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Jake Jordan,1 Heather Gage,1 Barbara Benton,2 Amyn Lalji,2 Christine Norton,3 H Jervoise N Andreyev2 1Surrey Health Economics Centre, School of Economics, University of Surrey, Guildford, 2Gastrointestinal Unit, Royal Marsden NHS Foundation Trust, 3Florence Nightingale Faculty of Nursing and Midwifery, King’s College, London, UK Background: Over 20 distressing gastrointestinal symptoms affect many patients after pelvic radiotherapy, but in the United Kingdom few are referred for assessment. Algorithmic-based treatment delivered by either a consultant gastroenterologist or a clinical nurse specialist has been shown in a randomized trial to be statistically and clinically more effective than provision of a self-help booklet. In this study, we assessed cost-effectiveness.Methods: Outcomes were measured at baseline (pre-randomization) and 6 months. Change in quality-adjusted life years (QALYs) was the primary outcome for the economic evaluation; a secondary analysis used change in the bowel subset score of the modified Inflammatory Bowel Disease Questionnaire (IBDQ-B). Intervention costs, British pounds 2013, covered visits with the gastroenterologist or nurse, investigations, medications and treatments. Incremental outcomes and incremental costs were estimated simultaneously using multivariate linear regression. Uncertainty was handled non-parametrically using bootstrap with replacement.Results: The mean (SD) cost of treatment was £895 (499) for the nurse and £1101 (567) for the consultant. The nurse was dominated by usual care, which was cheaper and achieved better outcomes. The mean cost per QALY gained from the consultant, compared to usual care, was £250,455; comparing the consultant to the nurse, it was £25,875. Algorithmic care produced better outcomes compared to the booklet only, as reflected in the IBDQ-B results, at a cost of ~£1,000.Conclusion: Algorithmic treatment of radiation bowel injury by a consultant or a nurse results in significant symptom relief for patients but was not found to be cost-effective according to the National Institute for Health and Care Excellence (NICE) criteria. Keywords: pelvic radiotherapy, algorithmic care, gastroenterologist, clinical nurse specialist

Male and female rats were whole-body exposed to VX vapor in a 1000-L single-pass exposure chamber. Estimated exposure dosages producing lethal (LCT50) effects in 50% of exposed male and female rats were established for 10, 60, and 240 min exposure durations. A potency comparison with GB and GF shows that VX becomes increasingly more potent than these G agents with increasing exposure duration. VX is approximately 4–30 times more potent than GB and 5–15 times more potent than GF. Gender differences in the estimated median dosages were not significant at the 10, 60, and 240 min exposure durations. An empirical toxic load model was developed and the toxic load exponent for lethality (n) in the equation Cn× T = k was determined to be n = 0.92. The VX–G regeneration assay was successfully used as a biomarker for the presence of VX in the blood plasma and RBC fractions of the blood 24 h postexposure. [ABSTRACT FROM AUTHOR]

The article focuses on the development of neurotransmitters by microdialysis sampling in the pharmacological aspect. A synapse comprises a presynaptic terminal and a post-synaptic bouton divided by a gap. Chemicals release into the synaptic gap move with receptors on the post-synaptic neuron. Transporter proteins stop the chemical signal. The paper supplies the factors resulting to the contention with translating microdialysis data. Microdialysis sampling offers substantial insights into brain function when appropriate care is taken in interpreting results.

Background.—Military hospitals currently use gestational age-specific growth curves based on data collected in Denver, Colo, from 1948 to 1961. A number of population and environmental factors and medical practice changes may make ihese curves nonrepresentative. Objective.—Determine if presently used growth curves represent norms for infants born in military hospitals and create new curves for use in military hospitals. Methods.—Data were collected from medical records of tertiary- and primary-care military hospitals. We created growth curves created for birth weight, length, and head circumference and compared these curves at gestational ages 23–42 weeks to previously published norms and to 1998 national vital statistics. Racial and ethnic differences between groups were compared. A retrospective analysis of blood-glucose measurements for healthy term infants was performed to identify potential safety issues. Results.—Significant increases in growth parameters were noted for infants born in military hospitals. Specific racial and ethnic groups within the military also had an increase when compared with these groups in the United States as a whole. Less than 1% of infants classified as large for gestational age (LGA) according by old standards but average for gestational age (AGA) according to new curves experienced hypoglycemia. Conclusion.—Published growth curves may not represent infants born in military hospitals. Term infants born in military hospitals as a group and in racial and ethnic subgroups are larger than term infants born in US civilian hospitals. Prospective use of curves will help to validate their long-term applicability in military and civilian nurseries. [ABSTRACT FROM AUTHOR]

Describes the evolution of the partnership between various health and development agencies in Africa. Details on the campaign against river blindness; Socio-economic consequences of onchocerciasis; Prospects of adapting the various strategies of the African Programme for Onchocerciasis Control.

Investigates the effect of the African Programme for Onchocerciasis (APOC) on the economy. Cost-effectiveness of APOC; Economic rate of return; Reduction in health-related expenditures.

Presents news briefs on languages in the U.S. as of February 1931. Several meanings of blow-out; Application of the term ham on human anatomy; Expressions used in Boyd County.

Dry-aging is a practice that involves storing meat at refrigerated temperatures without protective packaging. Despite the increase in dry-aged beef popularity, relatively little is known about commercial dry-aging parameters. Thus, the objectives of this study were to determine dry-aging parameters of commercial aging facilities and their influence on eating quality (acceptability, flavor, tenderness, and juiciness) of dry-aged beef from locations across the United States. Sixty-six Certified Angus Beef® brand bone-in beef strip loins (IMPS #175) were randomly assigned to ten commercial dry-aging facilities across the United States. An additional six strip loins were wet-aged for 45-days as a negative control. Strip loins were shipped overnight to aging locations where a 45-day dry aging period transpired before being returned for subsequent analysis, upon completion of aging. Objective color, pH, and water activity were measured post aging, at the time of processing. Strip loins were then fabricated, and steaks were vacuum packaged and frozen until further analysis. Intrinsic quality parameters objective color (L*, a*, b*), pH, and water activity were not different (P > 0.05) between strip loins aged 45 days by location. Cooler conditions including temperature, percent relative humidity, and air speed were different (P < 0.01) across aging locations. Pacific Northwest consumer panelists indicated a difference in overall acceptability (P < 0.01), tenderness (P = 0.01), and flavor (P < 0.01) based on aging location. Additionally, consumers detected (P < 0.01) unique dry-aging flavors for individual aging locations including cheesy and nutty attributes. Research indicates individual dry-aging facility conditions aid in producing unique dry-aged beef products according to U.S. consumers from the Pacific Northwest Region. [ABSTRACT FROM AUTHOR]

There is considerable effort in the area of proteomics to map and catalog the unique proteomic profile of each organelle. Subcellular fractionation enables the simplification of complex protein mixtures and thereby facilitates this type of proteomic analysis. Pierce developed three organelle enrichment kits for lysosomes, peroxisomes, and nuclei that enable enrichment of intact organelles from cells and/or tissue. Mechanical lysis was employed to effectively lyse cells and tissue, and density gradient centrifugation was used as a method to separate each organelle of interest. The procedure was optimized for diverse cell lines, including A431, HeLa, and HepG2 as well as multiple tissues from Sprague-Dawley rats including liver, heart, and kidney. The purity of the isolated organelles was assessed by Western blot analysis using antibodies against specific marker proteins on targeted organelles. Benchmarking was performed against commercially available kits and a higher yield with significantly less contamination was demonstrated with each of the Pierce protocols. Isolated organelles may be used for a number of downstream applications, including 2D/MS, electron microscopy, disease profiling, gene expression, signal transduction, and interaction or localization studies. [ABSTRACT FROM AUTHOR]

We describe the challenges and opportunities we encountered when developing a hybrid version of the Linpack benchmark for the Los Alamos National Laboratory Roadrunner supercomputing system, which combines traditional x86-64 host processors with IBM PowerXCelle™ 8i accelerator processors. The challenges included determining the proper division of the host and accelerator roles in the computation, transfer of data between the host and accelerator memory domains, alignment of data for communication and computation, and data format differences between the two processors. We also describe our approach to modeling the performance of the hybrid system and compare our performance estimates to witnessed performance on the system at different scales and levels of memory consumption. Through careful attention to these issues, we have produced a hybrid version of the Linpack benchmark for the Roadrunner system that achieves 77.8% of peak performance on a single compute node and 74.6% of peak performance over the entire system, making this system the first to achieve a Linpack result exceeding one petaflops (1015 floating-point operations per second). [ABSTRACT FROM AUTHOR]

Demonstrates the beneficial effects of several treatments of onchocerciasis with ivermectin in Nigerian women. Social consequences of skin improvement in two Nigerian women; Decreased itching and a much better appearance of the skin; Very little improvement in the atrophy.

Establishes a sustainable community-directed treatment with ivermectin in onchocerciasis-endemic areas outside of the remit of the Onchocerciasis Control Programme in West Africa. Treatment of individuals with onchocerciasis; Details on the strengthening of primary health care through capacity building; Functional integration of health care activities.

Background: Superselective lateral neck dissection (SSND), defined as dissection of 2 or less contiguous lateral cervical nodal levels, has emerged as a treatment option for metastatic papillary thyroid carcinoma (PTC), in place of a selective neck dissection (SND). There are few studies exploring outcomes of SSND compared to SND in this context., Materials and Methods: This was a single institution retrospective study. All patients who were diagnosed with PTC and had a lateral neck dissection from 2019 to 2022 were reviewed. Patient demographics and outcomes were compared., Results: A total of 136 patients met inclusion criteria. About 106 (78%) had a SND and 30 (22%) had a SSND. There was no significant difference between patients who underwent SND versus SSND regarding frequency of post-operative complications, length of stay (2.49 vs 2.31 days), post-operative thyroglobulin >10 ng/mL (21 vs 3 patients), regional recurrence (14% vs 17%), reoperation rates (16.7% vs 17.4%), or adjuvant radioactive iodine therapy (75% vs 63%; P  > .05)., Conclusions: SSND for PTC had similar short-term clinical outcomes when compared to SND., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Chromatin plays a pivotal role in genome expression, maintenance, and replication. To better understand chromatin organization, we developed a novel proximity-tagging method which assigns unique DNA barcodes to molecules that associate in 3D space. Using this method - Proximity Copy Paste (PCP) - we mapped the connectivity of individual nucleosomes in Saccharomyces cerevisiae . We show that chromatin is predominantly organized into regularly spaced nucleosome arrays whose properties differ according to transcriptional activity. Additionally, by mapping long-range, multi-way interactions we provide evidence that metaphase chromosomes are compacted by arrayed cohesin hubs. Using single-molecule nuclease footprinting data we define distinct chromatin states within a mixed population to show that noncanonical nucleosomes are a stable feature of chromatin. PCP is a versatile method allowing the connectivity of individual molecules to be mapped at high-resolution.

Pathogen removal in wastewater offers a chance to recover water and nutrients for crop production, reducing environmental contamination and public health risks. However, the risk of pathogens regrowing in treated effluents can endanger public health if reused in agriculture, attracting stringent reuse standards. While advanced oxidation processes (AOPs) promise to reduce pathogens, eliminating regrowth potential in AOP-treated effluents requires further scrutiny. This review aimed to summarize the available evidence on understanding pathogen reduction and regrowth potential in AOP-treated effluents, following best practices for scoping reviews like the preferred reporting items for systematic reviews and meta-analysis (PRISMA). It covers recent pathogen studies under AOPs, current AOP investigations, the impact of AOP dosage and retention time on pathogen control, and challenges in reusing AOP-treated effluents for crop production. Additionally, it identifies areas needing improvement or complementary treatments for pathogen-free effluents with no regrowth potential. The review concludes by summarizing key findings and suggesting research areas for further exploration., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Regenerating Family Member 3 Alpha (REG3A) is an antimicrobial protein secreted by the intestine and pancreas with additional immunomodulatory properties. Previously, we published that REG3A expression in ischemic stroke patient systemic blood, during mechanical thrombectomy (MT), is significantly associated with inflammatory cytokines and patient function on admission. This paper, however, did not investigate post-acute death rates. Therefore, we investigated plasma REG3A protein expression, during MT, in patients (n = 141) that survived or died within the end of the follow-up after MT. Subjects who died had significantly higher systemic plasma REG3A levels at the time of MT compared to survivors ( p = 0.001). Age, sex, time from last known normal, and admission NIHSS were included as predictors to control for confounding variables and were all examined to determine their association in patient mortality. Logistic regression was used to demonstrate that higher odds of death were associated with increased REG3A levels ( p = 0.002). REG3A demonstrated acceptable discrimination (AUC (95% CI): 0.669 (0.566-0.772) in predicting mortality. The overall model with age, sex, time from last known normal, and admission NIHSS discriminated well between survivors and those who died (AUC (95% CI): 0.784 (0.703-0.864)). In conclusion, REG3A could be promising as a biomarker to prognosticate stroke outcomes and stratify high-risk groups following acute ischemic stroke.

Background: Discoid lateral meniscus (DLM) is the most common congenital abnormality of the meniscus. Tears are common; treatment is frequently not definitive, often requiring reoperation., Purpose: To report the clinical manifestations, physical characteristics, operative treatments and findings, complications, and reoperations of DLM in pediatric patients from multiple centers across North America., Study Design: Case series; Level of evidence, 4., Methods: Consecutive patients who underwent treatment for symptomatic DLM at 9 institutions between 2000 and 2020 were included. Patient data, presenting symptoms and signs, surgical findings, treatments rendered, and postoperative complications, including reoperation rates, were collected. Means with ranges and counts with proportions are reported for continuous and categorical variables, respectively, and comparisons were made using either the chi-square or Fisher exact test., Results: In total, 784 patients (867 knees) were included with a mean age at diagnosis of 12 years (range, 1-22 years) and a mean follow-up of 22.6 months (range, 0-154 months). Common preoperative symptoms were locking (33%) and snapping (30%). At surgery, tears in the DLM were present in 647 knees (594 patients [76%]); 95 knees (11%) had multiple tears; and in 140 knees, tears extended into >1 zone. Tears, when present, were more common within the posterior horn (41%) or body (34%) than the anterior horn (25%). Peripheral rim instability was reported in 241 knees (28%). Significantly more knees had instability posteriorly (15%; P = .0004) and anteriorly (9%; P = .0013) than along the body (3%). Tear type was most commonly complex (38%) or horizontal (34%). A total of 358 knees in 333 patients with tears (42% of all patients) underwent repair (55% of knees with tears). A total of 175 complications were reported, occurring in 139 knees in 134 patients (17%); 116 of these knees with complications (83%) had a single complication, while 23 (17%) had >1. Of the 784 patients, 105 (13%) underwent reoperation, undergoing 135 additional procedures related to their DLM. Of those, 60 (44%) were repeat arthroscopy and meniscal trim; 40 (30%), arthroscopy and meniscal repair; and 17 (13%), an articular cartilage procedure., Conclusion: Locking and snapping were common presenting symptoms. Over three-quarters of patients had meniscal tears, which were most often complex and located posteriorly. Seventeen percent of patients experienced complications, and a sixth of patients with complications had >1. Reoperation was typically for persistent symptoms or meniscal retear., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: G.A.S. has received educational and research support from Arthrex and Summit Surgical. S.C. has received support from Stryker and Smith & Nephew for education and presentations. Z.S.S. has received consulting fees from Arthrex. C.J.F. has received support for education from Arthrex. R.J.L. has received research support from Vericel. D.W.G. has received royalties and consulting fees from Arthrex Inc; royalties from Pega Medical; hospitality payments from OrthoPediatrics; and speaker fees from Synthes. J.A.S. has received consulting fees from Arthrex and Micromed. B.H. has received consulting fees from and holds stock in Imagen Technologies and has received fees for education and education consulting from Arthrex and Kairos. E.L.N. has received support for education from Supreme Orthopedic Systems and Arthrex. T.S. has received support for education from MedInc of Texas. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Objective: Respiratory arrest plays an important role in sudden unexpected death in epilepsy (SUDEP). Adenosine is of interest in SUDEP pathophysiology due to its influence on seizures and breathing. The objective of this investigation was to examine the role of adenosine in seizure severity, seizure-induced respiratory disruption, and seizure-induced death using mouse models. Understanding adenosinergic contributions to seizure cessation and seizure-induced death may provide insights into how SUDEP can be prevented while avoiding increased seizure severity., Methods: Our approach was to examine: (1) seizure severity and seizure-induced death after 15 mA electroshock seizures and during repeated pentylenetetrazol (PTZ) administration in wild-type mice (Adk +/+ ) and transgenic mice with reduced adenosine metabolism (Adk +/- ); (2) the postictal hypercapnic ventilatory response (HCVR) in wild-type mice (the postictal HCVR could not be examined in Adk +/- mice due to their high mortality rate); and (3) the effects of adenosinergic drugs on seizure severity and seizure-induced death following maximal electroshock (MES)., Results: Adk +/- mice were more vulnerable to seizure-induced death in the 15 mA electroshock and repeated PTZ models. Despite increased mortality, Adk +/- mice had comparable seizure severity in the PTZ model and reduced seizure severity in the 15 mA electroshock model. Breathing and HCVR were suppressed by 15 mA electroshock seizures in wild-type mice. Pharmacological inhibition of adenosine metabolism decreased MES seizure severity but did not increase mortality. A 1 selective and nonselective adenosine receptor antagonists increased seizure-induced death following MES., Significance: Adenosine has opposing effects on seizure severity and seizure-induced death. On the one hand, our seizure severity data highlight the importance of adenosine in seizure suppression. On the other hand, our mortality data indicate that excessive extracellular adenosine signaling can increase the risk of seizure-induced respiratory arrest., (© 2024 The Author(s). Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)