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Gilad J Regev,1,2 Roi Treister,3 Silviu Brill,2,4 Dror Ofir,1,2 Khalil Salame,1,2 Zvi Lidar,1,2 Morsi Khashan,1,2 Rivka Litvin,5 Uri Hochberg2,4 1Spine Surgery Unit, Neurosurgical Department, Tel Aviv Medical Center, Tel Aviv, Israel; 2Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel; 3The Cheryl Spencer Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel; 4Institute of Pain Medicine, Division of Anesthesiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; 5Department of surgery, Tel Aviv Medical Center, Tel Aviv, IsraelCorrespondence: Uri Hochberg, Institute of Pain Medicine, Division of Anesthesiology, Tel Aviv Medical Center, 6 Weismann St. Tel-Aviv, Israel, Tel +972-3-6974477, Email urih@tlvmc.gov.ilPurpose: While advanced medical technology and unlimited access to medical information might benefit and empower patients, these same advantages may pose some risks, especially in the cases where patients have direct access to advanced imaging studies. The aim of this work was to evaluate three domains related to patients with lower back pain: the patients’ perceptions, misconceptions and the experience of anxiety-related symptoms following direct access to their thoraco-lumbar spine radiology report. An additional aim was the assessment of possible associations with catastrophization.Patients and Methods: Patients who were referred to the spine clinic, following the completion of a CT or MRI of their thoraco-lumbar spine were surveyed. Patient perceptions of the importance of having direct access to their imaging report and of the concern they attribute to the medical terms found in their report were evaluated using a set of questionnaires. The medical terms severity scores were then correlated to a reference clinical score created for the same medical terms by spine surgeons. Lastly, patients’ anxiety-related symptoms and Pain Catastrophizing Scale (PCS) after reading their radiology report were evaluated.Results: Data from 162 participants (44.6% female), with mean age of 53.1 ± 15.6 years, were collected. Sixty-three percent of the patients stated that reading their report helped them gain better understanding of their medical condition and 84% agreed that having early access to the report helped improve communication with the physician. Patients’ degree of concern associated with the medical terms in their imaging report ranged between 2.07 and 3.75, on a scale of 1– 5. The patient’s degree of concerns were significantly higher for six common medical terms and significantly lower in one, when compared to experts’ opinions. A mean (± SD) of 2.86± 2.79 anxiety-related symptoms was reported. The mean Pain Catastrophizing Scale (PSC) score was 29.18 ± 11.86, ranging from 2 to 52. Both the degree of concerns and the number of symptoms reported were significantly associated with the PCS.Conclusion: Direct access to radiology reports might provoke anxiety symptoms, especially in patients with a tendency for catastrophic thinking. Increasing awareness amongst spine clinicians and radiologist about possible risks associated with direct access to radiology reports could contribute to preventing patients’ misconceptions and unnecessary anxiety-related symptoms.Keywords: low back pain, pain catastrophizing, anxiety, radiology reports

The goal of the present work is to optimize the composition of amorphous molecular semiconductor (AMS) films based on poly(N-vinylcarbazole), to upgrade the process of registration of light fields, and to reveal the role of volume charges in the formation of ordered nanostructures, using reversible templates. It is found that, when gold condenses on the AMS surface, the surface relief increases, and the distribution and symmetry of localized gold clusters are determined by the electric field pattern on the AMS surface. The role of the absorption parameter and the composite substrate is determined, basing on the study of the absorption parameters of the composite with photo-induced charge. The optimal conditions of the composite application for the study of the spectral characteristics of the investigated structures are determined. [ABSTRACT FROM AUTHOR]

The comparative study of gold nanoclusters phase formation processes in the matrix of poly-N-vinilcarbazole ( PVCa) at co-condensation from the gas phase in local electric field near the surface of the template and on the surface of neutral substrates is investigated. TEM studies have directly observed the golden critical nuclei in the PVCa matrix and determine their size. Experimentally proved that the size of the gold critical nuclei is 1.9 nm, whereas in the non-uniform electric field of the template is reduced it to 1.2 nm. Modelling the influence of polarization component on Au nucleation within the thermodynamic approach to electrically charged and neutral gold nanoclusters showed the possibility of the existence of the measured changes in the critical nucleus size in the field 108-1010 V/m. [ABSTRACT FROM AUTHOR]

Introduction Systemic sclerosis (SSc) is a connective tissue disease with multi-system involvement and it has an increased risk of developing hematologic malignancies. This study aims to report the association between hematologic malignancies with SSc and to characterize in-hospital demographics and outcomes in patients with hematologic malignancies with and without SSc. Methods We performed a retrospective review of pooled data from the National Inpatient Sample (NIS) database from 2016 to 2020. Crude prevalence of hematologic malignancies among hospitalized patients with and without SSc was calculated. Logistic regression was used for statistical significance of differences in prevalence while adjusting for confounders. Demographic characteristics and outcomes of patients with hematologic malignancies with and without SSc was compared. Statistical analysis was done using chi-square and multivariate logistic regression. Results Among all adult hospitalizations, the prevalence of hematologic malignancy was 1.87% compared to 2.66% among patients with SSc (adjusted odds ratio (aOR) 1.52, p <0.01). Relative to the non-SSc group, the SSc group had higher odds of in-patient mortality (OR 1.43; 95% confidence interval (CI) 1.11 - 1.87; p<0.01). The prevalence of lymphoma was 0.71% compared to 1.04% among patients with SSc (aOR 1.6, p < 0.01). Relative to the non-SSc group, the lymphoma-SSc group had similar odds of in-patient mortality (OR 0.93; 95% CI 0.55 - 1.59; p=0.80). The prevalence of leukemia was 0.79% compared to 1.28% among patients with SSc (aOR 1.74, p < 0.01). The leukemia-SSc group had higher odds of in-patient mortality (OR 1.78; 95% CI 1.29 - 2.46; p<0.01). For myeloma, there was no difference in the prevalence in adults with and without SSc (0.4 vs. 0.38%, aOR 0.96, p=0.64) and there was no difference of in-hospital mortality. Conclusions There is a positive significant association between hematologic malignancies including lymphoma and leukemia, and SSc. This association was not seen between myeloma and SSc. There is increased in-hospital mortality of patients with leukemia and SSc.

Sickle cell disease (SCD) is an inherited disorder caused secondary to a mutation in the hemoglobin beta subunit. There is sparse information regarding the trends in outcomes of SCD admissions in the past decade where rapid advances have been made in treatment. In this study, we wanted to analyze the trends and outcomes of SCD admissions in the United States from 2011 to 2019 and the influence of socio-economic status. Data were obtained from the National Inpatient Sample (NIS) database using the International Classification of Disease (ICD-9) and ICD-10 codes. Trends for primary in-hospital outcomes including mortality, length of stay (LOS), and total hospitalization charges (THC) were assessed. The impact of economic status on these outcomes was also studied. There was an annual percent change (APC) in the number of admissions for SCD of + 2.5% from 2010 to 2015 (95% CI: 1.3-3.8%, p = 0.003). However, there was no significant change in the number of admissions between 2015 and 2019 (95% CI - 1.8-0.7%, p = 0.323). The overall mortality across the years has decreased by about 4% yearly at the population level (p = 0.008, 95% CI 2-8%). However, the inpatient mortality for the high-income group had decreased significantly from 2010 to 2019, whereas there was no difference in the mortality rate for the low-income group across the decade. Despite the advances in the understanding of SCD and its treatment, its benefits have not reached all the people affected. Meaningful progress in healthcare is not achievable unless these economic disparities are addressed. Economic policies to address these inequities are the need of the hour., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Background: The coronavirus disease 2019 (COVID-19) pandemic has received considerable attention in the scientific community due to its impact on healthcare systems and various diseases. However, little focus has been given to its effect on cancer treatment., Aim: To determine the effect of COVID-19 pandemic on cancer patients' care., Methods: A retrospective review of a Nationwide Readmission Database (NRD) was conducted to analyze hospitalization patterns of patients receiving inpatient chemotherapy (IPCT) during the COVID-19 pandemic in 2020. Two cohorts were defined based on readmission within 30 d and 90 d. Demographic information, readmission rates, hospital-specific variables, length of hospital stay (LOS), and treatment costs were analyzed. Comorbidities were assessed using the Elixhauser comorbidity index. Multivariate Cox regression analysis was performed to identify independent predictors of readmission. Statistical analysis was conducted using Stata ® Version 16 software. As the NRD data is anonymous and cannot be used to identify patients, institutional review board approval was not required for this study., Results: A total of 87755 hospitalizations for IPCT were identified during the pandemic. Among the 30-day index admission cohort, 55005 patients were included, with 32903 readmissions observed, resulting in a readmission rate of 59.8%. For the 90-day index admission cohort, 33142 patients were included, with 24503 readmissions observed, leading to a readmission rate of 73.93%. The most common causes of readmission included encounters with chemotherapy (66.7%), neutropenia (4.36%), and sepsis (3.3%). Comorbidities were significantly higher among readmitted hospitalizations compared to index hospitalizations in both readmission cohorts. The total cost of readmission for both cohorts amounted to 1193000000.00 dollars. Major predictors of 30-day readmission included peripheral vascular disorders [Hazard ratio (HR) = 1.09, P < 0.05], paralysis (HR = 1.26, P < 0.001), and human immunodeficiency virus/acquired immuno-deficiency syndrome (HR = 1.14, P = 0.03). Predictors of 90-day readmission included lymphoma (HR = 1.14, P < 0.01), paralysis (HR = 1.21, P = 0.02), and peripheral vascular disorders (HR = 1.15, P < 0.01)., Conclusion: The COVID-19 pandemic has significantly impacted the management of patients undergoing IPCT. These findings highlight the urgent need for a more strategic approach to the care of patients receiving IPCT during pandemics., Competing Interests: Conflict-of-interest statement: The authors hereby declare no conflict of interest., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Immune thrombocytopenia (ITP) is a diagnosis of exclusion characterized by a low platelet count in patients for whom other etiologies have been ruled out. It occurs due to autoimmune-mediated platelet destruction and thrombopoietin deficiency. ITP is a rare hematologic disorder in adults, and scarce information exists on the hospitalization outcomes among these patients. To address this knowledge gap, we conducted a nationwide population-based study from 2010 to 2019 using the National Inpatient Sample. We found a trend toward an increase in the annual admissions for ITP (from 392.2 to 417.3, p = 0.07). There was a decrease in mortality exclusively for White patients over the period studied (p = 0.03), which was not seen in Black or Hispanic patients. There was an increase in total charges adjusted for inflation for all subgroups (p < 0.01). Length of stay decreased during the decade analyzed (p < 0.01) for the total population and most subgroups. The rates of epistaxis and melena increased (p < 0.01), while rates of intracranial hemorrhage and hematemesis did not change significantly. Advances have been made in the ITP management over the past decade. However, this has not resulted in a decrease in the number of hospitalizations or total healthcare charges during hospitalization. Furthermore, a decrease in mortality was observed in White patients but not in other races. Prospective studies are needed to better characterize the financial burden of the disease, as well as to investigate racial variability in access to care, disease behavior, and response to treatment., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Carotenoids are conjugated linear molecules built from the repetition of terpene units, which display a large structural diversity in nature. They may, in particular, contain several types of side or end groups, which tune their functional properties, such as absorption position and photochemistry. We report here a detailed experimental study of the absorption and vibrational properties of allene-containing carotenoids, together with an extensive modeling of these experimental data. Our calculations can satisfactorily explain the electronic properties of vaucheriaxanthin, where the allene group introduces the equivalent of one C═C double bond into the conjugated C═C chain. The position of the electronic absorption of fucoxanthin and butanoyloxyfucoxanthin requires long-range corrections to be found correctly on the red side of that of vaucheriaxanthin; however, these corrections tend to overestimate the effect of the conjugated and nonconjugated C═O groups in these molecules. We show that the resonance Raman spectra of these carotenoids are largely perturbed by the presence of the allene group, with the two major Raman contributions split into two components. These perturbations are satisfactorily explained by modeling, through a gain in the Raman intensity of the C═C antisymmetric stretching mode, induced by the presence of the allene group in the carotenoid C═C chain.

Calculating the spectroscopic properties of complex conjugated organic molecules in their relaxed state is far from simple. An additional complexity arises for flexible molecules in solution, where the rotational energy barriers are low enough so that nonminimum conformations may become dynamically populated. These metastable conformations quickly relax during the minimization procedures preliminary to density functional theory calculations, and so accounting for their contribution to the experimentally observed properties is problematic. We describe a strategy for stabilizing these nonminimum conformations in silico , allowing their properties to be calculated. Diadinoxanthin and alloxanthin present atypical vibrational properties in solution, indicating the presence of several conformations. Performing energy calculations in vacuo and polarizable continuum model calculations in different solvents, we found three different conformations with values for the δ dihedral angle of the end ring ca. 0, 180, and 90° with respect to the plane of the conjugated chain. The latter conformation, a nonglobal minimum, is not stable during the minimization necessary for modeling its spectroscopic properties. To circumvent this classical problem, we used a Car-Parinello MD supermolecular approach, in which diadinoxanthin was solvated by water molecules so that metastable conformations were stabilized by hydrogen-bonding interactions. We progressively removed the number of solvating waters to find the minimum required for this stabilization. This strategy represents the first modeling of a carotenoid in a distorted conformation and provides an accurate interpretation of the experimental data.

Mutational profiling has demonstrated utility in predicting the likelihood of disease progression in patients with myelofibrosis (MF). However, there is limited data regarding the prognostic utility of genetic profiling in MF patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HCT). We performed high-throughput sequencing of 585 genes on pre-transplant samples from 101 patients with MF who underwent allo-HCT and evaluated the association of mutations and clinical variables with transplantation outcomes. Overall survival (OS) at 5 years post-transplantation was 52%, and relapse-free survival (RFS) was 51.1 % for this cohort. Nonrelapse mortality (NRM) accounted for most deaths. Patient's age, donor's age, donor type, and Dynamic International Prognostic Scoring System score at diagnosis did not predict for outcomes. Mutations known to be associated with increased risk of disease progression, such as ASXL1, SRSF2, IDH1/2, EZH2, and TP53, did not impact OS or RFS. The presence of U2AF1 (P = .007) or DNMT3A (P = .034) mutations was associated with worse OS. A Mutation-Enhanced International Prognostic Scoring System 70 score was available for 80 patients (79%), and there were no differences in outcomes between patients with high risk scores and those with intermediate and low risk scores. Collectively, these data identify mutational predictors of outcome in MF patients undergoing allo-HCT. These genetic biomarkers in conjunction with clinical variables may have important utility in guiding transplantation decision making., (Copyright © 2019. Published by Elsevier Inc.)

The soil chromophyte alga Xanthonema (X.) debile contains only non-carbonyl carotenoids and Chl-a. X. debile has an antenna system denoted Xanthophyte light-harvesting complex (XLH) that contains the carotenoids diadinoxanthin, heteroxanthin, and vaucheriaxanthin. The XLH pigment stoichiometry was calculated by chromatographic techniques and the pigment-binding structure studied by resonance Raman spectroscopy. The pigment ratio obtained by HPLC was found to be close to 8:1:2:1 Chl-a:heteroxanthin:diadinoxanthin:vaucheriaxanthin. The resonance Raman spectra suggest the presence of 8-10 Chl-a, all of which are 5-coordinated to the central Mg, with 1-3 Chl-a possessing a macrocycle distorted from the relaxed conformation. The three populations of carotenoids are in the all-trans configuration. Vaucheriaxanthin absorbs around 500-530 nm, diadinoxanthin at 494 nm and heteroxanthin at 487 nm at 4.5 K. The effective conjugation length of heteroxanthin and diadinoxanthin has been determined as 9.4 in both cases; the environment polarizability of the heteroxanthin and diadinoxanthin binding pockets is 0.270 and 0.305, respectively.

Resonance Raman spectroscopy was used to evaluate pigment-binding site properties in the violaxanthin-chlorophyll-a-binding protein (VCP) from Nannochloropsis oceanica. The pigments bound to this antenna protein are chlorophyll-a, violaxanthin, and vaucheriaxanthin. The molecular structures of bound Chl-a molecules are discussed with respect to those of the plant antenna proteins LHCII and CP29, the crystal structures of which are known. We show that three populations of carotenoid molecules are bound by VCP, each of which is in an all-trans configuration. We assign the lower-energy absorption transition of each of these as follows. One violaxanthin population absorbs at 485 nm, while the second population is red-shifted and absorbs at 503 nm. The vaucheriaxanthin population absorbs at 525 nm, a position red-shifted by 2138 cm -1 as compared to isolated vaucheriaxanthin in n-hexane. The red-shifted violaxanthin is slightly less planar than the blue-absorbing one, as observed for the two central luteins in LHCII, and we suggest that these violaxanthins occupy the two equivalent binding sites in VCP at the centre of the cross-brace. The presence of a highly red-shifted vaucheriaxanthin in VCP is reminiscent of the situation of FCP, in which (even more) highly red-shifted populations of fucoxanthin are present. Tuning carotenoids to absorb in the green-yellow region of the visible spectrum appears to be a common evolutionary response to competition with other photosynthetic species in the aquatic environment.

Resonance Raman spectroscopy was used to evaluate pigment structure in the FCP-like light-harvesting complex of Chromera velia (Chromera light-harvesting complex or CLH). This antenna protein contains chlorophyll a, violaxanthin and a new isofucoxanthin-like carotenoid (called Ifx-l). We show that Ifx-l is present in two non-equivalent binding pockets with different conformations, having their (0,0) absorption maxima at 515 and 548nm respectively. In this complex, only one violaxanthin population absorbing at 486nm is observed. All the CLH-bound carotenoid molecules are in all-trans configuration, and among the two Ifx-l carotenoid molecules, the red one is twisted, as is the red-absorbing lutein in LHCII trimers. Analysis of the carbonyl stretching region for Chl a excitations indicates CLH binds up to seven Chl a molecules in five non-equivalent binding sites, in reasonable agreement with sequence analyses which have identified eight potential coordinating residues. The binding modes and conformations of CLH-bound pigments are discussed with respect to the known structures of LHCII and FCP., (Copyright © 2016 Elsevier B.V. All rights reserved.)

The structure and composition of the light harvesting complexes from the unicellular alga Chromera velia were studied by means of optical spectroscopy, biochemical and electron microscopy methods. Two different types of antennae systems were identified. One exhibited a molecular weight (18-19kDa) similar to FCP (fucoxanthin chlorophyll protein) complexes from diatoms, however, single particle analysis and circular dichroism spectroscopy indicated similarity of this structure to the recently characterized XLH antenna of xanthophytes. In light of these data we denote this antenna complex CLH, for "Chromera Light Harvesting" complex. The other system was identified as the photosystem I with bound Light Harvesting Complexes (PSI-LHCr) related to the red algae LHCI antennae. The result of this study is the finding that C. velia, when grown in natural light conditions, possesses light harvesting antennae typically found in two different, evolutionary distant, groups of photosynthetic organisms., (Copyright © 2013 Elsevier B.V. All rights reserved.)

The light-induced electron transport in purple bacterium Rhodobacter sphaeroides was studied in vivo by means of kinetic difference absorption spectroscopy and kinetics of bacteriochlorophyll fluorescence yield. Measurements of redox state of the oxidised primary donor and cytochrome c and the membrane potential revealed a complex pattern of changes of the electron flow. Effects of the membrane potential on the fluorescence yield were also analysed, and a model for the fluorescence induction curve is presented. The data indicate substantial positive effect of the membrane potential on the fluorescence emission in vivo. Moreover, light-induced changes in light scattering were observed, which suggests occurrence of structural changes on the level of the photosynthetic membrane.

Differential kinetic absorption spectra were measured during actinic illumination of photosystem II reaction centres and core complexes in the presence of electron acceptors silicomolybdate and ferricyanide. The spectra of samples with ferricyanide differ from those with both ferricyanide and silicomolybdate. Near-infrared spectra show temporary beta-carotene and peripheral chlorophyll oxidation during room temperature actinic illumination. Peripheral chlorophyll is photooxidized even after decay of beta-carotene oxidation activity and significant reduction of beta-carotene content in both reaction centres and photosystem II core complexes. Besides, new carotenoid cation is observed after about 1 s of actinic illumination in the reaction centres when silicomolybdate is present. Similar result was observed in PSII core complexes. HPLC analyses of illuminated reaction centres reveal several novel carotenoids, whereas no new carotenoid species were observed in HPLC of illuminated core complexes. Our data support the proposal that pigments of inner antenna are a sink of cations originating in the photosystem II reaction centre.