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• Extensive resection in chest wall malignancy is mandatory, oftentimes leaving large defects that affect normal respiration. • Various materials for chest wall reconstruction are at hand but a definite guideline is not yet available. • Titanium meshes provide the suitable strength, rigidity, and flexibility for a chest wall reconstruction material. • Titanium mesh is a promising alternative for a chest wall reconstruction material. Some chest wall tumors require extensive excision that alters its stability and integrity. Various materials are available as a prosthetic albeit currently lacking in clear guidelines regarding the material of choice. Titanium-based mesh offers appropriate properties for chest wall reconstruction, making it a promising choice of prosthetic. A 50-year-old male presenting with a chest lump was suspected of a chondrosarcoma of the chest wall. Preoperative pulmonary rehabilitation and smoking cessation was performed 1 month prior to surgery. After a wide excision procedure, we utilized titanium mesh as a reconstructive material. Pathology evaluation reported the examined tissue as a myxofibrosarcoma. The patient was successfully weaned off of ventilator in less than 24 h with satisfactory postoperative outcome. The various available material has each of its strengths and drawbacks and it is crucial to choose the most fitting option to acquire better postoperative outcome as well as maintaining the quality of life. The use of titanium mesh in thoracic reconstruction has not been widely explored and reported, therefore, it is important to underline its advantages and disadvantages as a potential choice for prosthetic. Titanium mesh provides appropriate features for a chest wall reconstruction; therefore, it can be considered as a promising alternative material. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the topographic matching of oblong osteochondral allografts to treat large oval medial femoral condyle (MFC) lesions using computer simulation models. The secondary objective was to determine whether lateral femoral condyle (LFC) grafts would have a similar surface matching when compared with MFC grafts in this setting.Methods: Human femoral hemicondyles (10 MFCs, 7 LFCs) underwent 3-dimensional computed tomography. Models were created from computed tomography images and exported into point-cloud models. Donor-recipient matches with large condylar width mismatch were excluded. The remaining specimen were divided into 3 donor-recipient groups with 2 defect sizes (17 × 30 mm and 20 × 30 mm): 20 MFC donor (MFCd)-MFC recipient (MFCr), 27 ipsilateral LFC donor (LFCd)-MFCr, and 26 contralateral LFCd-MFCr. Grafts were optimally virtually aligned with the MFCr defect. Mismatch of the articular cartilage and subchondral bone surfaces between the graft and the defect and articular step-off were calculated.Results: MFCd grafts resulted in articular cartilage surface mismatch and peripheral step of less than 0.5 mm for both defect sizes. The subchondral bone surface mismatch was significantly greater than the articular cartilage surface mismatch (P < .01) in both defect sizes). Conversely, the ipsilateral and contralateral LFCd grafts resulted in significantly greater articular cartilage surface mismatch and step-off for both defect sizes when compared to MFCd grafts (P < .01).Conclusions: Oblong MFC allografts provide acceptable topographic matching for large oval MFC lesions when condylar width differences are minimized. However, concern exists in using oblong LFC allografts for MFC defects, as this can result in increased peripheral step-off and surface mismatch.Clinical Relevance: These data reinforce the ability to use oblong MFC osteochondral allograft for treating oval cartilage lesions of the MFC when condylar width is considered. Although other studies have demonstrated LFCs can be used to treat circular defects on the MFC, this may not be true for oblong grafts. [ABSTRACT FROM AUTHOR]

Purpose: To investigate patient return to sport and satisfaction after meniscal allograft transplantation (MAT).Methods: Patients undergoing MAT using a bone bridge technique between 2013 and 2015 with minimum 2-year follow-up were retrospectively reviewed. They completed a survey regarding return to sport, satisfaction, and subsequent surgery in addition to patient-reported outcome measures.Results: Of 117 patients, 87 (74.4%) were available at an average follow-up of 3.64 years (range, 2.01-5.13 years). The mean age at the time of surgery was 28.99 ± 8.26 years. Lateral MAT was performed in 44 cases (50.6%); medial MAT, 42 (48.3%); and combined medial and lateral MAT, 1 (1.1%). Concomitant procedures were performed in 72 patients (82.7%) including cartilage restoration (n = 65, 74.7%), realignment (n = 9, 10.3%), and anterior cruciate ligament reconstruction (n = 9, 10.3%). Patients experienced significant improvement in the Lysholm score (P < .001), International Knee Documentation Committee score (P < .001), Knee Injury and Osteoarthritis Outcome Score (KOOS)-Quality of Life (P < .001), KOOS-Activities of Daily Living (ADL) (P < .001), KOOS-Pain (P < .001), KOOS-Sports (P = .001), KOOS-Symptoms (P = .003), Short Form 12 physical score (P < .001), and Veterans Rand-12 physical score (P < .001). Reoperation was performed in 26 patients (29.9%); failure occurred in 12 patients (13.8%; total knee arthroplasty in 1, unicompartmental arthroplasty in 2, and total meniscectomy in 9). Overall, 77.0% of patients were satisfied with their outcome. Prior to MAT, 82 patients (94.3%) participated in sporting activities; 62 patients (75.6%) returned to at least one sport at 12.58 ± 6.20 months postoperatively, with 30 (48.4%) reaching their preoperative level of intensity and 72 (87.8%) discontinuing at least one of their preoperative sports. The most common reasons for sports discontinuation postoperatively were prevention of further damage (73.6%), pain with activity (51.4%), fear of further injury (48.6%), surgeon recommendation (33.3%), and swelling with activity (30.6%). Patients were satisfied with their sports participation at a rate of 62.1%.Conclusions: In a complex patient population undergoing arthroscopic MAT, 75.6% of patients were able to return to at least one sport at an average of 12.58 ± 6.20 months postoperatively. The level of sport declined, with 93.5% of patients restricting involvement to recreational sports after MAT and 48.4% returning to their preoperative level of activity intensity. In addition, 87.8% of patients reported discontinuing a sport in which they had participated preoperatively. The most common reasons for decreasing level of sport were prevention of further damage, pain or swelling with sports, and fear of further injury. The reoperation rate after MAT was 29.9%. Most patients were satisfied with the outcome of surgery, with 77.0% satisfied in general and 62.1% satisfied with their ability to play sports.Level Of Evidence: Level IV, retrospective case series. [ABSTRACT FROM AUTHOR]

Purpose: To define the contributions of the of the medial patellofemoral ligament (MPFL) and medial quadriceps tendon femoral ligament (MQTFL) to lateral patellar translation as the knee moves through a 90° arc of motion.Methods: Six pairs of bilateral cadaveric knee specimens (12 knees) were dissected and potted in perfect lateral position using fluoroscopy. An eye screw was placed in the midpoint on the lateral aspect of the patella. Each knee underwent testing in 4 conditions after sequential sectioning: intact, lateral retinacular release, randomized MQTFL or MPFL sectioning, and complete proximal medial patellar restraint (PMPR) sectioning. With a custom machined jig, all knees were tested at 0, 10, 20, 30, 45, 60, and 90° of flexion on an MTS machine with 20N of lateral patellar force applied and displacement recorded.Results: PMPR extensor mechanism insertion on all specimens was identified 50% on the quadriceps tendon and 50% on the proximal aspect of the medial patella. Isolated MPFL sectioning resulted in significantly increased lateral displacement compared to the lateral release state at all flexion angles tested except 0°. There was significantly increased lateral patellar displacement with complete sectioning compared with isolated proximal sectioning at all degrees of knee flexion except 0°. However, complete sectioning following isolated MPFL sectioning did not demonstrate significance at any angle.Conclusions: Compared with the MQTFL, the MPFL is primarily responsible for resistance to lateral patellar translation throughout a 0° to 90° arc of motion. The MPFL provides a similar resistance to lateral patellar displacement as the fully intact PMPR; however, the MQTFL may contribute to resistance in full extension.Clinical Significance: Proximal medial patellar restraint reconstruction techniques involving both the patellar and quadriceps insertion have been described; however, the unique contributions of the native anatomy to lateral patellar restraint have not been investigated. [ABSTRACT FROM AUTHOR]

Purpose: To assess the timeline of return to work (RTW) following opening-wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) of the medial femoral condyle.Methods: Consecutive patients undergoing HTO + OCA due to focal chondral deficiency and varus deformity were retrospectively identified and reviewed at a minimum of 2 years following surgery. Patients completed a subjective work questionnaire, a visual analog scale for pain, Single Assessment Numerical Evaluation, and a satisfaction questionnaire.Results: Twenty-eight patients (average age: 36.0 ± 7.9 years) were included at 6.7 ± 4.1 years postoperatively. Twenty-six patients were employed before surgery and 25 patients (96.2%) returned to work following HTO + OCA. However, only 88.5% of patients were able to return to the same level of occupational intensity by 3.5 ± 2.9 months postoperatively. The rate of RTW to the same occupational intensity for sedentary, light, medium, and heavy intensity occupations was 100%, 100%, 88.9%, and 80% (P = .8), whereas the duration of RTW was 9.0 ± 7.1 months, 1.7 ± 1.4 months, 2.7 ± 0.9 months, and 4.2 ± 1.9 months (P = .006), respectively. Two patients (7.7%) underwent knee replacement by 5.3 ± 3.1 years postoperatively due to progression of osteoarthritis in the medial compartment.Conclusions: In patients with focal chondral deficiency and varus deformity, HTO + OCA provides a high rate of RTW (96.2%) by 3.5 ± 2.9 months postoperatively. However, patients with greater-intensity occupations may take longer to return to work than those with less physically demanding occupations.Level Of Evidence: IV, Retrospective Case Series. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the time and rate of return to sport (RTS), as well as outcomes, in young and active patients receiving concomitant lateral meniscal allograft transplantation (MAT) and distal femoral varus osteotomy (DFVO) for lateral meniscal deficiency and valgus malalignment.Methods: This was a retrospective study of consecutive patients who underwent concomitant MAT and DFVO by a single surgeon. The exclusion criteria were any concomitant procedures other than cartilage restoration procedures for focal full-thickness cartilage defects of the lateral femoral condyle and less than 2 years of follow-up. At final follow-up, patients were asked to complete a subjective sports questionnaire, the Marx Activity Rating Scale, a visual analog scale (VAS), the Single Assessment Numeric Evaluation, and a satisfaction questionnaire. Changes in patient-reported outcome measures were assessed using nonparametric statistical testing.Results: A total of 21 patients met the inclusion criteria, of whom 17 were included for analysis at an average follow-up of 7.5 years (range, 2.2-13.3 years). The average age at the time of surgery was 23.3 years (range, 16.9-36.2 years), and 76.5% of patients were female patients. The average VAS score decreased from 5.7 preoperatively to 2.6 postoperatively (P = .02). Of the 15 patients who participated in sports within 3 years prior to their surgical procedure, 14 (82.4%) returned to 1 or more sports at an average of 16.9 months (range, 6-36 months); however, only 46.7% were able to return to their preinjury level of participation or higher. Furthermore, 88.2% of patients reported being satisfied with their sport-related outcomes. Direct rates of sport-specific return were as follows: weightlifting, 100%; skiing, 100%; running, 66.7%; and basketball, 50%.Conclusions: In our study population, concomitant MAT and DFVO afforded a high rate of RTS at an average of 16.9 months postoperatively, as well as a significant decrease in VAS pain scores. These findings are essential to note when counseling patients receiving these procedures who wish to resume sports and physical activities so that they may expect an extensive recovery process before they can RTS.Level Of Evidence: Level IV, case series. [ABSTRACT FROM AUTHOR]

Purpose: (1) To examine the timeline of return to sport (RTS) and return to work (RTW) after high tibial osteotomy (HTO) with concomitant medial meniscal allograft transplant (MAT), (2) to evaluate the degree of function on RTS and RTW, and (3) to identify reasons patients do not return to sport- or work-related activity.Methods: Patients undergoing HTO plus MAT were reviewed retrospectively at a minimum of 2 years postoperatively. The exclusion criterion was any concomitant procedure except cartilage restoration for focal full-thickness medial femoral condylar defects. Patients completed a subjective sport and work questionnaire, a visual analog scale for pain, the Single Assessment Numeric Evaluation, and a satisfaction questionnaire.Results: Twenty-two patients (aged 35.1 ± 8.1 years) were included at 9.3 ± 3.7 years postoperatively. Sixteen patients participated in sports within 3 years before surgery, and 14 patients (87.5%) returned to sport by 9.7 ± 3.8 months postoperatively. Only 7 patients (43.8%) returned to their preinjury status. Eighteen patients were employed within 3 years before surgery, and all patients returned to work; however, only 16 patients (88.9%) returned at the same occupational intensity by 3.1 ± 2.4 months. The rates of RTW for light-, medium-, and heavy-intensity occupations were 100%, 75.0%, and 85.7%, respectively, whereas the duration of RTW was 2.1 months, 2.3 months, and 4.8 months, respectively. Of the patients, 20 (90.9%) reported at least 1 complaint postoperatively, with 13 patients (59.1%) returning to the operating room for recurrent symptoms, including 1 patient who received a knee replacement at 7.75 years postoperatively.Conclusions: In patients with medial meniscal deficiency and varus deformity, HTO plus MAT provided high rates of RTS (87.5%) and RTW (100%) by 9.7 months and 3.1 months, respectively. It is imperative that clinicians manage expectations because patients may RTS and RTW after HTO plus MAT; however, return to high-intensity activities or occupations may be unlikely or delayed.Level Of Evidence: Level IV, retrospective case series. [ABSTRACT FROM AUTHOR]

Purpose: To provide updated surgical trends of cartilage procedures differentiated by the classic groups of palliative, repair, and restorative modalities.Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2010-2016 for the following cartilage procedures: chondroplasty, microfracture, arthroscopic osteochondral autograft or allograft transplantation, open osteochondral autograft or allograft transplantation, and autologous chondrocyte implantation. Demographic variables and short-term (30-day) complications were analyzed with 1-way analysis of variance and post hoc analysis. Linear regression analysis was performed to analyze trends over time.Results: A total of 15,609 procedures performed between 2010 and 2016 were analyzed. On average, 342.2 ± 27.9 cartilage procedures were performed per 100,000 operations. There was a linear increase in the management of overall cartilage procedures per 100,000 operations (P = .002). There were also linear increases in arthroscopic osteochondral autograft transplantation, arthroscopic osteochondral allograft transplantation, open osteochondral autograft transplantation, open osteochondral allograft transplantation, and autologous chondrocyte implantation (P < .001, P = .037, P = .001, P = .006, and P = .002, respectively). Meniscectomy was the most frequently performed concomitant procedure (9.7%-64.2% of cases). Chondroplasty and microfracture showed no change in frequency over time (P = .140 and P = .720, respectively). The overall complication rate was 2.1% for chondroplasty, 1.4% for microfracture, 1.8% for arthroscopic osteochondral autograft transplantation, 1.0% for arthroscopic osteochondral allograft transplantation, 1.4% for open osteochondral autograft transplantation, 1.1% for open osteochondral allograft transplantation, and 0.75% for autologous chondrocyte implantation. Deep vein thrombosis was the most common complication, occurring in 0.4% to 1.0% of cases. No statistically significant difference was found in complication rates between procedures (P = .105).Conclusions: Cartilage restoration is becoming an increasingly popular modality to address chondral defects. Minimal complication rates suggest that these procedures may be safely performed concomitantly with other interventions.Level Of Evidence: Level IV, retrospective database analysis. [ABSTRACT FROM AUTHOR]

In this study, an economical two-stage method was proposed for the production of natural astaxanthin from Haematococcus pluvialis without a medium replacement step. In stage 1, H. pluvialis were grown under low light illumination until they reached optimal biomass. In stage 2, cells were switched to astaxanthin induction conditions utilizing the combination of high light illumination and elevated carbon dioxide levels (5 or 15%). The introduction of CO 2 altered the C/N balance creating a nutrient deficiency without a change of media. The resulting astaxanthin yield was 2–3 times that of using either stressor alone. This astaxanthin induction method has many advantages over current methods including no medium replacement and a short induction time of less than four days. [ABSTRACT FROM AUTHOR]

This article reviews the benefits of corticosteroid, viscosupplementation, platelet-rich plasma, and autologous mesenchymal stem cell injections for the treatment of patients with knee osteoarthritis. Integrating injections into both clinical and surgical practices is complicated given existing health insurance reimbursement policies. This review describes the outcomes associated with these interventions and appropriate methods of navigating the existing reimbursement pathways to help providers implement these treatments into their practices. [ABSTRACT FROM AUTHOR]

We have recently reported that flavonoids of cocoa inhibit the mammalian 15-lipoxygenase-1—a catalyst of enzymatic lipid peroxidation. To elucidate the structure–activity relationship of the inhibitory effect, we investigated the effects of 18 selected flavonoids of variable structure on pure rabbit reticulocyte and soybean 15-lipoxygenases using linoleic acid as substrate. Moreover, the inhibition by quercetin was studied in detail to gain insight into the mode of action. Quercetin was found to modulate the time-course of the reaction of both lipoxygenases by three distinct effects: (i) prolongation of the lag period, (ii) rapid decrease in the initial rate after the lag phase was overcome, (iii) time-dependent inactivation of the enzyme during reaction but not in the absence of substrate. A comparison of the ic50 for the rapid inhibition of rabbit reticulocyte 15-lipoxygenase-1 revealed that (i) the presence of a hydroxyl group in the flavonoid molecule is not essential, (ii) a catechol arrangement reinforces the inhibitory effect, (iii) in the presence of a catechol arrangement the inhibitory potency inversely correlates with the number of hydroxyl groups, (iv) a 2,3-double bond in the C ring strengthens the inhibitory effect. The flavone luteolin turned out to be the most potent inhibitor of the mammalian enzyme with an ic50 of 0.6 μM followed by baicalein (1 μM) and fisetin (1.5 μM). [Copyright &y& Elsevier]

• Minimally invasive thymectomy is the primary surgical means for myasthenia gravis. • Subxiphoid VATS method has the benefit of less blood loss and shorter hospital stay. • Subxiphoid surgical port placement eliminates postoperative intercostal neuralgia. • Subxiphoid uniportal thymectomy is safe and feasible for selected patients. Myasthenia gravis (MG) is a well-known disease in adults, but the prevalence in children population is low. One treatment option is thymectomy. Transsternal procedure have been the primary approach, but recent trends lean toward minimally invasive technique with triportal and, recently, uniportal thoracoscopic method. This is related to the suggested less blood loss and hospital length of stay. Hereby we report a case of a 4-year-old boy suffering from Juvenile Myasthenia Gravis (JMG) with thymic hyperplasia who underwent extended thymectomy via subxiphoid uniportal Video-Assisted Thoracoscopic Surgery (VATS) in our hospital. Pathology evaluation reported a case of thymic hyperplasia. The postoperative outcome was uneventful and satisfactory. Subxiphoid uniportal approach for thymectomy is relatively new and has not been widely reported. It is important to highlight its advantages and disadvantages compared to other means for thymectomy. Subxiphoid uniportal VATS is a safe and feasible approach for thymectomy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to establish minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient-acceptable symptom state (PASS) after meniscectomy and factors associated with achieving these goals.Methods: A prospectively maintained institutional registry was retrospectively reviewed for all patients undergoing isolated arthroscopic partial meniscectomy from 2014 through 2017. MCID, SCB, and PASS were calculated for the International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores by using the anchor-based methodology and nonparametric receiver operating characteristic curves. Subscores included joint replacement (JR), physical function (PF), symptoms (Sx), pain, activities of daily living (ADL), sport, and quality of life (QOL).Results: A total of 269 patients were analyzed in the study, which reported outcomes between 6 and 7 months after surgery. The average age of our population was 48.9 ± 12.4 years. Twenty patients reported no change, 53 reported minimal improvement, and 137 reported substantial change after surgery; whereas 59 patients reported worse outcomes. One hundred seventy-seven patients were satisfied and 92 were not satisfied with the outcome of surgery. Established MCID/SCB/PASS for the IKDC, KOOS JR, KOOS PF, KOOS Sx, KOOS Pain, KOOS ADL, and KOOS QOL were 10.6/25.3/57.9, 10.7/13.2/68.3, -8.2/-11.3/26.2, 8.9/7.1/71.4, 9.7/22.2/76.4, 11.0/16.9/89.0, 12.5/27.5/55.6, and 15.6/34.4/46.9, respectively. Higher preoperative scores were associated with reduced odds of achieving MCID and SCB but greater odds of achieving PASS for nearly all scores (P < .05). Workers' compensation status, degenerative tears, medial-sided tears, and root tears were associated with reduced odds of achieving 2 or more clinically meaningful outcomes in 2 or more scores (P < .05).Conclusions: Clinically meaningful outcomes were established by patient self-assessment. Variables associated with achieving these outcomes include preoperative score (positively correlated with MCID/SCB, negatively correlated with PASS); workers' compensation; degenerative, medial-sided tears; and root tears (remaining negatively correlated with MCID/SCB/PASS). These variables should be accordingly measured for confounding in future outcome reporting. [ABSTRACT FROM AUTHOR]

Articular cartilage lesions of the tibial plateau are an uncommonly encountered clinical entity, and they have been comparatively less well studied than femoral condyle or patellofemoral defects. The management of these lesions is complicated by the challenging geometry, difficult surgical approach, and proximity to important anatomic structures, and thus, treating these lesions by previously established methods, such as osteochondral allograft transplantation or osteochondral autograft transfer, can be a technically challenging endeavor. These lesions remain readily available to undergo microfracture, and this is the preferred method of management in the senior author's practice. Although less technically difficult and less invasive than other techniques, microfracture is currently limited by concerns over the long-term durability of the method. Current research seeks to improve the quality of cartilage fill stimulated by microfracture, and adjunct techniques have become increasingly popular. In this technical report, we present a technique for arthroscopic treatment of an isolated tibial plateau defect with microfracture using a micronized allogeneic cartilage (BioCartilage; Arthrex, Naples, FL) and platelet-rich plasma adjunct. [ABSTRACT FROM AUTHOR]

Abstract: The effects of glucose on enhanced biological phosphorus removal (EBPR) activated sludge enriched with acetate was investigated using sequencing batch reactors. A glucose/acetate mixture was serially added to the test reactor in ratios of 25/75%, 50/50%, and 75/25% and the EBPR activity was compared to the control reactor fed with 100% acetate. P removal increased at a statistically significant level to a near-complete in the test reactor when the mixture increased to 50/50%. However, EBPR deteriorated when the glucose/acetate mixture increased to 75/25% in the test reactor and when the control reactor abruptly switched to 100% glucose. These results, in contrast to the EBPR conventional wisdom, suggest that the addition of glucose at moderate levels in wastewaters does not impede and may enhance EBPR, and that glucose waste products should be explored as an economical sustainable alternative when COD enhancement of EBPR is needed. [Copyright &y& Elsevier]

Abstract: Polymer micelles and vesicles form upon hydration of amphiphilic block copolymers in dilute aqueous solution. Present challenges with these self-assemblies include understanding how molecular structure and polydispersity determine nano- and mesoscopic shape and properties such as flexibility. With charged copolymers, divalent ionic ligands can rigidify polymer vesicle membranes and also induce microphase separation into domains of weak polyelectrolyte gels. In this review, we focus on the underlying physical and molecular questions concerning copolymer assembly and associated challenges and implications for nano-delivery materials. We also highlight molecular simulation techniques that can be used to investigate properties of assemblies, such as curvature, patterning, and other ionic effects in functional polymeric membranes and micelles. [Copyright &y& Elsevier]

• Administration of oxytocin and naltrexone synergistically affect energy balance. • Subthreshold doses of oxytocin and naltrexone decrease 10% sucrose intake. • Oxytocin and naltrexone decrease cumulative intake of a fat/sugar diet over 24 days. • Oxytocin and naltrexone injection affected gene expression of feeding peptides. In a recent case report involving a male with hypothalamic obesity, concurrent administration of oxytocin (OT) and an opioid receptor antagonist, naltrexone (NTX), synergistically affected energy balance. Here, by using laboratory rats, we examined whether the reported synergy between OT and NTX in the context of food intake extends beyond that one unique case. We found that intravenous OT+NTX combination, at doses subthreshold for each of the drugs individually, decreased episodic consumption of a 10% sucrose solution in non-deprived animals. Daily administration of OT and NTX just before a scheduled, 2-hour, high-fat high-sugar (HFHS) meal over 24 days, decreased cumulative HFHS diet intake, but without a change in body weight due to compensatory standard chow intake during the remainder of the day. The NTX-OT treatment affected expression of several feeding-related genes in the hypothalamus, brain stem and nucleus accumbens, brain regions essential for the regulation of energy- and reward-driven consumption. We conclude that OT and NTX act synergistically to decrease food consumption in rats and that this transient effect is accompanied by changes in brain processes relevant to feeding. [ABSTRACT FROM AUTHOR]

Purpose: Wound healing complications are a major concern after open reduction and internal fixation (ORIF) in patients with calcaneal fractures. Microcirculation is known to play a key role in bone and soft tissue healing. The present study aimed to characterize and contrast the dynamics of changes in microcirculation comparing two different surgical procedures: A) ORIF and B) a minimally invasive approach (MIA).Methods: Blood flow (BF[AU]), oxygen saturation (sO2[%]) and relative amount of haemoglobin (rHb[AU]) were measured at two depths (2 mm and 8 mm) non-invasively by spectrophotometry (Micro-Lightguide O2C®, LEA Medizintechnik, Giessen, Germany) before surgery and every 24 h after surgery for a duration of six days. A linear mixed model (LMM) was used to analyse longitudinal data and repeated measurements.Results: Nineteen patients (44 years, range 21.9-71.0 years) were enrolled in the study. Surgical treatment consisted of ORIF (n = =15) and MIA (n = =9). The postoperative BF and sO2 at the 2 mm and 8 mm depths were higher in the ORIF group (BF: p < 0.001, p = =0.003; sO2: p = =0.001, p = =0.011). The BF at the 2 mm and 8 mm depths increased after surgery (2 mm: p = =0.003, 8 mm: p = =0.001) in both groups. This increase did not correlate with the surgical technique. sO2 and rHb values at the 8 mm depth decreased after surgery (sO2: p = =0.008, rHb: p < 0.001) in both groups, whereas sO2 at the 2 mm depth increased after surgery (p = =0.003). Furthermore, the surgical technique correlated with the postsurgical course of sO2 values at the 2 mm depth (p = =0.042).Conclusions: The spectrophotometry results were in line with the generally accepted phases of soft tissue wound healing. Postsurgical changes in microcirculation are predominantly independent of surgical techniques and may be primarily determined by wound and fracture healing. Future studies should focus on the potential of spectrophotometry to monitor wound healing after surgery. Moreover, studies with longer observation periods are needed in order to examine the changes in microcirculation during all wound-healing phases. [ABSTRACT FROM AUTHOR]

Liver sinusoidal endothelial cells (LSEC) represent a unique, organ-specific type of discontinuous endothelial cells. LSEC instruct the hepatic vascular niche by paracrine-acting angiocrine factors. Recently, we have shown that LSEC-specific transcriptional regulator GATA4 induces expression of BMP2 in cultured endothelial cells (EC) in vitro. Furthermore, angiocrine Bmp2 signaling in the liver in vivo was demonstrated to control iron homeostasis. Here, we investigated GATA4-dependent autocrine BMP2 signaling in endothelial cells by gene expression profiling. GATA4 induced a large cluster of inflammatory endothelial response genes in cultured EC, which is similar to previously identified virus-induced and interferon-associated responses. Treating the cells with the BMP2 inhibitor Noggin counter-regulated the GATA4-dependent inflammatory phenotype of EC, indicating that BMP2 is indeed the major driver. In contrast to continuous EC, LSEC were less prone to activation by BMP2. Notably, GATA4-dependent induction of the inflammatory EC response gene cluster was attenuated by over-expression of the LSEC-specific transcriptional modifier LMO3 while hepatocyte activation was fully preserved, indicating conserved BMP2 synthesis. In summary, our data suggest that transcriptional counter-regulation by GATA4 and LMO3 in LSEC prevents autocrine induction of an inflammatory phenotype, while maintaining angiocrine BMP2-mediated cell-cell communication in the liver vascular niche. [ABSTRACT FROM AUTHOR]

APOL1 risk alleles are associated with increased cardiovascular and chronic kidney disease (CKD) risk. It is unknown whether knowledge of APOL1 risk status motivates patients and providers to attain recommended blood pressure (BP) targets to reduce cardiovascular disease. Multicenter, pragmatic, randomized controlled clinical trial. 6650 individuals with African ancestry and hypertension from 13 health systems. APOL1 genotyping with clinical decision support (CDS) results are returned to participants and providers immediately (intervention) or at 6 months (control). A subset of participants are re-randomized to pharmacogenomic testing for relevant antihypertensive medications (pharmacogenomic sub-study). CDS alerts encourage appropriate CKD screening and antihypertensive agent use. Blood pressure and surveys are assessed at baseline, 3 and 6 months. The primary outcome is change in systolic BP from enrollment to 3 months in individuals with two APOL1 risk alleles. Secondary outcomes include new diagnoses of CKD, systolic blood pressure at 6 months, diastolic BP, and survey results. The pharmacogenomic sub-study will evaluate the relationship of pharmacogenomic genotype and change in systolic BP between baseline and 3 months. To date, the trial has enrolled 3423 participants. The effect of patient and provider knowledge of APOL1 genotype on systolic blood pressure has not been well-studied. GUARDD-US addresses whether blood pressure improves when patients and providers have this information. GUARDD-US provides a CDS framework for primary care and specialty clinics to incorporate APOL1 genetic risk and pharmacogenomic prescribing in the electronic health record. ClinicalTrials.gov NCT04191824 [ABSTRACT FROM AUTHOR]

Abstract: Polymersomes are self-assembled shells of amphiphilic block copolymers that are currently being developed by many groups for fundamental insights into the nature of self-assembled states as well as for a variety of applications. While recent reviews have highlighted distinctive properties—particularly stability—that are strongly influenced by both copolymer type and polymer molecular weight, here we first review some of the more recent developments in computational molecular dynamics (MD) schemes that lend insight into assembly. We then review polymersome loading, in vivo stealthiness, degradation-based disassembly for controlled release, and tumor shrinkage in vivo. Comparisons of polymersomes with viral capsids are shown to encompass and inspire many aspects of current and emerging designs. [Copyright &y& Elsevier]