Παρασκευή, 14 Απριλίου 2017

IJERPH, Vol. 14, Pages 425: Gaseous Elemental Mercury and Total and Leached Mercury in Building Materials from the Former Hg-Mining Area of Abbadia San Salvatore (Central Italy)

Mercury has a strong environmental impact since both its organic and inorganic forms are toxic, and it represents a pollutant of global concern. Liquid Hg is highly volatile and can be released during natural and anthropogenic processes in the hydrosphere, biosphere and atmosphere. In this study, the distribution of Gaseous Elemental Mercury (GEM) and the total and leached mercury concentrations on paint, plaster, roof tiles, concrete, metals, dust and wood structures were determined in the main buildings and structures of the former Hg-mining area of Abbadia San Salvatore (Siena, Central Italy). The mining complex (divided into seven units) covers a surface of about 65 ha and contains mining structures and managers’ and workers’ buildings. Nine surveys of GEM measurements were carried out from July 2011 to August 2015 for the buildings and structures located in Units 2, 3 and 6, the latter being the area where liquid mercury was produced. Measurements were also performed in February, April, July, September and December 2016 in the edifices and mining structures of Unit 6. GEM concentrations showed a strong variability in time and space mostly depending on ambient temperature and the operational activities that were carried out in each building. The Unit 2 surveys carried out in the hotter period (from June to September) showed GEM concentrations up to 27,500 ng·m−3, while in Unit 6, they were on average much higher, and occasionally, they saturated the GEM measurement device (>50,000 ng·m−3). Concentrations of total (in mg·kg−1) and leached (in μg·L−1) mercury measured in different building materials (up to 46,580 mg·kg−1 and 4470 mg·L−1, respectively) were highly variable, being related to the edifice or mining structure from which they were collected. The results obtained in this study are of relevant interest for operational cleanings to be carried out during reclamation activities.

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IJERPH, Vol. 14, Pages 424: Work Characteristics Associated with Physical Functioning in Women

Women make up almost half of the labor force with older women becoming a growing segment of the population. Work characteristics influence physical functioning and women are at particular risk for physical limitations. However, little research has explored the effects of work characteristics on women’s physical functioning. U.S. women between the ages of 50 and 79 were enrolled in the Women’s Health Initiative Observational Study between 1993 and 1998. Women provided job titles and years worked at their three longest-held jobs (n = 79,147). Jobs were linked to characteristics in the Occupational Information Network. Three categories of job characteristics related to substantive complexity, physical demand, and social collaboration emerged. The association between job characteristics and physical limitations in later life, measured using a SF-36 Physical Functioning score <25th percentile, was examined using modified Poisson regression. After controlling for confounding variables, high physical demand was positively associated with physical limitations (RR = 1.09 CI: 1.06–1.12) and substantively complex work was negatively associated (RR = 0.94, CI: 0.91–0.96). Jobs requiring complex problem solving, active learning, and critical thinking were associated with better physical functioning. Employers should explore opportunities to reduce strain from physically demanding jobs and incorporate substantively complex tasks into women’s work to improve long-term health.

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The acute pulmonary and thrombotic effects of cerium oxide nanoparticles after intratracheal instillation in mice

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Biocompatible nanoemulsions based on hemp oil and less surfactants for oral delivery of baicalein with enhanced bioavailability

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Efficacy of silk fibroin–nano silver against Staphylococcus aureus biofilms in a rabbit model of sinusitis

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EGFR-targeted delivery of DOX-loaded Fe3O4@polydopamine multifunctional nanocomposites for MRI and antitumor chemo-photothermal therapy

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Man speaks out about his HPV-associated throat cancer - Charlotte Observer


Man speaks out about his HPV-associated throat cancer
Charlotte Observer
Robert Fox, 42, contracted and survived cancer that developed from an HPV infection, the virus best known for causing cervical cancer in women. And he wants men to know they can get it, too. "It was a shock," the Montana man said. "It's a cancer I ...



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Nomograms to estimate long-term overall survival and tongue cancer-specific survival of patients with tongue squamous cell carcinoma

Abstract

The aim of this study was to construct nomograms to predict long-term overall survival (OS) and tongue cancer-specific survival (TCSS) of tongue squamous cell carcinoma (TSCC) patients based on clinical and tumor characteristics. Clinical, tumor, and treatment characteristics of 12,674 patients diagnosed with TSCC between 2004 and 2013 were collected from the Surveillance, Epidemiology, and End Results database. These patients were then divided into surgery and nonsurgery cohorts, and nomograms were developed for each of these groups. The step-down method and cumulative incidence function were used for model selection to determine the significant prognostic factors associated with OS and TCSS. These prognostic variables were incorporated into nomograms. An external cohort was used to validate the surgery nomograms. Seven variables were used to create the surgery nomograms for OS and TCSS, which had c-indexes of 0.709 and 0.728, respectively; for the external validation cohort, the c-indexes were 0.691 and 0.711, respectively. Nine variables were used to create the nonsurgery nomograms for OS and TCSS, which had c-indexes of 0.750 and 0.754, respectively. The calibration curves of the 5- and 8-year surgery and nonsurgery nomograms showed excellent agreement between the probabilities and observed values. By incorporating clinicopathological and host characteristics in patients, we are the first to establish nomograms that accurately predict prognosis for individual patients with TSCC. These nomograms ought to provide more personalized and reliable prognostic information, and improve clinical decision-making for TSCC patients.

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Tongue squamous cell carcinoma (TSCC) is the most common type of oral carcinoma, with significantly worse prognosis compared to other head and neck squamous cell carcinomas (HNSCC). In this study, we have used a large population-based cohort to create a series of nomograms that can provide 5- and 8-year overall survival and tongue cause-specific survival for patients with TSCC for the first time. These accurate and easy-to-use nomograms ought to be helpful in improved individual management.



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Transcriptome analysis of the effects of chitosan on the hyperlipidemia and oxidative stress in high-fat diet fed mice

Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Bin Wang, Sicong Zhang, Xiaoya Wang, Shuo Yang, Qixing Jiang, Yanshun Xu, Wenshui Xia
Transcriptome analysis was performed to investigate the alterations in gene expression after chitosan (CS) treatment on the liver of mice fed with high-fat diet (HFD). The results showed that the body weight, the liver weight and the epididymal fat mass of HFD mice, which were 62.98%, 46.51% and 239.37%, respectively, higher than those of control mice, could be significantly decreased by chitosan supplementation. Also, high-fat diet increased both plasma lipid and liver lipid as compared with the control mice. Chitosan supplementation decreased the plasma lipid and liver lipid, increased the lipoprotein lipase (LPL) and hepatic lipase (HL) activity, increased T-AOC and decreased MDA in the liver and the epididymis adipose as compared with the HFD mice. Transcriptome analysis indicated that increased Mups, Lcn2, Gstm3 and CYP2E1 expressions clearly indicated HFD induced lipid metabolism disorder and oxidative damage. Especially, chitosan treatment decreased the Mup17 and Lcn2 expressions by 64.32% and 82.43% respectively as compared with those of HFD mice. These results indicated that chitosan possess the ability to improve the impairment of lipid metabolism as strongly associated with increased Mups expressions and gene expressions related to oxidative stress.



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Fibrillar assembly of bacterial cellulose in the presence of wood-based hemicelluloses

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Paavo A. Penttilä, Tomoya Imai, Junji Sugiyama
Composite materials mimicking the plant cell wall structure were made by culturing cellulose-producing bacteria together with secondary-wall hemicelluloses from wood. The effects of spruce galactoglucomannan (GGM) and beech xylan on the nanoscale morphology of bacterial cellulose were studied in the original, hydrated state with small-angle X-ray scattering (SAXS). The SAXS intensities were fitted with a model covering multiple levels of the hierarchical structure. Additional information on the structure of dried samples was obtained using scanning and transmission electron microscopy and infra-red spectroscopy. Both hemicelluloses induced a partial conversion of the cellulose crystal structure from Iα to Iβ and a reduction of the cross-sectional dimensions of the cellulose microfibrils, thereby affecting also their packing into bundles. The differences were more pronounced in samples with xylan instead of GGM, and they became more significant with higher hemicellulose concentrations.



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Anti-obesity effect and protection of liver-kidney functions by Codium fragile sulphated polysaccharide on high fat diet induced obese rats

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Rihab Ben Abdallah Kolsi, Neila Jardak, Faten Hajkacem, Rim Chaaben, Imed jribi, Abdelfattah El Feki, Tarak Rebai, Kamel Jamoussi, Lotfi Fki, Hafedh Belghith, Karima Belghith
The present study investigates the hypolipidemic effects of sulphated polysaccharide obtained from Codium fragile (CFSP) in induced obese rats (HFD).The results showed an increase in body weight of HFD rats by 21.56% as compared to control normal rats. Moreover, serum lipase activity underwent an increase which led to an increase in the levels of total cholesterol (T-Ch), triglycerides (TG) and low density lipoprotein cholesterol (LDL-Ch) in serum associeted with a decrease in the level of high density lipoprotein cholesterol (HDL-Ch) in untreated HFD rats. This diet has disrupted the antioxidant status by decreasing the activities of antioxidant enzymes (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX)) and subsequently an increase in thiobarbituric acid reactive substances (TBARS) level in liver and kidney of obese rats. All these disturbances are significantly corrected by CFSP administration with no fatty deposits in the liver and a protective effect against renal histological alteration. This confirms the important role of this polysaccharide in the fight against oxidative stress and the prevention of hyperlipidemia.



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Formation and cleaning function of physically cross-linked dual strengthened water-soluble chitosan-based core-shell particles

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Yanrui Dong, Congming Xiao
Facile and mild ionic cross-linking and freezing/thawing technologies were applied to prepare double strengthened core-shell particles by using water-soluble chitosan (WSC), sodium alginate (SA) and poly(vinyl alcohol) (PVA) as starting materials. The aqueous solution contained WSC and PVA was dropped in ethanol to form beads. The beads were converted into WSC/PVA hydrogel particles by being subjected to three freeze/thaw cycles. Subsequently, ionic cross-linked hydrogel layer was formed around each WSC/PVA particle to generate core-shell particulates. Fourier transform infrared spectra confirmed the combination among various components. Dynamic mechanical thermal analysis indicated that the storage modulus of the core-shell hydrogel was improved obviously. Thermogravimetric analysis exhibited the thermal stability of the particles was also enhanced by incorporation of PVA. It was found that the particles were able to adsorb carbon dioxide, lead ion and copper ion. The adsorption capacities of dry particles toward carbon dioxide, Pb(II) and Cu(II) could reach 199.62, 39.28 and 26.03mg/g, respectively. The rates of the particles for binding Pb(II) and Cu(II) at initial stage were 26.57 and 4.30%/min, respectively. These experimental results suggested that the particles were an efficient sorbent for removing hazardous substances such as carbon dioxide and heavy-metal ions.



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Multi-scale structures and functional properties of starches from Indica hybrid, Japonica and waxy rice

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Shujun Wang, Peiyan Li, Jinglin Yu, Peng Guo, Shuo Wang
The structural and functional properties of starches from three rice grains differing in amylose content (19.9, 13.4 and 0.8% for Japonica, Indica hybrid and waxy rice, respectively) were investigated using a range of characterization methods Indica hybrid starch (IHS) had the highest proportion of intermediate (DP 13–24) and long branch chains (DP≥37) and the lowest proportion of short branch chains (DP 6–12), whereas the opposite results were observed for Japonica starch (JS). The results for waxy rice starch (WS) were between those of IHS and JS. Rice starches showed a typical A-type X-ray diffraction pattern with the relative crystallinity ranging from 33.4% for JS to 39.4% for WS. Significant differences were observed in lamellar distance and short-range molecular order characterized by IR ratio of absorbances at 1047/1022cm−1 and full width of half maximum (FWHM) of the band at 480cm−1. WS showed a higher swelling power and a lower close packing concentration at temperatures from 60 to 90°C. The lower peak viscosity of WS was attributed to the formation of less rigid swollen granules at a concentrated regime. WS showed a higher in vitro digestibility compared with IHS and JS.



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Laccase – methacrylyol functionalized magnetic particles: Highly immobilized, reusable, and efficacious for methyl red decolourization

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Publication date: September 2017
Source:International Journal of Biological Macromolecules, Volume 102
Author(s): Jiahong Lin, Qiujie Lai, Yingju Liu, Shi Chen, Xueyi Le, Xiaohua Zhou
Magnetically retrievable formulations of laccase potentially promising for biomedical and environmental applications were constructed by immobilization of the enzyme on the surface of magnetic nanoparticles functionalized by siloxane layers with active amino and methacrylyol moieties. The functional magnetic particles were prepared using a hydrolytic polycondensation reaction of tetraethoxysilane with 3-methacryloxypropyltrimethoxysilane (MPS). The results indicated that the amounts of laccase loading on the methacrylyol functional magnetic particles were approximately 150mg/g under the optimum conditions. The stability of the immobilized laccase was highly enhanced against thermal treatments and provided better long-term storage. Compared to free laccase, the immobilized laccase exhibited significantly higher decolourisation efficiency in the decolorization of a representative dye, methyl red, which resulted from the magnetic particles adsorption and enzymatic catalysis. These results show its great potential for industrial applications.



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April means Oral Cancer Awareness month - kcentv.com


kcentv.com

April means Oral Cancer Awareness month
kcentv.com
Heather Egbert had surgery to remove cancer from under her tongue just days ago. Now, during Oral Cancer Awareness Month, her mission is to minimize who has to go through what she has since February. "I had been living with something that looked like ...
Dentist's Chair: Watch for signs of oral cancerReading Eagle

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Clinical trials are a crucial part of medical treatment for cancer: Dr Vikram Kekatpure - pharmabiz.com


Clinical trials are a crucial part of medical treatment for cancer: Dr Vikram Kekatpure
pharmabiz.com
Head and neck cancer is one of the most common diseases affecting mouth, throat, larynx, nose, paranasal sinuses, or salivary glands among the Indian population. Its rise is a major concern. About 80 per cent is caused due to tobacco use, both chewing ...



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Colorectal cancer rates rising dramatically in young adults - Healio


Colorectal cancer rates rising dramatically in young adults
Healio
Still, these studies have not examined the temporal trend simultaneously by age, calendar period and year of birth. To characterize trends in population-based CRC occurrence by tumor location, age at diagnosis, and year of birth, researchers used ...

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Clinical trials are a crucial part of medical treatment for cancer: Dr Vikram Kekatpure - pharmabiz.com


Clinical trials are a crucial part of medical treatment for cancer: Dr Vikram Kekatpure
pharmabiz.com
Head and neck cancer is one of the most common diseases affecting mouth, throat, larynx, nose, paranasal sinuses, or salivary glands among the Indian population. Its rise is a major concern. About 80 per cent is caused due to tobacco use, both chewing ...



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Immunological Memory of Group 2 Innate Lymphoid Cells

Publication date: Available online 14 April 2017
Source:Trends in Immunology
Author(s): Itziar Martinez-Gonzalez, Laura Mathä, Catherine A. Steer, Fumio Takei
Immunological memory has long been described as a property of the adaptive immune system that results in potent responses on exposure to an antigen encountered previously. While this definition appears to exclude cells that do not express antigen receptors, recent studies have shown that innate immune cells, including natural killer (NK) cells, macrophages, and, more recently, group 2 innate lymphoid cells (ILC2s) can record previous activations and respond more vigorously on reactivation. Here we review the similarities and differences between these forms of memory and the underlying mechanisms. Based on these insights, we propose to revise the definition of immunological memory, as the capacity to remember being previously activated and respond more efficiently on reactivation regardless of antigen specificity.



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Evolutionary Origins of cGAS-STING Signaling

Publication date: Available online 14 April 2017
Source:Trends in Immunology
Author(s): Shally R. Margolis, Stephen C. Wilson, Russell E. Vance
Detection of foreign nucleic acids is an important strategy for innate immune recognition of pathogens. In vertebrates, pathogen-derived DNA is sensed in the cytosol by cGAS, which produces the cyclic dinucleotide (CDN) second messenger cGAMP to activate the signaling adaptor STING. While induction of antiviral type I interferons (IFNs) is the major outcome of STING activation in vertebrates, it has recently become clear that core components of the cGAS-STING pathway evolved more than 600 million years ago, predating the evolution of type I IFNs. Here we discuss the evolutionary origins of the cGAS-STING pathway, and consider the possibility that the ancestral functions of STING may have included activation of antibacterial immunity.



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Complement C3-Targeted Therapy: Replacing Long-Held Assertions with Evidence-Based Discovery

Publication date: Available online 14 April 2017
Source:Trends in Immunology
Author(s): Dimitrios C. Mastellos, Edimara S. Reis, Daniel Ricklin, Richard J. Smith, John D. Lambris
Complement dysregulation underlies several inflammatory disorders, and terminal complement inhibition has thus far afforded significant clinical gains. Nonetheless, emerging pathologies, fueled by complement imbalance and therapy-skewing genetic variance, underscore the need for more comprehensive, disease-tailored interventions. Modulation at the level of C3, a multifaceted orchestrator of the complement cascade, opens up prospects for broader therapeutic efficacy by targeting multiple pathogenic pathways modulated by C3-triggered proinflammatory crosstalk. Notably, C3 intervention is emerging as a viable therapeutic strategy for renal disorders with predominantly complement-driven etiology, such as C3 glomerulopathy (C3G). Using C3G as a paradigm, we argue that concerns about the feasibility of long-term C3 intervention need to be placed into perspective and weighed against actual therapeutic outcomes in prospective clinical trials.



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Patterns, Receptors, and Signals: Regulation of Phagosome Maturation

Publication date: Available online 14 April 2017
Source:Trends in Immunology
Author(s): Anne-Marie Pauwels, Matthias Trost, Rudi Beyaert, Eik Hoffmann
Recognition of microbial pathogens and dead cells and their phagocytic uptake by specialized immune cells are essential to maintain host homeostasis. Phagosomes undergo fusion and fission events with endosomal and lysosomal compartments, a process called ‘phagosome maturation’, which leads to the degradation of the phagosomal content. However, many phagocytic cells also act as antigen-presenting cells and must balance degradation and peptide preservation. Emerging evidence indicates that receptor engagement by phagosomal cargo, as well as inflammatory mediators and cellular activation affect many aspects of phagosome maturation. Unsurprisingly, pathogens have developed strategies to hijack this machinery, thereby interfering with host immunity. Here, we highlight progress in this field, summarize findings on the impact of immune signals, and discuss consequences for pathogen elimination.



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IJMS, Vol. 18, Pages 838: Applying Broadband Dielectric Spectroscopy (BDS) for the Biophysical Characterization of Mammalian Tissues under a Variety of Cellular Stresses

The dielectric properties of biological tissues can contribute non-invasively to a better characterization and understanding of the structural properties and physiology of living organisms. The question we asked, is whether these induced changes are effected by an endogenous or exogenous cellular stress, and can they be detected non-invasively in the form of a dielectric response, e.g., an AC conductivity switch in the broadband frequency spectrum. This study constitutes the first methodological approach for the detection of environmental stress-induced damage in mammalian tissues by the means of broadband dielectric spectroscopy (BDS) at the frequencies of 1–106 Hz. Firstly, we used non-ionizing (NIR) and ionizing radiation (IR) as a typical environmental stress. Specifically, rats were exposed to either digital enhanced cordless telecommunication (DECT) radio frequency electromagnetic radiation or to γ-radiation, respectively. The other type of stress, characterized usually by high genomic instability, was the pathophysiological state of human cancer (lung and prostate). Analyzing the results of isothermal dielectric measurements provided information on the tissues’ water fraction. In most cases, our methodology proved sufficient in detecting structural changes, especially in the case of IR and malignancy. Useful specific dielectric response patterns are detected and correlated with each type of stress. Our results point towards the development of a dielectric-based methodology for better understanding and, in a relatively invasive way, the biological and structural changes effected by radiation and developing lung or prostate cancer often associated with genomic instability.

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What you're not being told about 'free' public head and neck cancer screening events - HealthNewsReview.org


HealthNewsReview.org

What you're not being told about 'free' public head and neck cancer screening events
HealthNewsReview.org
'Tis the season of oral, head, and neck cancer screenings, with a plethora of free public events taking place at health clinics and hospitals all over the country right now. Judging by the abundant and largely uncritical news coverage, it's been a ...
Head, neck cancer screenings at Naval Hospital Camp LejeuneCamp Lejeune Globe
UHC Offers Free Oral, Head, and Neck Cancer Screenings - KadnFOX 15
Local dad shares his story about Oral Cancer | 13NEWSNOW.com13newsnow.com

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Viscosities encountered during the cryopreservation of dimethyl sulphoxide systems

Publication date: Available online 14 April 2017
Source:Cryobiology
Author(s): P. Kilbride, G.J. Morris
This study determined the viscous conditions experienced by cells in the unfrozen freeze concentrated channels between ice crystals in slow cooling protocols. This was examined for both the binary Me2SO-water and the ternary Me2SO-NaCl-water systems.Viscosity increases from 6.9 ± 0.1 mPa s at −14.4 ± 0.3 °C to 958 ± 27 mPa s at −64.3 ± 0.4 °C in the binary system, and up to 55387 ± 1068 mPa s at −75 ± 0.5 °C in the ternary (10% Me2SO, 0.9% NaCl by weight) solution were seen. This increase in viscosity limits molecular diffusion, reducing adsorption onto the crystal plane. These viscosities are significantly lower than observed in glycerol based systems and so cells in freeze concentrated channels cooled to between −60 °C and −75 °C will reside in a thick fluid not a near-solid state as is often assumed.In addition, the viscosities experienced during cooling of various Me2SO based vitrification solutions is determined to below −70 °C, as is the impact which additional solutes exert on viscosity. These data show that additional solutes in a cryopreservation system cause disproportionate increases in viscosity. This in turn impacts diffusion rates and mixing abilities of high concentrations of cryoprotectants, and have applications to understanding the fundamental cooling responses of cells to Me2SO based cryopreservation solutions.



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A Longitudinal Study of Smokeless Tobacco Use and Mortality in the United States

Abstract

Few studies in the United States have examined longitudinally the mortality risks associated with use of smokeless tobacco (SLT). The sample of this study was composed of participants from the National Longitudinal Mortality Study who completed a single Tobacco Use Supplement to the Current Population Survey between the years 1985 and 2011. Using survival methods, SLT use at the baseline survey was examined as a predictor of all-cause mortality and cause-specific mortalities in models that excluded individuals who had ever smoked cigarettes, cigars, or used pipes (final n=349,282). The participants had median and maximum follow-up times of 8.8 and 26.3 years, respectively. Regression analyses indicated that compared to the never tobacco users, the current SLT users did not have elevated mortality risks from all cancers combined, the digestive system cancers and cerebrovascular disease. However, current SLT users had a higher mortality risk for coronary heart disease (CHD) (HR(95% C.I.)=1.24 (1.05, 1.46)) relative to never tobacco users. In a separate model, the elevated risk for CHD mortality corresponded to the use of moist snuff (HR(95% C.I.) =1.30 (1.03, 1.63)). The associations with CHD mortality could be attributed to long-term nicotine exposure, other SLT constituents (e.g., metals), or the confounding effects of CHD risk factors not accounted for in this study. The study's findings could contribute to the ongoing dialogue on tobacco harm reduction and the U.S. FDA's evaluation of Modified Risk Tobacco Product applications submitted by American SLT manufacturers. This article is protected by copyright. All rights reserved.



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'This cancer stuff sucks ... you don't have to fight anymore' - WXIA-TV


WXIA-TV

'This cancer stuff sucks ... you don't have to fight anymore'
WXIA-TV
Ruth took Nolan to an ear, nose and throat specialist (ENT) who immediately suggested removing his adenoids and tonsils. On Nov. 6, doctors performed the procedures, and shortly thereafter, Nolan began having uncontrollable nosebleeds. On Nov.

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Coherent Nanotwins and Dynamic Disorder in Cesium Lead Halide Perovskite Nanocrystals

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ACS Nano
DOI: 10.1021/acsnano.7b00017
ancac3?d=yIl2AUoC8zA


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DNA Bipedal Motor Achieves a Large Number of Steps Due to Operation Using Microfluidics-Based Interface

TOC Graphic

ACS Nano
DOI: 10.1021/acsnano.7b00547
ancac3?d=yIl2AUoC8zA


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Isolation and characterization of a thermostable F420:NADPH oxidoreductase from Thermobifida fusca [Microbiology]

F420H2-dependent enzymes reduce a wide range of substrates that are otherwise recalcitrant to enzyme-catalyzed reduction, and their potential for applications in biocatalysis has attracted increasingly attention. Thermobifida fusca is a moderately thermophilic bacterium and holds high biocatalytic potential as a source for several highly thermostable enzymes. We report here on the isolation and characterization of a thermostable F420:NADPH oxidoreductase (Tfu-FNO) from T. fusca, being the first F420-dependent enzyme described from this bacterium. Tfu-FNO was heterologously expressed in Escherichia coli, yielding up to 200 mg recombinant enzyme per liter of culture. We found that Tfu-FNO is highly thermostable, reaching its highest activity at 65 °C and that Tfu-FNO is likely to act in vivo as an F420 reductase at the expense of NADPH, similar to its counterpart in Streptomyces griseus. We obtained the crystal structure of FNO in complex with NADP+ at 1.8 Å resolution, providing the first bacterial FNO structure. The overall architecture and NADP+-binding site of Tfu-FNO were highly similar to those of the Archaeoglobus fulgidus FNO (Af-FNO). The active site is located in a hydrophobic pocket between an N-terminal dinucleotide-binding domain and a smaller C-terminal do-main. Residues interacting with the 2′-phosphate of NADP+ were probed by targeted mutagenesis, indicating that Thr28, Ser50, Arg51, and Arg55 are important for discriminating between NADP+ and NAD+. Interestingly, a T28A mutant increased the kinetic efficiency more than three-fold as compared with the wild-type enzyme when NADH is the substrate. The biochemical and structural data presented here provide crucial insights into the molecular recognition of the two cofactors, F420 and NAD(P)H by FNO.

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The aurora kinase inhibitor AMG 900 increases apoptosis and induces chemosensitivity to anticancer drugs in the NCI-H295 adrenocortical carcinoma cell line.

Adrenocortical tumor (ACT) is a malignancy with a low incidence rate and the current therapy for advanced disease has a limited impact on overall patient survival. A previous study from our group suggested that elevated expression of aurora-A and aurora-B is associated with poor outcome in childhood ACT. Similar results were also reported for adult ACTs. The present in-vitro study shows that AMG 900 inhibits aurora kinases in adrenocortical carcinoma cells. AMG 900 inhibited cell proliferation in NCI-H295 cells as well as in the ACT primary cultures and caused apoptosis in the cell line NCI-H295. Furthermore, it potentialized the mitotane, doxorubicin, and etoposide effects on apoptosis induction and acted synergistically with mitotane and doxorubicin in the inhibition of proliferation. In addition, we found that AMG 900 activated Notch signaling and rendered the cells sensitive to the combination of AMG 900 and Notch signaling inhibition. Altogether, these data show that aurora kinases inhibition using AMG 900 may be an adjuvant therapy to treat patients with invasive or recurrent adrenocortical carcinomas. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Lacrimal Sac Pneumatocele Following Blunt Nasal Trauma.

Pneumatocele of the lacrimal sac is an uncommon entity and has been rarely reported in literature. The valvular function of the Hasner's valve at the lower end of nasolacrimal duct is presumed to prevent the retrograde reflux of air into the lacrimal sac with increased intranasal pressure as in valsalva maneuver. Loss of this valvular function as noted with persistent positive airway pressure ventilation can cause retrograde air reflux into lacrimal sac. The authors report a case of lacrimal sac pneumatocele which developed following blunt nasal trauma involving the bony nasolacrimal duct. (C) 2017 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

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Ponatinib Extends Survival Over Transplant in Chronic Phase CML

Treatment with ponatinib yielded better overall survival compared with allogeneic stem cell transplantation in patients with chronic phase chronic myeloid leukemia with a T315I mutation. (Source: CancerNetwork)

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Beating HPV-Positive Throat Cancer - Huffington Post


Huffington Post

Beating HPV-Positive Throat Cancer
Huffington Post
The biopsy showed that Clinton had Stage IVa oral squamous cell carcinoma (OSCC) at the base of his tongue—and the cancer was HPV positive. HPV stands for the human papillomavirus and a recent survey found that more than 42% of Americans are ...



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Beating HPV-Positive Throat Cancer - Huffington Post


Huffington Post

Beating HPV-Positive Throat Cancer
Huffington Post
“The majority of tonsil and tongue base (“throat”) cancers are HPV-positive, but smoking is still a major risk factor. Typically, non-smoking patients with HPV-positive tonsil/tongue base cancers present with a lump in the neck, implying that the ...



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Step by step argumentative research paper



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Pathways to Freedom | Secrets: Signs and Symbols

Harriet Tubman was not satisfied with her own freedom, returning many times to free family members and others, taking them to the North or Canada. Underground Railroad: The William Still Story is a production of 90th Parallel Productions Ltd in association with Rogers Broadcasting Limited and WNED-TV Buffalo/Toronto

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Concentration Camps - Jewish Virtual Library

The Holocaust: Concentration Camps. Category » The Holocaust: Basic History Frequent Asked Questions. Question: Who decided to create the concentration camps? A: The very first decision to open concentration camps for political opponents was

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7Phone Apps You Don’t Want Your Boyfriend To Have

There's a lot more that you have to consider if you're thinking about burying a shipping container to be used as a bunker. They're not designed for that and you could John Piper, author of What’s the Difference?: Manhood and Womanhood Defined According to the Bible, explained why men, and not women, should be the leaders in their

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Advantages and Disadvantages - The Children's University

Solar Power. Solar power is the the conversion of the energy from the sun to usable electricity. The most common source of solar power utilizes photovoltaic cells to If labour markets are competitive, higher wages will cause unemployment (Q3-Q2). Trades unions can cause wages to go above equilibrium through the threat of strikes e

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Mother Earth Living: Healthy Homes, Natural Health, Green

Directed by Thomas Carter. With Julia Stiles, Sean Patrick Thomas, Kerry Washington, Fredro Starr. A white midwestern girl moves to Chicago, where her new boyfriend Mother Teresa who devoted her life for the service of the poor, downtrodden, under privileged and destitute is an epitome of self†assured simplicity.

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Smithsonian Source--Primary Sources:

A private, non-profit educational and cultural organization established to preserve and share the Boston Tea Party history. At the end of March 1770, just three weeks after the Boston Massacre, a grand jury had indicted Captain Preston and his men as well as four civilians accused of

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WEEKLY ESSAY WRITING CHALLENGE - INSIGHTS

Child Labor. Child labor has been an international concern because it damages, spoils and destroys the future of children. The problem of child labor is a serious Muhammad Akbar Notezai speaks with New Delhi-based freelance journalist and scholar Amit Ranjan on South Asian water issues, the Indus Waters Treaty, and Pakistan’s

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CSR|NYC Strategies

What is utilitarianism? in normative ethics, a tradition stemming from the late 18th- and 19th-century English philosophers and economists Jeremy Bentham and John John Stuart Mill's On Liberty (1859) is the classic statement and defence of the view that governmental encroachment upon the freedom of individuals is almost never

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Writing persuasive or argumentative essays

Writing assignment series Persuasive or argumentative essays In persuasive or argumentative writing, we try to convince others to agree with our facts, share our values, This page contains the Argument topics for the Analytical Writing section of the GRE® General Test. When you take the test, you will be presented with one Argument

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Writing - Writing Prompts, Lessons, Activities, Poetry

Creative writing prompts can be great tools to help you get your creative juices flowing. Grab a spiral notebook and scroll through the prompts below till you find Guess what? Here's something fresh for your lessons! It's a growing collection of visual writing prompts so that you're never out of writing ideas again! Present

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How to Make Polymer Clay Covered Pens.

Find great deals on eBay for papermate pens and pen lot. Shop with confidence. Welcome! is the home of Write Brothers®'s award-winning software and resources. No matter what kind of writer you are, this site has something for you.

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Electrical Read-Out of a Single Spin Using an Exchange-Coupled Quantum Dot

TOC Graphic

ACS Nano
DOI: 10.1021/acsnano.7b00451
ancac3?d=yIl2AUoC8zA


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Mesh fixation in endoscopic inguinal hernia repair: evaluation of methodology based on a systematic review of randomised clinical trials

Abstract

Background

The issue of mesh fixation in endoscopic inguinal hernia repair is frequently debated and still no conclusive data exist on differences between methods regarding long-term outcome and postoperative complications. The quantity of trials and the simultaneous lack of high-quality evidence raise the question how future trials should be planned.

Methods

PubMed, EMBASE and the Cochrane Library were searched, using the filters "randomised clinical trials" and "humans". Trials that compared one method of mesh fixation with another fixation method or with non-fixation in endoscopic inguinal hernia repair were eligible. To be included, the trial was required to have assessed at least one of the following primary outcome parameters: recurrence; surgical site infection; chronic pain; or quality-of-life.

Results

Fourteen trials assessing 2161 patients and 2562 hernia repairs were included. Only two trials were rated as low risk for bias. Eight trials evaluated recurrence or surgical site infection; none of these could show significant differences between methods of fixation. Two of 11 trials assessing chronic pain described significant differences between methods of fixation. One of two trials evaluating quality-of-life showed significant differences between fixation methods in certain functions.

Conclusion

High-quality evidence for differences between the assessed mesh fixation techniques is still lacking. From a socioeconomic and ethical point of view, it is necessary that future trials will be properly designed. As small- and medium-sized single-centre trials have proven unable to find answers, register studies or multi-centre studies with an evident focus on methodology and study design are needed in order to answer questions about mesh fixation in inguinal hernia repair.



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Pure 3D laparoscopic living donor right hemihepatectomy in a donor with separate right posterior and right anterior hepatic ducts and portal veins

Abstract

Background

Despite increases in the performance of pure laparoscopic living donor hepatectomy, variations in the bile duct or portal vein have been regarded as relative contraindications to this technique [13]. This report describes a donor with separate right posterior and right anterior hepatic ducts and portal veins who underwent pure laparoscopic living donor right hemihepatectomy, integrated with 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography [1, 4, 5].

Methods

A 50-year-old man offered to donate part of his liver to his older brother, who required a transplant for hepatitis B-associated liver cirrhosis and hepatocellular carcinoma. Donor height was 178.0 cm, body weight was 82.7 kg, and body mass index was 26.1 kg/m2. Preoperative computed tomography and magnetic resonance cholangiopancreatography showed that the donor had separate right posterior and right anterior hepatic ducts and portal veins. The entire procedure was performed under 3D laparoscopic view. Following intravenous injections of 0.05 mg/kg ICG, ICG near-infrared fluorescence camera was used to demarcate the exact transection line and determine the optimal bile duct division point.

Results

The total operation time was 443 min; the donor required no transfusions and experienced no intraoperative complications. The graft weighed 1146 g with a graft-to-recipient weight ratio of 1.88%. The optimal bile duct division point was identified using ICG fluorescence cholangiography, and the bile duct was divided with good patency without any stricture. The right anterior and posterior portal veins were transected with endostaplers without any torsion. The patient was discharged on postoperative day 8, with no complications.

Conclusion

Using a 3D view and ICG fluorescence cholangiography, pure 3D laparoscopic living donor right hemihepatectomy is feasible in a donor with separate right posterior and right anterior hepatic ducts and portal veins.



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25th International Congress of the European Association for Endoscopic Surgery (EAES) Frankfurt, Germany, 14–17 June 2017



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Peroral endoscopic myotomy compared with pneumatic dilation for newly diagnosed achalasia

Abstract

Background

This study retrospectively compared the safety and efficacy of two endoscopic techniques for treating newly diagnosed achalasia, pneumatic dilation (PD), and peroral endoscopic myotomy (POEM).

Methods

Demographics, clinical and manometric data, and outcomes were collected from the medical records of patients who received POEM or PD as the primary therapy for achalasia at our hospital from January 2012 to August 2015.

Results

Of 72 patients, 32 and 40 received POEM and PD, respectively. The two groups had similar preoperative features. On short-term follow-up, improvements in high-resolution esophageal manometry and barium esophagogram parameters were similar. For PD, the success rates at 3, 6, 12, 24, and 36 months were 95, 88, 75, 72, and 60%, respectively. For POEM, these were 96, 96, 96, 93, and 93% (P = 0.013, log-rank test). On subgroup analysis, the success rate was higher with POEM than that with PD in all 3 manometric subtypes, but only that of type III was statistically significant. POEM required significantly longer operative time and hospitalization than did PD (P < 0.001). Four POEM patients experienced subcutaneous emphysema. The rate of gastroesophageal reflux was higher in patients treated by POEM (18.8%) than that in PD (10%; P = 0.286).

Conclusions

In the intermediate term, the remission rate of symptoms associated with POEM therapy was better than that with PD for newly diagnosed achalasia, especially in patients with type III achalasia. The short-term outcomes of the two therapies were similar.



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The effect of a novel minimally invasive strategy for infected necrotizing pancreatitis

Abstract

Background

Step-up approach consisting of multiple minimally invasive techniques has gradually become the mainstream for managing infected pancreatic necrosis (IPN). In the present study, we aimed to compare the safety and efficacy of a novel four-step approach and the conventional approach in managing IPN.

Methods

According to the treatment strategy, consecutive patients fulfilling the inclusion criteria were put into two time intervals to conduct a before-and-after comparison: the conventional group (2010–2011) and the novel four-step group (2012–2013). The conventional group was essentially open necrosectomy for any patient who failed percutaneous drainage of infected necrosis. And the novel drainage approach consisted of four different steps including percutaneous drainage, negative pressure irrigation, endoscopic necrosectomy and open necrosectomy in sequence. The primary endpoint was major complications (new-onset organ failure, sepsis or local complications, etc.). Secondary endpoints included mortality during hospitalization, need of emergency surgery, duration of organ failure and sepsis, etc.

Results

Of the 229 recruited patients, 92 were treated with the conventional approach and the remaining 137 were managed with the novel four-step approach. New-onset major complications occurred in 72 patients (78.3%) in the two-step group and 75 patients (54.7%) in the four-step group (p < 0.001). For other important endpoints, although there was no statistical difference in mortality between the two groups (p = 0.403), significantly fewer patients in the four-step group required emergency surgery when compared with the conventional group [14.6% (20/137) vs. 45.6% (42/92), p < 0.001]. In addition, stratified analysis revealed that the four-step approach group presented significantly lower incidence of new-onset organ failure and other major complications in patients with the most severe type of AP.

Conclusion

Comparing with the conventional approach, the novel four-step approach significantly reduced the rate of new-onset major complications and requirement of emergency operations in treating IPN, especially in those with the most severe type of acute pancreatitis.



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Validation of a novel endoscopic program for measuring the size of gastrointestinal lesions

Abstract

Background

Valid and reliable methods for measurement of lesion sizes during endoscopy have not been established.

Methods

We developed a novel software program (ENDOVER; Poinbionics, Seoul, Republic of Korea) to measure lesions sizes and assessed its validity and reliability. To validate the program, we measured standard coin sizes and estimated measurement errors. To assess program reliability, 32 pictures of endoscopically resected specimens were used to measure tissue sizes six times in a 24-h interval by two examiners. Intraclass correlation coefficients (ICCs) were used to assess intraobserver and interobserver agreements. Agreement between the program and pathological measurements was assessed by absolute differences.

Results

The nominal standard sizes of 10-won, 100-won, and 500-won coins were 18.0, 24.0, and 26.5 mm, and the calculated sizes were 18.09, 24.48, and 26.31 mm, respectively. ICCs of the long and short diameters were, respectively, 0.92 [95% confidence interval (CI) 0.87–0.95] and 0.93 (CI 0.89–0.96) for examiner 1 and 0.88 (CI 0.81–0.93) and 0.92 (CI 0.87–0.95) for examiner 2. Interobserver ICCs of the long and short diameters were 0.97 (CI 0.94–0.99) and 0.97 (CI 0.94–0.99), respectively. The mean absolute differences between the program and pathological measurements were 4.4 and 4.7 mm for the long and short diameters, respectively.

Conclusions

Our findings indicate that the novel measurement program is a valid and reliable method for estimation of lesion sizes from endoscopic findings during and after examination.



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An appraisal of the learning curve in robotic general surgery

Abstract

Background

Robotic-assisted surgery is used with increasing frequency in general surgery for a variety of applications. In spite of this increase in usage, the learning curve is not yet defined. This study reviews the literature on the learning curve in robotic general surgery to inform adopters of the technology.

Methods

PubMed and EMBASE searches yielded 3690 abstracts published between July 1986 and March 2016. The abstracts were evaluated based on the following inclusion criteria: written in English, reporting original work, focus on general surgery operations, and with explicit statistical methods.

Results

Twenty-six full-length articles were included in final analysis. The articles described the learning curves in colorectal (9 articles, 35%), foregut/bariatric (8, 31%), biliary (5, 19%), and solid organ (4, 15%) surgery. Eighteen of 26 (69%) articles report single-surgeon experiences. Time was used as a measure of the learning curve in all studies (100%); outcomes were examined in 10 (38%). In 12 studies (46%), the authors identified three phases of the learning curve. Numbers of cases needed to achieve plateau performance were wide-ranging but overlapping for different kinds of operations: 19–128 cases for colorectal, 8–95 for foregut/bariatric, 20–48 for biliary, and 10–80 for solid organ surgery.

Conclusion

Although robotic surgery is increasingly utilized in general surgery, the literature provides few guidelines on the learning curve for adoption. In this heterogeneous sample of reviewed articles, the number of cases needed to achieve plateau performance varies by case type and the learning curve may have multiple phases as surgeons add more complex cases to their case mix with growing experience. Time is the most common determinant for the learning curve. The literature lacks a uniform assessment of outcomes and complications, which would arguably reflect expertise in a more meaningful way than time to perform the operation alone.



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Attainment and retention of force moderation following laparoscopic resection training with visual force feedback

Abstract

Background

Laparoscopic training with visual force feedback can lead to immediate improvements in force moderation. However, the long-term retention of this kind of learning and its potential decay are yet unclear.

Methods

A laparoscopic resection task and force sensing apparatus were designed to assess the benefits of visual force feedback training. Twenty-two male university students with no previous experience in laparoscopy underwent relevant FLS proficiency training. Participants were randomly assigned to either a control or treatment group. Both groups trained on the task for 2 weeks as follows: initial baseline, sixteen training trials, and post-test immediately after. The treatment group had visual force feedback during training, whereas the control group did not. Participants then performed four weekly test trials to assess long-term retention of training. Outcomes recorded were maximum pulling and pushing forces, completion time, and rated task difficulty.

Results

Extreme maximum pulling force values were tapered throughout both the training and retention periods. Average maximum pushing forces were significantly lowered towards the end of training and during retention period. No significant decay of applied force learning was found during the 4-week retention period. Completion time and rated task difficulty were higher during training, but results indicate that the difference eventually fades during the retention period. Significant differences in aptitude across participants were found.

Conclusions

Visual force feedback training improves on certain aspects of force moderation in a laparoscopic resection task. Results suggest that with enough training there is no significant decay of learning within the first month of the retention period. It is essential to account for differences in aptitude between individuals in this type of longitudinal research. This study shows how an inexpensive force measuring system can be used with an FLS Trainer System after some retrofitting. Surgical instructors can develop their own tasks and adjust force feedback levels accordingly.



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A modified uncut Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy: preliminary results and initial experience

Abstract

Objective

To investigate the safety and feasibility of totally laparoscopic uncut Roux-en-Y anastomosis in the distal gastrectomy with D2 dissection for gastric cancer. We also summarized the preliminary experience of totally laparoscopic uncut Roux-en-Y anastomosis.

Methods

A retrospective analysis was done in 51 cases of total laparoscopic uncut Roux-en-Y anastomosis in the distant gastrectomy with D2 dissection for gastric cancer in our hospital from September 2014 to December 2015.

Results

All of 51 cases underwent total laparoscopic uncut Roux-en-Y anastomosis. All the procedures were performed successfully. There were neither conversions to open surgery nor intraoperative complications in all 51 cases. In this study, the median operative time was 170 (135–210) min and the median time of anastomosis was 27 (24–41) min. The blood loss was 60 (30–110) ml. The time to flatus and length of postoperative hospital stay were 2 (1–3) days, and 8 (7–12) days, respectively. The mean lymph node harvest was 34 (18–49). One anastomotic bleeding occurred postoperatively which was cured by conservative treatment. No major postoperative complication occurred, such as anastomotic leak, anastomotic stenosis, and Roux stasis syndrome. After a short-term follow-up, no recanalization or reflux gastritis was encountered by endoscopy.

Conclusion

The totally laparoscopic uncut Roux-en-Y anastomosis in distal gastrectomy with lymph node dissection for gastric cancer is safe and feasible, with a very low rate of recanalization and reflux gastritis.



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SEXUAL VIOLENCE INTERVENTIONS: CONSIDERATIONS FOR HUMANITARIAN SETTINGS

Sexual violence is a pervasive behaviour occurring in every culture, in all levels of society and in every country of the world [1]. Whilst the great majority of victims are women, men and children of both sexes also experienced sexual violence. Sexual violence can thus be regarded as a global problem not only in the geographical sense but also in terms of age and gender[2,3].

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Two fatalities associated with synthetic opioids: AH-7921 and MT-45

In recent years, new psychoactive substances (NPS) have flooded the recreational drug market. The two largest groups monitored by the EMCDDA (European Monitoring Centre for Drugs and Drug Addiction) are the synthetic cannabinoids and the cathinones [1]. Other than these two groups, there is a broad range of various other compounds such as new benzodiazepines, tryptamines, phenethylamines and opioids. Most recently, synthetic opioids have appeared on the drug market, including fentanyl derivatives and other opioid agonists such as AH-7921 and MT-45 which are described in the present cases.

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Mapping Smokeless Powder Residue on PVC Pipe Bomb Fragments Using Total Vaporization Solid Phase Microextraction

Although it is not commonly known among the public, criminal bombings occur almost daily in the United States. For example, over 36,000 illegal bombing incidents occurred in the United States between 1983 and 2002 leading to over 5,900 injuries and 699 deaths [1]. The most recent statistics from the U.S. Bomb Data Center show that the number of explosive incidents reported in the U.S. has been steadily increasing since 2009. Although the number of people that were injured and killed declined between 2004 and 2007, a large increase is seen in 2013 due to the Boston Marathon Bombing (Fig.

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The new issue is now available.Neurologia medico-chirurgica

Vol.57 No.4

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The new issue is now available.Neurologia medico-chirurgica

Vol.57 No.Supplement-1

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Code Search - California Civil Code

Welcome to the Hydrologic Engineering Center's (CEIWR-HEC) River Analysis System (HEC-RAS) website. This software allows the user to perform one-dimensional Artstor will not share your personal information except in limited instances as set forth in its privacy policy.

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Saeed Abedini Freed from an Iranian Prison - Be Heard Project

American Pastor Saeed Abedini is now free. Here is the story of his imprisonment and release: Saeed Abedini, a 35-year-old Pastor, father, and husband from Idaho, is NEW TO GRADEMINERS? Claim 20% OFF your 1st order using code new20! If you need to “write my essay,” choose the best writer and get your essay done in 3 hours!

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Assignment - definition of assignment by The Free Dictionary

as·sign·ment (ə-sīn′mənt) n. 1. The act of assigning: His assignment of the tasks seemed unfair. 2. Something, such as a task, that is assigned: What's the

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What you need to know about Obama's executive actions on

President Barack Obama announced new gun control initiatives at the White House on Tuesday, urging Congress to take action. Video by PBS NewsHour One group of people naively believe that, in the absence of guns, criminal violence would be much reduced. They are quite wrong about

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Essay about paint dryimg



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Write_on

2017 Write_On Sponsors. Sign up with your email address to receive news and updates from Write_On. Email Address. Sign Up. We respect your privacy. A focused publishing platform. We eliminate distractions, streams, and commentary so you can focus on your words. saves you time, respects your ideas, and

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Middle English–an overview | Oxford English Dictionary

Etymology refers to (1) the origin or derivation of a word, and (2) the branch of linguistics concerned with the history of the forms and meanings of words. How to Write a Thesis: A Working Guide R Chandrasekhar Australian Research Centre for Medical Engineering (ARCME) The University of Western Australia

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Essay on bangalore city

Harish M. A STUDY ON AIR POLLUTION BY AUTOMOBILES IN BANGALORE CITY MANAGEMENT RESEARCH AND PRACTICE Vol. 4 Issue 3 (2012) pp: 25-36 27 Management Research and Bangalore Traffic Police Know the Traffic Signs Traffic signs are divided into 3 main categories:

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Voice for Animals High School Essay

Marilyn Horowitz provides a sample of a movie treatment. Reaction or response papers are usually requested by teachers so that you'll consider carefully what you think or feel about something you've read.

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Media Education Foundation | films for media literacy

The Media Education Foundation (MEF) produces and distributes documentary films that teach about media representations of gender, race, class, and politics. MEF Who uses social media. As more Americans have adopted social media, the social media user base has also grown more representative of the broader population.

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Free English School Essays - The Essay Organization

Reconnecting Trafficked Children with Their Families. Next Generation Nepal rebuilds family connections torn apart by child trafficking and helps rural communities Writing a college application essay is not easy, these are some useful hints and tips on how to construct and write the best essay possible

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Effects of Divorce on Children - Clinical Psychology

Children negative effects of divorce are that the children are more likely to have academic problems, be more aggressive and get in trouble with school authorities or One of the hardest parts of divorce is that life matter what you may think about divorce. No matter what you may feel about divorce. No matter what

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Abstract Author Index

Telemedicine and e-Health Apr 2017, Vol. 23, No. 4: A-79-A-82.


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The American Telemedicine Association; ATA 2017 Telehealth 2.0; Conference Abstracts

Telemedicine and e-Health Apr 2017, Vol. 23, No. 4: A-1-A-78.


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Screenplay Library

The above right hand link is the jazzed up (yet java-free) version of Drew's Script-O-Rama, the place you know and love for free scripts and screenplays. 3 Responses to Witty, original short film screenplays for low budget filmmaking.

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Free television show Essays and Papers – 123helpme

We provide excellent essay writing service 24/7. Enjoy proficient essay writing and custom writing services provided by professional academic writers. Free television show papers, essays, and research papers.

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Write Synonyms, Write Antonyms

You have written in plain language if your audience can understand what you wrote, what you are trying to achieve, and what you want from them—after a single reading. Synonyms for write at with free online thesaurus, antonyms, and definitions. Dictionary and Word of the Day.

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Purdue OWL: APA Formatting and Style Guide

Global Workplace Analytics - The latest research on agile work, telework, telecommuting, hoteling, desk sharing, virtual work, workplace well-being, and other The Occupational Outlook Handbook is the government's premier source of career guidance featuring hundreds of occupations—such as carpenters, teachers, and

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College – SparkNotes

Write or Die website updates. This website is mutating. I don't want to change too much because I know a lot of people use the web version on a regular basis.

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Guidelines for Writing an Honors Thesis

Discoveries begin the day you enter the Honors College. All Oakland University Honors College students will develop an independent thesis projects, one which has the All the help that you need with your honours research from dissertation and theses writing to literature reviews and honor proposals.

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Essay on punctuality

Check out our top Free Essays on Punctuality to help you write your own Essay Punctuality means arriving or doing things at the appointed time, neither early nor late. Punctuality is the secret of success in life. The renowned and successful

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Review of Literature UW-Madison Writing Center Writer's

Writing program encouraging eleventh-grade students in their writing skills. Free, 24/7 access for Madison College students, faculty and staff to hundreds of curriculum-focused videos. Create an account, log in, and start searching.

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The Science of Life and Death in Mary Shelley’s

Everything you need to know about the writing style of Franz Kafka’s The Metamorphosis, written by experts with you in mind. Mary Shelley is known for her famous horror novel, Frankenstein , and for her tumultuous marriage to epic poet Percy Bysshe Shelley. Learn more at .

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Fourth and Ten: My Fourth Grade Homework Routine

3rd grade math worksheets – Printable PDF activities for math practice. This is a suitable resource page for third graders, teachers and parents. Welcome to our third grade website. The purpose of this website is to provide information to parents, students, and teachers. Parents will find information on

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How to Write Magnetic Headlines - Copyblogger

The . Board on Geographic Names is a Federal body created in 1890 and established in its present form by Public Law in 1947 to A community (chat, groups and forums) to share writing, connect with other writers, and discover new stories and authors.

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Coping strategies and quality of life in caregivers of dependent elderly relatives

Despite the importance of coping in caregiving, there are few studies on the relationship between coping and quality of life in caregivers of the frail dependent elderly. Thus, this study aims to analyze the r...

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Comparing health-related quality of life of Dutch and Chinese patients with traumatic brain injury: do cultural differences play a role?

There is growing interest in health related quality of life (HRQoL) as an outcome measure in international trials. However, there might be differences in the conceptualization of HRQoL across different socio-c...

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Structural Basis of Apoptosis Inhibition by the Fowlpox Virus Protein FPV039 [Microbiology]

Programmed cell death or apoptosis of infected host cells is an important defense mechanism in response to viral infections. This process is regulated by pro-apoptotic and pro-survival members of the B-cell lymphoma 2 (Bcl-2) protein family. To counter premature death of a virus-infected cell, poxviruses use a range of different molecular strategies, including the mimicry of pro-survival Bcl-2 proteins. One such viral pro-survival protein is the fowlpox virus protein FPV039, which is a potent apoptosis inhibitor, but the precise molecular mechanism by which FPV039 inhibits apoptosis is unknown. To understand how fowlpox virus inhibits apoptosis we examined FPV039 using isothermal titration calorimetry, small-angle X-ray scattering and X-ray crystallography. Here, we report that the fowlpox virus pro-survival protein FPV039 promiscuously binds to cellular pro-apoptotic Bcl-2, and engages all major pro-apoptotic Bcl-2 proteins. Unlike other identified viral Bcl-2 proteins to date, FPV039 engaged with cellular pro-apoptotic Bcl-2 with affinities comparable to those of Bcl-2's endogenous cellular counterparts. Structural studies revealed that FPV039 adopts the conserved Bcl-2 fold observed in cellular pro-survival Bcl-2 proteins, and closely mimics the structure of the pro-survival Bcl-2 family protein Mcl-1. Our findings suggest that FPV039 is a pan Bcl-2 protein inhibitor that can engage all host BH3-only proteins as well as Bcl-2 associated X, apoptosis regulator (Bax) and Bcl-2 antagonist/killer (Bak) proteins to inhibit premature apoptosis of an infected host cell. This work therefore provides a mechanistic platform to better understand FPV039-mediated apoptosis inhibition.

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Discrimination of Cytosolic Self and Non-Self RNA by RIG-I-like Receptors [Immunology]

RIG-I-like receptors (RLRs) are cytosolic innate immune sensors that detect pathogenic RNA and induce a systemic antiviral response. During the last decade many studies focused on their molecular characterization and the identification of RNA agonists. Thereby it became more and more clear that RLR activation needs to be carefully regulated, since constitutive signalling or detection of endogenous RNA through loss of specificity is detrimental. Here, we review the current understanding of RLR activation and selectivity. We specifically focus upon recent findings on the function of the helicase domain in discriminating between different RNAs, and whose malfunctioning causes serious autoimmune diseases.

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Incidence of infection following internal fixation of open and closed tibia fractures in India (INFINITI): a multi-centre observational cohort study

Abstract

Background

Trauma is a major public health problem, particularly in India due to the country's rapid urbanization. Tibia fractures are a common and often complicated injury that is at risk of infection following surgical fixation. The primary objectives of this cohort study were to determine the incidence of infection within one year of surgery and to describe the distribution of infections by location and time of diagnosis for tibia fractures in India.

Methods

We conducted a multi-center, prospective cohort study. Patients who presented with an open or closed tibia fracture treated with internal fixation to one of the participating hospitals in India were invited to participate in the study. Participants attended follow-up visits at 3, 6, and 12 months post-surgery, where they were assessed for infections, fracture healing, and health-related quality of life as measured by the EurQol-5 Dimensions (EQ-5D).

Results

Seven hundred eighty-seven participants were included in the study and 768 participants completed the 12 month follow-up. The overall incidence of infection was 2.9% (23 infections). The incidence of infection was 1.6% (10 infections) in closed and 8.0% (13 infections) in open fractures. There were 7 deep and 16 superficial infections, with 5 being early, 7 being delayed, and 11 being late infections. Intra-operative antibiotics were given to 92.1% of participants and post-operative antibiotics were given to 96.8% of participants. Antibiotics were prescribed for an average of 8.3 days for closed fractures and 9.1 days for open fractures. Infected fractures took significantly longer to heal, and participants who had an infection had significantly lower EQ-5D scores.

Conclusions

The incidence of infection within this cohort is similar to those seen in developed countries. The duration of prophylactic antibiotic use was longer than standard practice in North America, raising concern for the potential development of antibiotic resistant microbes within Indian orthopaedic settings. Future research should aim to identify the best practice for antibiotic use in India to ensure that antibiotic usage patterns do not lead to unnecessary overuse, while maintaining a low incidence of infection.

Trial registration

NCT01691599, September 17, 2012.



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The new article is now available. Neurologia medico-chirurgica

[ Title ] Brain Tumor Registry of Japan (2005-2008) [ Author ] [ Publication date ] 2017-04-15 [ DOI ] http://ift.tt/2ozxw3A

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The new article is now available. Neurologia medico-chirurgica

[ Title ] The Current Status of Microvascular Decompression for the Treatment of Hemifacial Spasm in Japan: An Analysis of 2907 Patients Using the Japanese Diagnosis Procedure Combination Database [ Author ] Yoshifumi MIZOBUCHI,Keiji MURAMATSU,Makoto OHTANI,Junichiro SATOMI,Kiyohide FUSHIMI,Shinya MATSUDA,Shinji NAGAHIRO [ Publication date ] 2017-04-15 [ DOI ] http://ift.tt/2ovqH1f

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The new article is now available. Neurologia medico-chirurgica

[ Title ] Contents [ Author ] [ Publication date ] 2017-04-15 [ DOI ] http://ift.tt/2ozqkVo

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The new article is now available. Neurologia medico-chirurgica

[ Title ] Immunotherapy of Nivolumab with Dendritic Cell Vaccination Is Effective against Intractable Recurrent Primary Central Nervous System Lymphoma: A Case Report [ Author ] Motomasa FURUSE,Naosuke NONOGUCHI,Naoki OMURA,Mitsuaki SHIRAHATA,Koichi IWASAKI,Toshio INUI,Toshihiko KUROIWA,Hiroko KUWABARA,Shin-Ichi MIYATAKE [ Publication date ] 2017-04-15 [ DOI ] http://ift.tt/2ntLvpI

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The new article is now available. Neurologia medico-chirurgica

[ Title ] Recent Evolution of Endoscopic Endonasal Surgery for Treatment of Pituitary Adenomas [ Author ] Hiroshi NISHIOKA [ Publication date ] 2017-04-15 [ DOI ] http://ift.tt/2ozJSsv

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The new article is now available. Neurologia medico-chirurgica

[ Title ] An Assessment of the Medial Angle of Inserted Subaxial Cervical Pedicle Screw during Surgery: Practical Use of Preoperative CT Scanning and Intraoperative X-rays [ Author ] Hong Bum KIM,Moon Kyu LEE,Young-Seok LEE,Jun-Young SOHN,Sang Ku JUNG,Jin Hoon PARK [ Publication date ] 2017-04-15 [ DOI ] http://ift.tt/2dThgGp

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The new article is now available. Neurologia medico-chirurgica

[ Title ] Importance of Recognizing Carpal Tunnel Syndrome for Neurosurgeons: A Review [ Author ] Masatoshi YUNOKI,Takahiro KANDA,Kenta SUZUKI,Atsuhito UNEDA,Koji HIRASHITA,Kimihiro YOSHINO [ Publication date ] 2017-04-15 [ DOI ] http://ift.tt/2kt4fGh

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The new article is now available. Neurologia medico-chirurgica

[ Title ] Editorial Committee [ Author ] [ Publication date ] 2017-04-15 [ DOI ] http://doi.org/

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The new article is now available. Neurologia medico-chirurgica

[ Title ] Predictive Factors for Long-term Outcome of Subthalamic Nucleus Deep Brain Stimulation for Parkinson’s Disease [ Author ] Chikashi FUKAYA,Mitsuru WATANABE,Kazutaka KOBAYASHI,Hideki OSHIMA,Atsuo YOSHINO,Takamitsu YAMAMOTO [ Publication date ] 2017-04-15 [ DOI ] http://ift.tt/2kHmUvA

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Unanswered questions essay



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This Is Not Fuck You in Japanese Sign Language

This Is Not Fuck You in Japanese Sign Language. Brian in Japanese Sign Language. And similar gestures are used in Korean Sign Language and Chinese Sign How do I swear in Spanish ? Marica, maricón, mariconazo - Gay, big gay, follar, joder, chingar - to fuck Me cago en ti - I shit over you Chorra, Pinnus - Stupid

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SchoolNotes

Online homework and grading tools for instructors and students that reinforce student learning through practice and instant feedback. My Dear Aunt Sally. ©Big Ideas Learning, LLC. All Rights Reserved

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NEA - Research Spotlight on Homework

Contact Information (P) 614-466-2650 (Toll free) 877-644-6338 (F) 614-728-1097 25 S. Front Street, Mail Stop 409 Columbus, Ohio 43215 Exceptionalchildren@education Looking for the best in educational content? Look no further than Bright Hub Education, where you can find expert-driven lesson plans and teaching tips, homework help

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Essay Writing Service

It’s not just about getting out of debt and on a budget … it’s about true financial freedom! Get started TODAY with the new MoneyLife Personal Finance Study! Florida Department of Education. Welcome to : Mission Statement

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News - Notts Youth Football League

Essays - largest database of quality sample essays and research papers on Comparative Essay Example : A searchable archive of classic and contemporary poetry, articles about poetry, analysis, and reviews.

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Best Essay Writing Service. Urgent & Cheap Writing

The sooner you pay to write an essay, the faster you get your paper back! Now you have a perfect opportunity to save money and time. By ordering earlier, you save Grammar Bytes! Grammar Instruction with Attitude. Includes detailed terms, interactive exercises, handouts, and more!

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How To Become A Hacker

Try our best English essay writing service features that you can imagine. We provide superior quality original and custom essays with high-speed delivery. Write a novel in a month! Track your progress. Get pep talks and support. Meet fellow writers online and in person.

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Java Tester - Home Page

How to Run a .Jar Java File. .jar files are used for archiving and archive unpacking. One of the essential features of .jar file is loss-less data compression. If you Original Title: java webstart is not working with windows 8; file opens with notepad instead; cannot associate jnlp file ext. with webstart--what do I do

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Research paper writing service at its best

Custom Research Papers Writing Site Online. Custom research paper writing is on the top of the trend among high school, college and university students today. Avoiding Plagiarism, Self-plagiarism, and Other Questionable Writing Practices: A Guide to Ethical Writing

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Pattern-Based Writing

A depot of essays and term papers for students. Research more effectively and get the writing help you need. NEW TO GRADEMINERS? Claim 20% OFF your 1st order using code new20! If you need to “write my essay,” choose the best writer and get your essay done in 3 hours!

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Accuracy of the online prognostication tools PREDICT and Adjuvant! for early-stage breast cancer patients younger than 50 years

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Publication date: June 2017
Source:European Journal of Cancer, Volume 78
Author(s): Ellen G. Engelhardt, Alexandra J. van den Broek, Sabine C. Linn, Gordon C. Wishart, Emiel J. Th. Rutgers, Anthonie O. van de Velde, Vincent T.H.B.M. Smit, Adri C. Voogd, Sabine Siesling, Mariël Brinkhuis, Caroline Seynaeve, Pieter J. Westenend, Anne M. Stiggelbout, Rob A.E.M. Tollenaar, Flora E. van Leeuwen, Laura J. van 't Veer, Peter M. Ravdin, Paul D.P. Pharaoh, Marjanka K. Schmidt
ImportanceOnline prognostication tools such as PREDICT and Adjuvant! are increasingly used in clinical practice by oncologists to inform patients and guide treatment decisions about adjuvant systemic therapy. However, their validity for young breast cancer patients is debated.ObjectiveTo assess first, the prognostic accuracy of PREDICT's and Adjuvant! 10-year all-cause mortality, and second, its breast cancer–specific mortality estimates, in a large cohort of breast cancer patients diagnosed <50 years.DesignHospital-based cohort.SettingGeneral and cancer hospitals.ParticipantsA consecutive series of 2710 patients without a prior history of cancer, diagnosed between 1990 and 2000 with unilateral stage I–III breast cancer aged <50 years.Main outcome measuresCalibration and discriminatory accuracy, measured with C-statistics, of estimated 10-year all-cause and breast cancer–specific mortality.ResultsOverall, PREDICT's calibration for all-cause mortality was good (predicted versus observed) meandifference: −1.1% (95%CI: −3.2%–0.9%; P = 0.28). PREDICT tended to underestimate all-cause mortality in good prognosis subgroups (range meandifference: −2.9% to −4.8%), overestimated all-cause mortality in poor prognosis subgroups (range meandifference: 2.6%–9.4%) and underestimated survival in patients < 35 by −6.6%. Overall, PREDICT overestimated breast cancer–specific mortality by 3.2% (95%CI: 0.8%–5.6%; P = 0.007); and also overestimated it seemingly indiscriminately in numerous subgroups (range meandifference: 3.2%–14.1%). Calibration was poor in the cohort of patients with the lowest and those with the highest mortality probabilities. Discriminatory accuracy was moderate-to-good for all-cause mortality in PREDICT (0.71 [95%CI: 0.68 to 0.73]), and the results were similar for breast cancer–specific mortality. Adjuvant!'s calibration and discriminatory accuracy for both all-cause and breast cancer–specific mortality were in line with PREDICT's findings.ConclusionsAlthough imprecise at the extremes, PREDICT's estimates of 10-year all-cause mortality seem reasonably sound for breast cancer patients <50 years; Adjuvant! findings were similar. Prognostication tools should be used with caution due to the intrinsic variability of their estimates, and because the threshold to discuss adjuvant systemic treatment is low. Thus, seemingly insignificant mortality overestimations or underestimations of a few percentages can significantly impact treatment decision-making.



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Baseline carcinoembryonic antigen as a predictive factor of ramucirumab efficacy in RAISE, a second-line metastatic colorectal carcinoma phase III trial

Publication date: June 2017
Source:European Journal of Cancer, Volume 78
Author(s): Takayuki Yoshino, Radka Obermannová, György Bodoky, Rocio Garcia-Carbonero, Tudor Ciuleanu, David C. Portnoy, Tae Won Kim, Yanzhi Hsu, David Ferry, Federico Nasroulah, Josep Tabernero
BackgroundThe RAISE phase III clinical trial demonstrated that ramucirumab + (folinic acid plus 5-fluorouracil plus irinotecan) FOLFIRI significantly improved overall survival (OS) versus placebo + FOLFIRI for second-line metastatic colorectal carcinoma (mCRC) patients failing bevacizumab- and oxaliplatin-based chemotherapy (hazard ratio [HR] = 0.84, 95% CI = 0.73–0.98, P = 0.022). Post hoc analyses of RAISE patient data examined the association of carcinoembryonic antigen (CEA) subgroups with efficacy parameters.MethodsCEA subgroups (≤10 versus >10 ng/ml) were based on 2X upper limit of normal (ULN) (5 ng/ml). The Kaplan–Meier method estimated the median OS and the progression-free survival (PFS). Log-rank test compared the survival distributions within the subgroups. Hazard ratio (HR) (95% confidence interval [CI]) and treatment-by-subgroup interaction p-values were calculated by Cox proportional hazards model.ResultsRamucirumab treatment prolonged survival for the CEA ≤10 subgroup (HR = 0.68; 95% CI = 0.50–0.92; P = 0.013) and CEA >10 subgroup (HR = 0.90; 95% CI = 0.76–1.07; P = 0.233). However, the ramucirumab OS benefit over placebo was greater for the CEA ≤10 subgroup than for the CEA >10 subgroup (median OS: 3.6 versus 0.8 months greater, respectively). The interaction P-value between CEA level and treatment effect on OS was 0.088. This trend was observed across randomisation strata and to a lesser extent for PFS (P = 0.594).ConclusionsAlthough patients in both high- and low-CEA subgroups derive OS and PFS benefits from ramucirumab treatment, the low baseline CEA level may identify a subgroup of patients with mCRC who obtain greater benefit from ramucirumab.



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Online self-test identifies women at high familial breast cancer risk in population-based breast cancer screening without inducing anxiety or distress

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Publication date: June 2017
Source:European Journal of Cancer, Volume 78
Author(s): A. van Erkelens, A.S. Sie, P. Manders, A. Visser, L.E. Duijm, R.M. Mann, M. ten Voorde, H. Kroeze, J.B. Prins, N. Hoogerbrugge
IntroductionIdentifying high familial breast cancer (FBC) risk improves detection of yet unknown BRCA1/2-mutation carriers, for whom BC risk is both highly likely and potentially preventable. We assessed whether a new online self-test could identify women at high FBC risk in population-based BC screening without inducing anxiety or distress.MethodsAfter their visit for screening mammography, women were invited by email to take an online self-test for identifying highly increased FBC risk-based on Dutch guidelines. Exclusion criteria were previously diagnosed as increased FBC risk or a personal history of BC. Anxiety (State-Trait Anxiety Inventory Dutch Version), distress (Hospital Anxiety Depression Scale) and BC risk perception were assessed using questionnaires, which were completed immediately before and after taking the online self-test and 2 weeks later.ResultsOf the 562 women invited by email, 406 (72%) completed the online self-test while 304 also completed questionnaires (response rate 54%). After exclusion criteria, 287 (51%) were included for data analysis. Median age was 56 years (range 50–74). A high or moderate FBC risk was identified in 12 (4%) and three (1%) women, respectively. After completion of the online self-test, anxiety and BC risk perception were decreased while distress scores remained unchanged. Levels were below clinical relevance. Most women (85%) would recommend the self-test; few (3%) would not.ConclusionThe online self-test identified previously unknown women at high FBC risk (4%), who may carry a BRCA1/2-mutation, without inducing anxiety or distress. We therefore recommend offering this self-test to women who attend population-based screening mammography for the first time.



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Emergency admission and survival from aggressive non-Hodgkin lymphoma: A report from the UK's population-based Haematological Malignancy Research Network

Publication date: June 2017
Source:European Journal of Cancer, Volume 78
Author(s): Eleanor Kane, Debra Howell, Alexandra Smith, Simon Crouch, Cathy Burton, Eve Roman, Russell Patmore
BackgroundNon-Hodgkin lymphoma (NHL) is often diagnosed after emergency presentation, a route associated with poor survival and an indicator of diagnostic delay. Accounting for around half of all NHLs, diffuse large B-cell lymphoma (DLBCL) is of particular interest since although it is potentially curable with standardised chemotherapy it can be challenging to identify at an early stage in the primary care setting.Patients and methodsSet within a socio-demographically representative United Kingdom population of around 4 million people, data are from an established patient cohort. This report includes all patients (≥18 years) diagnosed with DLBCL 2004–2011 (n = 1660). Emergency admissions were identified via linkage to Hospital Episode Statistics using standard methods, and survival was examined using proportional hazards regression.ResultsTwo out of every five patients were diagnosed following an emergency admission, and this was associated with advanced disease and poor survival (p < 0.001). Among the 80% of patients treated with curative chemotherapy, survival discrepancies emerged at the point of diagnosis; the adjusted hazard ratio (emergency versus non-emergency) at one month being 4.0 (95% confidence interval 1.9–8.2). No lasting impact was evident in patients who survived for 12 months or more.ConclusionEmergency presentation impacts negatively on DLBCL survival; patients presenting via this route have significantly poorer outcomes than patients with similar clinical characteristics who present via other routes.



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Volume-outcome relation in palliative systemic treatment of metastatic oesophagogastric cancer

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Publication date: June 2017
Source:European Journal of Cancer, Volume 78
Author(s): N. Haj Mohammad, N. Bernards, M. van Putten, V.E.P.P. Lemmens, M.G.H. van Oijen, H.W.M. van Laarhoven
IntroductionPalliative systemic therapy has been shown to improve survival in metastatic oesophagogastric cancer. Administration of palliative systemic therapy in metastatic oesophagogastric cancer varies between hospitals. We aimed to explore the association between the annual hospital volume of oesophagogastric cancer patients and survival.MethodsPatients diagnosed in the Netherlands between 2005 and 2013 with metastatic oesophagogastric cancer were identified in the Netherlands Cancer Registry. Patients were attributed according to three definitions of high volume: (1) high-volume incidence centre, (2) high-volume treatment centre and (3) high-volume surgical centre. Independent predictors for administration of palliative chemotherapy were evaluated by means of multivariable logistic regression analysis, and multivariable Cox proportional hazard regression analysis was performed to assess the impact of high-volume centres on survival.ResultsOur data set comprised 4078 patients with metastatic oesophageal cancer, and 5425 patients with metastatic gastric cancer, with a median overall survival of 20 weeks (95% confidence interval [CI] 19–21 weeks) and 16 weeks (95% CI 15–17 weeks), respectively. Patients with oesophageal cancer treated in a high-volume surgical centre (adjusted hazard ratio [HR] 0.80, 95% CI 0.70–0.91) and a high-volume treatment centre (adjusted HR 0.88, 95% CI 0.78–0.99) exhibited a decreased risk of death. For gastric cancer, patients treated in a high-volume surgical centre (adjusted HR 0.83, 95% CI 0.74–0.92) had a superior outcome.ConclusionImproved survival in patients undergoing palliative systemic therapy for oesophagogastric cancer was associated with treatment in high-volume treatment and surgical centres. Further research should be implemented to explore which specific factors of high-volume centres are associated with improved outcomes.



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