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usc Background: higher vitamin D status has been suggested to have beneficial effects on the brain. Objectives: to investigate the association between 25-hydroxyvitamin D [25(OH)D], neuroimaging features, and the risk of dementia and stroke. Methods: we used prospective data from the UK Biobank (37–73 y at baseline) to examine the association between 25(OH)D concentrations with neuroimaging outcomes (N = 33,523) and the risk of dementia and stroke (N = 427,690; 3414 and 5339 incident cases, respectively). Observational analyses were adjusted for age, sex, ethnicity, month, center, and socioeconomic, lifestyle, sun behavior, and illness-related factors. Nonlinear Mendelian randomization (MR) analyses were used to test for underlying causality for neuroimaging outcomes (N = 23,901) and dementia and stroke (N = 294,514; 2399 and 3760 cases, respectively). Result: associations between 25(OH)D and total, gray matter, white matter, and hippocampal volumes were nonlinear, with lower volumes both for low and high concentrations (adjusted P-nonlinear ≤ 0.04). 25(OH)D had an inverse association with white matter hyperintensity volume [per 10 nmol/L 25(OH)D; adjusted β: –6.1; 95% CI: –11.5, –7.0]. Vitamin D deficiency was associated with an increased risk of dementia and stroke, with the strongest associations for those with 25(OH)D

This study explored human papillomavirus (HPV) amplification in breast benign and malignant lesions by chromogenic in situ hybridization (CISH) and the concordance of p16 expression by immunohistochemistry.The presence of HPV6/11 and HPV16/18 in 33 cases of intraductal papilloma, 34 cases of ductal carcinoma in situ (DCIS), and 56 cases of invasive breast carcinoma (IBC) was evaluated using matched-background breast parenchyma and breast reduction as control groups. Association with clinicopathologic factors including prognosis was assessed.HPV 6/11 was observed in 0 cases (0%) of breast reduction, one case (3%) of intraductal papilloma, 11 cases (32.4%) of DCIS, and eight cases (14.3%) of IBC. HPV 16/18 was detected in three cases of (9.1%) breast reduction, six cases (18.8%) of intraductal papillomas, 14 cases (41.2%) of DCIS, and 25 cases (44.6%) of IBC. There was no difference in the HPV status between intraductal papilloma and breast reduction. HPV amplification in intraductal papilloma did not associate with developing atypia or carcinoma after long-term follow-up. However, HPV 6/11 and HPV 16/18 amplification was significantly higher in both DCIS and IBC when compared with breast reduction (P.05). Compared with background breast parenchyma, HPV 16/18 amplification was significantly higher in both DCIS and IBC (P = .003 and P = .013, respectively). No correlation between p16 immunohistochemical staining and either of the HPV CISH testing was found (P.05).HPV infection was detected in both breast lesions and background parenchyma. HPV infection may play a role in the pathogenesis of breast cancer but is not associated with intraductal papilloma. Immunohistochemical stain for p16 is not a good surrogate marker for HPV infection in breast lesions.

Summary Hemorrhoidectomy specimens serve as an excellent resource for study of incidental anal pathology. Detection of most incidental findings is quite rare, although diagnosing clinically significant lesions can have profound impact on the clinical follow-ups. While there are many case reports of incidental findings in hemorrhoidectomy specimens, there are few large studies focused on this topic. The aim of this study was to describe the spectrum and likelihood of detecting incidental findings in hemorrhoidectomy specimens. We reviewed all hemorrhoidectomy specimens that showed incidental clinically significant diagnoses over a 16-year period (2003–2019) for this study. Patient's age, sex, and significant clinical history (Human Immunodeficiency Virus (HIV) status, precursor lesions, other malignancy) were recorded from clinical notes. We identified incidental clinically significant findings in 72 of 1612 (4.5%) specimens. We identified 7 incidental malignancies (squamous cell carcinoma, verrucous carcinoma, adenocarcinoma, mixed adenocarcinoma and neuroendocrine carcinoma, poorly differentiated neuroendocrine carcinoma, melanoma), 54 anal intraepithelial neoplasias (AINs), and 11 benign findings (melanocytic lesions, colorectal polyps, angiokeratoma, infectious/inflammatory). Within the AIN group, the detection of low-grade squamous intraepithelial lesions (LSILs) remained steady; there was a recent, sustained rise in detection of high-grade squamous intraepithelial lesions (HSILs), with more cases showing HSILs (2.6%) than only LSILs (0.7%). In 72.2% of patients, the incidental secondary finding represented a first diagnosis for that entity in the anal canal. Thirty seven percent of patients with anal dysplasia in the hemorrhoidectomy specimen had a prior diagnosis of squamous dysplasia in the anogenital tract. Overall, significant incidental findings were detected in 4.5% (72/1612) of hemorrhoidectomies, supporting routine histological examination of these specimens.

Failure to rescue (FTR) is gaining popularity as a quality metric. The relationship between patient frailty and FTR after cardiovascular surgery has not been fully explored. This study aimed to utilize a national database to examine the impact of patient frailty on FTR.Of 5,199,534 patients undergoing cardiovascular surgery between 2000 and 2014, 75,851 (1.5%) were identified from the Nationwide Inpatient Sample database as frail based on the Johns Hopkins Adjusted Clinical Groups frailty-defining diagnoses indicator. Propensity-score matching was used to adjust for patient- and hospital-level characteristics and comorbidities when comparing frail and nonfrail patients.Frail patients were on average older (68 ± 12 years vs 65 ± 12 years; P.001) and had more comorbidities including heart failure, and chronic lung, liver, or renal disease. Among 68,472 matched pairs, frail patients had significantly higher rates of FTR (13.4% vs 11.9%; P .001). This contributed to a $39,796 increase in cost per hospitalization (P.001). Renal failure, respiratory failure, pneumonia, and sepsis were most commonly associated with FTR in frail patients. When hospitals were stratified by risk-adjusted mortality, low-mortality (1st quintile) centers had significantly lower FTR rates and costs among frail patients when compared to high-mortality (5th quintile) centers.Frailty contributes significantly to FTR after cardiovascular surgery. Frail patients can expect better outcomes with lower costs at cardiac surgical centers of excellence that can adequately manage postoperative outcomes. Preoperative assessment of frailty may better guide risk estimation and identification of patients who would benefit from appropriate prehabilitative interventions to optimize outcomes.

Porous nanoarchitectures of metal oxide semiconductors (MOS) are promising advanced materials due to their relatively higher surface area, more active sites and are beneficial for variety of applications. Herein, we report a simple method for making porous Indium oxide nanocubes (PINC) using a novel surfactant based biogenic hydrothermal method followed by a nanoscale Kirkendall effect. The nucleation and growth of PINCs were optimized by controlling amount of Cetyl Trimethylammonium Bromide (CTAB), which helps to control the size of nanocubes. The formation of porosity on the nanocubes through the nanoscale Kirkendall effect was proposed. Furthermore, the PINC based films were employed to fabricate solid-state chemiresistive gas sensor and sensing properties were studied. The PINC based film sensor was found to respond towards Carbon dioxide (CO2), Acetone ((CH3)2CO), Ammonia (NH3), and Nitrogen dioxide (NO2) gases. However, It exhibited highest gas response to NO2 gas (response S = 3450) with a shorter response (Rs = 14s) and recovery time (Rc = 115s) at 100 °C operating temperature. Besides, the sensing properties such as linearity, selectivity and real-time sensing analysis were also studied systematically. Herein, we demonstrated the effect of porosity and size of nanocubes on the sensing properties of PINC based sensor device.

In present study, a flexible, room temperature operable, and selective ammonia (NH3) sensor based on polyaniline and tungsten oxide (PAni-WO3) hybrid nanocomposite was successfully developed on polyethylene terephthalate (PET) substrate by in-situ chemical oxidative polymerization process and reported. Structural elucidation, surface morphology, and materials composition of flexible PAni-WO3 hybrid nanocomposites was analyzed systematically through X-ray diffraction, field emission scanning electron microscopy, transmission electron microscopy, and X-ray photoelectron spectroscopy, respectively. Gas sensing properties of flexible PAni-WO3 hybrid sensors was studied thoroughly and compared with pristine PAni and WO3 sensors. It was observed that the flexible sensor with 50 wt% WO3 content showed an excellent selectivity towards NH3 gas at room temperature along with 121% response towards 100 ppm. As-fabricated PAni-WO3 hybrid flexible sensors are capable to detect 1 ppm concentration of NH3 (Response = 9%) along with excellent stability and response reproducibility. Impedance spectroscopy was employed to quantify the gas sensing behavior of flexible PAni-WO3 sensor in presence of target gases and fresh air and resulting plots are simulated by equivalent circuits. Based on impedance results, the gas sensing mechanism of flexible PAni-WO3 nanocomposites in presence of NH3 atmosphere is described.

In present work, a facile spray pyrolysis technique has been applied for the synthesis of cadmium oxide (CdO) thin films at 673 K using aqueous cadmium acetate solution and reported. Primarily, as-synthesized CdO thin films are characterized for their structure and surface morphology corroborations and afterward used for energy storage applications. X-ray diffraction and X-ray photoelectron spectroscopy analysis supports to the formation of cubic crystalline phase of CdO. A homogeneous network of elongated rod-type surface morphology of CdO films was confirmed through scanning electron microscopy analysis. In addition, hydrophilic character of CdO thin film was corroborated through contact angle measurement. Electrochemical properties of as-synthesized CdO thin film electrode was studied in various aqueous electrolytes by means of cyclic voltammetry, charge-discharge, and impedance spectroscopy techniques and discussed. Electrochemical studies of CdO thin film electrode demonstrates a maximum specific capacitance of 344 F/g at 5 mV/s scan rate in 2 M KOH electrolyte.

An influence of processing temperature on structural, morphological, and chemiresistive properties of cerium oxide (CeO2) films, deposited on glass substrate by a spin-coating method and composed of nanocrystallites (NCs), has been systematically investigated and reported. As-deposited CeO2 films demonstrate the cubic polycrystalline crystal structure and mixed-agglomerated type of surface morphology with several crevices, elevating easy and deep percolation to gas molecules for enhanced adsorption-desorption process. Chemiresistive gas sensing performance of CeO2 films studied to various target gases and operating temperatures; demonstrates excellent selectivity, rapid response/recovery time signatures, and consistent operation repeatability to nitrogen dioxide (NO2) gas @200 °C, over other target gases, along with superior response repeatability. The response signature of sensor increases from 6% to 45% when NO2 gas ppm level is increased from 5 to 100. Chemiresistive change in the CeO2 film sensor in presence of NO2 gas has been studied thoroughly and explored using band model and impedance spectroscopy analysis.

Designing heterostructure materials for better gas sensing performance is a key for obtaining low-temperature gas sensor device technologies. Herein, CuO nanoparticle-ZnO nanowire heterostructure-based gas sensors have been fabricated by thermal evaporation followed by annealing in argon and air atmospheres and named respectively as NWG and NWA sensors. X-ray diffraction demonstrates the monoclinic structure of CuO and hexagonal wurtzite structure of ZnO and, thus, the formation of heterostructure. Morphological analysis confirms the ZnO nanowires (NWs) were well-linked to CuO nanoparticles (NPs). At an optimized temperature of 150 °C, the heterostructure sensor exhibits a maximum response (NWG, 175%) to NO2 over other oxidizing/reducing target gases on the exposure of 100 ppm concentration. This heterostructure sensor, noteworthy, responds to an extremely low exposure of NO2 gas (1 ppm). The interactions of oxidizing NO2 gas with ZnO/CuO heterostructure sensors has effectively been scrutinized using impedance spectroscopy analysis.

Axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) are autologous anti-CD19 chimeric antigen receptor T (CAR T) cell therapies for the treatment of patients with relapsed/refractory large B cell lymphoma (RR-LBCL). Both can induce durable responses; however, cross-trial comparisons are difficult due to differences in study design. In this study, the registration trials of axi-cel and tisa-cel were compared using a matching adjusted indirect comparison (MAIC). A MAIC was performed to adjust for differences in patient characteristics between trials. The estimates for the ZUMA-1 (axi-cel) trial were adjusted using patient-level data to match the study population in JULIET (tisa-cel) for key variables: International Prognostic Index), Eastern Cooperative Oncology Group score, stage, refractoriness or relapsed disease, double/triple hit status, cell of origin, and number of prior lines of therapy. The endpoints analyzed were response, overall survival (OS), and adverse events. After adjusting for differences in patient characteristics between trials, axi-cel was associated with a greater objective response rate (relative risk [RR]=1.61; 95% confidence interval [CI], 1.29 to 2.01) and complete response (RR = 1.62; 95% CI, 1.16 to 2.27) than tisa-cel among patients who underwent infusion. The OS from infusion onward comparing axi-cel to tisa-cel had a hazard ratio of 0.51 (95% CI, 0.31 to 0.83). The indirect comparison showed a higher rate of grade 1 to 2 cytokine release syndrome (CRS) in ZUMA-1 compared with JULIET (RR = 2.03; 95% CI, 1.55 to 2.65) and similar rates of grade ≥3 CRS and neurologic events. In the absence of a direct head-to-head study, the MAIC statistical technique suggests axi-cel may have superior efficacy but a greater risk of grade 1 to 2 CRS. Future real-world studies can further inform the relative efficacy and safety of CAR T therapies in RR-LBCL.

In the present manuscript, polyaniline (PAni), nickel oxide (NiO), and a fine nanosheet-type network of PAni-NiO hybrid film electrodes are prepared using electrodeposition technique and envisaged as electrode materials in electrochemical capacitor application. Furthermore, these film electrodes are characterized for their structural and morphological studies with the help of X-ray diffraction and scanning electron microscopy measurements, respectively. Atomic force microscopy revelation affords the roughnesses of electrode surfaces. Contact angle elucidation explodes the hydrophilic nature of PAni, NiO and PAni-NiO hybrid electrode surfaces. Electrochemical measurements confirm that the PAni-NiO hybrid electrode shows synergic effect as its specific capacitance measured at a scan rate of 5 mV/s in 1 M Na 2 SO 4 electrolyte is noticeably higher (936.36 F/g) than the PAni and NiO electrodes (601 and 263.5 F/g). All these electrodes exhibit remarkable capacity retention performance after 2000 cycles. The nanosheet network of PAni-NiO hybrid electrode offer a great reaction surface area for rapid ion and electron transfer with good stability as well, which all are advantageous for enhancing the electrochemical capacitance performance.