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The cellular structure of food tissue is complex, and it is difficult to understand the morphological changes during drying. Three different cellular environments, namely intracellular space, intercellular space, and cell wall in food tissue contain a different proportion of water. It is crucial to understand the moisture migration mechanisms from different cellular environments during drying for improving energy efficiency and for ensuring better quality dried foods. Due to the lack of sufficient understanding of transport mechanisms of different types of water, existing mathematical models for food drying have been developed without considering these components separately. Therefore, the main aim of the present work is to investigate the transport mechanisms of cellular water during drying. Experiments were performed using 1 H NMR T 2 relaxometry to investigate the proportion of different types of water at various stages of drying, taking apple as a sample. It was found that intercellular water migrates from intracellular region to the intercellular spaces mainly through rupturing of the cell membranes during drying of apple tissue. The cell membrane ruptures take place at various stages of drying rather than collapsing at one time. Interestingly, the trends of rupturing the cell membranes follow mostly a uniform pattern as rupturing takes places almost at a regular interval. The results were compared with the rupturing mechanism in the low porous material (potato) reported in authors' previous study. It was also observed that most of the cell membranes of potato tissue rupture at middle stages of drying while apple tissues rapture mostly uniformly. The penetration rate of heat energy with the pressure gradient between intracellular and intercellular environments are the predominant factors that cause the rupturing the cell membranes., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Loss-of-function mutations in human endosomal Na + (K + )/H + exchangers (NHEs) NHE6 and NHE9 are implicated in neurological disorders including Christianson syndrome, autism, and attention deficit and hyperactivity disorder. These mutations disrupt retention of surface receptors within neurons and glial cells by affecting their delivery to lysosomes for degradation. However, the molecular basis of how these endosomal NHEs control endocytic trafficking is unclear. Using Saccharomyces cerevisiae as a model, we conducted cell-free organelle fusion assays to show that transport activity of the orthologous endosomal NHE Nhx1 is important for multivesicular body (MVB)-vacuolar lysosome fusion, the last step of endocytosis required for surface protein degradation. We find that deleting Nhx1 disrupts the fusogenicity of the MVB, not the vacuole, by targeting pH-sensitive machinery downstream of the Rab-GTPase Ypt7 needed for SNARE-mediated lipid bilayer merger. All contributing mechanisms are evolutionarily conserved offering new insight into the etiology of human disorders linked to loss of endosomal NHE function., (© 2018 Karim and Brett. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).)

When marked for degradation, surface receptor and transporter proteins are internalized and delivered to endosomes where they are packaged into intralumenal vesicles (ILVs). Many rounds of ILV formation create multivesicular bodies (MVBs) that fuse with lysosomes exposing ILVs to hydrolases for catabolism. Despite being critical for protein degradation, the molecular underpinnings of MVB-lysosome fusion remain unclear, although machinery underlying other lysosome fusion events is implicated. But how then is specificity conferred? And how is MVB maturation and fusion coordinated for efficient protein degradation? To address these questions, we developed a cell-free MVB-lysosome fusion assay using Saccharomyces cerevisiae as a model. After confirming that the Rab7 ortholog Ypt7 and the multisubunit tethering complex HOPS (homotypic fusion and vacuole protein sorting complex) are required, we found that the Qa-SNARE Pep12 distinguishes this event from homotypic lysosome fusion. Mutations that impair MVB maturation block fusion by preventing Ypt7 activation, confirming that a Rab-cascade mechanism harmonizes MVB maturation with lysosome fusion., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Pore formation in food samples is a common physical phenomenon observed during dehydration processes. The pore evolution during drying significantly affects the physical properties and quality of dried foods. Therefore, it should be taken into consideration when predicting transport processes in the drying sample. Characteristics of pore formation depend on the drying process parameters, product properties and processing time. Understanding the physics of pore formation and evolution during drying will assist in accurately predicting the drying kinetics and quality of food materials. Researchers have been trying to develop mathematical models to describe the pore formation and evolution during drying. In this study, existing porosity models are critically analysed and limitations are identified. Better insight into the factors affecting porosity is provided, and suggestions are proposed to overcome the limitations. These include considerations of process parameters such as glass transition temperature, sample temperature, and variable material properties in the porosity models. Several researchers have proposed models for porosity prediction of food materials during drying. However, these models are either very simplistic or empirical in nature and failed to consider relevant significant factors that influence porosity. In-depth understanding of characteristics of the pore is required for developing a generic model of porosity. A micro-level analysis of pore formation is presented for better understanding, which will help in developing an accurate and generic porosity model.

Heterogeneous and hygroscopic characteristics of plant-based food material make it complex in structure, and therefore water distribution in its different cellular environments is very complex. There are three different cellular environments, namely the intercellular environment, the intracellular environment, and the cell wall environment inside the food structure. According to the bonding strength, intracellular water is defined as loosely bound water, cell wall water is categorized as strongly bound water, and intercellular water is known as free water (FW). During food drying, optimization of the heat and mass transfer process is crucial for the energy efficiency of the process and the quality of the product. For optimizing heat and mass transfer during food processing, understanding these three types of waters (strongly bound, loosely bound, and free water) in plant-based food material is essential. However, there are few studies that investigate cellular level water distribution and transport. As there is no direct method for determining the cellular level water distributions, various indirect methods have been applied to investigate the cellular level water distribution, and there is, as yet, no consensus on the appropriate method for measuring cellular level water in plant-based food material. Therefore, the main aim of this paper is to present a comprehensive review on the available methods to investigate the cellular level water, the characteristics of water at different cellular levels and its transport mechanism during drying. The effect of bound water transport on quality of food product is also discussed. This review article presents a comparative study of different methods that can be applied to investigate cellular water such as nuclear magnetic resonance (NMR), bioelectric impedance analysis (BIA), differential scanning calorimetry (DSC), and dilatometry. The article closes with a discussion of current challenges to investigating cellular water., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Introduction: Quadrilateral plate fractures constitute one of the most challenging components of acetabular fractures. The objective of this study is to describe and evaluate the novel technique of buttress screw fixation of the quadrilateral plate component of the acetabular fractures., Patients & Methods: Forty cases of acetabular fracture with associated quadrilateral plate component were included in the study. Mean age was 35 years (range, 16-68years), with a mean follow-up 16.4 months (range, 9-36months). Fixation of the quadrilateral plate was achieved by one or more buttress screws. The screws were inserted through the reconstruction plate, and placed close to the edge of the pelvic brim. To effectively achieve the 3-point fixation principle, the screw was inserted through the plate hole then outside the bone rubbing on the pelvic surface of the quadrilateral plate., Results: Anatomical reduction of the quadrilateral plate component of the fractures was achieved in all but one patient. The modified Merle D'Aubigné and Postel score was excellent in 13 cases, good in 23 cases, fair in three cases, and poor in one case. No screw displacement or failures were observed during follow-up evaluation. No major complications related to this technique were observed in this series., Conclusion: Buttress screw fixation of the quadrilateral plate fracture component in associated acetabular fractures is a safe and effective technique for reduction and fixation of these challenging fractures with no major complications related to this novel technique., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Prevalence of stunting among under-five children in Bangladesh is 36%, varying with geographic and socio-economic characteristics. Previously, research groups statistically modelled the effect of 10 individual nutrition-specific interventions targeting the critical first 1000 days of life from conception, on lives saved and costs incurred in countries with the highest burden of stunted children. However, primary research on the combined effects of these interventions is limited. Our study directly addresses this gap by examining the effect of combinations of 5 preventive interventions on length-for-age z-scores (LAZ) among 2-years old children., Methods: This community-based cluster randomised trial (c-RCT) compares 4 intervention combinations against one comparison arm. Intervention combinations are: 1) Behaviour change communication (BCC) on maternal nutrition during pregnancy, exclusive breastfeeding, and complementary feeding, along with prenatal nutritional supplement (PNS) and complementary food supplement (CFS); 2) BCC with PNS; 3) BCC with CFS; and 4) BCC alone. The comparison arm receives only routine health and nutrition services. From a rural district, 125 clusters were selected and randomly assigned to any one of the five study arms by block randomisation. A bespoke automated tab-based system was developed linking data collection, intervention delivery and project supervision. Total sample size is 1500 pregnant women, with minimum 1050 resultant children expected to be retained, powered to detect a difference of at least 0.4 in the mean LAZ score of children at 24 months, the main outcome variable, between the comparison arm and each intervention arm. Length and other anthropometric measurements, nutritional intake and other relevant data on mother and children are being collected during enrolment, twice during pregnancy, postpartum monthly till 6 months, and every third month thereafter till 24 months., Discussion: This c-RCT explores the effectiveness of bundles of preventive nutrition intervention approaches addressing the critical window of opportunity to mitigate childhood stunting. The results will provide robust evidence as to which bundle(s) can have significant effect on linear growth of children. Our study also will have policy-level implications for prioritising intervention(s) tackling stunting., Trial Registration: The study was retrospectively registered on May 2, 2016 and is available online at ClinicalTrials.gov (ID: NCT02768181 ).

Autoimmune hepatitis (AIH) is a chronic inflammation of liver with unclear etiology. It is frequently associated other autoimmune diseases, and its association with celiac disease (CD) is well established. In this article, we describe the case of a 50-year-old male with long-standing AIH taking azathioprine for 10 years, evaluated for flares in transaminases. Despite adding high-dose corticosteroids, his transaminases and bilirubin remained high. Serology for CD was ordered, which revealed elevated tissue transglutaminase antibody IgG and endomysial IgA, which was further confirmed by endoscopic biopsy. Strict gluten-free diet was advised and now for over 2 years he is in remission with azathioprine and budesonide. This emphasizes the role of gluten-free diet in reversing liver dysfunction in patients with AIH, and clinicians should consider screening for CD in patients with AIH with persistent elevation of liver enzymes despite immunosuppressant treatment., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Food materials are complex in nature as it has heterogeneous, amorphous, hygroscopic and porous properties. During processing, microstructure of food materials changes which significantly affects other properties of food. An appropriate understanding of the microstructure of the raw food material and its evolution during processing is critical in order to understand and accurately describe dehydration processes and quality anticipation. This review critically assesses the factors that influence the modification of microstructure in the course of drying of fruits and vegetables. The effect of simultaneous heat and mass transfer on microstructure in various drying methods is investigated. Effects of changes in microstructure on other functional properties of dried foods are discussed. After an extensive review of the literature, it is found that development of food structure significantly depends on fresh food properties and process parameters. Also, modification of microstructure influences the other properties of final product. An enhanced understanding of the relationships between food microstructure, drying process parameters and final product quality will facilitate the energy efficient optimum design of the food processor in order to achieve high-quality food.

Salinity, one of the major environmental constraints, threatens soil health and consequently agricultural productivity worldwide. Acacia auriculiformis , being a halophyte, offers diverse benefits against soil salinity; however, the defense mechanisms underlying salt-tolerant capacity in A. auriculiformis are still elusive. In this study, we aimed to elucidate mechanisms regulating the adaptability of the multi-purpose perennial species A. auriculiformis to salt stress. The growth, ion homeostasis, osmoprotection, tissue tolerance and Na + exclusion, and anatomical adjustments of A. auriculiformis grown in varied doses of seawater for 90 and 150 days were assessed. Results showed that diluted seawater caused notable reductions in the level of growth-related parameters, relative water content, stomatal conductance, photosynthetic pigments, proteins, and carbohydrates in dose- and time-dependent manners. However, the percent reduction of these parameters did not exceed 50% of those of control plants. Na + contents in phyllodes and roots increased with increasing levels of salinity, whereas K + contents and K + /Na + ratio decreased significantly in comparison with control plants. A. auriculiformis retained more Na + in the roots and maintained higher levels of K + , Ca 2+ and Mg 2+ , and K + /Na + ratio in phyllodes than roots through ion selective capacity. The contents of proline, total free amino acids, total sugars and reducing sugars significantly accumulated together with the levels of malondialdehyde and electrolyte leakage in the phyllodes, particularly at day 150 th of salt treatment. Anatomical investigations revealed various anatomical changes in the tissues of phyllodes, stems and roots by salt stress, such as increase in the size of spongy parenchyma of phyllodes, endodermal thickness of stems and roots, and the diameter of root vascular bundle, relative to control counterparts. Furthermore, the estimated values for Na + exclusion and tissue tolerance index suggested that A. auriculiformis efficiently adopted these two mechanisms to address higher salinity levels. Our results conclude that the adaptability of A. auriculiformis to salinity is closely associated with ion selectivity, increased accumulation of osmoprotectants, efficient Na + retention in roots, anatomical adjustments, Na + exclusion and tissue tolerance mechanisms.

Lysosomes rely on their resident transporter proteins to return products of catabolism to the cell for reuse and for cellular signaling, metal storage, and maintaining the lumenal environment. Despite their importance, little is known about the lifetime of these transporters or how they are regulated. Using Saccharomyces cerevisiae as a model, we discovered a new pathway intrinsic to homotypic lysosome membrane fusion that is responsible for their degradation. Transporter proteins are selectively sorted by the docking machinery into an area between apposing lysosome membranes, which is internalized and degraded by lumenal hydrolases upon organelle fusion. These proteins have diverse lifetimes that are regulated in response to protein misfolding, changing substrate levels, or TOR activation. Analogous to endocytosis for controlling surface protein levels, the "intralumenal fragment pathway" is critical for lysosome membrane remodeling required for organelle function in the context of cellular protein quality control, ion homeostasis, and metabolism., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Lysosomal membrane fusion mediates the last step of the autophagy and endocytosis pathways and supports organelle remodeling and biogenesis. Because fusogenic proteins and lipids concentrate in a ring at the vertex between apposing organelle membranes, the encircled area of membrane can be severed and internalized within the lumen as a fragment upon lipid bilayer fusion. How or why this intralumenal fragment forms during fusion, however, is not entirely clear. To better understand this process, we studied fragment formation during homotypic vacuolar lysosome membrane fusion in Saccharomyces cerevisiae Using cell-free fusion assays and light microscopy, we find that GTPase activation and trans-SNARE complex zippering have opposing effects on fragment formation and verify that this affects the morphology of the fusion product and regulates transporter protein degradation. We show that fragment formwation is limited by stalk expansion, a key intermediate of the lipid bilayer fusion reaction. Using electron microscopy, we present images of hemifusion diaphragms that form as stalks expand and propose a model describing how the fusion machinery regulates fragment formation during lysosome fusion to control morphology and protein lifetimes., (© 2017 Mattie et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).)

Background: This study aims to evaluate the clinical and quality of health outcomes in patients undergoing laparoscopic repair of intrathoracic stomach with or without gastric volvulus., Materials and Methods: From January 2007 to December 2013, a prospectively maintained data, of patients undergoing surgical repair of intrathoracic stomach, with or without gastric volvulus, was reviewed. Patient demographics, ASA grade, diagnostic technique, semiurgent/emergency status, type of volvulus if present, details of surgery and perioperative complications were recorded. Validated SF-36 questionnaires were completed by patients to record preoperative and postoperative quality of life (QoL) status. Patients managed by nonoperative measures were excluded from the study., Results: Thirty patients were identified with intrathoracic stomach. Fourteen patients had gastric volvulus. Twenty-seven patients (10 emergency, 17 semiurgent) underwent laparoscopic repair of intrathoracic stomach and were included in the study. Mean operating time was 156 (SD, 37.5; range, 105 to 230) minutes. All 27 operations were completed by laparoscopic approach. There was no conversion to open procedure or mortality at 30 days. Mean hospital stay was 5.2 (range, 1 to 15) days. There were 3 (11%) early postoperative complications. One (3.7%) patient developed recurrence at 2 years which required reoperation. Mean follow-up was 10.5 (range, 1 to 36) months. ASA grade and operative time determined the postoperative hospital stay (P=0.001, 0.001, respectively), whereas body mass index and age were shown to have no influence. Patient-reported QoL scores improved across all scales of the health questionnaire after surgery especially bodily pain, social functioning, and physical functioning., Conclusions: Laparoscopic surgery is a safe and effective treatment option for intrathoracic stomach, with or without gastric volvulus. It is associated with low rates of complications and recurrence. Self-reported patient data shows significant improvement to overall QoL after surgery for intrathoracic stomach.

The hemochorial placenta develops from the coordinated multilineage differentiation of trophoblast stem (TS) cells. An invasive trophoblast cell lineage remodels uterine spiral arteries, facilitating nutrient flow, failure of which is associated with pathological conditions such as preeclampsia, intrauterine growth restriction, and preterm birth. Hypoxia plays an instructive role in influencing trophoblast cell differentiation and regulating placental organization. Key downstream hypoxia-activated events were delineated using rat TS cells and tested in vivo, using trophoblast-specific lentiviral gene delivery and genome editing. DNA microarray analyses performed on rat TS cells exposed to ambient or low oxygen and pregnant rats exposed to ambient or hypoxic conditions showed up-regulation of genes characteristic of an invasive/vascular remodeling/inflammatory phenotype. Among the shared up-regulated genes was matrix metallopeptidase 12 (MMP12). To explore the functional importance of MMP12 in trophoblast cell-directed spiral artery remodeling, we generated an Mmp12 mutant rat model using transcription activator-like nucleases-mediated genome editing. Homozygous mutant placentation sites showed decreased hypoxia-dependent endovascular trophoblast invasion and impaired trophoblast-directed spiral artery remodeling. A link was established between hypoxia/HIF and MMP12; however, evidence did not support Mmp12 as a direct target of HIF action. Lysine demethylase 3A (KDM3A) was identified as mediator of hypoxia/HIF regulation of Mmp12 Knockdown of KDM3A in rat TS cells inhibited the expression of a subset of the hypoxia-hypoxia inducible factor (HIF)-dependent transcripts, including Mmp12, altered H3K9 methylation status, and decreased hypoxia-induced trophoblast cell invasion in vitro and in vivo. The hypoxia-HIF-KDM3A-MMP12 regulatory circuit is conserved and facilitates placental adaptations to environmental challenges., Competing Interests: The authors declare no conflict of interest.

Background: Visceral Leishmaniasis (VL), a severe parasitic disease, could be fatal if diagnosis and treatment is delayed. Post kala-azar dermal leishmaniasis (PKDL), a skin related outcome, is a potential reservoir for the spread of VL. Diagnostic tests available for VL such as tissue aspiration are invasive and painful although they are capable of evaluating the treatment response. Serological tests although less invasive than tissue aspiration are incompetent to assess cure. Parasitological examination of slit-skin smear along with the clinical symptoms is routinely used for diagnosis of PKDL. Therefore, a noninvasive test with acceptable sensitivity and competency, additionally, to decide cure would be an asset in disease management and control., Methodology/principal Findings: We describe here, the development of antibody-capture ELISA and field adaptable dipstick test as noninvasive diagnostic tools for VL and PKDL and as a test of cure in VL treatment. Sensitivity and specificity of urine-ELISA were 97.94% (95/97) and 100% (75/75) respectively, for VL. Importantly, dipstick test demonstrated 100% sensitivity (97/97) and specificity (75/75) in VL diagnosis. Degree of agreement of the two methods with tissue aspiration was 98.83% (κ = 0.97) and 100% (κ = 1), for ELISA and dipstick test, respectively. Both the tests had 100% positivity for PKDL (14/14) cases. ELISA and dipstick test illustrated treatment efficacy in about 90% (16/18) VL cases when eventually turned negative after six months of treatment., Conclusions/significance: ELISA and dipstick test found immensely effective for diagnosis of VL and PKDL through urine samples thus, may substitute the existing invasive diagnostics. Utility of these tests as indirect methods of monitoring parasite clearance can define infected versus cured. Urine-based dipstick test is simple, sensitive and above all noninvasive method that may help not only in active VL case detection but also to ascertain treatment response. It can therefore, be deployed widely for interventions in disease management of VL particularly in poor resource outskirts., Competing Interests: The authors declare no competing interests

Purpose: This work aimed at studying the effect of tourniquet use on surgical performance and peri-operative outcomes of anatomic single-bundle ACL reconstruction., Methods: Eighty-four patients undergoing ACL surgery were randomized into two groups: the tourniquet (A) group and the non-tourniquet (B) group. Post-operative pain, need for analgesics, the volume of blood obtained in the drain, girth diameter changes in the thigh and calf, muscle strength and amount of haemarthrosis were used as outcome measures to compare the two groups., Results: Fifty-eight patients were available for analysis. In the A group, the degree of pain and need to analgesics was significantly higher at 4 and 10 h. The volume measured in the surgical drain, at 24 h post-operative, was higher in the A group (p = 0.001). The calf and thigh girth diameters at 2 weeks showed a highly significant girth difference between the two groups (p = 0.001)., Conclusion: This study showed that tourniquet use in ACL reconstruction increases immediate post-operative symptoms of pain and haemarthrosis and that the effects on muscle strength are only temporary. The tourniquet can be replaced by using of a mixture of morphine and adrenaline with no interference with the quality of visibility, nor operative time., Level of Evidence: I.

The progesterone receptor (PGR) is a ligand-activated transcription factor with key roles in the regulation of female fertility. Much has been learned of the actions of PGR signaling through the use of pharmacologic inhibitors and genetic manipulation, using mouse mutagenesis. Characterization of rats with a null mutation at the Pgr locus has forced a reexamination of the role of progesterone in the regulation of the female reproductive cycle. We generated two Pgr mutant rat models, using genome editing. In both cases, deletions yielded a null mutation resulting from a nonsense frame-shift and the emergence of a stop codon. Similar to Pgr null mice, Pgr null rats were infertile because of deficits in sexual behavior, ovulation, and uterine endometrial differentiation. However, in contrast to the reported phenotype of female mice with disruptions in Pgr signaling, Pgr null female rats exhibit robust estrous cycles. Cyclic changes in vaginal cytology, uterine histology, serum hormone levels, and wheel running activity were evident in Pgr null female rats, similar to wild-type controls. Furthermore, exogenous progesterone treatment inhibited estrous cycles in wild-type female rats but not in Pgr-null female rats. As previously reported, pharmacologic antagonism supports a role for PGR signaling in the regulation of the ovulatory gonadotropin surge, a result at variance with experimentation using genetic ablation of PGR signaling. To conclude, our findings in the Pgr null rat challenge current assumptions and prompt a reevaluation of the hormonal control of reproductive cyclicity.

This prospective study was conducted to compare the outcome of endoscopic sinus surgery (ESS) using SNOT-20 score chart (subjective) and Lund & Kennedy scoring chart (objective) and carried out in the Department of Otolaryngology & Head-Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Dhaka Medical College Hospital (DMCH) & Shaheed Suhrawardy Medical College Hospital (ShSMCH) from July 2010 to March 2012. Total 73 admitted cases were selected purposively for ESS, male 53(72.60%) and female 20(27.40%). Among the study participants 10(13.7%) had chronic rhinosinusitis with bilateral polyposis and 26(35.62%) had chronic rhinosinusitis with unilateral polyposis and 12(16.44%) had bilateral chronic rhinosinusitis without polyposis and 25(34.25%) had unilateral chronic rhinosinusitis without polyposis. Surgical procedures done among the patients were Uncinectomy (infundibulectomy), Middle Meatal Antrostomy; Anterior Ethmoidectomy; Sphenoidotomy, Associated septoplasty and no significant per or post operative complications were noted. In Chronic rhinosinusitis (CRS) with polyposis pre operative SNOT-20 mean and SD 1.322±0.341 and post ESS snot-20 mean and SD 0.3472±0.0755, CRS without polyposis pre operative SNOT-20 mean and SD 0.9297±0.86 and post ESS SNOT-20 mean and SD 1986±0.0558. In CRS with polyposis pre operative Lund & Kennedy score of endoscopic assessment, mean and SD 5.333±2.255 and post ESS mean and SD 1.31±1.009. In CRS without polyposis pre op Lund & Kennedy score mean and SD 3.108±1.074 and post ESS mean and SD 0.76±0.641.Post ESS SNOT-20 in CRS with Polyposis, 't' test result was 27.58 which was significant (p<0.001) and in CRS without Polyposis was 21.622 which was significant (p<0.001); Lund & Kennedy Score of post ESS in CRS with Polyposis 't' test result was 7.763 which was significant (p<0.001), CRS without Polyposis was 7.177 which was significant (p<0.001).This implies that outcome of ESS in treatment of CRS with or without polyposis had statistically significant role. Symptomatic relief and quality of life improvement after ESS was compared by improvement in post operative scores of SNOT-20 & Lund-Kennedy score of endoscopic assessment. Post operative lower values were considered to be better improvement status. The results of the study suggests that ESS performed in Chronic Rhinosinusitis without Polyposis cases, relief of symptoms and quality of life improved was better than Chronic Rhinosinusitis with Polyposis cases postoperatively as compared by SNOT-20 and Lund & Kennedy score of endoscopic assessment.

Background: Nurses play a key role in providing care for the critically ill in the intensive care unit (ICU). The physical, psychological, emotional and spiritual intimate care given by Kurdish nurses allows them to develop a therapeutic relationship with terminally ill patients in the ICU., Aims: This study sought to explore the meaning of caring for terminally ill patients from the perspective of Kurdish ICU nurses., Design: Van Manen's (1990) hermeneutic phenomenological design was adopted., Method: The data were collected through in-depth semi-structured interviews with a purposive sample of 10 nurses working in ICUs. Interviews were transcribed and finally analysed according to Van Manen's method., Results: Four major themes including emotional labour, death as a positive dimension, optimistic rather than futile care and working within constraints emerged., Conclusions: Kurdish nurses in their caring encounters with terminally ill patients experienced a range of feelings from emotional strain to being optimistic while working within limited resources in the ICU. Further research is needed to explore the experiences of nurses with other cultures of caring for terminally ill patients in ICUs., Relevance to Practice: End-of-life care in ICU is emotionally challenging, therefore, nurses in this setting require psychological and spiritual support to ensure optimal care provision., (© 2015 British Association of Critical Care Nurses.)

Background: Hypertension is a major risk factor for several cardiovascular diseases (CVD). The prevalence of hypertension is increasing in Bangladesh, especially in urban areas. The objective of this study was to estimate the prevalence of hypertension and its risk factors in an urban area of Bangladesh., Methods: We conducted a cross-sectional survey involving participants aged ≥ 25 years in an urban area in Dhaka between June-December 2012, using multi-stage random sampling. Data on socioeconomic status, tobacco use, physical activity, diet, extra-salt use, family history of hypertension, CVD, anthropometric measurements and blood pressure were collected using modified WHO-STEPS protocol. Hypertension and pre-hypertension were defined according to JNC-7. Multiple logistic regressions models were used to identify risk factors associated with hypertension., Results: The overall age-adjusted prevalence hypertension and pre-hypertension among 730 participants was 23.7% and 19%, respectively, which was higher among males compared to females (23.6% vs 21.71% and 21.7% vs 17.0%, respectively). Bivariate analysis showed significant relationship of hypertension with age, BMI, no physical activity, tobacco use, extra salt intake and family history of stroke/cardiovascular disease. In the multivariate model, factors significantly associated with hypertension were older age (OR 19.18, 95% CI 13.58-28.11), smoking (OR 3.47, 95% CI 2.85-5.19), extra salt intake (OR 1.13, 95% CI 1.04-2.21), and high waist circumference (OR 3.41, 95% CI 2.81-5.29)., Conclusions: The prevalence of hypertension and pre-hypertension was high among our study participants. Population-based intervention programs and policies for increased awareness about the risk factors, and life-style modification are essential for prevention of hypertension.

A 74-year-old woman with end-stage renal disease presented with clinical symptoms of encapsulating peritoneal sclerosis 2 years after switching from peritoneal dialysis to haemodialysis. Imaging revealed a large cystic structure in her abdomen and her final diagnosis was made by exploratory laparotomy. A 10 cm×15 cm fibrous rind was excised from the peritoneum and the patient was subsequently started on tamoxifen 20 mg daily and prednisone 20 mg daily. Given her reduction in clinical symptoms and concerns about the long-term effects of corticosteroids, prednisone was tapered and she remained on tamoxifen monotherapy. 1 year postsurgery, she presented with symptoms of nausea, vomiting and anorexia. A repeat CT of the abdomen confirmed a recurrence of encapsulating peritoneal sclerosis. Prednisone and tamoxifen were restarted at increased dosages of 25 and 40 mg daily, respectively. The patient's symptoms were ameliorated within 2 weeks of drug therapy modification., (2015 BMJ Publishing Group Ltd.)

Epithelial barrier integrity is dependent on progenitor cells that either divide to replenish themselves or differentiate into a specialized epithelium. This paradigm exists in human placenta, where cytotrophoblast cells either propagate or undergo a unique differentiation program: fusion into an overlying syncytiotrophoblast. Syncytiotrophoblast is the primary barrier regulating the exchange of nutrients and gases between maternal and fetal blood and is the principal site for synthesizing hormones vital for human pregnancy. How trophoblast cells regulate their differentiation into a syncytium is not well understood. In this study, we show that the transcription factor OVO-like 1 (OVOL1), a homolog of Drosophila ovo, regulates the transition from progenitor to differentiated trophoblast cells. OVOL1 is expressed in human placenta and was robustly induced following stimulation of trophoblast differentiation. Disruption of OVOL1 abrogated cytotrophoblast fusion and inhibited the expression of a broad set of genes required for trophoblast cell fusion and hormonogenesis. OVOL1 was required to suppress genes that maintain cytotrophoblast cells in a progenitor state, including MYC, ID1, TP63, and ASCL2, and bound specifically to regions upstream of each of these genes. Our results reveal an important function of OVOL1 as a regulator of trophoblast progenitor cell fate during human trophoblast development.

In this report, we investigated the consequences of neonatal progesterone exposure on adult rat uterine function. Female pups were subcutaneously injected with vehicle or progesterone from postnatal days 3 to 9. Early progesterone exposure affected endometrial gland biogenesis, puberty, decidualization, and fertility. Because decidualization and pregnancy success are directly linked to progesterone action on the uterus, we investigated the responsiveness of the adult uterus to progesterone. We first identified progesterone-dependent uterine gene expression using RNA sequencing and quantitative RT-PCR in Holtzman Sprague-Dawley rats and progesterone-resistant Brown Norway rats. The impact of neonatal progesterone treatment on adult uterine progesterone responsiveness was next investigated using quantitative RT-PCR. Progesterone resistance affected the spectrum and total number of progesterone-responsive genes and the magnitude of uterine responses for a subset of progesterone targets. Several progesterone-responsive genes in adult uterus exhibited significantly dampened responses in neonatally progesterone-treated females compared with those of vehicle-treated controls, whereas other progesterone-responsive transcripts did not differ between female rats exposed to vehicle or progesterone as neonates. The organizational actions of progesterone on the uterus were dependent on signaling through the progesterone receptor but not estrogen receptor 1. To summarize, neonatal progesterone exposure leads to disturbances in endometrial gland biogenesis, progesterone resistance, and uterine dysfunction. Neonatal progesterone effectively programs adult uterine responsiveness to progesterone.

Placentation is a process that establishes the maternal-fetal interface and is required for successful pregnancy. The epithelial component of the placenta consists of trophoblast cells, which possess the capacity for multilineage differentiation and are responsible for placenta-specific functions. FOS-like antigen 1 (FOSL1), a component of AP-1 transcription factor complexes, contributes to the regulation of placental development. FOSL1 expression is restricted to trophoblast giant cells and invasive trophoblast cells. In the present study, we characterized the FOSL1 regulatory pathway in rat trophoblast cells. Transcriptome profiling in control and FOSL1 knockdown cells identified FOSL1-dependent gene sets linked to endocrine and invasive functions. FOSL1 was shown to occupy AP-1 binding sites within these gene loci, as determined by chromatin immunoprecipitation (ChIP). Complementary in vivo experiments using trophoblast-specific lentiviral delivery of FOSL1 short hairpin RNAs (shRNAs) provided in vivo validation of FOSL1 targets. FOSL1 actions require a dimerization partner. Coimmunoprecipitation, coimmunolocalization, and ChIP analyses showed that FOSL1 interacts with JUNB and, to a lesser extent, JUN in differentiating trophoblast cells. Knockdown of FOSL1 and JUNB expression inhibited both endocrine and invasive properties of trophoblast cells. In summary, FOSL1 recruits JUNB to form AP-1 transcriptional complexes that specifically regulate the endocrine and invasive trophoblast phenotypes., (Copyright © 2015, American Society for Microbiology. All Rights Reserved.)

Background: South Asians have a higher overall incidence rate and younger age of onset for acute myocardial infarction (AMI) compared to Western populations. However, limited information is available on the association of preventable risk factors and outcomes of AMI among young individuals in Bangladesh. The aim of this study was to determine the risk factors and in-hospital outcome of AMI among young (age ≤40 years) adults in Bangladesh., Methods: We conducted a prospective observational study among consecutive 50 patients aged ≤40 years and 50 patients aged >40 years with acute ST Segment Elevation Myocardial Infarction (STEMI) and followed-up in-hospital at the National Institute of Cardiovascular Diseases (NICVD). Clinical characteristics, biochemical findings, diet, echocardiography and in-hospital outcomes were compared between the two groups. Multivariate logistic regression was performed to assess the association between risk factors and in-hospital outcome in young patients adjusting for other confounding variables., Results: The mean age of the young and older patient groups was 36.5 ± 4.6 years and 57.0 ± 9.1 years respectively. Male sex (OR 3.4, 95 % CI 1.2 - 9.75), smoking (OR 2.4, 95 % CI 1.04 - 5,62), family history of MI (OR 2.4, 95 % CI 1.11 - 5,54), homocysteine (OR 1.2, 95 % CI 1.08 - 1.36), eating rice ≥2 times daily (OR 3.5, 95 % CI 1.15 - 10.6) and eating beef (OR 4.5, 95 % CI 1.83 - 11.3) were significantly associated with the risk of AMI in the young group compared to older group. In multivariate analysis, older patients had significantly greater chance of developing heart failure (OR 7.5, 95 % CI 1.51 to 37.31), re-infarction (OR 7.0, 95 % CI 1.08 - 45.72), arrhythmia (OR 15.3, 95 % CI 2.69 - 87.77) and cardiogenic shock (OR 69.0, 95 % CI 5.81 - 85.52) than the younger group., Conclusion: Younger AMI patients have a different risk profile and better in-hospital outcomes compared to the older patients. Control of preventable risk factors such as smoking, unhealthy diet, obesity and dyslipidemia should be reinforced at an early age in Bangladesh.

Gravure printing is an attractive technique for patterning high-resolution features (<5 μm) at high speeds (>1 m/s), but its electronic applications have largely been limited to depositing nanoparticle inks and polymer solutions on plastic. Here, we extend the scope of gravure to a new class of materials and on to new substrates by developing viscous sol-gel precursors for printing fine lines and films of leading transparent conducting oxides (TCOs) on flexible glass. We explore two strategies for controlling sol-gel rheology: tuning the precursor concentration and tuning the content of viscous stabilizing agents. The sol-gel chemistries studied yield printable inks with viscosities of 20-160 cP. The morphology of printed lines of antimony-doped tin oxide (ATO) and tin-doped indium oxide (ITO) is studied as a function of ink formulation for lines as narrow as 35 μm, showing that concentrated inks form thicker lines with smoother edge morphologies. The electrical and optical properties of printed TCOs are characterized as a function of ink formulation and printed film thickness. XRD studies were also performed to understand the dependence of electrical performance on ink composition. Printed ITO lines and films achieve sheet resistance (Rs) as low as 200 and 100 Ω/□, respectively (ρ≈2×10(-3) Ω-cm) for single layers. Similarly, ATO lines and films have Rs as low as 700 and 400 Ω/□ with ρ≈7×10(-3) Ω-cm. High visible range transparency is observed for ITO (86-88%) and ATO (86-89%). Finally, the influence of moderate bending stress on ATO films is investigated, showing the potential for this work to scale to roll-to-roll (R2R) systems.

We report the first demonstration of inkjet-printed 4-terminal microelectromechanical (MEM) relays and inverters with hyper-abrupt switching that exhibit excellent electrical and mechanical characteristics. This first implementation of a printed 4-terminal device is critically important, since it allows for the realization of full complementary logic functions. The floated fourth terminal (body electrode), which allows the gate switching voltage to be adjusted, is bonded to movable channel beams via a printed epoxy layer in a planar structure, which can move downward together via the electrostatic force between the gate electrodes and body such that the channel can also actuate downward and touch the drain electrode. Because the body, channel, and drain electrodes are completely electrically separated, no detectable leakage or electrical interference between the electrodes is observed. The printed MEM relay exhibited an on-state resistance of only 3.48 Ω, immeasurable off-state leakage, subthreshold swing <1 mV/dec, and a stable operation over 10(4) cycles with a switching delay of 47 μs, and the relay inverter exhibits abrupt transitions between on/off states. The operation of the printed 4-terminal MEM relay was also verified against the results of a 3-dimensional (3D) finite element simulation.

Background and Aims: There is an increased trend in prevalence of pancreato-biliary disease in the elderly population. Consequently there is an increasing demand for endoscopic retrograde cholangiopancreatography (ERCP). The aims of this study were to compare ERCP outcomes in patients over 80 with those aged between 60 and 79 years and with the published literature., Methods and Results: Data were collected from a prospectively maintained database. All patients over the age of 60 years who underwent ERCP from May 2010 to May 2012 were identified. Two cohorts were formed, group A: 60-79 years (n = 66) and group B: > 80 years old (n = 49). Data on indications for ERCP, outcome, complications and repeat procedures were collected. One hundred and fifteen patients between the age of 60 and 92 years were identified. Group A had a total of 89 ERCPs and group B 69. Cannulation, overall procedure success, complication and mortality rates were comparable between both groups. Group B contained two cases of perforation with one associated mortality (1.4%) which did not reach statistical significance., Conclusions: ERCP in octogenarians is safe and effective when compared to patients aged 60-79., (© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Metastatic dissemination into lymph nodes of neck occurs frequently in head neck cancers which down grade the patient's curability and survival. Neck dissection is a curable option for its management. To evaluate the complications following different types of neck dissection. This cross sectional study was conducted among patients undergone different types of neck dissection due to cervical nodal metastasis and attended follow up during July 2010 to June 2011 in Department of ENTs and Head-Neck surgery Dhaka Medical College Hospital, Dhaka, Bangladesh. Among 30 selected patient, 23 were male (76.67%) and 7 were female (23.33%), age ranged from 31-72 years (Mean=59.1±5.44). In different modalities of neck dissection 11 were modified neck dissection (36.67%) and 10(33.33%) were radical neck dissection. Common indication was carcinoma of unknown origin (66.67%). Involved neck nodes were commonly level II-IV (69.99%). Nodal stage was N2(50%) and N3 (40%).Common immediate complications were bleeding 03(10%), facial oedema 02 (6.67%) and thoracic duct injury 02(6.67%). Intermediate complications were seroma 05(16.67%), wound infection 04(13.33%) and chylous fistula 02(6.67%), Late Complications were hypertrophic scar 07(23.33%) and shoulder syndrome 06(20%). Proper indications, skilled surgery along with early recognize and treatment in both early and late manifestations of neck dissection preventing its grave sequence.

Estrogens play pivotal roles in development and function of many organ systems, including the reproductive system. We have generated estrogen receptor 1 (Esr1)-knockout rats using zinc finger nuclease (ZFN) genome targeting. mRNAs encoding ZFNs targeted to exon 3 of Esr1 were microinjected into single-cell rat embryos and transferred to pseudopregnant recipients. Of 17 live births, 5 had biallelic and 1 had monoallelic Esr1 mutations. A founder with monoallelic mutations was backcrossed to a wild-type rat. Offspring possessed only wild-type Esr1 alleles or wild-type alleles and Esr1 alleles containing either 482 bp (Δ482) or 223 bp (Δ223) deletions, indicating mosaicism in the founder. These heterozygous mutants were bred for colony expansion, generation of homozygous mutants, and phenotypic characterization. The Δ482 Esr1 allele yielded altered transcript processing, including the absence of exon 3, aberrant splicing of exon 2 and 4, and a frameshift that generated premature stop codons located immediately after the codon for Thr157. ESR1 protein was not detected in homozygous Δ482 mutant uteri. ESR1 disruption affected sexually dimorphic postnatal growth patterns and serum levels of gonadotropins and sex steroid hormones. Both male and female Esr1-null rats were infertile. Esr1-null males had small testes with distended and dysplastic seminiferous tubules, whereas Esr1-null females possessed large polycystic ovaries, thread-like uteri, and poorly developed mammary glands. In addition, uteri of Esr1-null rats did not effectively respond to 17β-estradiol treatment, further demonstrating that the Δ482 Esr1 mutation created a null allele. This rat model provides a new experimental tool for investigating the pathophysiology of estrogen action.

Sinusitis is defined as a condition manifested by inflammation of the mucous membrane of the nose & paranasal sinuses, fluid within this cavities and or underlying bone. Chronic rhinosinusitis is diagnosed by the presence of two or more of the following factors facial congestion/fullness, nasal obstruction, nasal discharge or discolored post nasal drainage, hyposmia/anosmia or one major and two of the following minor factors, headache. Halitosis, fatigue, dental pain, cough, ear pressure, fullness. The use of endoscope during surgery of nose & para nasal sinuses improves visualization enable greater preservation of normal structures and reduces the necessity for wide exposure. This cross-sectional study on 50 cases of chronic rhinosinusitis carried out during a period of 6 months. All the cases of both endonasal endoscopic sinus surgery (EESS) group and conventional group assessed clinically endoscopicaly and by imaging both pre and post-operative period. Twenty five cases were EESS group. Twenty five cases of conventional group. Follow-up frequencies are 1st week, 2nd week, 3rd week, 1st month, 3rd months, 6th months. In both type majority of patients in between 21-40 years, most of the cases were male, majority of patients present with headache (80)%, nasal discharge (70%), nasal obstruction (62%), major indication incase of EESS group were ethmoidal polyp 52% & conventional surgery group were chronic sinusitis (56%). Commonest complications were cheek swelling 10(40%) incase of conventional group, crusting 12(84%) in EESS group. Complete recovery incase of EESS were in 21(84%) cases and conventional surgery group 16(64%). Endonasal endoscopic sinus surgery has provided a safe & efficient method for dealing with different sinonasal diseases.

The design and modelling of the buckling effect of Continuous Welded Rail (CWR) requires accurate material constants, especially at elevated temperatures. However, such material constants have rarely been found in literature. In this article, the Young's moduli and shear moduli of rail steel at elevated temperatures are determined by a new sonic resonance method developed in our group. A network analyser is used to excite a sample hanged inside a furnace through a simple tweeter type speaker. The vibration signal is picked up by a Polytec OFV-5000 Laser Vibrometer and then transferred back to the network analyser. Resonance frequencies in both the flexural and torsional modes are measured, and the Young's moduli and shear moduli are determined through the measured resonant frequencies. To validate the measured elastic constants, the measurements have been repeated by using the classic sonic resonance method. The comparisons of obtained moduli from the two methods show an excellent consistency of the results. In addition, the material elastic constants measured are validated by an ultrasound test based on a pulse-echo method and compared with previous published results at room temperature. The measured material data provides an invaluable reference for the design of CWR to avoid detrimental buckling failure., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Extravillous trophoblast invasion is a fundamental component of human placentation. Invading trophoblast cells promote blood flow to the conceptus by actively remodeling the uterine vasculature. The extent of trophoblast invasion is tightly regulated; aberrant invasion is linked with several obstetrical complications. However, the transcriptional networks responsible for controlling the extent of trophoblast invasion are not well defined. Previous studies have identified high levels of FOS (FOS, FOSB, FOS-like (FOSL) 1, and FOSL2) proteins in extravillous trophoblast cells. These proteins form part of the activating protein-1 (AP-1) transcription factor complex and are implicated in regulating gene networks controlling cellular invasion in diverse biological systems. Therefore, we hypothesized that FOS family proteins play a role in regulating trophoblast invasion. We assessed expression of FOS family proteins in trophoblast cell lines and human placentae at different gestational ages. FOS, FOSB, and FOSL1 proteins were robustly increased in trophoblast cells subject to wound-based migration assays as well as Matrigel-based invasion assays. FOS knockdown resulted in cessation of proliferation and an induction of migration and invasion concomitant with robust expression of matrix metalloproteinase (MMP) 1, MMP3, and MMP10. Conversely, FOSL1 knockdown abrogated trophoblast migration and invasion and inhibited the production of MMP1, MMP3, and MMP10. In human placenta, FOS was expressed in proximal anchoring villi in conjunction with phospho-ERK. FOSL1 was temporally expressed only in the distal-most extravillous trophoblast cells, which represent a migratory cell population. Therefore, FOS and FOSL1 exert opposing effects on trophoblast invasion.

Implantation of the embryo into the uterus triggers the initiation of hemochorial placentation. The hemochorial placenta facilitates the acquisition of maternal resources required for embryo/fetal growth. Uterine spiral arteries form the nutrient supply line for the placenta and fetus. This vascular conduit undergoes gestation stage-specific remodeling directed by maternal natural killer cells and embryo-derived invasive trophoblast lineages. The placentation site, including remodeling of the uterine spiral arteries, is shaped by environmental challenges. In this review, we discuss the cellular participants controlling pregnancy-dependent uterine spiral artery remodeling and mechanisms responsible for their development and function.

Purpose: To compare the utility of various hospital services used by morbidly obese patients before and after bariatric surgery., Methods: The subjects of this retrospective study were 73 consecutive patients, who underwent elective laparoscopic bariatric surgery between May 2008 and December 2010. There were 58 women and 15 men, with a median age of 45 years (IQR 26-65 years). The preoperative period ranged from 42 to 72 months (median 60 months) and the follow-up period ranged from 12 to 42 months (median 24 months). The health services analyzed included visits to emergency and outpatient departments, admissions to hospital, length of stay in hospital, and changes in regular medication before and after surgery. We also analyzed the economic results., Results: In the post-procedure period, outpatient clinic visits were reduced by 13.8% per year (p = 0.04), the number of hospital admissions per year were reduced by 40.2% (p = 0.01), the total length of stay in hospital was reduced by 52.28% per year (p = 0.04), and regular medications were reduced by 26% (p = 0.003). There was no change in the use of emergency services. The total estimated cost saving ranged between $32,593 and 41,177 per year., Conclusion: The utilization of various health services decreased soon after bariatric surgery, which translated into significant cost savings. This was mainly due to each patient's reduction in body weight and improvement in their chronic metabolic disorders.

Introduction: The increasing prevalence of obesity has now become a global concern. Forecasts of its health and financial ramifications have prompted the need for effective interventions. Bariatric surgery is an effective measure to control obesity and its related comorbidities, but its high up-front costs have raised questions about its cost-effectiveness. In this study we evaluated the health care-related direct cost savings after bariatric surgery., Methods: Data were prospectively obtained from patients who underwent bariatric surgery between May 2008 and April 2011, and a review was performed. These patients' annual cost of regular medications, hospital admissions and outpatient clinic visits were compared with the postoperative costs of these services. Data were collected from January 2005 to April 2012., Results: The analysis included 88 patients, 17 of whom were men and 71 were women. The procedures included 36 laparoscopic adjustable gastric banding, 33 sleeve gastrectomies and 19 Roux-en-Y gastric bypasses. All procedures were laparoscopic. Data were collected from patients during a median preoperative period of 60 months (range, 42-75 months) and a median postoperative period of 24 months (range, 12-45 moths). Annual savings were £11 452 on medications, £16 420 on hospital admissions and £2532 on outpatient clinic visits. Total annual savings were £30 404., Conclusion: Given the rising prevalence of morbid obesity, bariatric surgery is a cost-effective treatment for morbid obesity and should be made available to morbidly obese patients., (© 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.)

A 40-year-old woman presented with small bowel obstruction caused by an internal hernia through Peterson's defect. The patient was known to have midgut malrotation (MM) and also had laparoscopic Roux-en-Y gastric bypass for morbid obesity 6 years prior. An open revision of Roux-en-Y gastric bypass was performed as a result of ischemia of alimentary limb. She made a slow but uneventful recovery and was discharged home. MM is a rare congenital anomaly that requires the surgeon to be well aware of the unique variation in anatomy to perform a mirror image of the routine Roux-en-Y gastric bypass. At the end of this case report, we present a short literature review of published data related to MM encountered during Roux-en-Y gastric bypass.

We describe an apparatus for the measurement of acoustic wave propagation under uniaxial loading featuring a special mechanism designed to assure a uniform mechanical load on a cube-shaped sample of piezoelectric material. We demonstrate the utility of the apparatus by determining the effects of stresses on acoustic wave speed, which forms a foundation for the final determination of the third-order elastic constants of langasite and langatate single crystals. The transit time method is used to determine changes in acoustic wave velocity as the loading is varied. In order to minimize error and improve the accuracy of the wave speed measurements, the cross correlation method is used to determine the small changes in the time of flight. Typical experimental results are presented and discussed.

Introduction: The redundant skin left behind after laparoscopic ventral hernia repair overlies a dead space that is a potential site for seroma formation. This predisposes patients to surgical-site infection and compromises the cosmetic outcome of the procedure, which is a key feature of the minimally invasive approach. We present a simple technique to deal with this problem., Materials and Surgical Technique: This technique was used in six patients who underwent laparoscopic ventral hernia repair. Two patients were men and four were women. At the end of the procedure, glue (fibrin sealant) was injected in the dead space underneath the redundant skin and pressure was applied for some time; this attached the excessive skin to the underlying tissue. This obliterated the potential dead space, reducing the chances of seroma formation, and improved the cosmetic outcome of the procedure. Patients were reviewed 8 weeks after the procedure, and their body contours had returned to normal, with no skin redundancy., Discussion: Minimally invasive surgery offers the advantage of a shorter hospital stay, faster recovery and improved cosmetic outcome, achieving better patient satisfaction as a result. This simple technique at the end of laparoscopic ventral hernia repair, in which the redundant skin is attached to the underlying tissue, improves the immediate postoperative cosmetic outcome and also obliterates any potential dead space for seroma formation., (© 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.)

The study was aimed to find out the impact of metabolic syndrome in patients with acute myocardial infarction during hospital stay. This prospective study was carried out in coronary care unit, Mymensingh Medical College Hospital from August 2009 to May 2010. Patients were followed up for minimum 3 days to maximum 6 days after admission. Variables of this study were age, sex, smoking, anterior AMI, inferior AMI, Non STEMI, hyperglycemia, low high density lipoprotein (HDL), raised blood pressure, high triglyceride (TG), waist circumference, recurrent non fatal MI, heart failure (Killip class), arrhythmia (VT, VF), ejection fraction (EF), family history of cardiovascular (CV) risk factors. Considering inclusion and exclusion criteria total 100 patients were included and divided into two groups, Group A - Acute Myocardial Infarction (AMI) with Metabolic Syndrome (MS) and Group B - Acute Myocardial Infarction (AMI) without Metabolic Syndrome (MS). Investigations included ECG, FBS, fasting lipid profile, cardiac enzyme (troponin I) and echocardiography (2D & M mode). The data were analyzed by computer software SPSS version 12. Chi-square test, t test, ANOVA test was used as test of significance. Among the study population (n=100), female were 12.0%. Mean age of study population was 53.3±10.6 years vs. 47.5±11.3 years. Distribution of metabolic syndrome components in study population, High TG (?150mg/dl) was more prevalent (81.1% vs. 25.8%). Heart failure (Killip class) was significantly more in metabolic syndrome patients than those without metabolic syndrome (46.0 % vs. 20%). LV ejection fraction also lowers in metabolic syndrome patients (46.76±8.34 vs. 50.45±7.50) with MI. Among the components of metabolic syndrome, hyperglycemia had strongest association for development of heart failure (OR 3.05; 95% CI 0.80-12.14).

The mammalian placenta is remarkably distinct between species, suggesting a history of rapid evolutionary diversification. To gain insight into the molecular drivers of placental evolution, we compared biochemically predicted enhancers in mouse and rat trophoblast stem cells (TSCs) and found that species-specific enhancers are highly enriched for endogenous retroviruses (ERVs) on a genome-wide level. One of these ERV families, RLTR13D5, contributes hundreds of mouse-specific histone H3 lysine 4 monomethylation (H3K4me1)- and histone H3 lysine 27 acetylation (H3K27ac)-defined enhancers that functionally bind Cdx2, Eomes and Elf5-core factors that define the TSC regulatory network. Furthermore, we show that RLTR13D5 is capable of driving gene expression in rat placental cells. Analysis in other tissues shows that species-specific ERV enhancer activity is generally restricted to hypomethylated tissues, suggesting that tissues permissive for ERV activity gain access to an otherwise silenced source of regulatory variation. Overall, our results implicate ERV enhancer co-option as a mechanism underlying the extensive evolutionary diversification of placental development.

Peripheral axons are structurally plastic even in the adult, and altered axon density is implicated in many disorders and pain syndromes. However, mechanisms responsible for peripheral axon remodeling are poorly understood. Physiological plasticity is characteristic of the female reproductive tract: vaginal sensory innervation density is low under high estrogen conditions, such as term pregnancy, whereas density is high in low-estrogen conditions, such as menopause. We exploited this system in rats to identify factors responsible for adult peripheral neuroplasticity. Calcitonin gene-related peptide-immunoreactive sensory innervation is distributed primarily within the vaginal submucosa. Submucosal smooth muscle cells express bone morphogenetic protein 4 (BMP4). With low estrogen, BMP4 expression was elevated, indicating negative regulation by this hormone. Vaginal smooth muscle cells induced robust neurite outgrowth by cocultured dorsal root ganglion neurons, which was prevented by neutralizing BMP4 with noggin or anti-BMP4. Estrogen also prevented axon outgrowth, and this was reversed by exogenous BMP4. Nuclear accumulation of phosphorylated Smad1, a primary transcription factor for BMP4 signaling, was high in vagina-projecting sensory neurons after ovariectomy and reduced by estrogen. BMP4 regulation of innervation was confirmed in vivo using lentiviral transduction to overexpress BMP4 in an estrogen-independent manner. Submucosal regions with high virally induced BMP4 expression had high innervation density despite elevated estrogen. These findings show that BMP4, an important factor in early nervous system development and regeneration after injury, is a critical mediator of adult physiological plasticity as well. Altered BMP4 expression may therefore contribute to sensory hyperinnervation, a hallmark of several pain disorders, including vulvodynia.

The effect of ethylenediaminetetraacetic acid (EDTA) during electrokinetic decontamination (EKD) was investigated in this research. EDTA is a ligand that can form soluble complexes with precipitated heavy metals inside soil pores. Millpond sludge, primarily contaminated with lead (Pb) and zinc (Zn), was subjected to EKD with and without the presence of EDTA. Dilute EDTA solutions with strengths of 0.05 M and 0.125 M were injected into the millpond sludge by electroosmosis. Several beneficial effects of using EDTA were observed in this research. One was that the presence of EDTA substantially increased the electroosmotic (EO) flow in the millpond sludge indicating that it could significantly reduce the duration of EKD. Another advantage was that a significantly higher percentage of Pb and Zn removal was achieved from the solid phase due to the complexation of EDTA with these heavy metals. Also, EDTA was able to prevent the precipitation of metals at the cathode electrode, typically observed in EKD process.

Hemochorial placentation is characterized by extensive remodeling of the maternal vasculature, converting them to flaccid low resistance vessels. This process greatly facilitates exchange of nutrients and gases between the mother and the fetus. Two key modulators that orchestrate these vascular changes have been identified at the maternal fetal interface, natural killer (NK) cells and invasive trophoblast cells. Hypoxia-inducible factor (HIF) transcription factors direct cellular responses to low oxygen, influencing trophoblast lineage commitment and promoting development of the invasive trophoblast lineage. This short review focuses on role of NK cells on uterine spiral artery development and subsequent modulation of oxygen tensions at the maternal fetal interface.

The morphogenesis of the hemochorial placenta is dependent upon the precise expansion and differentiation of trophoblast stem (TS) cells. SATB homeobox 1 (SATB1) and SATB2 are related proteins that have been implicated as regulators of some stem cell populations. SATB1 is highly expressed in TS cells, which prompted an investigation of SATB1 and the related SATB2 as regulators of TS cells. SATB1 and SATB2 were highly expressed in rat TS cells maintained in the stem state and rapidly declined following induction of differentiation. SATB proteins were also present within the rat placenta during early stages of its morphogenesis and disappeared as gestation advanced. Silencing Satb1 or Satb2 expression decreased TS cell self-renewal and increased differentiation, whereas ectopic expression of SATB proteins promoted TS cell expansion and blunted differentiation. Eomes, a key transcriptional regulator of TS cells, was identified as a target for SATB proteins. SATB knockdown decreased Eomes transcript levels and promoter activity, whereas SATB ectopic expression increased Eomes transcript levels and promoter activity. Electrophoretic mobility shift assay as well as chromatin immunoprecipitation analyses demonstrated that SATB proteins physically associate with a regulatory site within the Eomes promoter. We conclude that SATB proteins promote TS cell renewal and inhibit differentiation. These actions are mediated in part by regulating the expression of the TS cell stem-associated transcription factor, EOMES.