With age, peripheral nerves undergo demyelination along with overall decrease in peripheral nerve conduction velocity in both sensory and motor nerves. Loss of innervation in muscles is thought to be a major factor in causing age-related sarcopenia including a decrease in muscle function. Dietary restriction attenuates the detrimental effects of aging in mice. Reduction of mTOR signaling is hypothesized to have overlapping mechanisms with dietary restriction. Furthermore, inhibition of mTOR via rapamycin treatment is known to extend lifespan in mice as well as improve peripheral nerve myelination. Therefore, I hypothesized that reducing mTORC1 signaling in neurons would be able to ameliorate the deleterious effects of aging in peripheral nerves. An overall decrease in nerve conduction velocity was observed in both tail sensory and sural nerves with age (15 vs. 30 months). In neuronal mTORC1 KD animals, there was an age-related preservation of both sural and sciatic nerve conduction. Rapamycin treatment produced similar effects with a trend towards increased sciatic nerve conduction velocity in rapamycin-treated wild-type mice at 19 months. The preserve sciatic nerve conduction velocity could be partially explained by preserved myelination. Neuronal mTORC1 knockdown animals had more myelin in the sciatic nerve at 30 mo. as compared to age-matched controls. Overall, these data indicate that mTORC1 signaling plays a role in the age-related decline in peripheral nerve myelination as well as nerve conduction velocity. Future therapeutics could utilize rapamycin or other rapalogs to combat the decline in peripheral nerve function associated with age and other diseases as well.


Longissimus dorsi muscle label-free quantitative proteomic reveals biological mechanisms associated with intramuscular fat deposition” published in Journal of Proteomics Longissimus dorsi muscle from Nelore steers and identified differentially abundant proteins associated with the intramuscular fat (IMF) content. An integrated transcriptome-assisted label-free quantitative proteomic approach by High Definition Mass Spectrometry (HDMSE) was employed to identify and quantify the proteins. A functional enrichment analysis using the differentially abundant proteins list was performed to understand the biological processes involved in IMF deposition. Moreover, to explore and clarify the biological mechanisms that influence IMF content, the mRNA data for the same trait from Cesar and collaborators The proteomic data presented in this article are associated with the research article entitled “ Specifications TableValue of the data•Bos indicus) Longissimus dorsi muscle promoted a better characterization of the protein profile of the samples.A customized protein database from RNA sequencing data of the Nelore  for intramuscular fat (IMF) content was compared Intramuscular fat (IMF), or marbling, is a relevant trait for the sensory attributes and nutritional values of beef. Individual differences of IMF content are notable and affect production systems. In this way, understanding of the biological mechanisms that regulate IMF deposition in beef cattle is essential to improve beef quality. The proteomic profile of 2Longissimus dorsi muscle samples from Nelore cattle at 24±1 month of age were collected during the first-hour post-mortem. We selected 10 samples with higher (H) and 10 samples with lower (L) genomic estimated breeding values (GEBV) for intramuscular fat to carried out proteomic analysis  device. The MS spectra were acquired with Waters MassLynx v.4.1 software and processed using Progenesis QI for Proteomics (QIP) 2.0 software. For protein identification and quantification, the raw data were searched against a Nelore transcriptome database built from RNA-sequencing data from LD muscle. Proteins identified are shown in p-value <0.05 by ANOVA test from Progenesis software (The peptides samples were separated using nanoACQUITY UPLC 2D Technology system software .4p<0.05) between groups The list of the differentially abundant proteins (


OBJECTIVES/SPECIFIC AIMS: This study seeks to test the feasibility and effectiveness of a brief acceptance and commitment therapy (ACT) treatment for chronic pain patients in a primary care clinic METHODS/STUDY POPULATION: Primary care patients aged 18 years and older with at least 1 pain condition for 12 weeks or more in duration will be recruited. Patients will be randomized into (a) ACT intervention or (b) control group. Participants in the ACT arm will attend 1 individual visit with an integrated behavioral health provider, followed by 3 weekly ACT classes and a booster class 2 months later. Control group will receive enhanced primary care that includes patient education handouts informed by cognitive behavioral science. Data analysis will include 1-way analysis of covariance (ANCOVA), multiple regression with bootstrapping. RESULTS/ANTICIPATED RESULTS: The overall hypothesis is that brief ACT treatment reduces physical disability, improves functioning, and reduces medication misuse in chronic pain patients when delivered by an integrated behavioral health provider in primary care. In addition, it is anticipated that improvements in patient functioning will be mediated by patient change in pain acceptance and patient engagement in value-consistent behaviors. DISCUSSION/SIGNIFICANCE OF IMPACT: This pilot study will establish preliminary data about the effectiveness of addressing chronic pain in a generalizable integrated primary care setting. Data will help support a larger trial in the future. Findings have potential to transform the way chronic pain is currently managed in primary care settings, with results that could decrease disability and improve functioning among patients suffering from chronic pain.


The Kessler 6 (K6) Psychological Distress Scale is a well-known screening instrument to screen for psychological distress of general population. While some studies  concluded that the K6 was appropriate for capturing psychological distress of diverse racial/ethnic groups, other studies  reported that it was less successful in screening for psychological distress of diverse racial/ethnic groups. Few studies conducted measurement equivalence test across older Asian immigrant subgroups. Using Multiple Group Analysis, this study examined whether parameters of the single factor model  is equivalent across the two Asian immigrants . Data were generated from the California Health Interview Survey. The configural model showed good fit . When all factor loadings were constrained, it indicated measurement non-invariance status between Chinese and Koran . Given findings of non-invariance on the full constrained model, the invariance test of each factor loading was performed additionally. It was focused on evaluating which items were similar or different across the two groups. The three items, ‘hopeless,’ ‘restless,’ and ‘depress,’ were significantly nonequivalent between the two groups. Clinicians/researchers should aware of the potential risk for misclassification when they try to screen for psychological distress in older Chinese or Korean immigrants. Professionals should pay attention to cross-cultural comparability when interpreting results from the K6.


A 56-year-old female presented with a complaint of left flank pain for two weeks. Her past medical history was unremarkable. A left pelvic calcification was observed on abdominal X-ray . UltrasoOvarian MCT is a cystic or solid tumor  which accounts for 10-20% of all ovarian tumors , but theEarly diagnosis and treatment in terms of a conservative surgical approach is recommended. Ovarian MCT should be considered in the differential diagnosis of distal ureteric obstruction causing proximal hydroureteronephrosis in young female patients .


Left ventricular assist devices (LVAD) have become a common treatment option in advanced heart failure. Lack of aortic valve opening during left ventricular unloading is a common complication and associated with a worse outcome. Maintaining a minimum pulse pressure is an important goal during the early postoperative period after LVAD implantation since it is commonly seen as secure sign of aortic valve opening.We report a case of an LVAD-supported patient with early permanent closure of the aortic valve despite a pulse pressure > 15 mmHg at all times following LVAD implantation. We demonstrate how careful assessment of the invasive arterial blood pressure curve can indicate aortic valve closure irrespective of pulsatile blood flow.A 69-year old male patient with terminal ischemic cardiomyopathy was referred for long-term mechanical circulatory support. Due to mild aortic regurgitation both an aortic bioprosthesis and a continuous-flow left ventricular assist device were implanted. Postoperative echocardiography documented a patent aortic bioprosthesis and an acceptable residual systolic left ventricular contractility. During invasive arterial blood pressure monitoring repetitive transient slight blood pressure decreases followed by slight blood pressure increases coincided with programmed LVAD flushing cycles. Permanent pulsatile flow with a pulse pressure of ≥15 mmHg conveyed systolic opening of the aortic valve. Echocardiography, however, proved early permanent aortic valve closure. In retrospect, transformation of the automated LVAD flushing cycles into visible changes of the arterial blood pressure curve during invasive blood pressure monitoring is indicative of ejection of the complete cardiac output through LVAD itself, and therefore an early clinical sign of aortic valve closure.We present this interesting didactic case to highlight caveats during the early postoperative period after LVAD implantation. Moreover, this case demonstrates that careful and differentiated observation of the arterial blood pressure waveform provides crucial information in this unique and growing patient population of continuous-flow LVAD support. Mechanical circulatory support has advanced considerably within the past two decades , 2. As oA 69-year old diabetic male with ischemic heart disease, severely reduced ejection fraction and surgical revascularization with quadruple coronary artery bypass grafting in 1997 presented to his family physician with nausea and dyspnea for 24 h in late August 2016. A subacute non-ST segment elevation myocardial infarction was diagnosed and partial thrombotic occlusion of the internal mammary bypass graft to the distal left anterior descending coronary artery was identified as culprit lesion. However, the remaining flow was reported to be TIMI grade 3. The venous bypass graft to the first diagonal branch was patent, whereas the remaining venous grafts to the intermediate and the posterior descending artery proved chronically occluded, as did all native coronary vessels. LV enddiastolic pressure (LVEDP) was severely increased (40 mmHg) and LV ejection fraction was below 15%. In spite of increasing congestion of the spontaneously breathing patient the remaining coronary flow was judged sufficient, and a conservative medical management was adjudicated and therapeutic anticoagulation and dual antiplatelet therapy were initiated. After initial recompensation the patient experienced repetitive hemodynamically relevant ventricular tachycardia that could not be controlled with ICD- and medical therapy and was associated with the repetitive need for inotropic support (INTERMACS level 3) . ConsequWe present a case of continuous-flow LVAD support in a patient with ischemic cardiomyopathy. Even though systolic contractility of the unloaded LV was sufficient to generate pulsatile blood flow, 7 days after LVAD and bioprosthetic AV implantation, no more systolic AV opening could be documented. This finding was evident by transformation of LVAD flushing cycles into systemic BP changes during preserved pulse pressure ≥ 15 mmHg as assessed by invasive arterial monitoring. The flushing cycle encompasses a reduction of the pump speed by 200 rpm below the set speed for 2 seconds, followed by an increased pump speed to 200 rpm above the set speed for 1 second before the pump returns to the programmed speed (Fig. In summary, the presence of pulsatile blood flow alone is insufficient proof of a patent aortic valve during continuous-flow LVAD support. Even in presence of remaining LV contractility, permanent AV closure may occur. However, transmission of LVAD flushing cycles and disappearance of the dicrotic notch in the arterial blood pressure waveform may hint toward AV closure early after continuous-flow LVAD implantation. Careful observation of the arterial blood pressure waveform during the early postoperative phase may provide highly relevant information on both cardiac function and valvular mechanics.


Childhood misfortune encompasses a diverse set of negative early life experiences that have damaging effects on lifespan development. We extended this topic by examining how early life misfortunes predicted changes in measures of physical functioning (FUNC) and body mass index (BMI) in adulthood (ages 25-75). We used 3-wave data  from the Midlife Development in the U.S. study across 20 years. Unconditional latent growth curve models  suggested significant (p < .05) mean-level change and variability in change for FUNC  and BMI . Higher levels of childhood misfortune  significantly predicted worse FUNC  and higher BMIs  at baseline and steeper increases over time. Findings underscore the need to address adult health problems that emerge much earlier in life.


Rapid disease progression and associated opportunistic infections contribute to high mortality rates among children aged <15 years with human immunodeficiency virus (HIV) infection  is also required to initiate ART for patients with newly diagnosed HIV infection. Lastly, community-based retention and adherence support are necessary to help maintain children with HIV infection on ART; patient tracking might help initiate ART for previously ineligible children or those lost to follow-up  guidelines have expanded the recommended criteria for life-saving antiretroviral therapy (ART) eligibility among children with human immunodeficiency virus (HIV) infection.All 20 sub-Saharan African countries included in this analysis adopted the 2013 WHO guidelines by 2015. In 2016, 13 of 20 countries adopted the 2016 guidelines to treat all children; however, approximately 56% of children aged <15 years with HIV infection in these countries were not receiving ART.Closing the ART coverage gap requires prompt adoption of WHO guidelines, and strengthening ART programs to identify children with HIV infection, link them to HIV treatment programs, and ensure their retention in care.


SUB3915640.In the original article, there was an error. Readers were unable to access the 16S sequencing data submitted to the Short Read Archive (SRA) under the accession number MATERIALS AND METHODS, DNA Isolation and 16S rRNA Gene Sequencing:A correction has been made to PRJNA486651”.“To avoid contamination, DNA isolation was performed using the cultured cells protocol supplied with the DNeasy Blood and Tissue Kit  in a laminar flow hood. The concentration of extracted DNA was determined through a Nanodrop ND-1000 spectrophotometer . The genomic DNA isolated from the clinical samples was amplified using primer sets specific for V4 regions . In order to evaluate contribution of extraneous DNA from reagents, extraction negative controls (no urine) and PCR negative controls (no template) were included. The resultant PCR products were purified by Qiaquick PCR purification kit . Finally, purified samples were normalized to equal DNA concentration and sequenced using the Illumina Miseq sequencer . The 16S rRNA gene sequences have been submitted to the Short Read Archive (SRA) under accession number The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.


Sternal cleft is a rare congenital chest malformation with an incidence of <0.15% and is predominant in girls (A full-term newborn aged 42 days and weighing 3370 g with a superior sternal cleft was transferred to our clinic. There was no antenatal diagnosis. The patient was initially followed up in the pediatric intensive care unit due to respiratory distress without intubation. Computed tomography and three-dimensional reconstruction revealed a superior U-shaped sternal cleft with displacement of the medial ends of the clavicles . LaboratSternal cleft is a rare anomaly of the chest wall . Accordi


We demonstrate optically pumped telecom-band lasing in single InAs/InP nanowires at room temperature. Telecom-band single nanowire lasers made by the bottom-up vapor-liquid-solid approach, which is technologically important in optical fiber communication systems, still remain challenging. Here, we report telecom-band single nanowire lasers operating at room temperature based on multi-quantum-disk InP/InAs heterostructure nanowires. Transmission electron microscopy studies show that highly uniform multi-quantum-disk InP/InAs structure is grown in InP nanowires by self-catalyzed vapor-liquid-solid mode using indium particle catalysts. Optical excitation of individual nanowires yielded lasing in telecom band operating at room temperature. We show the tunability of laser wavelength range in telecom band by modulating the thickness of single InAs quantum disks through quantum confinement along the axial direction. The demonstration of telecom-band single nanowire lasers operating at room temperature is a major step forward in providing practical integrable coherent light sources for optoelectronics and data communication. The discovery and continued development of the laser have revolutionized both science and industry  multi-quantum-disk (MQD) heterostructure . An MQD From the point view of the synthesis approach, most nanowires have been synthesized by selective area epitaxy  system, where the InP/InAs nanowire was grown via indium particle–catalyzed  VLS mode. We used InP (111)B as the substrate for vertically aligned nanowires on the substrate by epitaxial growth, as shown in the scanning electron microscopy (SEM) images . High-any direction remains coherent, while the lattice along the z direction is elongated in the InAs QDisk to relax strain energy. The compressively strained InAs QDisk is potentially expected to have several advantages, such as improved band imbalance and reduced threshold . These results indicate that the lasing is the longitudinal mode in the nanowire Fabry-Pérot cavity structure.To confirm the lasing mode, we calculated the mode spacing using Δλ = λ3, where N is the carrier density . We plotted the dependence of decay time on pump power (fig. S6A). With decreasing lifetime, the PL shows continuously increasing intensity. This indicates that the shortened lifetime is dominantly induced by stimulated emission. The decay evolution is a further indication of lasing behavior in the nanowire (We have further carried out time-resolved PL measurement at room temperature to clarify the evolution of PL decay process under increasing pump power  (43). AbAbove the lasing threshold, the lasing peak shows broadening line width and blue shift with increasing pump power (fig. S6B). The broadening peak above the threshold might be induced by temperature increase of the nanowire due to the heating effect by intense laser irradiation. The tiny blue shift (~1 nm) of the lasing peak might be due to the change of effective refractive index resulting from the high carrier concentration under intense laser irradiation. One more issue might be the blue shift of effective bandgap originated from quantum-confined stark effect due to screening effect by high carrier concentration, since the <111>-oriented MQD InP/InAs nanowire has strong spontaneous and piezoelectric polarizations  for a same nanowire. The nanowire shows reproducible lasing behavior even 1 week after the initial lasing measurement. In general, most nanowires showed stable lasing operation despite the surrounding air atmosphere and room temperature conditions.About the stability of nanowire lasing, we first conducted the lasing measurement at cryogenic temperatures . The lasing state was very stable and reproducible. This is attributed to the cryogenic temperature and vacuum environment. The heating effect induced by lasing pump could be effectively suppressed. We then performed the measurement at room temperature, and the surrounding atmosphere of nanowire samples was air. So the heat effect by laser irradiation may be serious and probably cause burning out of nanowires. However, later, we found that using the substrate with high thermal conductivity of a gold film was very helpful to suppress the heating effect. That is why we used gold film–covered SiOThe tunability of laser wavelength in a broad range, e.g., the full telecom band (1.2 to 1.6 μm), is considerably important for the development of practical applications. The MQD heterostructure serving as the active region provides the ability to modulate the photon emission energy by tuning the thickness of the InAs QDisk in a broad range through quantum confinement . The thiThe spontaneous emission PL spectra show that the dominant peak is shifted up to the high-energy (short-wavelength) side with reducing thickness of single InAs QDisks , indicatWe have then observed the stimulation emission for a number of nanowires by increasing excitation power . For nan−2 per pulse. The value is about 10 times higher than those of GaAs nanowires (~0.2 mJ cm−2 per pulse) (−2 per pulse) , we consider our MQD InP/InAs nanowire as strained quantum wells with a vertical wire structure. The InP/InAs heterostructure interface exhibits coherent growth despite as high as 3.1% lattice mismatch. We calculated the strain in our MQD InP/InAs nanowires (see Supplementary Text)−1 in micro-Raman measurement  plane and a tensile strain along the perpendicular <111> direction. This high strain has also been verified by transverse optical phonon shift to the high energy side as large as 15 cmWe demonstrate optically pumped telecom-band single nanowire lasers operating at room temperature based on MQD InP/InAs heterostructure nanowires. Our work represents a new level of complexity in nanowire structures with working wavelength in telecom-band range by a gold-free CMOS-compatible synthesis approach .The morphology of the nanowires was analyzed using a scanning electron microscope  at an accelerating voltage of 5 to 15 kV. The cross-sectional samples used for the TEM measurements were prepared by using a focused ion beam  system. The STEM analysis was performed in a JEM2100F  equipped with a HAADF detector and an x-ray energy-dispersive spectrometer. The aberration-corrected STEM analysis was carried out in a JEM-ARM200F  equipped with a HAADF detector. The strain analysis of MQD nanowires was performed by GPA software  facet mirrors could be resulted at both ends of a nanowire and hence construct a Fabry-Pérot cavity because of the refractive index difference between the nanowire and the surrounding air.We mechanically dispersed nanowires onto a gold film–covered SiOA mode-locked Ti:sapphire laser delivering several-picosecond pulses was used to pump a single nanowire. The pump wavelength was fixed at 800 nm with a repetition rate of 80 MHz. The pump laser spot with a circular shape was focused down to 2.0-μm diameter using 50× lens with a numerical aperture of 0.42. The detection parts contain a visible near-infrared CCD (charge-coupled device) camera and a highly sensitive short-wave infrared InGaAs photodiode array CCD with a long-wave-pass filter (cutoff wavelength of 1100 nm) for the microscope image and the PL image, respectively. To measure the PL spectrum, we coupled the emission into the multimode fiber and directed it to a grating spectrometer with a cooled InGaAs array.With regard to the time-resolved PL measurement, we used a femtosecond Ti:sapphire laser (repetition rate of 80 MHz) as a pump laser, a superconducting nanowire single-photon detector, and a time-correlated single-photon counting module for our time-resolved PL (


Hemangiomas are benign tumors usually found in the lower extremity yet their surgical management on the location in the foot is rarely documented.We report a case of a plantar intramuscular hemangioma in 25-year-old patient with a history of percutaneous therapy. Patient had undergone intralesional sclerotherapy 3 years prior to his admission with persistent pain on weight bearing activities.MRI demonstrated a multi lobulated lesion of the 1st IMS with a peripheral enhancement on gadolinium injection. The patient underwent elective surgery with complete excision and no functional impairment at the last follow-up 3 years after surgery.Intramuscular hemangiomas are rare occurrences. Steroid injection and sclerotherapy are effective non-operative methods. Complete excision of isolated hemangioma lesions allows definite diagnosis with no recurrence. Intramuscular hemangiomas (IMH) are benign neoplasms accounting for less than 1% of all hemangiomas . Foot loThe patient is a 24-year-old male with no prior trauma who presented with a 7 year history of forefoot pain placed on several over-the-counter drugs and other conservative treatments including percutaneous therapy. The patient recalled steroid injection and intralesional sclerotherapy three years prior to her admission with no relief. Physical examination demonstrated a firm mass on the plantar surface of the first intermetatarsal space (IMS) without motor nor sensory deficit. Vascular examination was unremarkable.Plain x-ray demonstrated a soft tissue widening of the 1st IMS with phleboliths Fig. .Fig. 1PlThe patient underwent surgery after written and informed consent was obtained. A plantar longitudinal approach across the 1st interosseous metatarsal space was undertaken. After careful dissection, an intramuscular tumor taking up the interosseous muscles was excised. Fig. . ImmediaIntramuscular hemangioma or angioma (IMH) is a benign vascular neoplasm of the skeletal muscle. It occurs in young adults before the third decade with a slight feminine predominance observed in most cases  .MalignaAlthough its pathogenesis still remains unclear, a congenital origin is often suggested  and a hiA palpable mass is found on physical examination at time of diagnosis in 98% of reported cases [Plantar intramuscular hemangiomas are seldom reported in literature. Wisniewski et al.  reportedPlain films may reveal phleboliths that are round lumps of calcifications primarily due to thrombosis within the lesion . MRI is Surgical excision is the mainstay treatment  as it alCompressive sclerotherapy, using a variety of products, radiotherapy and laser ablation have also been suggested as treatment options in large diffuse hemangiomas where excision is impractical. Uslu et al.  demonstrIMH are rare benign tumors that do not undergo spontaneous regression. Plantar IMH are nuisance to weight bearing activities and their management could cause a therapeutic dilemma. This case report demonstrates a unique presentation of intramuscular hemangioma due to its localization. The hemangioma was surgically excised with no recurrence or functional impairment of the foot.


Inefficient Mg-induced p-type doping has been remained a major obstacle in the development of GaN-based electronic devices for solid-state lighting and power applications. This study reports comparative structural analysis of defects in GaN layers on freestanding GaN substrates where Mg incorporation is carried out via two approaches: ion implantation and epitaxial doping. Scanning transmission electron microscopy revealed the existence of pyramidal and line defects only in Mg-implanted sample whereas Mg-doped sample did not show presence of these defects which suggests that nature of defects depends upon incorporation method. From secondary ion mass spectrometry, a direct correspondence is observed between Mg concentrations and location and type of these defects. Our investigations suggest that these pyramidal and line defects are Mg-rich species and their formation may lead to reduced free hole densities which is still a major concern for p-GaN-based material and devices. As freestanding GaN substrates offer a platform for realization of p-n junction-based vertical devices, comparative structural investigation of defects originated due to different Mg incorporation processes in GaN layers on such substrates is likely to give more insight towards understanding Mg self-compensation mechanisms and then optimizing Mg doping and/or implantation process for the advancement of GaN-based device technology. Any increase in Mg atomic concentrations beyond 1019 cm−3 lead to a decrease in the free hole concentration  direction pointing towards their head, their base on [0001] plane with six walls on  direction and two-line defects with features separated by few nanometers deeper in [0001] direction. Pyramidal domains are believed to be Mg


RTEL1 rs2297441  and rs3208008  were associated with PCa risk. These two risk single nucleotide polymorphisms (SNPs)  and another SNP PARP1 rs1136410  were also associated with leukocyte telomere length. These findings support that genetic determinants of telomere length may influence PCa risk.Telomere length measured in lymphocytes has been evaluated as a potential biomarker for prostate cancer (PCa) risk. Identifying genetic variants that affect telomere length and testing their association with disease could clarify any causal role. We therefore investigated associations between genetic variants in three telomere length-related genes and PCa risk in a case-control study. The influence of these variants on the leukocyte telomere lengths was then appraised by real-time PCR.  Telomeres are TTAGGG nucleotide repeats and a protein complex at chromosome ends that play an essential role in maintaining chromosomal stability. Due to the inability of DNA polymerase to fully extend 3' DNA ends, telomeres become gradually shorter with each cell division in the absence of telomerase activityTelomere length is influenced by inherited genetic factorsRTEL1, POT1 and PARP11) in relation to PCa risk in a case-control study. We also evaluated whether these genetic variants are associated with leukocyte telomere length to investigate a potential etiologic relationship.In the present study, we evaluated six potentially functional genetic variants from three telomere length-related genes (The study subjects were mostly from previously published case-control studyhttp://www.ncbi.nlm.nih.gov/) for potentially functional SNPs and SNPinfo (http://snpinfo.niehs.nih.gov/) to identify the candidate SNPs based on the following three criteria: (1) located at the regulatory or coding region of genes ; (2) the minor allele frequency (MAF) ≥ 5% in Chinese Han, Beijing descendants reported in HapMap; (3) affecting the activities of microRNA binding sites in the 3' UTR and transcription factor binding sites in the putative promoter region or changing the amino acid in the exons. All these six SNPs were genotyped by the TaqMan real-time PCR method as described previouslyWe searched the National Center for Biotechnology Information dbSNP database  and 95% confidence intervals (CIs) were calculated by univariable and multivariable unconditional logistic regression models to evaluate associations between the genotypes and risk of PCa without and with adjustment for confounding factors, respectively. Spearman rank correlation was used to investigate associations between telomere length and age. Telomere length was categorized into dichotomies based on the distribution. All statistical analyses were performed with SAS software .For all subjects, the χTable 1. Briefly, there were no statistical differences in the distributions of age and smoking status between two groups.The distributions of demographic characteristics of the subjects are shown in Table 2. The observed genotype frequencies of six SNPs in controls agreed with the Hardy-Weinberg equilibrium. Furthermore, the genotype distribution of RTEL1 rs2297441 and rs3208008 was significantly different between the cases and controls. In multivariate logistic regression analysis, RTEL1 rs2297441 and rs3208008 were associated with PCa risk. Compared with GG genotype, rs2297441 variant AA genotype was associated with an increased risk of PCa . Compared with AA genotype, rs3208008 variant AC/CC genotype was associated with an increased risk of PCa . However, no associations between the other four SNPs and PCa risk were observed.The genotype frequencies of six SNPs and their associations with PCa risk are summarized in P < 0.001). When participants were dichotomized according to the median telomere length value, significant differences in telomere length by genotype of RTEL1 rs2297441, RTEL1 rs3208008 and PARP1 rs1136410 were observed (Table 3). Compared with GG genotype, rs2297441 variant AA genotype was associated with shorter telomere length .To investigate whether the telomere length had prognostic significance, 426 patients were categorized into dichotomies based on their telomere length distribution . Telomere length was inversely associated with age -containing DNA helicase that is critical for facilitating telomere replication and maintaining the integrity of chromosome endsRTEL1 variants involved with genetic predispositions to cancers development. A principal component-adjusted GWAS study, comprising over 275 000 autosomal variants among 692 adult glioma cases and 3992 controls, identified two SNPs within intron 12 (rs6010620) and intron 17 (rs4809324) of RTEL1 that were significantly associated with glioma and astrocytoma predispositionRTEL1 geneRTEL1 rs41309931RTEL1 rs2738780, rs7261546 and rs6062299 were found to be associated with lung cancer development in Han Chinese populations in case-control studiesA number of GWASs and candidate gene studies have identified  RTEL1 variants associated with predisposition to cancers has confirmed the hypothesis that genetic factors underlying telomere length have an especially strong influence on cancer development. Definitive proof of such a role has emerged from the existence of genetic variants influencing both telomere length and cancer susceptibility. Nine common genetic variants have been identified that are associated with leukocyte telomere length at a level of genomewide significanceRTEL11 rs2297441 and rs3208008 risk alleles in the current study.The emergence ofRTEL1 is known to regulate telomere length, the precise function of RTEL1 variant genotypes in PCa development remains elusive. Our findings do not imply that telomere length acts directly on cancer risk and could reflect pleiotropic effects of telomere-length loci. It remains to be answered why another SNP PARP1 rs1136410 cause telomere shortening has no association with PCa risk. One potential explanation might be RTEL1 function as a tumour-suppressor geneEven though A large number of intrinsic and extrinsic factors, such as heredity, epigenetics, aging, stress, immune components, and hormones are all states have been previously associated with telomere shorteningRTEL11 rs2297441 and rs3208008). Our findings also suggest that candidate genes encoding proteins with known function in telomere biology variants contribute to telomere length associations. We expect that further replication and mechanistic studies will continue to provide insights into the etiology of PCa.In conclusion, here we present two novel candidates for PCa risk (


There has been an increasing trend for Congress and the Centers for Medicare and Medicaid Services (CMS) to add non-skilled services to coverage under Medicare Advantage and Medicaid inpatient hospital. At the same time there has been a 75% decline in home health aide visits, the only Medicare home health non-skilled service, as a percentage of all Medicare home health visits from 2000-2016. A literature review indicates no studies addressing the potential factors accounting from these seemingly contradictory trends. The present study is based on interviews of five Chief Executive Officers (CEOs), five Chief Financial Officers (CFOs), and eight Chief Nursing Officers (CNOs) from Medicare-certified home health agencies between October 2017-July 2018. Results indicated agreement among interviewees on three themes: the Medicare home health relies on a medical model which focuses on intermittent skilled care; the Medicare home health prospective payment system (PPS) exacerbated the focus on skilled care by rewarding higher reimbursement for skilled care based episodes; and a synergy has evolved of “less is better” regarding utilization of home health aide services and reimbursement. Policymakers are urged to consider adding coverage of non-skilled services under Medicare home health, similar to Medicare Advantage, by funding demonstration projects with appropriate changes in reimbursement.


A 29-year-old man with no significant medical history presented to the emergency department with severe pain, swelling, and inability to move his right knee. He was injured when he extended his right knee to hit a tennis ball after running to the net. On examination, high-riding patellae were found on both the injured and non-injured sides. A lateral view radiograph showed patella alta in both knees . MagnetiPatellar tendon rupture is an uncommon clinical presentation that generally affects patients younger than 40 years who actively engage in sporting activities.What do we already know about this clinical entity?Patellar tendon rupture is an uncommon clinical presentation. Patellar tendon rupture occurring in a patient with patella alta is quite rare.What is the major impact of the image(s)?Diagnosis based on radiographs is difficult because the non-injured side also showed patella alta in this case.How might this improve emergency medicine practice?Emergency doctors should suspect patella tendon rupture from the clinical findings. Considering our case such as non-injured side also showing patella alta, magnetic resonance imaging is essential for diagnosis.


A 74-year-old male with a history of metastatic prostate cancer presented to the emergency department with hypotension and shortness of breath. We assessed volume status using point-of-care ultrasound (POCUS) with a phased array probe in the subxiphoid orientation. This revealed a large inferior vena cava (IVC) thrombus extending from above the IVC bifurcation into the right atrium , Video. Venous thromboembolisms are estimated to occur in 0.1% of patients; 1.5% of patients hospitalized with deep vein thrombosis (DVT) were diagnosed with vena cava thrombosis, of whom 12% had a pulmonary embolism.5Recently, ultrasound has shown promise for quick identification of IVC thrombus.Once diagnosed, confirmation using CT imaging and admission to the hospital for anticoagulation and hemodynamic monitoring is recommended.3Our case highlights the use of POCUS to quickly identify etiologies of hypotensive and dyspneic patients. Further imaging should be obtained in IVC thrombosis patients to rule out PE or additional clots.What do we already know about this clinical entity?Inferior vena cava thrombosis is a rare, life-threatening condition that usually requires advanced imaging techniques to diagnose.What is the major impact of the image(s)?This image highlights the utility of the rapid ultrasound for shock and hypotension protocol for finding both obvious and less-obvious pathologies.How might this improve emergency medicine practice?Rapid diagnosis of undifferentiated hypotensive patients using point-of-care ultrasound expedites care and medical intervention.VideoRapid ultrasound for shock and hypotension protocol using the phased array probe in the subxiphoid orientation revealed a large thrombus situated in the inferior vena cava.


Two cases of testicular metastases of a clear cell renal cell carcinoma sharing a very similar ultrasonographic pattern are reported. The observed pattern – masses containing multiple tiny cyst-like areas – is very similar to that of a previously described ovarian metastasis of clear cell renal parenchymal tumor and can be explained by histopathologic features. Despite the small number of cases, this ultrasonographic pattern of testicular mass may be specific for metastasis of clear cell renal cell carcinoma origin. Only few ultrasonographic descriptions of testicular metastases have been reported in the literature. In textbooks, their sonographic appearance is usually described as solid hypoechoic lesions indistinguishable from other types of tumor . The maj2A 69-year-old man without relevant medical history presented with a small lump in the right testis. Ultrasound examination revealed a solitary intra-testicular hyperechoic 12 mm tumor with heterogeneous appearance and with multiple small cystic-like areas Figure . On coloA 77-year-old man presented with painless swelling of the left hemiscrotum. He underwent a partial left nephrectomy for a CCRCC five years earlier and later developed pulmonary metastases. On physical examination, there was a firm left testicular mandarin-sized mass. Scrotal sonography showed a hyperechoic intra-testicular mass (diameter 47 mm) replacing almost the entire left testis. This heterogeneous mass contained multiple small anechoic cystic-like areas Figure  and was The testis is an uncommon site for metastases, with a reported prevalence ranging between 0.02%  and 0.063Since ultrasonography has shown a high sensitivity in tumor detection nearly 100%) and in discrimination of intratesticular from extratesticular localization 97–99%) 0% and in12, ultra7–99% 0% The features of the two cases of testicular metastases of CCRCC are almost similar to sonographic pattern of an ovarian metastasis of a renal clear cell carcinoma previously described in the literature . In all This sonographic pattern reflects the gross morphology and underlying histologic characteristics of CCRCC (primary tumor as well as their metastases) which can be considered as quite specific. CCRCC commonly presents as a well-circumscribed mass with a capsule or pseudocapsule. Typically, it is characterized by solid nests and hollow tubules composed of polygonal epithelial cells with clear and abundant cytoplasm. The transparency of the cytoplasm results from intra-cytoplasmic accumulation of droplets of glycogen and lipids, giving rise to the yellow coloration at macroscopic examination and probably to increased echogenicity due to multiple intra-cellular interfaces. The tumor may also show cystic areas when luminal spaces of the tubular structures dilate and become filled with fluid, necrotic material and red blood cells, explaining the cystic areas on ultrasonography. Cellular nests and tubules are separated by a delicate branching network of highly vascularized connective tissue.Based on this sonographical-pathological correlation, facing a testicular lesion with these characteristics in an elderly male should raise suspicion of a metastases of CCRCC.The authors declare that they have no competing interests.


Intracardiac blood cysts (ICBC) are cardiac pseudoneoplasm commonly seen in infants below two months of age. ICBC typically resolve spontaneously; however, they can sometimes persist in adults and can cause detrimental consequences. A 47-year-old female presented to our facility with complaints of chest pain and was found to have an incidental subvalvular chordal mitral apparatus echolucent mass on transthoracic echocardiogram (TTE). A stress echocardiography was performed, which revealed transient left ventricle outflow tract (LVOT) obstruction in the absence of anginal symptoms. A cardiac magnetic resonance imaging (MRI) showed no evidence of increased mass enhancement confirming the diagnosis of a benign blood cyst of mitral apparatus. The cyst was treated conservatively with carvedilol to prevent worsening of exertional LVOT obstruction. A follow-up study done at six months showed stable exertional hemodynamics. There is no general consensus while managing ICBC. In asymptomatic, non-surgical patients stress echocardiography can offer valuable information by assessing the hemodynamic implications resulting from the cyst. Primary cardiac tumours (PCT) are rare, with an estimated incidence of less than 0.1% . IntracaA 47-year-old Caucasian female with a known medical history of essential hypertension being treated with labetalol came to the emergency department (ED) with complaints of non-exertional, intermittent (lasting one to two minutes), 3/10, left-sided chest pain which started three days ago. At the time of presentation, the patient was asymptomatic. She was afebrile with a blood pressure of 188/90 mmHg, heart rate of 73 beats per minute, respiratory rate of 16 per minute and normal oxygen saturation levels. Physical examination revealed a faint 1/6 systolic murmur which accentuated to 2/6 in intensity when she was made to go from crouching to standing. The remainder of the physical exam was unremarkable. The patient denied any pertinent family history. She was a former smoker and reported no allergies. Laboratory studies disclosed normal serum chemistry with normal troponin and brain natriuretic peptide (BNP) levels. Electrocardiogram (EKG) showed normal sinus rhythm with no ST-T wave changes. A chest radiograph identified borderline cardiomegaly with no evidence of infection or pulmonary vascular congestion. A transthoracic echocardiogram (TTE) was pursued, which revealed normal left ventricular (LV) size and function. LVOT appeared normal without sub-valvular ridge or asymmetric septal hypertrophy. Mitral valve demonstrated normal-appearing leaflets; however, there was a large centrally echolucent sub-valvular chordal cyst greater than 1 cm in the largest diameter Figure -3. A cardiac magnetic resonance imaging (MRI) showed no evidence of increased enhancement confirming the diagnosis of a benign subvalvular blood cyst of the mitral apparatus. In light of asymptomatic nature of the condition, mild to moderate LVOT obstruction at peak exertion in a beta-blocker deprived state, a conservative strategy was opted after multidisciplinary discussion with cardiothoracic surgery. The patient was resumed on carvedilol and was advised to maintain adequate hydration to avoid worsening of LVOT obstruction due to dehydration. A surveillance stress echocardiogram done during six months follow-up visit showed stable exertional hemodynamics.ICBCs are diverticula resulting from invagination of atrial endothelium into atrioventricular valves. Histologically the cyst walls are made up of fibrous connective tissue either formed by mucous degeneration or calcification. Congenital ICBC often results from lacunar remanence created during the embryological development of atrioventricular valves. Disturbed blood flow can lead to enlargement of blood cysts which against the norm of spontaneous disappearance can persist into adulthood. Other theories such as hematoma formation, vessel ectasia or dilation, and abnormal development of cardiac mesothelial progenitor cells have also been postulated . AcquireThe clinical course of ICBC can vary depending on the location and size of the cyst. Majority of the adults are asymptomatic and are diagnosed incidentally. LVOT obstruction from ICBC can result in exertional dyspnea or syncope . IsolateIn our case, given the episodic nature of patient’s symptoms a decision was made to perform an exercise stress echocardiogram to establish hemodynamic consequences from the mass. Though there have been previously reported cases of LVOT obstruction, to the best of our knowledge this is the first case in which ICBC was worked up with exercise stress echocardiography. Stress echocardiography is a non-invasive valuable tool which can help evoke underlying dynamic LVOT and ascertain the need for surgical removal. Due to the patient’s reluctance to have surgical intervention and asymptomatic nature of her condition at maximal stress, the patient was treated conservatively with optimum medical management and surveillance echocardiogram. Management of ICBC is controversial. Due to the lack of general consensus or guidelines, management varies based on the nature of the presenting symptoms and surgical appropriateness. Earlier recommendation by Paşaoğlu et al. was to resect all valvular cystic tumor to achieve a definitive diagnosis ,however,ICBCs are diverticula resulting from invagination of atrial endothelium into atrioventricular valves. The clinical course of ICBC varies depending on the degree of hemodynamic compromise. In symptomatic cases with dyspnea, stroke, and coronary artery embolism, surgical removal of the cyst in warranted. Exercise stress echocardiography offers an alternate approach to assess hemodynamic consequences from ICBC.


There are many proposed classification systems for traumatic thoracolumbar fractures (TLF). More recently published are the AO Spine Classification System and the Thoraco-Lumbar Injury Classification System (TLICS). There has been a paucity of high-level evidence to link these classification system subtypes with clinical outcomes and/or management strategies. Previously, post-traumatic burst fractures or two column injuries identified on computed tomography (CT) scan have been deemed stable injuries. The addition of magnetic resonance imaging (MRI) evaluation for concomitant ligamentous injuries in cases of incomplete burst fractures has been widely debated without high-level evidence. In this report, we present a case of an incomplete burst fracture at L1, AO-A3, which did not receive an MRI and presented with delayed paraplegia four weeks later. Several classification systems have been proposed for traumatic thoracolumbar fractures (TLF). The more recently published systems include the AO Spine Classification System and the Thoraco-Lumbar Injury Classification System (TLICS) -4. ThereA 28-year-old male was admitted after a motor vehicle collision (MVC) with low back pain and orthopedic fractures. The admission CT scan of his lumbar spine was read as a posterior superior endplate fracture at L1 extending to the posterior vertebral body, without posterior element displacement or disc space widening Figure . The disBurst fractures compromise the most commonly encountered TLF -14. The TLF are common injuries that occur after trauma. There are several classification systems that attempt to provide guidance for diagnostic and clinical management; however, there is little high-level evidence supporting these classification systems and their significance. In this case, a seemingly stable posterior vertebral body injury seen on CT was discovered to have significant ligamentous injury and instability after the MRI was obtained post mobilization. CT imaging alone may not be a completely reliable imaging modality to fully assess spinal integrity in cases of posterior vertebral body fractures. Patients with coinciding ligamentous injuries may present radiographically with only subtle findings on CT that can be easily missed with catastrophic neurologic consequences. Further outcome-based studies using these classification systems and imaging modalities should be performed in order to understand their significance in the management of patients with acute traumatic thoracolumbar fractures.


Salmonella enterica subsp. enterica serotype Heidelberg isolates collected from several chicken- and turkey-associated farm environments in the Midwestern United States were analyzed using whole-genome sequencing.Thirty-one different  Salmonella enterica subsp. enterica serotype Heidelberg isolates collected from several chicken- and turkey-associated farm environments in the Midwestern United States were analyzed using whole-genome sequencing. Availability of these genome sequences may shed light on Salmonella adaptation to different farm environments.Thirty-one different  Salmonella is one of the leading causes of human foodborne gastroenteritis in North America, with public health costs of approximately $695 million annually in the United States (https://wwwn.cdc.gov/norsdashboard/). Salmonella enterica subsp. enterica serotype Heidelberg is the most common serotype isolated in all poultry breeder types and throughout all levels of the production chain in the United States and Canada  and another set specific to the Salmonella. Heidelberg serotype  and compared to a known Salmonella Heidelberg strain . Sequencing libraries were prepared using 1 ng of genomic DNA with a Nextera XT DNA sample prep kit . PCR amplification was done in a Veriti 96-well thermal cycler machine  using Nextera XT Index 1 primers (N7XX) from the Nextera XT index kit (FC131‐1001). Illumina paired-end sequencing was performed on a MiSeq platform using 2 × 250 paired-end sequencing chemistry. The raw data files were demultiplexed and converted to FASTQ files using Casava v.1.8.2. . Quality control of the raw reads was performed using FastQC . The reads were trimmed and assembled with BBDuk  and SPAdes , respectively. The coverages of the assembled genomes were evaluated with BBMap .Salmonella adaptation to different niches in poultry production  and NCBI GenBank (BioProject number PRJNA417775) and are listed in Draft genomic sequences have been deposited in the NCBI Sequence Read Archive (SRA accession number


Current approaches for pathway analyses focus on representing gene expression levels on graph representations of pathways and conducting pathway enrichment among differentially expressed genes. However, gene expression levels by themselves do not reflect the overall picture as non-coding factors play an important role to regulate gene expression. To incorporate these non-coding factors into pathway analyses and to systematically prioritize genes in a pathway we introduce a new software: Triangulation of Perturbation Origins and Identification of Non-Coding Targets. Triangulation of Perturbation Origins and Identification of Non-Coding Targets is a pathway analysis tool, implemented in Java that identifies the significance of a gene under a condition (e.g. a disease phenotype) by studying graph representations of pathways, analyzing upstream and downstream gene interactions and integrating non-coding regions that may be regulating gene expression levels.https://github.uconn.edu/ajt06004/TriPOINT under the GPL v3.0 license.The TriPOINT open source software is freely available at Bioinformatics online. Methods for pathway analysis over the years have fallen into three categories  and  gene inconsistent with their upstream targets and (ii) genes that are highly supported by their upstream associated genes, which can be useful for identifying enriched pathways. To assess the significance of each score, TriPOINT calculates permuted P-values. Permuted P-values are obtained by randomly reassigning gene expression values between genes from the expression values provided and recalculating scores based on the number of permutations to generate a null distribution.TriPOINT utilizes graph representations of pathways obtained from GRAPHITE  profiled by The Cancer Genome Atlas . Among these genes/pathways with negative triangulation scores, we identified ACVR1 and BMPR1A in the ‘Signaling pathways regulating pluripotency of stem cells’ KEGG pathway as among the top genes/pathways using these scoring criteria (triangulation scores. ACVR1 and BMPR1A have each been previously associated with breast cancer (We obtained 864 gene/pathway combinations with criteria . We alsoConflict of Interest: none declared.bty998_Supplementary_InformationClick here for additional data file.


The current study investigates whether metal deposition onto an existing nanorod can be carried out using an ionic liquid, and the effect this has on catalytic performance. Platinum, gold, and silver nanoparticles were deposited onto CdSe@CdS (core@shell) nanorods from metal salts in an ionic liquid (1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide) without additional surfactants or reducing agents. Photocatalytic dye degradation experiments showed that catalysts with platinum particles deposited using the ionic liquid out-performed similar materials synthesized using organic solvents and ligands. We concluded that metal particles can be deposited onto well-defined semiconductor nanorods using ionic liquids and metal salts without the need for additional reagents, and the deposited particles did not cause significant aggregation even when these materials were taken into organic media. It is possible that a broad range of metal/semiconductor heterostructured particles can be prepared using the methods reported here. Core@shell semiconductor nanorods with attached noble metal particles have been widely studied as photocatalysts, and any improvement on the synthesis of these materials has potential to impact a number of applications –4. DeposAnother widely investigated approach to nanoparticle synthesis uses ionic liquids as solvents for the synthesis of nanoparticles without the need for additional stabilizing surfactants –17. The 2 in the ionic liquid 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([bmim][Tf2N]) without needing to add any additional reagents. We also deposited platinum nanoparticle cocatalysts onto CdSe@CdS nanorods using a traditional organic system (toluene/triethylamine) as shown in 2N] for metal deposition was found to be applicable to other noble metals in addition to platinum. Gold and silver nanoparticles were also deposited onto CdSe@CdS nanorods without the need for additional surfactants or reducing agents.Herein, we demonstrate that an ionic liquid may be used to deposit nanoscopic noble metal particles onto a well-defined semiconductor nanorod substrate with diameters less than 10 nm. We found that photodeposition of platinum onto CdSe@CdS (core@shell) nanorods proceeded readily from Pt(acac)max = 509 nm)  2 without addition of triethylamine as a sacrificial reducing agent, followed by irradiation using a xenon arc lamp. Nanorod powders were difficult to disperse directly in [bmim][Tf2N], so the nanorods were dispersed in a small amount of chloroform prior to mixing with the ionic liquid. Complete evaporation of the chloroform then afforded well-dispersed nanorods in the ionic liquid. The mass of the nanorod powder, Pt(acac)2, and the ionic liquid were each measured prior to dispersing the nanorods in chloroform and combining with the ionic liquid; complete removal of the chloroform was confirmed by taking the mass of the nanorod dispersion in [bmim][Tf2N] after evaporation of the chloroform under reduced pressure.The obtained nanorods are capped with tightly bound phosphonic acid ligands bearing long hydrophobic alkyl chains. Rather than exchanging these ligands to allow these nanorods to be dispersed in polar media, platinum nanoparticles were deposited onto these CdSe@CdS nanorods in hydrophobic media based on the photochemical process reported by Alivisatos and coworkers , with th2N] . We chos tol-NR, , CdSe@Cd, IL-NR, , CdSe@Cd2N], the platinum decorated nanorods were extracted into toluene from the ionic liquid prior to purification by centrifugation. The final pellets obtained were dispersed in toluene for storage and subsequent experiments regardless of the solvent used for the platinum deposition reaction. TEM images of both products are shown in Platinum deposition under both solvent conditions initially afforded a mixture of platinum-decorated nanorods and additional platinum nanoparticles that were not attached to CdSe@CdS nanorods. For the platinum deposition conducted in toluene, the unattached platinum particles were removed by several dissolution and precipitation cycles using toluene and ethanol. For the platinum deposition conducted in [bmim][Tf2N] without needing to add a sacrificial reducing agent. The chemical species oxidized during platinum reduction and deposition onto these nanorods in [bmim][Tf2N] is not known at this time, though others have observed similar results. CoPt nanoparticles were previously formed in [bmim][Tf2N] using Pt(acac)2 and an ammonium bromide  or toluene/triethylamine.With two nearly identical samples in hand, we were able to compare the performance of two catalysts where the only notable difference was the synthetic history of the sample . We used2N] showed a measurably increased dye degradation rate compared to the sample prepared in toluene/triethylamine. Error bars corresponding to the standard deviation values of these experiments show that the obtained results are reproducible for these materials (2N] to rule out any possible effects from the ionic liquid itself (A known amount of the nanoparticle catalyst was combined with methylene blue and chloroform for photocatalytic dye degradation experiments , based oaterials . Note thd itself . AlthougThese heterostructured nanorod photocatalysts bleach methylene blue by donating electrons from platinum cocatalyst sites to the dye . Thus, t2N] without any additional surfactants or reducing agents to determine if this ionic liquid was generally useful for deposition of other metals (2N] as described above, AuCl3 dissolved in [bmim][Tf2N] was added, and the mixture was heated in a 50 °C water bath for 10 minutes. The nanorod product was then extracted into toluene and a TEM sample was prepared without further purification (2N] and AgNO3 at 50 °C (We then investigated reduction of gold and silver in the presence of CdSe@CdS nanorods using [bmim][Tfr metals . For golfication . We obseat 50 °C . Due to 2N] without the need for additional surfactants or reducing agents. These procedures resulted in heterostructured particles with similar morphology and elemental composition compared to particles synthesized using traditional organic solvents and ligands. The performance of the resulting materials with metal cocatalysts deposited in [bmim][Tf2N] showed only modest improvement over materials prepared in conventional solvents, which is attributed to the fact that the semiconductor nanorod substrate was still capped with insulating organic ligands in both samples. The methods reported herein could be used to achieve a multistep synthesis of metal-decorated core@shell particles using only ionic liquids to determine if the increased surface availability will benefit catalytic performance. This approach using an ionic liquid for deposition of metal particles onto semiconductor nanoparticles may enable greener synthetic approaches involving recycling the ionic liquid solvent, and the large liquid range of the ionic liquid also allows studying of photocatalysis over a broad range of temperatures.In conclusion, we have demonstrated that deposition of noble metal nanoparticles onto CdSe@CdS nanorods is possible using the ionic liquid [bmim][TfFile 1Synthetic procedures and raw data for methylene blue degradation experiments.


Dear Editor,We all must have faced difficulty in inserting nasogastric tube (NGT) during general anesthesia (GA). Procedure seems to be very straightforward but has got consequences in terms of failure, which can cause bleeding and alteration in hemodynamic variables. The overall failure rate turned out to be around 50-60%.


Human peripheral blood monocytes are isolated by flotation from a dense leukocyte-rich plasma (LRP) through two lower-density barriers prepared from OptiPrep™. The separation from lymphocytes depends on the more rapid rate of flotation of the monocytes because of their slightly lower density and larger size. The method works optimally only with fresh (within 2 h of drawing) EDTA-anticoagulated blood.


Prostate cancer (PCa) is the most frequently diagnosed among men malignant disease that remains poorly characterized at the molecular level. Advanced PCa is not curable, and the current treatment methods can only increase the life expectancy by several months. Identification of the genetic aberrations in tumor cells provides clues to understanding the mechanisms of PCa pathogenesis and the basis for developing new therapeutic approaches. Here we present data on somatic mutations, namely single nucleotide variations (SNVs), small insertions and deletions, detected in prostate tumor tissue obtained from Russian patients with PCa. Moreover, we provide a raw dataset on the whole exome and targeted DNA sequencing of tumor and non-tumor prostate tissue obtained from Russian patients with PCa and benign prostatic hyperplasia (BPH). This data is available at NCBI Sequence Read Archive under Accession No. PRJNA506922. DNA extracted from these samples was used to construct 61 whole exome and 25 targeted DNA libraries that were sequenced using Ion Proton platform. The corresponding raw sequencing data (reads in FASTQ format) was deposited at NCBI SRA database under project accession No. PRJNA506922.The data on whole exome sequencing of samples from PCa patients (50 matched samples from 25 patients) was analyzed to detect somatic mutations in prostate cancer tissue. Reads were mapped to the GRCh37 assembly of the human genome. Paired variant calling performed for matched samples allowed to filter germline mutations and detect somatic variants in tumor tissue. The information on identified somatic alterations is presented in VCF format in Moreover, variant annotation was performed using Variant Effect Predictor (VEP) which identifies genes and transcripts affected by genetic alterations and predicts their consequences on protein sequences .Fig. 1SuIn addition, SIFT and PolyPhen algorithms were implemented to predict the effect of amino acid substitution caused by a variant on the structure and function of a protein . The VEP22.1All patients had signed an informed consent form. Tissue samples were obtained from 26 patients with PCa and 8 patients with BPH from City Clinical Hospital No. 50 via radical prostatectomy or TURP, respectively. All patients had not received specific therapy prior to sample collection. Clinical patient data including serum PSA level, Gleason grade, TNM clinical and pathological stage, extraprostatic extension, seminal vesicles and perineural invasion, surgical margins status is provided in 2.2Amplification of exonic regions was performed using Ion AmpliSeq Exome RDY Kit (Thermo Fisher Scientific). Considering the quality of FFPE-derived DNA the number of cycles in this amplification step was raised to 13–15 instead of 10 recommended by the manufacturer. Further steps of library preparation were carried out in accordance with the manufacturer's instructions.2.3GeneRead DNAseq Targeted Human Prostate Cancer Panel (Qiagen) was used for targeted enrichment of the extracted DNA. This amplification procedure was also modified as for exome libraries to account for DNA quality extracted from FFPE tissue samples. Number of PCR cycles was raised to 20–22 instead of 18 recommended for standard DNA samples. Subsequent library construction was performed using GeneRead Library Prep workflow (Qiagen) following the manufacturer's recommendations.2.4Quality of the constructed libraries was assessed by 2100 Bioanalyzer (Agilent Genomics) using Agilent High Sensitivity DNA Kit (Agilent Genomics). High-throughput sequencing was performed on Ion Proton platform using ION PI HI-Q Sequencing 200 Kit and Ion PI Chip Kit v2 (Thermo Fisher Scientific) following the recommendations of the manufacturer. Base calling was performed by Torrent Suite 5.0, fastqCreator v3.4.56313.2.5bwa mem tool from BWA package with the following non-default parameters: -c 250 -M 1)DP > 102)QUAL >203)AF in normal sample <0.005 or AF in normal sample is at least three times less than AF in tumor sample.Reads were mapped to the human genome (GRCh37 assembly) with At least two callers should have called a mutation as a somatic to include it into the final somatic call set. The resulting lists of somatic variants were filtered according to the target regions of AmpliSeq Exome Kit provided by the manufacturer and off-target variants were excluded. The final sets for each individual were combined into a single multi-sample VCF file See . Variant


Several studies have demonstrated beneficial effects of views on aging (VoA) on health, while the reverse relationship is seldom in focus. Serious health events  are life-threatening and remind individuals of the finitude of life possibly changing their VoA. The present study investigates the effect of cardiovascular events (CVE) on longitudinal changes in VoA using pooled data of three waves of the German Ageing Survey . To account for alternative explanations, individuals without CVE were matched to the individuals with CVE (n = 202) using a propensity-score-matching approach. Individuals who experienced a CVE showed more adverse changes in three VoA indicators  than individuals without CVE. Results show that CVE can change how we view our own aging which in turn affects future health changes. Following a CVE people may benefit from promoting positive VoA.


OBJECTIVES/SPECIFIC AIMS: The objective of this work is to determine the mechanistic consequences of BRCA1 mutants in inter-strand crosslink (ICL) repair. METHODS/STUDY POPULATION: Our lab uses Xenopus egg extracts to study ICL repair. These extracts can be depleted of endogenous BRCA1 by immunoprecipitation. The goal of this work is to rescue endogenous depletion with in vitro translated, wild type BRCA1. Once achieved, we can supplement the depleted extract with BRCA1 mutants to access their function in ICL repair. RESULTS/ANTICIPATED RESULTS: We hypothesize that the BRCT and RING domain mutations will abrogate ICL repair, while mutations in the coiled coil region will not affect repair. DISCUSSION/SIGNIFICANCE OF IMPACT: These findings will have an immense impact on the understanding of BRCA1 domains. Importantly these results will spur personalized therapy of BRCA1 mutants by showing which domains are sensitive to cross-linking agents.


Providing care of older parents is a family obligation for children with Mexican cultural contexts . Nevertheless, little is known about how parents with Mexican cultural backgrounds believe about their family obligations. The current study conceptualized Mexican American older adults’ sense of family obligation. Data was collected from 307 Mexican Americans  through an online survey. A 2-factor model: Expectation on children’s caregiving (3-item) and Efforts to reduce children’s burden (7-item) were identified as the best-fit model through EFA and CFA analyses . The component of efforts to reduce children’s burden predicted participants’ generativity assessed by the scale of McAdams and Aubin (1992). The findings suggest that Mexican American older adults expect their children to take care of them, as they feel obligated to reduce their children’s caregiving burden. The function of the cultural value in intergenerational relations is discussed.


Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon benign proliferation of fibrous stroma, containing slitlike pseudovascular spaces lined by myofibroblasts. Less than 200 cases of PASH have been described in the English literature with the largest series including 40 cases. A 48-year-old woman with no particular past medical history, presented with a complaint of a slow, progressive, painless left breast mass. The patient underwent mammography which revealed a well delineated left breast nodule with microcalcifications classified BI-RADS 4. An excisional biopsy was performed on the mass to confirm the histological diagnosis. The specimen was a well-circumscribed whitish tumor measuring 3 x 3 cm with several microcysts (A). Histological examination revealed proliferation of fibrous stroma, with spindle cells and a network of slit-like empty clefts within acellular hyalinized stroma (B). The spindle cells were positive for CD34 and smooth muscle actin but were negative for Factor VIII. The final pathological diagnosis was nodular PASH. Postoperative course was uneventful and the patient is still being followed-up.


This data article features supplementary figures and tables related to the article “Differential Multivariable risk prediction of appropriate shock vs. competing mortality – a prospective cohort study to estimate benefits from implantable cardioverter defibrillator therapy”  [1]. The figures show the clinical study CONSORT graph  and the correlation scatter plot for risk scores of appropriate shock vs. mortality . The tables show the results for the univariate Cox regressions for prediction of mortality and appropriate shock. For further information, please see Bergau et al. (2018) [1]. The rationale, objectives and design of the study including statistical plan and sample size calculations have been published previously. In brief, the study enrolled a contemporary implantable cardioverter defibrillator cohort to test multiple carefully selected risk markers of clinical relevance for prediction of mortality and arrhythmias. The large majority of patients underwent non-invasive programmed ventricular stimulation via their implanted ICDs. Inducibility of sustained ventricular arrhythmia was defined as induction of a single monomorphic ventricular tachycardia lasting for 30 seconds or two polymorphic ventricular tachycardia/ventricular fibrillation episodes requiring cardioversion. A 24-h Holter monitoring was performed using standard devices. The primary endpoint was all-cause mortality. First appropriate implantable cardioverter defibrillator shock was selected as a key secondary endpoint. Cox regression analysis was implemented as described. Risk models for shock and mortality were developed using forward selection among a set of known potential risk factors  , Table 3


Advances in determining prion structure have been severely impeded by the difficulty in recovering relatively homogeneous prion particles from infected brain and definitively associating infectivity with the PrP assembly state. Recently, however, images of highly infectious ex vivo PrP rods that produce prion-strain specific disease phenotypes in mice have been obtained using cryo-electron microscopy and atomic force microscopy. These images have provided the most detailed description of ex vivo mammalian prions reported to date and have established that prions isolated from multiple strains have a common hierarchical structure. Misfolded PrP is assembled into 20 nm wide rods containing two fibers, each with double helical repeating substructure, separated by a characteristic central gap 8–10 nm in width. Irregularly structured material with adhesive properties distinct to that of the fibers is present within the central gap of the rod. Prions are clearly distinguishable from non-infectious recombinant PrP fibrils generated in vitro and from all other propagating protein structures so far described in other neurodegenerative diseases. The basic architecture of mammalian prions appears to be exceptional and fundamental to their lethal pathogenicity.Prions are lethal pathogens, which cause fatal neurodegenerative diseases in mammals. They are unique infectious agents and are composed of self-propagating multi-chain assemblies of misfolded host-encoded prion protein (PrP). Understanding prion structure is fundamental to understanding prion disease pathogenesis however to date, the high-resolution structure of authentic  Prion diseases are a closely related group of neurodegenerative conditions which affect both humans and animals. They include bovine spongiform encephalopathy (BSE) in cattle, scrapie in sheep and goats, chronic wasting disease (CWD) in deer and elk, and the human prion diseases, kuru, Creutzfeldt-Jakob disease (CJD), variant CJD (vCJD), fatal familial insomnia (FFI) and Gerstmann–Sträussler–Scheinker disease  and Parkinson’s disease where propagating assemblies of amyloid-β, tau and α-synuclein are being studied  with terms such as propagons and prionoids being proposed  is a highly conserved cell surface glycosylphosphatidylinositol (GPI)-anchored sialoglycoprotein with an ordered C-terminal domain containing three α-helices, a short anti-parallel β-sheet and a flexible disordered N-terminal domain . Such prototypical PrPSc comprises a small proportion of total disease-related PrP isoforms and while it is clearly an infectious structure its specific contribution to other aspects of disease pathogenesis remains unclear  may comprise the neurotoxic species, and that prototypical PrPSc and indeed prions per se may not themselves be highly neurotoxic  has been reported, specific-infectivities are generally too low for meaningful structural analysis  and that the morphology of the prion rods was incompatible with a uniform virus structure  formed by a double helical arrangement of two protofilaments , negative-stain electron tomography, cryo-EM and atomic force microscopy (AFM) have recently revealed a common three-dimensional architecture  cannot be applied with any certainty to the PrP rods  their basic architecture can now be compared with fibrillar assemblies of other proteins that propagate in other neurodegenerative diseases . Based uPrion-infected transgenic mice expressing mutant GPI-anchorless PrP replicate authentic prions (that are transmissible to wild-type mice) but they also develop intense PrP amyloid plaques in their brain which are not seen in the brain of prion-infected wild-type mice  would be expected to be capable of co-propagating both authentic prions (infectious PrP rods) and alternative transmissible PrP amyloid assemblies, patients with different PRNP stop mutations which produce C-terminally truncated PrP devoid of N-linked glycans (for example Y163X; Mead et al., Importantly, such co-propagation of infectious paired-fiber PrP rods and distinct single-fiber amyloid PrP assemblies may also be occurring in some inherited prion diseases in particular in patients with GSS disease phenotypes in which amyloid plaques are a prominent neuropathological feature (see Terry et al., Prion-infected brain contains multiple disease-related PrP assemblies. Infectious PrP rods comprise authentic prions that generate a lethal transmissible spongiform encephalopathy when inoculated into a susceptible host. Neurotoxicity accompanying the propagation of authentic prions is thought to involve the generation of a distinct toxic PrP species whose steady-state level may determine the rate of neurodegeneration. In some inherited prion diseases transmissible PrP amyloids only may be generated while in others transmissible PrP amyloids may variably co-propagate with authentic prions and act as a major modifier of clinicopathological phenotype. Studying the transmission properties of synthetic prion preparations is complex and experiments should be carefully designed and interpreted in order to differentiate between the generation of authentic lethal prions and transmissible PrP amyloids. At present, propagating fibrillar assemblies of proteins in other neurodegenerative diseases appear to have biological and structural properties that are more closely aligned with transmissible PrP amyloids rather than authentic lethal prions.CT and JW wrote the article.JW is a shareholder of D-Gen Limited, an academic spin-out company working in the field of prion disease diagnosis, decontamination, and therapeutics. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The present study considers how race combines with chronological age to shape kidney function among older adults. We analyzed cross-sectional data from a nationally representative study of older adults. Our measure of kidney function derived from the cystatin C-based estimated glomerular filtration rate. We use a pattern variable to divide White and Black respondents into four groups based on their age group membership: early midlife (age 52–59), late midlife (age 60–69), young old (age 70–79), and oldest old (80s+ years). Results from our ordinary least squares models reveal that Blacks and Whites in late midlife, young old, and oldest old exhibited poorer kidney function than Whites in early midlife. Our study uncovers evidence of race by age disparities in kidney function among older adults. Future longitudinal studies will provide further insight into how and why race combines with age to pattern kidney function over time.


A 74-year-old female presented with a 6-month history of easy bruising as manifested by purpura after minor trauma to her face. Her physical examination was unremarkable except for the presence of pinch purpura scattered on her face . LaboratCutaneous manifestations are reported in 30%-40% of AL amyloidosis cases . The les


Twenty seven years old lady presented to the emergency department accompanied by family members with complaint of fluctuating consciousness and fever for the past three days. Upon further questioning the patient has been complaining of headache for two months, decreased appetite for the past month and had a travel history to Ethiopia five months ago. Family members were not sure about any history of weight loss, the patient took a one week course of antibiotics for tooth infection two weeks ago. Physical examination showed an ill looking, vitally stable lady on chest auscultation diffuse crackles heard bilaterally. Septic work up including CSF sample was ordered to rule-out meningitis chest X-ray was also ordered. Chest X-ray result showed a clinical image specious of miliary TB (A) and results were confirmed by a positive acid fast stain of the CSF. Patient was taken to isolation and proper management was started with a final diagnosis of TB meningitis. A follow-up MRI showed few hyper-intense foci in deep white matter of left frontal lobe (B).