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Percutaneous selective Arterial Embolization is increasingly being used to control intractable hemorrhage in emergency setting. Here we describe management of a patient of post Caeserean section bleed from left Inferior epigastric artery who presented with vaginal bleeding, abdominal wall hematoma, dissecting into peritoneal cavity and resulting in hemoperitoneum.

Background:Approximately 25% of patients with staphylococcus aureus bacteremia (SAB) develop infective endocarditis (IE), which has a consequent mortality of 46%. Current guidelines recommend routine transthoracic echocardiography (TTE) for patients with SAB; transesophageal echocardiogram (TEE) is reserved for those patients in whom initial TTE is negative and clinical suspicion for IE remains high. We sought to elucidate high risk features of SAB associated with the development of IE that warrant a TEE after a negative TTE.Methods:This retrospective study included 213 patients who were diagnosed with SAB at the University of New Mexico Hospital between 2010-2020. A pre-determined list of clinical risk factors along with TTE and TEE status was extracted from the electronic medical record (Table 1). Our primary outcome was the development of IE in patients with SAB. Multivariate logistic regression analysis was used to identify clinical risk factors for IE. Sensitivity and specificity of TTE and TEE was also calculated (Table 1).Results:Out of 213 patients with SAB, 68 patients met diagnostic criteria for infectious endocarditis. Most patients (n=209) underwent TTE and 117 patients underwent subsequent TEE. Initial TTE was diagnostic in 42 patients with a sensitivity of 63% and specificity of 94%; 45 patients had a diagnostic TEE with a sensitivity of 83% and specificity of 98%. Multivariate analysis showed significantly increased risk of IE in patients who had a permanent pacemaker (aOR 32.3, CI 5.23 - 281, p<0.001) or a persistent fever (aOR 6.97, CI 2.42 - 21.0, P<0.001).Conclusions:The routine use of TEE in patients with SAB for the diagnosis of IE may not be necessary and introduces unnecessary procedural risk. Based on our analysis, we recommend that SAB patients with a permanent pacemaker (or other intracardiac prosthetic) or a persistent fever despite appropriate antibiotic therapy be screened with TEE when initial TTE is negative.

This paper depicts the analog investigation of a Novel Stacked Oxide Top Bottom Gated Junctionless (TBG-JL) Fin-shaped Field Effect Transistor (FinFET) structure. The structure is designed in this way to enhance the switching performance and curtail the Short Channel Effects (SCEs). The study is done on Silvaco Atlas TCAD tools for the Novel Stacked Oxide FinFET device and analyzed against Top-Bottom Gated Junctionless FinFET and Traditional FinFET. The Novel device shows 280 times improvement in switching ratio when stacked against the Traditional JL FinFET at identical gate length at room temperature (300K). The results from device simulation affirm that the Novel device has better analog performance over Traditional Junctionless FinFET and diminishes the Short Channel Effects (SCEs) a cut above the Traditional Junctionless FinFET.

Methamphetamine (MA), which remains one of the widely used drugs of abuse, is metabolized by the cytochrome P450 (P450) family of enzymes in humans. However, metabolism of methamphetamine in macaques is poorly understood. Therefore, we first developed and validated a very sensitive liquid chromatography with tandem mass spectrometry (LC-MS/MS) method using solid phase extraction of rhesus plasma with a lower limit of quantitation at 1.09 ng/ml for MA and its metabolites, 4-hydroxy methamphetamine (4-OH MA), amphetamine (AM), 4-OH amphetamine (4-OH AM), and norephedrine. We then analyzed plasma samples of MA-treated rhesus, which showed >10-fold higher concentrations of AM (∼29 ng/ml) and 4-OH AM (∼28 ng/ml) than MA (∼2 ng/ml). Because the plasma levels of MA metabolites in rhesus were much higher than in human samples, we examined MA metabolism in human and rhesus microsomes. Interestingly, the results showed that AM and 4-OH AM were formed more rapidly and that the catalytic efficiency (Vmax/Km) for the formation of AM was ∼8-fold higher in rhesus than in human microsomes. We further examined the differences in these kinetic characteristics using three selective inhibitors of each human CYP2D6 and CYP3A4 enzymes. The results showed that each of these inhibitors inhibited both d- and l-MA metabolism by 20%–60% in human microsomes but not in rhesus microsomes. The differences between human and rhesus CYP2D6 and CYP3A4 enzymes were further assessed by docking studies for both d and l-MA. In conclusion, our results demonstrated an enhanced MA metabolism in rhesus compared with humans, which is likely to be caused by differences in MA-metabolizing P450 enzymes between these species.

Metastatic lesions to the oral cavity are rare, accounting for only 1–8% of all oral malignancies, and involvement of mandibular condyle is a rare phenomenon. The present literature review found only 99 cases reported to date (including the present case). There has been only one documented case of condylar metastatic carcinoma from the bladder. We report the second case of metastasis to the mandibular condyle from a known primary urothelial carcinoma of the bladder. Condylar metastasis can present with non-specific TMJ dysfunction symptoms and can be misdiagnosed. Radiographic findings are typically non-specific, and the differential diagnosis should include osteomyelitis, primary malignant tumors, and metastatic spread. Either a fine needle aspiration or biopsy should be performed to obtain a histopathological diagnosis. Furthermore, metastasis to the condyle can be the first indication of an undiscovered distant primary tumor, making timely evaluation and management crucial from an oncologic perspective.

Spinal muscular atrophy (SMA) is the leading genetic cause of infant mortality. Most SMA cases are associated with the low levels of SMN owing to deletion of Survival Motor Neuron 1 (SMN1). SMN2, a nearly identical copy of SMN1, fails to compensate for the loss of SMN1 due to predominant skipping of exon 7. Hence, correction of aberrant splicing of SMN2 exon 7 holds the potential for cure of SMA. Here we report an 8-mer antisense oligonucleotide (ASO) to have a profound stimulatory response on correction of aberrant splicing of SMN2 exon 7 by binding to a unique GC-rich sequence located within intron 7 of SMN2. We confirm that the splicing-switching ability of this short ASO comes with a high degree of specificity and reduced off-target effect compared to larger ASOs targeting the same sequence. We further demonstrate that a single low nanomolar dose of this 8-mer ASO substantially increases the levels of SMN and a host of factors including Gemin 2, Gemin 8, ZPR1, hnRNP Q and Tra2-β1 known to be down regulated in SMA. Our findings underscore the advantages and unmatched potential of very short ASOs in splicing modulation in vivo.

Introduction:Recent changes in reimbursement policies for inpatient rehabilitation facility (IRF) providers prompted the adoption of Quality Indicators (QI) on the IRF Patient Assessment Instrument leading to the discontinuation of the Functional Independence Measure (FIM). Given that the FIM has shown associations with motor assessments and self-efficacy measures during early stroke recovery, the purpose of this study was to confirm if similar associations exist with QI.Methods:Participants with acute ischemic and hemorrhagic stroke completed a battery of assessments at the time of IRF admission and discharge: Total QI (summation of self-care and mobility items), Upper Extremity Fugl-Meyer (UEFM), Action Research Arm Test (ARAT), and Stroke Self-Efficacy Questionnaire (SSEQ). We determined associations between QI and these measures by computing correlation coefficients with an alpha value=.01 denoting significance following a Bonferroni correction.Results:Fourteen individuals (7 females, age=65.9±9.0 years, 8.1±3.5 days post-stroke) with moderate-severe motor deficit completed study procedures. Table 1 summarizes admission and discharge scores and associations with QI.Conclusions:Significant associations between motor assessments and QI from this ongoing study parallel similar associations involving the FIM. The implementation of QI in IRFs necessitates additional work to validate our findings and to determine psychometric properties of QI to enhance clinical research in stroke rehabilitation.

The oxidation of thirty-six monosubstituted benzaldehydes by hexa-methylenetetramine-bromine (HABR), in aqueous acetic acid solution, leads to the formation of the corresponding benzoic acids. The reaction is first order with respect to HABR. Michaelis-Menten–type kinetics were observed with respect to aldehyde. The reaction failed to induce the polymerization of acrylonitrile. There is no effect of hexamethylenetetramine on the reaction rate. The oxidation of [²H]benzaldehyde (PhCDO) indicated the presence of a substantial kinetic isotope effect. The effect of solvent composition indicated that the reaction rate increases with an increase in the polarity of the solvent. The rates of oxidation of meta- and para-substituted benzaldehydes showed excellent correlations in terms of Charton's triparametric LDR equation, whereas the oxidation of ortho-substituted benzaldehydes correlated well with tetraparametric LDRS equation. The oxidation of para-substituted benzaldehydes is more susceptible to the delocalization effect but the oxidation of ortho- and meta-substituted compounds displayed a greater dependence on the field effect. The positive value of γ suggests the presence of an electron-deficient reaction center in the rate-determining step. The reaction is subjected to steric acceleration when ortho-substituents are present. © 2000 John Wiley & Sons, Inc. Int J Chem Kinet 32: 615–622, 2000

The zinc finger protein ZPR1 translocates from the cytoplasm to the nucleus after treatment of cells with mitogens. The function of nuclear ZPR1 has not been defined. Here we demonstrate that ZPR1 accumulates in the nucleolus of proliferating cells. The role of ZPR1 was examined using a gene disruption strategy. Cells lacking ZPR1 are not viable. Biochemical analysis demonstrated that the loss of ZPR1 caused disruption of nucleolar function, including preribosomal RNA expression. These data establish ZPR1 as an essential protein that is required for normal nucleolar function in proliferating cells.

Nuclear quadrupole hyperfine structure in the rotational spectrum of Ar–N2O has been resolved in the 7–18 GHz region using a Fourier transform microwave spectrometer. Analysis of the hyperfine lines enables not only the determination of the rotational and centrifugal distortion constants to greater precision than previous studies, but also provides values for the nuclear quadrupole coupling constants of each14N nucleus. The coupling constants for Ar–N2O, when compared to those for free N2O, show that the electric field gradient at the terminal nitrogen nucleus in the N2O subunit is not affected by the presence of Ar, whereas that at the central nitrogen nucleus is affected slightly. This result, in contrast to recent findings in HCCH–N2O, supports the usual practice of extracting geometrical information for a van der Waals molecule from the nuclear quadrupole coupling tensor(s) of the complex.

The two mutants of the moss Funaria hygrometrica(auxin-sensitive and auxin-insensitive), isolated after UV irradiation of protoplasts derived from the wild strain protonema cultures, have been biochemically characterized and found to exhibit variations in the endogenous free-pool levels of tryptophan (a precursor for IAA biosynthesis), IAA and cAMP. Both of the mutants have a several-fold higher tryptophan content compared with the wild strain protonema. Whereas mutant 87.13 (auxin-sensitive) is deficient in free-pool IAA, the auxin-insensitive mutant (86.1) accumulates several-fold higher levels of endogenous IAA compared with the wild strain. The two mutants (87.13 and 86.1) also differ considerably in their cAMP content in comparison to wild type. IAA (10−5mol/L) marginally lowers the cAMP content in the wild type protonema whereas it significandy lowers the cAMP content in the two mutants. The fact that the auxin-insensitive mutant (86.1) remains as chloronema despite a drastic lowering of endogenous cAMP content by IAA treatment suggests that this mutant (86.1) represents an element in the signal transduction pathway elicited by IAA or IAA and cAMP, leading eventually to cellular differentiation in moss protonema. However, the possibility that some, as yet unknown, biochemical factor(s), in addition to IAA and cAMP, play(s) a regulatory role in protonema differentiation also deserves consideration.

The zinc finger protein ZPR1 translocates from the cytoplasm to the nucleus after treatment of cells with mitogens. The function of nuclear ZPR1 has not been defined. Here we demonstrate that ZPR1 accumulates in the nucleolus of proliferating cells. The role of ZPR1 was examined using a gene disruption strategy. Cells lacking ZPR1 are not viable. Biochemical analysis demonstrated that the loss of ZPR1 caused disruption of nucleolar function, including preribosomal RNA expression. These data establish ZPR1 as an essential protein that is required for normal nucleolar function in proliferating cells.

Astrocyte gene expression is altered in mouse models of Huntington’s disease and in postmortem brain samples from patients with HD.

To investigate the association between retinal nerve fiber layer (RNFL) thickness and blood pressure (BP) in subjects with systemic hypertension.

The oxidation of vicinal diols by hexamethylenetetramine-bromine (HABR) proceeds by a glycol-bond fission viaan intermediate complex whereas non-vicinal diols behave like monohydric alcohols towards HABR.