractions was given after each of the first and second courses of chemotherapy. Those in complete remission following the induction phase received prophylactic cranial irradiation. Those assigned to maintenance received a further six cycles of CVM after induction. The overall survival of patients randomised to maintenance therapy was significantly inferior to that of those randomised to no maintenance therapy . Among patients achieving a complete remission of disease on induction therapy those receiving maintenance also showed a trend towards inferior survival . Deaths in each group of patients were predominantly due to tumour progression. The results do not support the use of maintenance chemotherapy after the use of intensive combined therapy induction programmes in the management of limited small cell bronchogenic carcinoma.


Caenorhabditis elegans, several nematode species are unable to mount an RNAi response when exposed to exogenous double stranded RNA (dsRNA). These include the satellite model organisms Pristionchus pacificus and Oscheius tipulae. Available data also suggest that the RNAi pathway targeting exogenous dsRNA may not be fully functional in some animal parasitic nematodes. The genus Panagrolaimus contains bacterial feeding nematodes which occupy a diversity of niches ranging from polar, temperate and semi-arid soils to terrestrial mosses. Thus many Panagrolaimus species are adapted to tolerate freezing and desiccation and are excellent systems to study the molecular basis of environmental stress tolerance. We investigated whether Panagrolaimus is susceptible to RNAi to determine whether this nematode could be used in large scale RNAi studies in functional genomics.Gene silencing by RNA interference (RNAi) is a powerful tool for functional genomics. Although RNAi was first described in Panagrolaimus sp. PS1159 and Panagrolaimus superbus. Both nematode species displayed embryonic lethal RNAi phenotypes following ingestion of Escherichia coli expressing dsRNA for the C. elegans embryonic lethal genes Ce-lmn-1 and Ce-ran-4. Embryonic lethal RNAi phenotypes were also obtained in both species upon ingestion of dsRNA for the Panagrolaimus genes ef1b and rps-2. Single nematode RT-PCR showed that a significant reduction in mRNA transcript levels occurred for the target ef1b and rps-2 genes in RNAi treated Panagrolaimus sp. 1159 nematodes. Visible RNAi phenotypes were also observed when P. superbus was exposed to dsRNA for structural genes encoding contractile proteins. All RNAi phenotypes were highly penetrant, particularly in P. superbus.We studied two species: Panagrolaimus is amenable to RNAi by feeding will allow the development of high throughput methods of RNAi screening for P. superbus. This greatly enhances the utility of this nematode as a model system for the study of the molecular biology of anhydrobiosis and cryobiosis and as a possible satellite model nematode for comparative and functional genomics. Our data also identify another nematode infraorder which is amenable to RNAi and provide additional information on the diversity of RNAi phenotypes in nematodes.This demonstration that  Caenorhabditis elegans  was constructed using 18S small subunit rRNA gene sequences.  Bootstrap values  are placed next to the nodes.Click here for file


A low-mol.-wt compound isolated from rat Walker 256 carcinoma and found to induce neovascularization in vivo was tested on cultures of cow brain-derived endothelial cells (CBEC) growing on plastic and collagen substrates. This factor had a mitogenic effect on CBEC cultured on native collagen gels and for this reason has been called "endothelial-cell-stimulating angiogenesis factor" (ESAF). CBEC growing on plastic culture dishes or denatured collagen films were not stimulated by ESAF. The mitogenic effect of ESAF was equally apparent when added to cells already attached to the native collagen substrate or when the collagen substrate was pre-incubated with ESAF before plating the cells. A floating collagen gel pre-incubated with ESAF in cultures of CBEC growing on plastic dishes did not stimulate cell growth. Our data indicate that the substrate influences cell behaviour and that CBEC only respond to ESAF when growing on a native collagen substrate.


The possibility of using tirapazamine (SR 4233) to identify hypoxic cells in multicell spheroids and murine tumours was examined by measuring tirapazamine-induced DNA damage to individual cells from multicell spheroids and SCCVII murine tumours. Fluorescence microscopy and image analysis were used to measure the extent of migration of DNA from individual cells embedded in agarose and exposed to an electric field. Using both the alkaline and neutral versions of the comet assay, at least 20 times more single-strand breaks were observed in cells from fully anoxic than fully oxic Chinese hamster V79 spheroids exposed to 30 microM tirapazamine, and about 10 times more single- than double-strand breaks were observed. Cells from spheroids containing about 50% radiobiologically hypoxic cells showed a pattern of tirapazamine breaks which translated to approximately 30% well-oxygenated in SCCVII tumors growing in C3H mice was also demonstrated. Cells close to tumour blood vessels showed less DNA damage by 20 mg kg-1 tirapazamine than cells distant from blood vessels. Rejoining of single-strand breaks was exponential, with a half-time of about 1 h under aerobic conditions, but rejoining half-time increased to 2 h for cells allowed to repair under anoxic conditions. While tirapazamine damage to DNA measured using the comet assay cannot provide a direct measure of hypoxic fraction, the degree of heterogeneity in DNA damage can be used to estimate the range and distribution of individual cell oxygen contents within spheroids and tumours.


Post biopsy arterio-venous fistula in renal transplant range in incidence from 15-16%. Spontaneous resolution of 75% A-V fistulas is seen within four weeks. We report a patient with post biopsy arterio-venous fistula who had developed unexplained hypertension with no definite feature of rejection on biopsy. Doppler application revealed an arterio-venous fistula which showed spontaneous resolution in six weeks. In renal transplants post biopsy fistulas are well known. Most resolve spontaneously only few which are large need intervention. We report a case in whom we had done renal biopsy and who developed post biopsy AV fistula which we documented on color Doppler. He was followed for 6 weeks after which we noticed a spontaneous resolution. Most of the post biopsy AV fistula need follow up and are likely to resolve after some period.We evaluated a 46-year-old male, who had received live donor renal transplant one year ago, for a recent onset of hypertension. We performed three renal biopsies over a period of three months with no evidence of chronic transplant rejection. The patient was referred to the Radiology department for ultrasonography (USG) Doppler of the transplant. We performed a color Doppler study of the transplant kidney, which revealed an arteriovenous (AV) fistula in the lower pole involving lobar vessels with markedly increased peak systolic velocity PSV; >170 cm/s), end diastolic velocity  and a reduced resistive index (RI = 0.45). Arterialization of the venous waveform was evident along with perivascular random color assignment [Figs. 70 cm/s, The incidence of post-biopsy renal transplant AV fistulas range from 15% to 16%.138In most cases, color and duplex Doppler USG easily demonstrate AV fistulas besides other obvious vascular and nonvascular complications and requires invasive procedures such as renal angiography.


Two AKR sublines appear atypical in possessing theta C3H. One of these two sublines - AKR/FuA - is notably resistant to lymphomata and is also characterized by reduced levels of the group specific murine leukaemia viral (MuLV) antigen. This suggested a possible association between theta status tumour susceptibility and viral content. Results here show no reduction in viral antigen titres in the other theta C3H tumour susceptible subline AKR/Cum, thus eliminating the possible association of theta status with the extent of MuLV replication.


Mechanisms for improving photodynamic therapy (PDT) were investigated in the murine RIF1 tumour using meso-tetrahydroxyphenylchlorin (m-THPC) or bacteriochlorin a (BCA) as photosensitisers and comparing these results with Photofrin-mediated PDT. The 86Rb extraction technique was used to measure changes in perfusion at various times after interstitial PDT. Non-curative combinations of light doses with m-THPC and BCA PDT markedly decreased vascular perfusion. This decrease was more pronounced for both new photosensitisers than for Photofrin. Comparison of tumour perfusion after PDT with tumour response revealed an inverse correlation for all three photosensitisers, but the relationship was less clear for m-THPC and BCA. In vivo/in vitro experiments were performed after Photofrin or m-THPC PDT in order to assess direct tumour kill (immediate plating) vs indirect vascular effects (delayed plating). For both photosensitisers, there was little direct cell killing but clonogenic survival decreased as the interval between treatment and excision increased. When m-THPC PDT was combined with mitomycin C (MMC), light doses could be decreased by a factor of 2 for equal tumour effects. Lower light and m-THPC doses could be used compared with Photofrin PDT in combination with MMC. BCA PDT with MMC did not result in a greater tumour response compared with BCA PDT alone. Reduction in both light and photosensitiser does for effective PDT regimes in combination with MMC offers substantial clinical advantages, since both treatment time and skin photosensitisation will be reduced.


The data describe a rational design and scale-up of LED-based photobioreactors for producing value-added algal biomass while removing waste CO2 from flu gases from power plants. The dataset were created from growth rate experiments for biomass production including direct biomass productivity data, PBR size and setup parameters, medium composition as well as indirect energy cost and overhead in Iceland. A complete economic analysis is formed through a cost breakdown as well as PBR scalability predictions.The data presented in this article are related to the research article entitled “Sugar-stimulated CO The key data are from the design parameters of LED-based photobioreactor systems as well as the experimentally derived biomass productivity data . As show22 level (mixed with air), LED illumination (different spectra and intensities), temperature and pH in the medium. Artificial light supplied to the PBRs was based on LEDs consisting of narrow spectrum of red light, blue light or combined red and blue light A bubble column LED-based PBR system was tested and used for economic analysis of mass production. The PBR systems are setup with controllable key parameters including input COC. vulgaris  achieved in a previous study A fast-growing algal strain


The idea that positive-sense RNA (+RNA) viruses may be to some extent taxonomically unified arose when unexpected similarities between animal and plant virus genomes were discovered (reviewed in reference The question thus arises, whether the membrane association of the polymerase was a primordial characteristic of viruses in branches 2 and 3, which may have facilitated virus replication in early eukaryotic cells possessing internal membranes. The phylogeny of RdRps cannot answer this question, since the membrane-binding sites in viral replicases reside outside the conserved core RdRp domain . Further


In 2013 RheinMain University launched its bachelor’s degree program Health Care Economics requiring each student to participate in a mandatory two-month nursing internship. A preliminary risk assessment revealed serious risks for both students and patients and had to be addressed by appropriate measures such as mandatory systematic safety training for each student.A short-term educational intervention named “Survival-Day” was designed to minimize risks related to nursing internships of students. This intervention consists of six 45-min-units with theoretical input (2 units) and hands-on training (4 units) imparting basic knowledge and skills in CPR, hand hygiene and handling of masks and protective gowns, prevention of needle stick injuries, fire protection and firefighting. Performance of CPR was assessed using computerized manikins. Acceptance, necessity and usability were assessed anonymously by standardized written questionnaires after completion of nursing internships.462 students have completed the Survival-Day until January 2019. CPR performance showed acceptable adherence rates to guideline recommendations . The majority of students performed aseptic health care activities (66%), treated patients with multi-resistant pathogens (62%) and disposed sharp instruments such as blood-contaminated needles (76%). According to students’ self-reports about these hazardous activities, less than 50% of these students received adequate safety training at nursing facilities. However, no sentinel events such as needle stick injuries or students becoming second victim have been reported.Our study reveals severe discrepancies between legal obligation of nursing facilities to ensure safety instructions for nursing interns and initial training as perceived by this group. Mandatory initial training before conduction of hazardous tasks was mainly covered by our short-term educational intervention . Regarding responsibility for their students a preliminary safety instruction program like the Survival-Day should be considered for all educational institutions sending students to nursing internships unless mandatory and sufficient safety trainings for nursing interns can be guaranteed by nursing facilities. Since 2013 RheinMain University of Applied Sciences has offered a bachelor’s program in Health Care Economics (BHCE). This includes a mandatory two-month nursing internship in order to gain detailed and realistic knowledge and understanding of patient care, regarded to be crucial for sustainable professional success. The RheinMain University has formal contracts with nursing facilities defining common aspects of nursing internships, which are not specific for the health care sector. Due to greatly varying standards and capacities in these nursing facilities regarding initial trainings for interns, a general contractual agreement ensuring standardized training by all nursing facilities is not realistic.Because of this lack of adequate training nursing internships can be categorized as danger-prone activities with relevant risks for the safety of patients and students –8. FurthUndoubtedly, infectious hazards belong to the most important dangers in the area of health care –24. HoweThe Survival-Day was invented to close gaps in knowledge and skills in order to empower non-nursing BHCE students to safely fulfill assigned tasks during their mandatory nursing internship since we hypothesized that induction training at nursing facilities might be inadequate due to lack of time due to staff shortage. Results of acceptance, necessity and usability of this training program will be presented in this paper.The intervention consists of six 45-min teaching units as shown in Table Completion of learning objectives for firefighting, prevention of needle stick injuries, handling of protective gowns and masks and hand hygiene were assessed by teaching staff until sufficient performance was achieved during the intervention. Overall acceptance and recommendation rate were assessed for evaluation of the first event in January 2015 prior to nursing internships by using the German school grade system (1 = very good to 6 = unsatisfactory). Acceptance of this short-term intervention and on-site instructions at nursing facilities were assessed. Therefore, all students who finished their nursing internship between July 2017 and September 2018 were asked to complete a standardized content-validated questionnaire also using the German school grade system.All questionnaires were completely anonymized to ensure standards of data protection. Anonymized use of data for scientific reasons was declared in all questionnaires. Descriptive analysis was done using Microsoft Excel© 2016.Since the initial intervention in January 2014 a total number of 462 non-nursing BHCE students have participated in this educational intervention, as shown in Table n = 346) compared to similar educational interventions [Performance rates of in-hospital BLS showed an overall acceptable ERC BLS scores . Overall acceptance of the initial session in January 2015 was very good with a mean score of 1.9 (median 2) and recommendation rate of 94%. Overall acceptance remained high after 2017 with mean grade 2.3 (median 2) compared to very mixed results for initial trainings at nursing facilities with mean grade 3.5 (median 3). Remarkably 24% of all students rated initial training at nursing sites to be deficient (grade 5) or unsatisfactory (grade 6). According to students’ feedback concerning initial training at nursing facilities 54% of all students only received a rudimental initial training, while 30% reported to have had no initial training all. Detailed aspects of non-nursing students’ tasks at nursing sites as shown in Table As presumed by our previous risk assessment tasks with extraordinary damage potential like detection of medical emergencies and assistance during CPR  as well as firefighting  were quite rare but did occur.Among all 402 non-nursing BHCE students successfully completing nursing internships until January 2019 no case of needle stick injury, second victim phenomenon or other serious harm of patients or students has been reported so far.Health care workers are exposed to numerous potential hazards , 28–36. Since students are free to choose any nursing facility in Germany or comparable to German nursing standards, assessment of students’ perceptions can be regarded as representative and evaluation of self-effectiveness can be regarded reasonable under the given circumstances. Quantification of risks for rare events like assistance during CPR or firefighting on a ward seemed to be adequate since these rare events occurred in this comparably small group of students with expected frequencies.It should be assumed that deficits in initial training during nursing internships will also affect students in other educational settings such as nursing internships for high-school students or future medical students. To our knowledge there is no other preventive educational intervention like “Survival-Day” in any high-school or medical school in Germany.We implemented a short-term intervention that was widely accepted and regarded more helpful by non-nursing BHCE students preparing for their tasks at nursing internship than their received initial training at nursing facilities.One fourth of all BHCE students reported inadequate initial training at nursing facilities in general. Also more than half of all students were exposed to hazardous activities without preliminary safety training at nursing facilities supporting our primary hypothesis of inadequate initial training of nursing interns. This justifies the need of our curricular safety training Survival-Day in order ensure necessary safety training to keep non-nursing students as well as patients free from avoidable harm that otherwise could be caused.As long as mandatory safety trainings for all non-nursing interns are not implemented at nursing facilities, educational institutions, sending students to nursing internships should implement short-term educational interventions like the Survival-Day @ Wiesbaden Business School to ensure minimum standards of occupational and patient safety during nursing internships.


Mycoplasma phocirhinis strain 852T was examined for determinants of tropism or virulence. It encodes multiple orthologs of an immunosuppressor that may predispose susceptibility to infection or influence outcomes of intercurrent diseases in marine mammals.The genome of  Mycoplasma phocirhinis strain 852T was examined for determinants of tropism or virulence. It encodes multiple orthologs of an immunosuppressor that may predispose susceptibility to infection or influence outcomes of intercurrent diseases in marine mammals.The genome of  Mycoplasma phocirhinis was first isolated from the respiratory tracts and hearts from harbor seals (Phoca vitulina L.) that died along the adjacent North and Baltic seacoasts during a mass mortality event in 1988  using an Easy-DNA genomic DNA purification kit . Libraries were constructed using the NEBNext UltraTMII DNA library prep kit  and dual-index NEBNext multiplex oligos  for Illumina MiSeq 2 × 150-bp paired-end sequencing. Trimming, adapter removal, and quality filtering with NxTrim v0.4.3  that have about 60% amino acid sequence similarity to mycoplasmal protein M, which binds the light chain of host IgG to block antigen-specific binding (M. phocirhinis to evade host defenses or modulate intercurrent distemper or influenza in seals. Although adherence and cytotoxicity of M. phocirhinis to epithelial cells has been demonstrated in a tracheal explant model (M. phocirhinis 852T genome sequence and annotation have been deposited in GenBank as BioProject PRJNA505803. The raw data are available in NCBI's Sequence Read Archive as SRX5310557.The


Introduction. The multifocal lumbar pathology including disc herniation and stenosis in the spinal canal or foramen has been considered the most difficult to approach surgically. It often requires mandatory dual approaches and/or fusion techniques. Traditional percutaneous endoscopic lumbar transforaminal and interlaminar approach has been focused on unifocal disc herniation. However, the development of endoscopic spinal instruments and surgical technique has broadened surgical indication and therapeutic boundary in endoscopic spine surgery. Cases Presentation. The authors present outcomes of four patients with multilumbar pathology including highly inferior migrated disc combined with lateral recess stenosis, multifocal disc herniation, bilateral disc herniations in spinal canal and foraminal disc herniation combined with central canal stenosis. They were successfully treated by percutaneous uniportal full endoscopic approach with single incision. Conclusion. Percutaneous endoscopic spine surgery is a safe and effective tool to figure out multilumbar pathology in a minimal invasive way. Traditional percutaneous endoscopic lumbar transforaminal and interlaminar approach has been focused on unifocal disc herniation –5. HowevThe multifocal lumbar pathology including disc herniation and stenosis in the spinal canal or foramen has been considered the most difficult to approach surgically. It often requires mandatory dual approaches and/or fusion techniques. Endoscopic surgical techniques may reduce the need for these more invasive methods. A uniportal full endoscopic approach with single incision can satisfactorily resolve these challenging cases. Here we present outcomes of four patients with multipathologies in the lumbar spine who were successfully managed with a single endoscopic approach.A 60-year-old woman suffered from left gluteal, thigh, and calf pain along the L5 dermatome for two months. Manual muscle test for the left great-toe dorsiflexion and the ankle dorsiflexion showed grades III and IV, respectively. She also suffered from neurogenic intermittent claudication symptom (50 m). Magnetic resonance (MR) images demonstrated disc extrusion and downmigrated disc herniation combined with spinal canal and lateral recess stenosis at L4–5 level . AlthougA 50-year-old woman visited the clinic because of severe right-leg radiating pain along the L2 and L3 dermatome. She has a history of fusion surgery five years ago. MR images revealed intracanal and extraforaminal multifocal soft disc herniation at the L3-4 level . AlthougA 58-year-old woman presented with acute onset left-leg radiating pain. She also had constant right-leg radiating leg pain for one year. Bilateral straight leg raise test was positive. MR images showed L5–S1 bilateral herniated disc . DespiteA 77-year-old woman presented with complaints of radicular pain in the right gluteal region and anterolateral aspect of her thigh and leg for three months. She was also suffering from neurogenic claudication symptom. She could not walk more than 50 meters continuously. MR images of the lumbar spine revealed extraforaminal disc combined with central canal stenosis on L4-5 . A plainSpinal disease is the natural aging process. Such degenerative change induces lumbar spinal disease which has a variable spectrum ranging from simple disc herniation to severe degenerative spondylosis such as listhesis, stenosis, and kyphoscoliotic deformity. Among those diseases, a simple single lumbar pathology could be mostly figured out by a single therapeutic modality and approach. However, multifocal or combined different type of pathology in the lumbar spine would need more invasive surgical methods such as two staged dual approaches or fusion technique in order to solve such different and complex combined pathologies.We presented outcomes of four patients with multilumbar pathology who were successfully treated by a single endoscopic approach. If endoscopy was not used, more invasive treatments would have been needed for these cases.Endoscopic operations such as arthroscopy and laparoscopy are becoming standard operations nowadays. Lumbar spinal diseases ranging from simple contained disc to complicated cases such as highly migrated disc herniation and other pathology combined with bony degeneration to produce foraminal and canal stenosis can now be treated with full-endoscopic surgery using various accesses and techniques –13. ManyThe lens located on the tip of the tube-shaped endoscope to see the operative field can be referred to as the “operative eye”. The “operative eye” can be placed very close to the operative target directly passing anatomical structures in endoscopic spine surgery. Unlike traditional bare-eye or microscopic surgery, it is not necessary to destroy much of normal structures to access the target pathology and secure operative corridor to see the operative field. In the first case, traditional laminotomy techniques could be used for lateral recess decompression with removal of the highly inferior migrated disc herniation. However, these surgical options could not avoid injury to posterior segmental structures by dissection of the paravertebral muscle and the partial removal of the lamina and facet joint. Target oriented direct accessibility in endoscopic surgery mentioned above helped us minimize the operative iatrogenic injury and save normal segmental spinal structures in current cases. It led to good clinical outcome such as patient's fast recovery and early return to regular activity despite their multilumbar pathology.Operative instruments used in endoscopic spine surgery are relatively small compared to near anatomical spinal structures. The “operative eye” on the tip of such a small endoscope can navigate around the target with minimal pivoting movement of the endoscope via an initial single skin portal. Moreover, recent development of the endoscopic drill system has expanded surgical boundary where the endoscope could not previously approach or move around. Such characteristics of endoscopic spinal surgery provided probing and small sized working spot, enabling authors to explore a relatively large operative field and manage two different distant targets simultaneously in current cases. The second and third cases showed navigability of the spinal endoscope that helped us treat the multilumbar pathology successfully.Variability of endoscopic surgical angle is another distinct feature of spinal endoscope regarding surgical success in current series. Only a slight withdrawal of endoscope after the initial approach can give surgeons the opportunity to reapproach, change the working trajectory, and manipulate structures around different surgical targets without needing another skin incision or different secondary surgical corridor as shown in the second and third cases. The optical angle of a spinal endoscope is 15-20 degrees. With rotation or tilting of the endoscope, an endoscopic operative angle can provide a more variable surgical view and working trajectory. It helps the surgeon reach farther targets that could not be reached by microscope. It also helps surgeons explore hidden areas easily without destroying normal anatomical structures needed to be removed to observe the target with traditional surgical methods. The fourth case was a good example of endoscopic surgery which was performed by a precise, targeted approach via the least invasive surgical route using the endoscopic angled and long-distance visibility. Instead of using dual approach for both spinal canal decompression and removal of extraforaminal disc herniation or the fusion method with wide decompression, endoscopic contralateral approach was chosen. It achieved the same surgical goal. Optimized oblique sublaminoplasty for canal decompression and removal of far lateral disc from contralateral side were possible due to the long distance of the visibility, natural optical angle, and tilting maneuver of the spinal endoscope.In the current case series, satisfactory clinical results were acquired from all patients by using minimally invasive endoscopic procedure. However, percutaneous endoscopic spine surgery is not omnipotent. Although all cases in the current series were successfully resolved by a single endoscopic approach, these techniques cannot be applied to all forms of lumbar spinal diseases, especially for those with severe lumbar spinal stenosis with spondylolisthesis or instability. It should be performed carefully for selected patients. Percutaneous endoscopic spine surgery has a steep learning curve as previously reported by many authors , 16–19. Percutaneous endoscopic spine surgery is a safe and effective tool to resolve multilumbar pathology in a minimal invasive way. It can be an alternative to traditional surgical methods by minimizing iatrogenic injury to normal segmental structures and providing good clinical outcome to the patients.


An approach for optimizing fuel particle reactivity involves the metallurgical process of pre-stressing. This study examined the effects of pre-stressing on aluminum (Al) particle ignition delay and burn times upon thermal ignition by laser heating. Pre-stressing was by annealing Al powder at 573 K and quenching ranged from slow  identified as pre-stressed (PS) Al to fast  identified as super quenched (SQ) Al. Synchrotron X-ray Diffraction (XRD) analysis quantified an order of magnitude which increased dilatational strain that resulted from PS Al and SQ Al compared to untreated (UN) Al powder. The results show PS Al particles exhibit reduced ignition delay times resulting from elevated strain that relaxes upon laser heating. SQ Al particles exhibit faster burn times resulting from delamination at the particle core-shell interface that reduces dilatational strain and promotes accelerated diffusion reactions. These results link the mechanical property of strain to reaction mechanisms associated with shell mechanics that explain ignition and burning behavior, and show pre-stressing has the potential to improve particle reactivity. For propulsion applications, ignition delay and burn times of Al particles are important to understand because reduced Al particle burn time and ignition delay can provide added energy to facilitate propellant surface burning regression or reduce particle agglomeration on the burning propellant surface [Aluminum (Al) is an important solid fuel for propulsion and pyrotechnic applications because of its high  were treated through an annealing and quenching process that is detailed elsewhere ,3 but suThe PS Al, SQ Al, and untreated Al (UN Al) powders were analyzed using Synchrotron XRD at the Advanced Light Source facility at Lawrence Berkeley National Laboratory on beamline 12.3.2. This beamline uses a micron focused synchrotron X-ray beam to determine dilatational strain and a white micro-beam technique ,17 to de2 laser focused down to a 200 µm spot size as shown in ® script analyzed burn time and ignition delay data by tracking particle residence time and location of first light respectively, as shown in A 1-g powder sample of PS Al, SQ Al, or UN Al powder was loaded into the particle injector shown −15 J, while the energy required to heat the same particle to the melting temperature of alumina is approximately 1 × 10−7 J.Synchrotron XRD measurements in The SQ Al particles had the shortest burn times , with burn times for all particle treatments converging at 90% of the total particle population . Shorter2O3 passivation shell. Annealing and quenching the Al particles may alter the surface hydration layer and affect surface energy forces that promote agglomeration. It is assumed that after annealed and quenched particles were exposed to ambient conditions, they would naturally rehydrate. Visual inspection of the Al powders reveals no apparent differences in agglomeration behavior that would contribute to the behaviors observed in Aluminum particles inherently include a surface hydration layer surrounding the AlThe results presented in 2 laser beam. Pre-stressed Al particles quenched slowly (PS Al) exhibit reduced ignition delay times while pre-stressed particles quenched quickly (SQ Al) exhibit reduced burn times. Elevated strain energy may contribute to a reduction of energy needed to ignite the particles thereby leading to reduced ignition delay time. Shell-core delamination associated with SQ Al particles facilitates diffusion reactions thereby reducing burn times. Altering the mechanical properties of the shell-core particles alters their reaction mechanism. This study links reactive behavior with mechanistic understanding associated with the mechanical property of dilatational strain. Aluminum particles have been pre-stressed using two different quenching treatments that increase their dilatational strain. Quenching slowly elevates the particle strain and quenching quickly promotes delamination at the core-shell particle interface and reduces particle strain. Both quenching treatments produce Al particles at elevated strain compared with untreated Al. The mechanical alteration of the Al particles affects their ignition and burning behavior when subjected to a CO


Few studies have examined caregiver reactions to their loved ones receiving the results of an Amyloid PET scan which can be indicative of Alzheimer’s disease. Therefore, we examine: 1) What are care partner’s reactions to their loved one receiving negative or positive amyloid PET scan results?, and 2) To what extent are scan results and diagnostic category (dementia vs. mild cognitive impairment) associated with care partner depressive symptoms (PHQ-2) and anxiety (STAI-6)? Using data from 1,799 care partners in the CARE IDEAS study, we applied a sequential mixed-methods design and explored the reactions of 192 care partners who answered open-ended interview questions after learning about the Amyloid PET scan results. We first conducted qualitative content analysis of transcripts from open-ended questions to explore caregivers’ emotional responses after their loved one received an Amyloid PET scan result. The qualitative data suggest that when the scan results fit care partner’s expectations, i.e. positive scan when the patient has dementia and negative scan when the patient has mild impairment, care partners report satisfaction with this information and relief, rather than shock and frustration. Adjusted logistic regression models of survey responses support this finding; having dementia and a positive scan both increased the likelihood of care partners having high levels of anxiety, and a significant interaction indicated that a positive scan was associated with high anxiety among care partners of patients with mild cognitive impairment but not dementia. Only lower education and higher impairment in everyday cognitive function were associated with high depressive symptoms.


An unexpected 18F-FDG uptake in left ventricule which mimicked either trombus or physiological papillary muscle was detected. Filling defect of intravenous contrast in CT images was also demonstrated in left ventricule cavity. Magnetic resonance imaging scan confirmed cardiac mass with metastatic features of malign melanoma in left ventricule.A 58-year old patient with a history of subungual malign melanoma was referred to our department for a


Sleep disturbances are core symptoms of posttraumatic stress disorder (PTSD), and recent studies also suggest a link between PTSD and cognitive impairment. There is some evidence of an association between sleep disturbances and cognitive abilities, such as memory, though few studies have focused on older adults and fewer still among those with mental health conditions. This study examined the association between subjective memory complaints and sleep  in older veterans with PTSD. Fifty-four veterans with PTSD  participated in the study. Sleep was assessed using the Pittsburgh Sleep Quality Inventory (PSQI) and the PSQI Addendum for PTSD (PSQI-A). Memory was assessed using the Frequency of Forgetting Scale (FOF) derived from the Memory Functioning Questionnaire. The relationship between sleep quality parameters and FOF were examined using bivariate correlations and independent samples t test. Over 60% of participants met military-specific criteria for poor sleep . Overall sleep quality on the PSQI-A was significantly associated with worse memory . Among specific sleep parameters , greater daytime dysfunction due to sleepiness was significantly associated with worse memory . Between-group analyses comparing memory complaints across participants classified as ‘poor’ versus ‘good’ sleepers on the PSQI-A approached significance (t(52)=1.93, p=.06). This study suggests that poor sleep may be a correlate of memory complaints among older adults with PTSD. Future studies are needed to determine whether poor sleep is an underlying factor in the link between PTSD and cognitive impairment.


The experiment studies the effect of technical and social sources of complexity on effort required to complete abstracted design tasks. Parameter design tasks define a set of input design parameters and functional requirements modeled with a linear coupling matrix. Selecting design variables to meet all functional requirements within error limits completes a task. Technical complexity arises from the number and degree of coupling between design parameters. Social complexity arises from the number of designers involved in a task. The experiment includes 10 sessions with between 19 and 24 rounds of randomly generated parameter design tasks each having between two and six design variables and one, two, or three designers. Designers completed individual tasks in parallel during rounds. This article contains raw and post-processed data from 374 completed tasks ranging in effort from a few seconds for simple tasks to more than 15 min for complex ones. Specifications tableValue of the data•Parameter design tasks are an important class of abstract engineering design problems for behavioral experiments because of their generalizability and reproducibility.•This dataset provides a baseline of individual and small group performance on randomly generated fully decoupled and fully coupled tasks for cross-validation of future studies using parameter design tasks.•Researchers may use this dataset to investigate temporal activities and search strategies within individual tasks to train computational design agents or explain the effectiveness of individual designers or design teams.1This dataset is included in supplementary data in multiple file formats. The session configuration data (raw/config.json) in JSON format describes details for each session. Key-value pairs in The designer data (raw/designers.csv) in comma-delimited CSV format describes demographic information collected from participants. Columns in The experiment configuration data (raw/session#/experiment#.json) in JSON format describes the conditions for experimental rounds. Key-value pairs in The experimental log data (raw/session#/session#.log) in comma-delimited text format describes actions taking place during a session. Columns in The post-processor script (post/processor.py) written in the Python language includes a main function to execute the script. The post-processor reads raw data and configuration files to build an in-memory model of a session with the following class hierarchy: PostProcessor composes Session composes Round composes Task composes Action. Each class provides helper functions for post-processing functions.The post-processor outputs task summary data (post/tasks.csv) in CSV format where each row describes results of a task during a design experiment. Columns in 22.1The study was conducted using an IRB approved protocol. It includes 30 graduate students in technical design-related fields such as aerospace and systems engineering. Participants were assigned to 90-min sessions in cohorts of three based on mutual availability. Sessions were conducted in university classrooms with the three designers and research administrator seated around a single table with computer displays positioned to restrict screen sharing.The study includes 19 (for sessions 1–3) or 24 (for sessions 4–10) rounds of tasks in partially randomized order to avoid coupled tasks with four variables in first ten rounds. Tasks vary the number of designers, number of design variables, and degree of coupling following the experimental conditions in 2.2Design tasks are based on previous work defining a class of randomly generated parameter design tasks for experimental study Designers work on a task by selecting values of design parameters between upper and lower bounds of 1 and − 1 and observing the effect on functional requirements, attempting to reduce error below the threshold. Multi-actor tasks assign control over design parameters or visibility of functional requirements among multiple designers.2.3Participants interact with a graphical user interface illustrated in A distributed software layer based on the IEEE standard 1516 architecture for simulation interoperability communicates design changes between designer interfaces. A research administrator controls overall task progression from a separate console, which also logs actions. Any change to a design parameter immediately induces an update to show new functional requirements. A chime plays when all tasks are complete in a round, signaling the participants found an acceptable solution.


A 57-year-old male with gastroesophageal reflux disease and esophageal stricture with dilation presented as a cardiac catheterization lab activation for anterolateral ST-segment elevation myocardial infarction. He had suffered an unwitnessed syncopal episode after severe substernal chest pain. Electrocardiogram (ECG) showed anterolateral ST-segment elevation. Markers of myocardial injury were negative. He subsequently had an unremarkable coronary angiogram, echocardiogram, and cardiac magnetic resonance imaging (MRI). He had another episode of crushing chest pain and palpitations during his hospital stay, which correlated with ST-segment elevation, followed by a slow run of ventricular arrhythmia that terminated after a dose of sublingual nitroglycerin. A diagnosis of accelerated idioventricular rhythm (AIVR) following coronary artery vasospasm (CAV) was made. This clinical vignette presents a unique presentation of AIVR following an episode of Prinzmetal’s angina. Coronary artery vasospasm (CAV) is a constriction of coronary arteries and has been documented as a cause of myocardial injury, as well as fatal arrhythmia since the late 1950s . HoweverA 57-year-old Caucasian male was brought in by emergency medical services (EMS) with reports of severe substernal chest pain. The cardiac catheterization lab was activated for anterolateral ST-segment elevation noted on the electrocardiogram (ECG). He reported severe substernal chest pressure and belching followed by an unwitnessed syncopal episode. He had several seconds of cardiopulmonary resuscitation performed by bystanders prior to electromyostimulation (EMS) arrival. His past medical history includes gastroesophageal reflux disease and esophageal stricture with dilation.The ECG on admission showed anterolateral ST-segment elevation Figure . His vitStudies have found that the majority of arrhythmias associated with CAV were ventricular tachycardia, bigeminy, second and third degree atrioventricular (AV) block, and ventricular fibrillation -4. AIVR Accelerated idioventricular rhythm is a slow (50-120 bpm) ventricular rhythm that consists of three or more consecutive monomorphic ventricular beats with gradual onset. It is usually a benign and self-terminating arrhythmia. It does not require specific anti-arrhythmic therapy unless in the presence of hemodynamic instability . It has As part of the diagnostic approach to unexplained syncope, electrophysiological study (EPS) can be a useful tool. This was found to be most apparent in those subjects with concurrent structural heart disease . There iDespite being an uncommon arrhythmia, the presence of AIVR after CAV should always be in the differentials to avoid unnecessary work up and treatment in the long run. Review of telemetry with correlation to symptomatic events can provide valuable insight into the etiology of arrhythmias and help in determining the correct diagnosis.


OBJECTIVES/SPECIFIC AIMS: The long-term goal of this project is to develop a cost effective 3D printed multipurpose intravaginal ring (IVR) to prevent against unintended pregnancies and infectious diseases.Our goal is to develop a female-controlled method for prevention using innovative IVRs. METHODS/STUDY POPULATION: In vitro and in vivo characterization. RESULTS/ANTICIPATED RESULTS: Controlled and fine-tuned release kinetics 100% drug release from 3D printed IVRs compared with 10%–15% with traditional injection molded IVRs cost-effective engineering of multipurpose IVR with CLIP 3D printing technology. DISCUSSION/SIGNIFICANCE OF IMPACT: If successful, this project will revolutionize the engineering of IVRs and will have a global impact on human health. Not only we will help save millions of women around the world but also millions of children that are infected by their HIV-positive mothers through gestation or breast feeding.


This study examined whether perceived neighborhood social disorder predicted depressive symptoms among non-married older women (N = 823) drawn from the 2016 Health and Retirement Study. It also tested the stress buffering effect of friends support. A negative binomial regression model showed that higher perceived neighborhood social disorder was associated with higher depressive symptoms. Presence of good friends in the same neighborhood and number of close friends were protective factors, but no stress buffering effect of friends support was identified. This study highlights the adverse effect of negative perceptions of the neighborhood social environment on non-married older women’s depressive symptoms.


Paenibacillus polymyxa isolates and control efficacy of P. polymyxa ShX301 for controlling Verticillium wilt of cotton, isolated in experimental fields at the Sanyuan Agricultural Experiment Station of North-West Agriculture and Forestry University, Sanyuan county, Shaanxi province, China. Ultrastructural characteristics of P. polymyxa isolates made using technique of transmission electron microscopy. A strain ShX301 has a broad-spectrum antifungal activity against V. dahliae and other plant pathogens and has been used for in vitro experiments for controlling this disease in greenhouse, "Biocontrol potential of Paenibacillus polymyxa against Verticillium dahliae infecting cotton plants" We present the data corresponding to the ultrastructural characteristics of  Specifications tableValue of the data•Peanibacillus.Our data provide the evidence that hints the three-layered spore coat is possibly a common feature in genus •P. polymyxa strain ShX301 has great potential using as biocontrol bacterium for controlling Verticillium wilt of cotton.Biocontrol assay showed that •The data can be used for general analysis of bacterial identification and screening of biocontrol strains.1Paenibacillus polymyxa strain ShX301 was described P. motobuensis by Iida et al. P. polymyxa also shared the same characteristics with strain ShX301. The mature spores in the sporangia all had the three-layered spore coats in the four strains . The raw information related to disease incidence and severity contained in the 2For endospore observation, bacterial strains were grown on specific spore-forming medium  for two days at 25 °C Gossypium hirsutum cv. Ejing-1) were used. The disease assessment was carried out 45 days after planting. Disease severity was assessed for each plant on a 0 to 4 rating scale Paenibacillus polymyxa against Verticillium dahliae infecting cotton plants." The seeds of a susceptible cotton (


Our data demonstrates that dietary protein restriction increases energy expenditure and improves glucose homeostasis, and that this effect is largely mediated by the metabolic hormone fibroblast growth factor 21(FGF21). Considering that the central nervous system (CNS) is acknowledged as a major regulator of both energy and glucose homeostasis, we have extended our studies to identify the tissue site mediating these FGF21-dependent effects via dietary protein restriction. In this study, mice with dysfunctional FGF21-signaling in either the CNS or adipose tissue were fed a control or low protein (LP)-diet to assess changes in body weight and metabolic endpoints. Our data show that LP diet increased energy expenditure and reduced body weight in control littermates, but these effects were lost in mice bearing CNS-specific deletion of Klb. These data highlight a liver to brain FGF21-signal as the first known neuroendocrine mechanism to explain the coordinated metabolic changes induced by dietary protein restriction.


Understanding individual factors  associated with self-reported memory problems is important to refine identification of individuals at a higher risk of developing Alzheimer’s disease (AD). Using multilevel modeling, we examined the association of family history of AD and personality traits with self-reported memory problems in older adults . Results showed that individuals with a family history of AD reported more frequent memory problems and greater one-year memory decline. Similar findings were reported for individuals with higher extraversion scores. Further, older adults with higher neuroticism scores reported greater one- and ten-year memory decline. Neuroticism was positively related to frequency of memory problems, but only among participants with a family history of AD. Findings suggest that higher neuroticism and lower extraversion may increase older adults’ reports of memory problems. Family history of AD may further exacerbate this tendency.


Stent placement in the cephalic arch is being used with increasing frequency. Late complications of bare metal and stent grafts in dialysis access, in particular stent migration, are often under-reported and can lead to compromise of future dialysis circuits.A 52-year-old man developed acute arm swelling 2 days after creation of a left arm brachio-basilic arteriovenous graft. The axillary vein was found to be jailed by a previously deployed cephalic arch stent graft which had migrated into the subclavian vein. There was failure to cross through the fabric of the stent graft using conventional chronic total occlusion wires and techniques. A TruePath device was used successfully to cross through the fabric of migrated cephalic arch stent graft and recanalise the short subclavian-axillary vein occlusion.The adapted use of a drilling chronic total occlusion device to drill through the fabric of migrated stent graft was performed successfully to allow complete recanalisation of the occluded axillary vein. Stent-graft (SG) placement for cephalic arch stenosis in dysfunctional dialysis access is an option for patients, and a recent systematic review suggests that it may be more durable in the short term compared to angioplasty alone  initially created were abandoned. He underwent hemodialysis via a right brachiocephalic arteriovenous graft (AVG) but required multiple interventions to maintain patency. During a thrombolysis procedure, venoplasty of a cephalic arch occlusion resulted in a focal rupture for which conservative management with balloon tamponade was unsuccessful. An 8 × 60 mm Fluency SG  was deployed in the cephalic arch to manage the rupture. Following deployment, the SG showed no protrusion into the subclavian vein Fig. . On a suA new left loop brachiobasilic AVG was created inadvertently and the patient developed left arm swelling 2 days post-surgery. A graftogram showed complete occlusion of the axillary-subclavian vein from the migrated cephalic arch SG. Attempts to cross the axillary vein occlusion using 0.035″ standard guide wires, 0.018″ glide wires , a 0.014″ Winn 200 T  and 0.018″ Victory 25 g  CTO wires were all unsuccessful due to the inability to traverse the fabric of the Fluency SG , the peripheral end of the occluded SG was accessed Fig. . Using aLeft arm swelling improved significantly over the 3 days. Unfortunately, late infection of the AVG developed and was explanted 28 days post intervention. New long-term AVG dialysis access was created in the left lower limb. Six months after left subclavian-axillary vein stenting, an opportune catheter angiogram via his left groin AVG demonstrated continued patency, and without recoil, of the stented segment Fig. .Cephalic arch stenosis affects up to 34% of dysfunctional brachiocephalic AVFs (Bennett et al. Conventional techniques of crossing the occlusion were unsuccessful due to the SG fabric preventing wire passage. Due to vascular anatomy and potential inadvertent subclavian artery injury, sharp recanalisation employing a straight needle was deemed high risk. Bench-testing using a demonstration unit of the TruePath device and Fluency SG demonstrated controlled and easy traversal of the drilling tip of the device through the SG fabric. TruePath is guidewire-mounted mechanical recanalization device with a rotating distal diamond tip designed for true-lumen crossing of peripheral arterial occlusions. We adapted the previously reported balloon puncture technique, for placement of dialysis access catheters in occluded internal jugular veins (Too et al. The case report demonstrates the successful novel use of the TruePath device to drill through the fabric of a migrated cephalic arch stent graft which had jailed the axillary vein outflow causing acute arm swelling due to compromise of the axillary vein outflow. Migration of cephalic arch stent grafts are under-reported and can compromise future dialysis access options. The use of the TruePath device facilitated recanalization of the occluded axillary vein. The device and techniques used in this case can be utilised in similar situations, where conventional techniques would pose high risk of arterial injury or likely be futile.


Routine cancer screening is widely recognized as an effective strategy for reducing cancer mortality – the second leading cause of death in the U.S. Research shows cancer screening rates need to be improved, and men are less likely to uptake recommended screening than women. Cancer screening requires an array of tasks such as seeking up-to-date guidelines, making appointments, planning a hospital visit, and communicating with health care professionals in the complex health care systems. Importantly, modern health care systems are rapidly adopting technology such as web-based applications for information dissemination and communication with patients. This current study is designed to better understand the roles of problem-solving skills in the technology-rich environment (PSTRE) in two selected cancer screening behaviors among middle-aged and older men. We obtained nationally representative data with a sophisticated PSTRE assessment from the 2012/2014 Program for the International Assessment of Adult Competencies (PIAAC). Binary logistic regression models with survey weights were used to estimate the association between PSTRE scores (1 – 500 points) and two cancer screening behaviors of men who meet the recommended guideline of age between 45 to 74 years old . Results showed that greater PSTRE scores were positively associated with prostate cancer screening . Improvement in PSTRE may promote the specific cancer screening behaviors. Our findings also inform future interventions that seek to improve cancer screening among a vulnerable section of older populations.


We read with great interest the article by Yeh et al. about microcirculation in cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation (VA ECMO) . We woulThe heterogeneity of cardiogenic shock (CS) etiologies and its complex pathophysiology requires the thorough study of selected populations, especially when studying microcirculation. The inflammatory component in CS pathophysiology has become increasingly acknowledged  and it mThe authors outlined the usefulness of early microcirculatory parameters in predicting 28-day mortality in CS shortly after VA ECMO implantation . They foFinally, as almost 50% of CS patients are known to die despite having restored cardiac output [ We thank Montero et al. for their comments regarding our article investigating the microcirculation in patients with VA-ECMO life support . First,


Blair, was originally published Online First without open access. After online publication Novartis Pharma AG requested that the article be Open Choice to make the article an open access publication. Post-publication open access was funded by Novartis Pharma AG. The article is forthwith distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (The original article has been update.


Microbes modulate their metabolic and physiological mechanisms in response to changing environmental conditions. It is our interest toidentify small regulatory RNAs using microarray expression data (GSE26043) obtained from B. cereus ATCC 14579 in AgNO3 stress. Bydefinition, expression of transcripts from the Intergenic Regions (IGR) with >=2 fold under silver stress is predicted as novel small RNAs.Computational analysis of the IGR expression levels extracted from the available microarray data help in the identification of stressresponsive sRNAs with rare promoters  followed by terminator signals predicted using the sRNAscanner tool.We predicted 1512 sRNA specific regions on both positive and negative strands collectively. Thus, a non-redundant high scoring unique860 sRNAs with distinct promoter  and terminator signals are reported.These unique computationally predicted sRNA regions were verified with the highly expressing IGRs from the microarray data. It shouldbe noted that 14 sRNAs reported in earlier studies were also found in this dataset. This study has reported 71 additional sRNAs from thetranscriptome under metal stress response. Hence, we use global transcriptomics data for the identification of novel sRNAs in B. cereus. Wedescribed a general model using a procedure for the identification of small regulatory RNAs using microarray expression data withappropriate cross validation modules. It is found that some sRNAs reported in this study were found to have multiple rare promoters. Thisopens the possibility of sRNA activation under multiple stress condition. These sRNA data reported in this study should be characterizedfor their mRNA targets and molecular functional networks in future investigations. Microbes are often exposed to the changing environmentalconditions such as low temperature, oxidative stress and heavymetal stress, etc -6.To adOne such drastic environmental condition is heavy metal ionsexposure like Ag+, Cd2+, Hg2+, Co2+, Cu2+, Ni2+, Zn2+ thatcauses toxic effects in the microbial cell . To reduSmall untranslated regulatory RNAs are identified in all forms oflife. In eukaryotes it is referred as noncoding RNAs (ncRNAs) andprokaryotic counterparts are called as sRNAs . RecentlThe chromosomally encoded sRNA regulate the mRNA targets inresponse to the drastic environmental conditions like lowtemperature, heavy metal exposure, iron homeostasis, quorumsensing, outer membrane protein modification, etc. They functionas either positive or negative regulators of the gene expression.Several bioinformatics and experimental approaches have beendeveloped for genome wide identification of sRNAs. Informationon sRNAs was reported in BSRD database ; sRNAmapTranscriptional factors are the proteins bind at a particular site inthe upstream region of the gene, involve in the initiation oftranscription by enabling the binding of RNA polymerase. Sigmafactors are the exclusive regulators for transcription initiation inmicrobes. Based on the sequence analysis, major sigma factors areclassified into sigma 70 (S70), sigma 54 (S54) and extra cytoplasmicfunction (ECF) sigma factors -24 such The global expression profile [GSE26043] of the control and AgNO3exposed test samples at various time intervals were collected fromNCBI-GEO database. The expression data has 15000 oligo probesto monitor protein coding (10450) and Intergenic regions (4550) inboth sense and anti-sense directions. Details about the targetinggene/mRNA coordinates and respective probe information werecollected from the complete genome of B. cereus ATCC14579(NC_004722). We have created specific PERL script to calculate thecoordinates for empty IGRs from the above protein coding table.The normalized global expression pattern of coding and IGRs werealso collected from the above Affymetrix data. We have selectedthe IGR regions showing expression values >=2 fold comparedwith the control sample and proposing these regions to expressintergenic transcripts.Binding nucleotides along with their specific spacer regions ofvarious sigma factors were collected  and usedComplete genome sequence of the B. cereus ATCC 14579(NC_004722.fna) and corresponding coding region file(NC_004722.ptt) were retrieved from GenBank . RhoindeWe have overlapped the predicted sRNA locations with theintergenic region coordinates retrieved from the genomemicroarray by using the In-house developed awk script. If, any partof sRNA matches with the intergenic coordinates showingexpression in the microarray were confirmed as sRNA encodingIGR. Expression levels of these sRNA harboring IGRs at varioustime points were taken from the microarray data and presented inthe form of a heat maps .Bacterial sRNAs are novel regulators of gene expression involvedin diverse biological processes. A change in the environment oftencauses physiological stress and bacteria cope with that stress byaltering the expression of relevant genes and producing newproteins, which may allow the cell to repair damage or protect itselfin future. This stress-induced gene expression response is oftenmediated by proteins called sigma factors . Recent This study is aiming to identify novel stress responsive sRNAsusing virtual comparison of computational sRNA predictions withglobal transcriptome data collected under silver stress condition.The genome wide microarray experiment in B. cereus ATCC 14579was designed with custom designed oligo probes against CDS'sand IGR's to monitor their expression under various time intervals. It was We have constructed the promoter datasets for S24, S28, S32, S54and S70 using the PWM_create module given in sRNAscanner suite.We have applied these PWMs with their corresponding spacerregions in sRNAscanner to predict the intergenic sRNAs under predefinedparameters . Above sMost of the sRNAs were found to be regulated at high frequency bysRNA specific σ 70 (567) followed by σ 70 (506) and σ 24 (183) thanσ 28, σ 32 and σ 54. Initially 567 sRNAs were predicted to betranscribed by sRNA specific σ70, among them 380 sRNAs werefound to be unique and it may play a major role in stress tolerance.Expression profiles of the 367 IGRs within the microarray data haveshown significant transcripts . Among tThe total number of unique sRNAs in predicted sequences for eachsigma factor of Bacillus spp. was shown in The present study clearly demonstrated the use of globaltranscriptomics data for the identification of novel sRNAs in B.cereus. This methodology may be applied in any model organismsupported with the microarray and genome data. Proposedmethodology also retained fourteen novel sRNAs reported inearlier studies, which clearly validated the reliability of the appliedmethod. Interestingly, few sRNAs reported in this study werefound to have multiple rare promoters and it opens the possibilityof sRNA activation under multiple stress condition. Remaining,sRNAs reported in this study may be functionally characterized fortheir mRNA targets and molecular functional networks.


This review highlights the utilization of dendron-polymer conjugates as building blocks for the fabrication of nanosized drug delivery vehicles. The examples given provide an overview of the evolution of these delivery platforms, from simple micellar containers to smart stimuli- responsive drug delivery systems through their design at the macromolecular level. Variations in chemical composition and connectivity of the dendritic and polymeric segments provide a variety of self-assembled micellar nanostructures that embody desirable attributes of viable drug delivery systems. Recent decades have witnessed an increasing trend in the application of polymeric nanomaterials for cancer therapy ,2,3. WidAlthough the overall picture appears quite simplistic, there are several challenges in using micellar constructs as delivery platforms . When NPNanotherapeutic agents with an average size in the range of 10 to 200 nm can escape filtration through the kidneys, with a renal clearance cut off value around 5 nm. As a result, these NPs can stay in the blood stream circulating for prolonged periods of time. In this extra time frame, NPs have increased probability to extravasate to the tumor tissue leading to improved drug accumulation profiles . The ultNanotherapeutics can enhance a drug’s efficacy profile during three phases; initially by interaction with the reticuloendothelial system (RES) agents while in systemic circulation; secondly during extravasation from the blood vessel towards tumor environment and finally upon uptake by target cells and release of the delivered agents. RES is a system composed of macrophages widespread in multiple organs and sites, such as lymph nodes, adipose tissue, and bone marrow, but the most essential ones are those located in the spleen and liver, since they have the greatest potential to alter the clearance profiles of NPs. The NP-corona complex formed after introduction to serum may induce recognition by macrophages and removal of these particles via phagocytic routes, as macrophages can detect the NPs coated by these serum proteins ,23. ThusThe concept of three-dimensional branched polymers like dendrimers, possessing an alternative macromolecular structure compared to linear polymers was first proposed by Flory in the early 1950s . Howevern type monomers  rather than the standard AB monomers which result in linear polymers. They are synthesized in an iterative manner, thereby allowing an excellent unimolecular molecular weight distribution as well as providing control over desired core and/or peripheral functionalization . De. De74]. Pasut and coworkers reported β-glutamic acid dendrons to introduce multiple bone targeting groups. A linear dendritic construct was prepared by conjugating a 5 kDa PEG polymer with an amino-bisphosphonate alendronate (ALN) modified generation 2 β-glutamic acid dendron, where PTX was attached to the other end of PEG through an ester group . The ALNN-vinylcaprolactam) . Ge. Ge85]. It must be noted that while oligonucleotide based materials have been used as a cargo, dendrimeric constructs composed of oligonucleotides have been synthesized. For example, Tomalia and coworkers used complementary DNA strands at focal points of dendrons to assemble dendrimers through self-assembly . Likewis−6 mol/L), their counterparts where the peripheral groups were removed to expose hydroxyl groups were soluble under similar conditions. The authors postulated the potential of these self-assembled aggregates for possible applications in drug delivery.As mentioned earlier, formation of micellar structures from diblock and triblock copolymers was reported by Fréchet and coworkers in 1992 . A more w/w.This study was followed by a report by Nguyen and Hammond who reported the assembly of a ABA-type dendron-polymer-dendron conjugate composed of PAMAM dendrons as hydrophilic components and poly(propylene oxide) as the hydrophobic middle block . NotablySanyal and coworkers used an ABA type dendron-polymer-dendron conjugate with 10 kDa middle PEG segment connecting two identical polyester dendrons with generation 1–3. The dendron surfaces were further modified with combretastatin-A4 anti-angiogenic drug  91]. Si. Si91]. Nanostructured delivery agents can also be fabricated using a combination of diblock and triblock dendron-polymer conjugates. In a recent study, Sanyal and coworkers reported a modular micellar system for delivery of docetaxel. An AB type diblock dendron polymer conjugate was used to introduce targeting RGD (arginine-glycine-aspartic acid) peptides onto NP surface  92]. Th. Th92]. 50 values for primaquine and chloroquine were reported for assemblies formed using dendritic-linear-dendritic conjugates. Additionally, improved plasma circulation times and survival times were noted relative to free drugs in malaria infected mice.Although a majority of studies to date have focused on the delivery of anti-cancer drugs, these dendritic conjugates can also be utilized as delivery platforms for drugs against different diseases such as malaria. To overcome the high drug resistance of malaria parasites, provide improved cellular delivery of antimalarial drugs and achieve sustained drug release micellar assemblies were prepared using different Janus-like dendrons or ABA type dendritic-linear-dendritic conjugates . Enhancel-lactide) (PLA) based middle blocks, respectively. These polymers also yielded a mixture of unimolecular micelles and micellar aggregates in aqueous environment, which could be loaded with an anti-cancer drug, etoposide, with higher loading in the PCL-containing construct. Interestingly, the 32-arm PAMAM-PCL-PEG constructs exhibited lower drug loading for etoposide than the 16-arm counterpart, which authors suggest could be a result of higher PCL chain density in the star polymers obtained with the higher generation dendrimer . T. T107]. Dendronized polymers are another emerging class of macromolecular architecture that have been frequently utilized in recent years to obtain nanomaterials for drug delivery. These constructs comprise of dendrons conjugated as side chain residues along the backbone of a polymer. In a simple approach, amphiphilic constructs are obtained when hydrophilic synthetic or natural polymers are appended with dendrons that are either inherently hydrophobic or become so upon attachment of hydrophobic drug molecules.In a recent example, Gu and coworkers generated dendronized polymers composed of heparin backbone decorated with G2 lysine-based dendrons bearing DOX molecules  110]. A. A110]. The same group reported another dendronized copolymer composed of a 20 kDa dextran decorated with fluorinated G2 lysine dendrons as side chains conjugated to polymer backbone via acid-labile hydrazone linkers . DextranIn an alternative assembly strategy, Gu et al. used a G3 lysine dendron functionalized with DOX via hydrazone linkages appended with two mPEG tails at the dendron focal group . The denIn a subsequent study, the authors further modified this NP system by using a G2 lysine dendron and thickening their PEG corona by using four 2 kDa PEG tails . Additiol-lysine units thereby introducing an oxidation responsive disulfide linkage along the polymeric back bone. Thereafter, the backbone was further modified with G1 or G2 poly(l-lysine) dendrons with peripheral modifications with different hydrophobic or hydrophilic amino acids, thereby creating a combinatorial library of dendronized peptide polymers for siRNA delivery to NIH 3T3 cells.A conceptually different type of dendronized polymers was reported by Guan and coworkers . They emThe siRNA complexation with various dendronized polymers resulted in spherical NPs with diameters below 100 nm, which disintegrated upon treatment with glutathione (GSH) and released the siRNA. The in vitro transfection efficiency of NIH 3T3 cells with an anti-GFP siRNA demonstrated that polyplexes formed with the G2 construct containing 75 mol% histidine and 25 mol% tryptophan residue at dendron periphery at 80 primary amine/siRNA phosphate (N/P) ratio were able to provide improved GFP down regulation especially at lower serum conditions in comparison the lipofectamine. The effect of different amino acids at dendron periphery on the complex formation and transfection efficiency was evaluated.Dendritic polyglycerol (dOG) unit appended polymers are appealing building blocks with polyether internal cavities, biocompatibility similar to PEG and multiple hydroxyl groups enabling surface functionalization. Haag and coworkers conjugated polyglycerol dendrons modified with paclitaxel (PTX) through acetal linkages to hyaluronic acid (HA) to prepare HA-dOG-PTX-PM micelles. The HA shell serves as a protective natural polysaccharide layer, as well as enables active targeting of CD44 positive cancer cells  116]. T. T116]. The dendritic polyglycerol unit has also been used as side chain appendages in dendronized polymers. A hydrophobic polymer bearing glycerol dendrons as side chains self-assemble to generate micellar NPs . Haag an50 of 0.12 μM against 4T1 cells, compared to free DOX. Usually, in general, the free DOX is observed to possess more cytotoxicity in in vitro studies. Drug loaded micelles demonstrated 1.5 fold improved tumor growth inhibition relative to free DOX in BALB/c mice bearing 4T1 mammary tumors [A recent study from Imae and Chung and coworkers demonstrated that apart from using homopolymers components, diblock polymers where one of the block is dendronized can be used as building blocks for NPs effective for drug delivery. A linear polyelectrolyte block conjugated to a hydrophobic block with pendant dendrons assembled into micelles . DOX loay tumors .The brief survey of the abovementioned diverse polymeric structures that can be obtained through combination and dendrons and polymers, and are different than the classic AB and ABA type block copolymer systems, illustrate that variations in macromolecular architecture can yield novel NP based delivery vehicles.A diverse collection of nanosized aggregates can be obtained from macromolecular architectures derived from dendron-polymer conjugate based on simple combinations of dendritic and polymeric building blocks. Since their inception more than two decades ago, advances in synthetic polymer and dendrimer chemistry have witnessed the evolution of these dendron-polymer conjugate based nanosized aggregates as simple containers for therapeutic agents to smart drug delivery systems. The abovementioned examples provide a glimpse of how clever design of the discrete dendron-polymer conjugate yields through self-assembly a ‘more than the sum’ aggregate that brings novel attributes which qualifies these nanoparticles as viable drug delivery platforms. The confluence of organic chemistry and polymer science is enabling the design of dynamic constructs that are responsive to intrinsic and external cues to yield stimuli-responsive systems. Incorporation of bioactive motifs onto these nano-objects which would allow more specificity for triggered release will further advance these systems. To date, while the efficiency of most systems have been evaluated in vitro, a few examples in recent years have demonstrated through in vivo studies the promise that these self-assembled nanosized aggregates hold for shaping the future of nanotherapeutics. One of the challenges in the area of nanoparticle technology relates to large scale synthesis of the particles with homogenous properties such as size and polydispersity. For developing practical applications, it is important that delivery vehicles can be prepared in large amounts within certain specifications for preclinical and clinical test phases. To address such issues, may be new technologies such as continuous manufacturing techniques such as use of microfluidic flow systems can provide access to large amounts of homogenous nanoparticles. For a chemist, the flexibility in the chemical design of both dendritic and polymeric components, as well as the final dendron-polymer conjugates offers plenty of room for creativity to tailor effective drug delivery platforms.


Eighteen-year-old restrained male driver involved in a flip over motor vehicle accident resulting in a seatbelt injury triad . The patient did well after the surgical resection of the sigmoid colon, repair of the rectus abdominis muscle and endovascular repair of the aorta. Our objective is to shed light on this potentially fatal injury.  Seat-belt sign was described as a linear ecchymosis of the abdominal wall following a motor vehicle accident in 1962 by Garrett and Braunstein . The incEighteen-year-old restrained driver was brought to our emergency room after a flip over motor vehicle accident with back seat passenger fatality. Immediate intubation was done for a Glasgow coma scale of five. Focused assessment with sonography for trauma was negative. Bleeding scalp laceration repaired and left femur fracture splinted. He was admitted to the intensive care unit (ICU) after a pan scan concerning for filling defects  within the infra-renal aorta extending into the bilateral common iliac artery Figure  and a smIn spite of aggressive resuscitation, four hours after ICU admission, the patient continued to be acidotic ( lactic acid 4.3 mMol/L), tachycardic ( 120-130 beats per minutes), hypotensive (systolic blood pressure in the eighties) with a stable hemoglobin (12G/dl). The clinical picture was concerning for hallow viscous injury not apparent on initial computed tomographic (CT) scan as no other explanation for his worsening acidosis was found. Abdomen exploration with resection of de-vascularized sigmoid colon segment, ABTHERA (open abdomen negative pressure therapy) application with a planned return to the operating room the next day for re-exploration, colostomy diversion and repair of transected rectus abdominis muscle  is a significant life-threatening injury that should be considered in patients with significant trauma mechanism. Early diagnosis with CT improve patient outcomes. It may be associated with other organ injury and endovascular repair is a valuable minimally invasive option for critically ill patients.


OBJECTIVES/SPECIFIC AIMS: To learn the edit distance costs of a symbolic univariate time series representation through a stochastic finite-state transducer to predict patient outcomes in intensive care units. METHODS/STUDY POPULATION: High frequency data of patients in intensive care units were used as a data set. The nearest neighbor method with edit distance costs (learned by the FST) were used to classify the patient status within an hour after 10 hours of data. Several experiments were developed to estimate the parameters that better fit the model regarding the prediction metrics. RESULTS/ANTICIPATED RESULTS: Different metrics were obtained for the several parameters. These metrics were metrics . DISCUSSION/SIGNIFICANCE OF IMPACT: Our best results are compared with published works, where most of the metrics  were improved.


Thoracic endovascular aortic repair (TEVAR) is the therapeutic choice for type B aortic dissection. One of the most unfavored complications of this procedure is hemorrhage, which has a low incidence but high mortality. Renal hemorrhage (RH) after endovascular aortic repair has been rarely reported. We presented two cases of unexpected RH after TEVAR for complicated type B aortic dissection, and the potential causes, diagnosis and therapeutic management were discussed.A 67-year-old female developed hypotension and progressively decrease of hemoglobin within 5 h after TEVAR for acute complicated type B dissection. Bedside ultrasonography and abdominal computed tomography angiography revealed a massive right perinephric hematoma. The right renal angiography detected multiple tortuous vascular branches with diffuse perinephric bleeding. The main trunk of right renal artery was embolized. The patient recovered uneventfully and presented with normal renal function 6 months later. Another patient was a 69-year-old male who was admitted for endovascular repair of a chronic complicated type B aortic dissection. The patient presented with hemodynamic instability early after TEVAR. Bedside ultrasonography showed a giant left retroperitoneal hematoma. The abdominal angiography revealed two active bleeding sits located in the distal branches of left renal artery. A super-selective embolization of the two arteries was performed, however the patient developed abdominal compartment syndrome and died of multiple organ failure.Unexpected RH after endovascular repair of aortic dissection might be associated with iatrogenic and idiopathic factors. Close surveillance and clinician’s awareness of this rare complication is crucial for accurate and prompt diagnosis. Renal angiography and subsequent selective embolization of bleeding vessels are effective interventions for treating this fatal condition.The online version of this article (10.1186/s12893-018-0440-1) contains supplementary material, which is available to authorized users. Thoracic endovascular aortic repair (TEVAR) is the therapeutic choice for type B aortic dissection –3. One oA 67-year-old female patient presented in the emergency department with persistent chest pain for 12 h, followed by aggravating lower limbs numbness and oliguria, with a urine output of 40 ml after onset. Computed tomography angiography (CTA) revealed an acute type B aortic dissection with a primary entry tear approximating to the left subclavian artery (LSA) and extending to the iliac arteries  was inserted into the aortic true lumen via the right femoral artery, and the angiography showed poor perfusion of the right kidney and bilateral iliac arteries  without any hemodialysis. The patient recovered uneventfully, and no signs of hemorrhage of the right kidney were detected by pre-discharge CTA 7 days after TEVAR   and the second   thoracic stent grafts were accurately deployed without sacrificing LSA, and the entry tear was successfully occluded Additional file 2:The procedures of thoracic endovascular aortic repair and left renal embolization for the second patient. (MP4 11521 kb)