Search

The study describes the microstructural analysis of cylindrically-shaped functionally graded products sintered from iron powder with scheduled graded structure on the cross-section running from the core to the surface layer of the sinter. Different types of structure were produced using Distaloy SE powder in two compositions - one without the addition of carbon, and another with 0.6wt% C. Two methods were used to fill the die cavity and shape the products. The first method involving a two-step compaction of individual layers. The second method using an original technique of die filling enabled the formation of transition zone between the outer layer and the core still at the stage of product shaping. As part of microstructural analysis, structural constituents were identified and voids morphology was examined. Studies covered the effect of the type of the applied method on properties of the graded zone obtained in the manufactured products

Currently, due to the economic and ecological aspects, light alloys are increasingly important construction material, in particular in the transport industry. one of the popular foundry magnesium alloys is the alloy az91, which among others due to mechanical properties and technological features, is used, for example, for light structural parts. The paper presents the results of research on modification of the az91 alloy surface layer in the plasma electrolytic oxidation process. The change of usable properties of the produced coatings was obtained by introducing additions of silicon carbide or boron nitride. The thickness and hardness of the protective layers produced, resistance to scratches and corrosion resistance were determined. Moreover, the friction coefficient of the coating-steel pair was investigated. The quality of the connections made between the coating and the substrate, i.e. the magnesium alloy, was also evaluated. The results obtained for coatings with silicon carbide or boron nitride additives were always compared to the results obtained for unmodified samples. on the basis of the obtained results, it was shown that the introduction of boron nitride additive to the az91 alloy coating produced in the plasma electrolytic oxidation process significantly improves the resistance to: (i) corrosion and (ii) abrasive wear of the coating. [ABSTRACT FROM AUTHOR]

The publication presents the comparison of selected refining methods (gaseous and/or flux) based on mechanical properties of the obtained secondary silumin EN AC-AlSi7Mg0.3 (in accordance to the European Standard PN-EN 1706:2011). The point of reference was a similar primary alloy produced using pure batch materials. The mechanical properties measured in room temperature were used to calculate the materials quality index. The research showed, that properly carried out refinement process of secondary (recycled) alloys can bring their quality indexes close to those of their primary materials. The goal was to assess the efficiency of selected refining methods when applied to the examined group of casting silumins, by measuring the basic mechanical properties (in room temperature) before and after refining. The practical aspect was to choose an effective (ecologically, technologically and economically) method of refining of secondary EN AC-AlSi7Mg0.3 alloy used to cast car rims for JN METAL company in Ostowiec Świętokrzyski (Poland). [ABSTRACT FROM AUTHOR]

Using mobile devices such as smartphones or iPads for various interactive applications is currently very common. In the case of complex applications, e.g. chess games, the capabilities of these devices are insufficient to run the application in real time. One of the solutions is to use cloud computing. However, there is an optimization problem of mobile device and cloud resources allocation. An iterative heuristic algorithm for application distribution is proposed. The algorithm minimizes the energy cost of application execution with constrained execution time.

The recently deployed supercomputer Tryton, located in the Academic Computer Center of Gdansk University of Technology, provides great means for massive parallel processing. Moreover, the status of the Center as one of the main network nodes in the PIONIER network enables the fast and reliable transfer of data produced by miscellaneous devices scattered in the area of the whole country. The typical examples of such data are streams containing radio-telescope and satellite observations. Their analysis, especially with real-time constraints, can be challenging and requires the usage of dedicated software components. We propose a solution for such parallel analysis using the supercomputer, supervised by the KASKADA platform, which with the conjunction with immerse 3D visualization techniques can be used to solve problems such as pulsar detection and chronometric or oil-spill simulation on the sea surface.

A mechanical injection was used to determine the impact of injection rate on the TIMI frame count. The 1.0-ml/s increase in hand injection rates from the 10th to 90th percentiles for angiographers is associated with a minor decrease of <2 frames that is <7% of the corrected TIMI frame count. [ABSTRACT FROM AUTHOR]

Geopolymer materials, considered to be an alternative to Portland cement-based concretes, can be produced from various types of waste aluminosilicate raw materials. This article presents the results of research related to the use of diatomite as an additive in geopolymers. The results of testing geopolymer composites with 1%, 3%, and 5% additions of diatomite with a grain size of 0-0.063 mm after and without thermal treatment were presented. This article presents the physical properties of the diatomite additive, the morphology of diatomite particles SEMs, thermal analysis, and compressive strength test results. In this research, diatomite was treated as a substitute for both fly ash and metakaolin (replaced in amounts of 1 and 3%) and as a substitute for sand introduced as a filler (in this case, 5% of diatomite was added). As a result of this research, it was found that the addition of diatomite instead of the main geopolymerization precursors in amounts of 1 and 3% had a negative impact on the strength properties of geopolymers, as the compressive strength was reduced by up to 28%. The introduction of crushed diatomite instead of sand in an amount of 5% contributed to an increase in strength of up to 24%.

This comprehensive review investigates the potential of aluminum oxide (Al 2 O 3 ) as a highly effective adsorbent for organic dye degradation. Al 2 O 3 emerges as a promising solution to address environmental challenges associated with dye discharge due to its solid ceramic composition, robust mechanical properties, expansive surface area, and exceptional resistance to environmental degradation. The paper meticulously examines recent advancements in Al 2 O 3 -based materials, emphasizing their efficacy in both organic dye degradation and adsorption. Offering a nuanced understanding of Al 2 O 3 's pivotal role in environmental remediation, this review provides a valuable synthesis of the latest research developments in the field of dye degradation. It serves as an insightful resource, emphasizing the significant potential of aluminum oxide in mitigating the pressing environmental concerns linked to organic dye discharge. The application of Al 2 O 3 -based catalysts in the photocatalytic treatment of multi-component organic dyes necessitates further exploration, particularly in addressing real-world wastewater complexities.

Nitric oxide (NO) is an important signaling molecule that is involved in a wide range of physiological processes in plants, including responses to biotic and abiotic stresses. Changes in endogenous NO concentration lead to activation/deactivation of NO signaling and NO-related processes. This paper presents the current state of knowledge on NO biosynthesis and scavenging pathways in plant cells and highlights the role of NO in post-translational modifications of proteins (S-nitrosylation, nitration, and phosphorylation) in plants under optimal and stressful environmental conditions. Particular attention was paid to the interactions of NO with other signaling molecules: reactive oxygen species, abscisic acid, auxins (e.g., indole-3-acetic acid), salicylic acid, and jasmonic acid. In addition, potential common patterns of NO-dependent defense responses against attack and feeding by parasitic and molting Ecdysozoa species such as nematodes, insects, and arachnids were characterized. Our review definitely highlights the need for further research on the involvement of NO in interactions between host plants and Ecdysozoa parasites, especially arachnids.

Rapidly increasing industrialisation has human needs, but the consequences have added to the environmental harm. The pollution caused by several industries, including the dye industries, generates a large volume of wastewater containing dyes and hazardous chemicals that drains industrial effluents. The growing demand for readily available water, as well as the problem of polluted organic waste in reservoirs and streams, is a critical challenge for proper and sustainable development. Remediation has resulted in the need for an appropriate alternative to clear up the implications. Nanotechnology is an efficient and effective path to improve wastewater treatment/remediation. The effective surface properties and chemical activity of nanoparticles give them a better chance to remove or degrade the dye material from wastewater treatment. AgNPs (silver nanoparticles) are an efficient nanoparticle for the treatment of dye effluent that have been explored in many studies. The antimicrobial activity of AgNPs against several pathogens is well-recognised in the health and agriculture sectors. This review article summarises the applications of nanosilver-based particles in the dye removal/degradation process, effective water management strategies, and the field of agriculture.

In response to environmental stress, plants activate complex signalling, including being dependent on reactive oxygen-nitrogen-sulphur species. One of the key abiotic stresses is drought. As a result of drought, changes in the level of hydration of the plant occur, which obviously entails various metabolic alternations. The primary aim of this study was to determine the relationship between the response of barley to drought and the intensity of stress, therefore investigations were performed under various levels of water saturation deficit (WSD) in leaves at 15%, 30%, and 50%. In barley subjected to drought, most significant changes occurred under a slight dehydration level at 15%. It was observed that the gene expression of 9- cis -epoxycarotenoid dioxygenases, enzymes involved in ABA biosynthesis, increased significantly, and led to a higher concentration of ABA. This was most likely the result of an increase in the gene expression and enzyme activity of L-cysteine desulfhydrase, which is responsible for H 2 S synthesis. Our results suggest that the differential water deficit in leaves underlies the activation of an appropriate defence, with ABA metabolism at the centre of these processes. Furthermore, at 15% WSD, a dominant contribution of H 2 O 2 -dependent signalling was noted, but at 30% and 50% WSD, significant NO-dependent signalling occurred.

Environmental changes are inevitable with time, but their intensification and diversification, occurring in the last several decades due to the combination of both natural and human-made causes, are really a matter of great apprehension. As a consequence, plants are exposed to a variety of abiotic stressors that contribute to their morpho-physiological, biochemical, and molecular alterations, which affects plant growth and development as well as the quality and productivity of crops. Thus, novel strategies are still being developed to meet the challenges of the modern world related to climate changes and natural ecosystem degradation. Innovative methods that have recently received special attention include eco-friendly, easily available, inexpensive, and, very often, plant-based methods. However, such approaches require better cognition and understanding of plant adaptations and acclimation mechanisms in response to adverse conditions. In this succinct review, we have highlighted defense mechanisms against external stimuli (mainly exposure to elevated levels of metal elements) which can be activated through permanent microevolutionary changes in metal-tolerant species or through exogenously applied priming agents that may ensure plant acclimation and thereby elevated stress resistance.

Background: Protein denaturation and collagen contraction occur when living tissue is heated to well-defined temperatures. The result is reduced volume and surface area of the heated tissue., Objectives: To evaluate the adverse events of procedures in which a helium-based plasma technology (HPT) was used with and without ultrasound-assisted liposuction for the coagulation of soft tissue., Methods: A multicenter retrospective chart review was performed in which patients (n = 192) were divided into 2 groups: one that received only soft tissue coagulation and the other that received both soft tissue coagulation and liposuction. Each of the 2 groups was subdivided into patients with and without adverse events, including seroma. Odds ratios for adverse events were calculated for both demographic and surgical subgroups. Seroma data were analyzed separately., Results: No serious adverse events were observed. Forty-six (24.0%) patients reported 51 total adverse events. Seroma was the most frequently occurring adverse event with 13 patients (6.8%) reporting 17 (33.3%) events in 12 body areas. In these cases, all areas were treated with both liposuction and soft tissue coagulation. Seroma was not observed in patients receiving soft tissue coagulation alone. Patients aged 61 to 76 years and males were more likely to experience seroma or other adverse event than younger patients or females, respectively., Conclusions: The use of the HPT for soft tissue coagulation in combination with ultrasound for liposuction is associated with nonserious adverse events. The most frequently occurring adverse event, seroma, was not observed in patients treated with HPT alone., (© 2022 The Aesthetic Society.)

Rolled homogeneous armor steel (RHA) with a high tensile strength, toughness, and hardness is often used in military combat vehicles. RHA is a high-strength low alloy steel suitable for all battlefield usage in military vehicles. The present work examines the prediction output responses in the material removal rate (MRR), surface roughness (Ra), and kerf angle (Ka) for the AWJM of armor steel using regression and semi-empirical models. The AWJM trials were performed using an L27 factorial design with each process variable set to three levels, namely, the standoff distance (SOD), jet traversing speed (JT), and jet water pressure (P). A regression model was constructed using the response surface method (RSM) and data from the trials. Through dimensional analysis and with Buckingham's π-theorem, a semi-empirical model was built using both the experimental data and material property data. Predictions made by the models were proportionate with the results of the experiments under the same conditions. Microscopic investigations on MRR and Ra were performed using a scanning electron microscope (SEM). The optimal values of the output responses of the machined armor steel plate were obtained with higher MRR = 298.92 mm 3 /min, lower Ka = 0.651°, and lower Ra = 2.23 µm. The present work established that semi-empirical models accurately predict the output responses in the AWJM of armor steel.

The main aim of this work is to improve the structure and properties of the magnesium alloy ML5 by modifying it with alkaline earth metals (ALM). The separate and joint influence of calcium and barium on the macrostructure and microstructure of the alloy of Mg-Al-Zn system was investigated. The qualitative and quantitative estimation of the structural components was carried out. Alkali earth metals were included in complex intermetallic phases and serve as additional crystallization centers. Modification of magnesium alloys with alkaline earth metals is established in an amount of 0.05 to 0.1 wt. % increased the bulk percentage of intermetallic phases by ~1.5 times, shifting them towards smaller size groups while simultaneously forming spherical intermetallic phases located in the grain centre and serving as additional crystallization centers. In this case, grain size reduction and significant refinement of the alloy structural components were provided. The dependency of the separate and joint influence of alkali earth metals on the castings complex of properties of the magnesium alloy has been established. Thus, a separate modification of the ML5 alloy provided the maximum level of its strength and ductility with the addition of 0.1% Ca or Ba. The modification of the complex (0.1% Ca + 0.1% Ba) of the magnesium alloy decreased the dimensions of its structural components 1.5 times and increased the strength of the alloy by 20%, the ductility by 2 times and the long-term heat resistance 1.5 times due to the formation of the intermetallic phases of the complex composition. Linear dependences were obtained that describe the influence of the characteristics of the structural components of the modified magnesium alloy on its mechanical properties. The developed technology for modifying cast magnesium alloys with alkaline earth elements provides an improvement in casting quality and allows the reliability and durability of responsible casting operation.

The main aim of this research is to assess different fly ashes as raw materials for the manufacturing of geopolymers. Three different fly ashes have been investigated. First, a conventional fly ash from the Skawina coal power plant (Poland), obtained at a temperature of 900-1100 °C. Second, ultra-fine fly ash from a power plant in China; the side product received at 1300 °C. The third fly ash was waste was obtained after combustion in incineration plants. To predict the properties and suitability of materials in the geopolymerization process, methods based on X-ray analysis were used. The applied precursors were tested for elemental and chemical compounds. The investigations of geopolymer materials based on these three fly ashes are also presented. The materials produced on the basis of applied precursors were subjected to strength evaluation. The following research methods were applied for this study: density, X-ray fluorescence (XRF), X-ray diffraction analysis (XRD), Scanning Electron Microscopy (SEM), flexural and compressive strength. The obtained results show that materials based on fly ashes had a similar compressive strength (about 60 MPa), while significant differences were observed during the bending test from 0.1 to 5.3 MPa. Ultra-fine fly ash had a lower flexural strength compared to conventional fly ash. This study revealed the need for process optimization for materials based on a precursor from a waste incineration plant.

Abscisic acid (ABA) is a phytohormone that plays a key role in regulating several developmental processes as well as in response to stressful conditions such as drought. Activation of the ABA signaling cascade allows the induction of an appropriate physiological response. The basic components of the ABA signaling pathway have been recognized and characterized in recent years. Pyrabactin resistance, pyrabactin resistance-like, and the regulatory component of ABA receptors (PYR/PYL/RCAR) are the major components responsible for the regulation of the ABA signaling pathway. Here, we review recent findings concerning the PYR/PYL/RCAR receptor structure, function, and interaction with other components of the ABA signaling pathway as well as the termination mechanism of ABA signals in plant cells. Since ABA is one of the basic elements related to abiotic stress, which is increasingly common in the era of climate changes, understanding the perception and transduction of the signal related to this phytohormone is of paramount importance in further increasing crop tolerance to various stress factors.

Cereal plants under abiotic or biotic stressors to survive unfavourable conditions and continue growth and development, rapidly and precisely identify external stimuli and activate complex molecular, biochemical, and physiological responses. To elicit a response to the stress factors, interactions between reactive oxygen and nitrogen species, calcium ions, mitogen-activated protein kinases, calcium-dependent protein kinases, calcineurin B-like interacting protein kinase, phytohormones and transcription factors occur. The integration of all these elements enables the change of gene expression, and the release of the antioxidant defence and protein repair systems. There are still numerous gaps in knowledge on these subjects in the literature caused by the multitude of signalling cascade components, simultaneous activation of multiple pathways and the intersection of their individual elements in response to both single and multiple stresses. Here, signal transduction pathways in cereal plants under drought, salinity, heavy metal stress, pathogen, and pest attack, as well as the crosstalk between the reactions during double stress responses are discussed. This article is a summary of the latest discoveries on signal transduction pathways and it integrates the available information to better outline the whole research problem for future research challenges as well as for the creative breeding of stress-tolerant cultivars of cereals.

Abscisic acid (ABA) is well-known phytohormone involved in the control of plant natural developmental processes, as well as the stress response. Although in wheat (Triticum aestivum L.) and barley (Hordeum vulgare L.) its role in mechanism of the tolerance to most common abiotic stresses, such as drought, salinity, or extreme temperatures seems to be fairly well recognized, not many authors considered that changes in ABA content may also influence the sensitivity of cereals to adverse environmental factors, e.g., by accelerating senescence, lowering pollen fertility, and inducing seed dormancy. Moreover, recently, ABA has also been regarded as an element of the biotic stress response; however, its role is still highly unclear. Many studies connect the susceptibility to various diseases with increased concentration of this phytohormone. Therefore, in contrast to the original assumptions, the role of ABA in response to biotic and abiotic stress does not always have to be associated with survival mechanisms; on the contrary, in some cases, abscisic acid can be one of the factors that increases the susceptibility of plants to adverse biotic and abiotic environmental factors., Competing Interests: The authors declare no conflict of interest.

Background: Children with Down syndrome (DS) have increased risk of myeloid leukemia (ML), but specific treatment protocols ensure excellent outcome. This study was a retrospective analysis of the treatment results and genetic characteristics of ML of DS (ML-DS) in Poland from 2005 to 2019. Methods: All 54 patients with ML-DS registered in the Polish Pediatric Leukemia and Lymphoma Study Group in analyzed period were enrolled to the study. There were 34 children treated with Acute Myeloid Leukemia-Berlin-Frankfurt-Munster 2004 Interim Protocol (group I) and 20 patients treated with ML-DS 2006 Protocol (group II). In the first protocol, there was reduction of the antracyclines doses and intrathecal treatment for ML-DS compared to non-DS patients. In the second protocol, further reduction of the treatment was introduced (omission of etoposide in the last cycle, no maintenance therapy). Results: Probabilities of 5-year overall survival (OS), event-free survival (EFS), and relapse-free survival in the whole analyzed group were 0.85 ± 0.05, 0.83 ± 0.05, and 0.97 ± 0.03, respectively. No significant differences were found between two protocols in the terms of OS and EFS (0.79 ± 0.07 vs. 0.95 ± 0.05, p = 0.14, and 0.76 ± 0.07 vs. 0.95 ± 0.05, p = 0.12, respectively). All deaths were caused by the treatment-related toxicities. Reduction of the treatment-related mortality was noticed (20% in group I and 5% in group II). The only one relapse in the whole cohort occurred in the patient from group I, older than 4 years, without GATA1 gene mutation. He was treated successfully with IdaFLA cycle followed by hematopoietic stem cell transplantation from matched sibling donor. No significant prognostic factor was found in the study group probably due to low number of patients in the subgroups. Conclusions: The study confirms that the reduced intensity protocols are very effective in ML-DS patients. The only cause of deaths was toxicities; however, systematic decrease of the treatment-related mortality was noticed., (Copyright © 2020 Czogala, Pawinska-Wasikowska, Ksiazek, Sikorska-Fic, Matysiak, Skalska-Sadowska, Wachowiak, Rodziewicz-Konarska, Chybicka, Myszynska-Roslan, Krawczuk-Rybak, Grabowski, Kowalczyk, Maciejka-Kemblowska, Adamkiewicz-Drozynska, Bobeff, Mlynarski, Tomaszewska, Szczepanski, Pohorecka, Chodala-Grzywacz, Karolczyk, Mizia-Malarz, Mycko, Badowska, Zielezinska, Urasinski, Nykiel, Woszczyk, Ciebiera, Chaber, Skoczen and Balwierz.)

A loss of dehydration tolerance in wheat seedlings on the fifth day following imbibition is associated with a disturbance in cellular redox homeostasis, as documented by a shift of the reduced/oxidized glutathione ratio to a more oxidized state and a significant increase in the ratio of protein thiols to the total thiol group content. Therefore, the identification and characterization of redox-sensitive proteins are important steps toward understanding the molecular mechanisms of the loss of dehydration tolerance. In the present study, proteins that were differentially expressed between fully turgid (control), dehydrated tolerant (four-day-old) and dehydrated sensitive (six-day-old) wheat seedlings were analysed. Protein spots having at least a significant (p < 0.05) two-fold change in protein abundance were selected by Delta2D as differentially expressed, identified by MALDI-TOF and LC-MS/MS, and classified according to their function. The observed changes in the proteomic patterns of the differentially S-nitrosylated and S-glutathionylated proteins were highly specific in dehydration-tolerant and -sensitive wheat seedlings. The metabolic function of these proteins indicates that dehydration tolerance is mainly related to nucleic acids, protein metabolism, and energy metabolism. It has been proven that leaf-specific thionins BTH6 and DB4, chloroplastic 50S ribosomal protein L16, phospholipase A1-II delta, and chloroplastic thioredoxin M2 are both S-nitrosylated and S-glutathionylated upon water deficiency. Our results revealed the existence of interplay between S-nitrosylation and S-glutathionylation, two redox-regulated protein posttranslational modifications that could enhance plant defence mechanisms and/or facilitate the acclimation of plants to unfavourable environmental conditions., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Main Conclusion: In maize, leaf proteome responses evoked by soil drought applied separately differ from those evoked by mite feeding or both types of stresses occurring simultaneously. This study focuses on the involvement of proteomic changes in defence responses of a conventional maize cultivar (Bosman) to the two-spotted spider mite infestation, soil drought and both stresses coexisting for 6 days. Under watering cessation or mite feeding applied separately, the protein carbonylation was not directly linked to the antioxidant enzymes' activities. Protein carbonylation increased at higher and lower SOD, APX, GR, POX, PPO activities following soil drought and mite feeding, respectively. Combination of these stresses resulted in protein carbonylation decrease despite the increased activity of all antioxidant enzymes (except the CAT). However, maize protein network modification remains unknown upon biotic/abiotic stresses overlapping. Here, using multivariate chemometric methods, 94 leaf protein spots (out of 358 considered; 2-DE) were identified (LC-MS/MS) as differentiating the studied treatments. Only 43 of them had individual discrimination power. The soil drought increased abundance of leaf proteins related mainly to photosynthesis, carbohydrate metabolism, defence (molecular chaperons) and protection. On the contrary, mite feeding decreased the abundance of photosynthesis related proteins and enhanced the abundance of proteins protecting the mite-infested leaf against photoinhibition. The drought and mites occurring simultaneously increased abundance of proteins that may improve the efficiency of carbon fixation, as well as carbohydrate and amino acid metabolism. Furthermore, increased abundance of the Rubisco large subunit-binding protein (subunit β), fructose-bisphosphate aldolase and mitochondrial precursor of Mn-SOD and decreased abundance of the glycolysis-related enzymes in the mite-free leaf (in the vicinity of mite-infested leaf) illustrate the involvement of these proteins in systemic maize response to mite feeding., Competing Interests: The authors declare that they have no conflict of interest.

Introduction: Risk of abdominal free flaps complications and the risk of abdominal wound complications from surgery are significantly increased in patients with previous abdominal surgeries. Previous scars can limit the vascularized territories suitable for transfer and can lead to significant partial flap necrosis., Methods: A retrospective review of abdominal free flap breast reconstructions performed by the senior author (GKL) over 5 years (2008-2013). Patients were grouped based on the presence or absence of abdominal scars and specific type/location of scar(s). In addition, we analyzed patient information. including demographics, body mass index, smoking history, comorbid conditions, and most importantly, surgical techniques to optimize vascular perfusion., Results: We identified 169 patients that underwent abdominal perforator free flap breast reconstruction. One hundred nine patients underwent previous abdominal surgery. Within this group, we had 2 complete flap losses, 5 major flap complications, 9 minor flap complications, and 9 donor site complications. Sixty patients had no previous abdominal surgery. Of these patients, we had no complete flap losses, 2 major flap complications, 1 minor flap complication, and 4 donor site complications. Patients with previous abdominal surgeries undergoing abdominal free flap breast reconstruction had a statistically significant higher rate of flap complications (P=0.02). Donor site wound healing complications were not statistically significant (P=0.5). The subgroup of patients that had both a previous intra-abdominal surgery scar and Pfannenstiel scar (21 patients) were at greatest risk for both free flap (19% of patients) and donor site wound healing (19% of patients) complications., Conclusions: Abdominal scars increase the risk of complications to the free flap. Unlike previous studies, patients with abdominal scars do not appear to have a statistically significant increase for donor site complications. Using the data from our study, we developed an algorithm for abdominal flap harvest in patients with abdominal scars. The algorithm emphasizes the importance of bipedicled perforator flaps and supercharging/turbocharging when blood flow is required across scars or when a large volume of tissue is needed crossing the midline. In specific cases, where perforator viability is in question because of a previous abdominal surgical procedure, we recommend the inclusion of muscle (Muscle-Sparing-transverse rectus abdominis musculocutaneous vs transverse rectus abdominis musculocutaneous).

Water-deficit is accompanied by an increase in proteolysis. Phytocystatins are plant inhibitors of cysteine proteinases that belong to the papain and legumain family. A cDNA encoding the protein inhibitor TrcC-8 was identified in the vegetative organs of triticale. In response to water-deficit, increases in the mRNA levels of TrcC-8 were observed in leaf and root tissues. Immunoblot analysis indicated that accumulation of the TrcC-8 protein occurred after 72h of water-deficit in the seedlings. Using recombinant protein, inhibitory activity of TrcC-8 against cysteine proteases from triticale and wheat tissues was analyzed. Under water-deficit conditions, there are increases in cysteine proteinase activities in both plant tissues. The cysteine proteinase activities were inhibited by addition of the recombinant TrcC-8 protein. These results suggest a potential role for the triticale phytocystatin in modulating cysteine proteinase activities during water-deficit conditions., (Copyright © 2014 Elsevier GmbH. All rights reserved.)

Background: Although mantle radiation (ie, extended field radiation) represented the standard of care in the past for Hodgkin disease, contemporary treatment of lymphoma consists of a multimodal approach with chemotherapy. Patients who were exposed to mantle radiation have a higher risk of breast cancer and are more susceptible to postoperative complications after breast reconstruction due to radiation. In this study, we present postoperative outcomes in patients with a history of mantle radiation who underwent mastectomy and breast reconstruction., Methods: All patients at Stanford University Medical Center between January 2006 and December 2012 with a history of Hodgkin lymphoma treated with mantle radiation who received breast reconstruction were identified. A retrospective chart review was conducted analyzing patient demographics, history of Hodgkin treatment, type of reconstruction, follow-up, and complications. Complications were further classified into medical complications, donor-site complications, and recipient-site complications., Results: Sixteen patients with a history of Hodgkin disease and mantle radiation received breast reconstruction. The average age of the patients at their mastectomy was 46 (33-60) years, with the average age at the time of their mantle radiation of 20.5 (10-33) years with an average interval of radiation to breast cancer treatment of 24.8 (16-38) years. There were five unilateral and 11 bilateral reconstructions. All patients had immediate reconstruction with tissue expanders (14 patients) or autologous tissue (one muscle-sparing transverse rectus abdominis myocutaneous and one transverse upper gracilis flap). Eleven (69%) patients had postoperative complications. In the patients who had tissue expander reconstruction, there was an overall complication rate of 64%, which included capsular contracture (n=5, 56%), mastectomy flap necrosis (n=5, 56%), cellulitis (n=4, 44%), seroma (n=3, 33%), hematoma (n=1, 11%), and chronic pain (n=1, 11%). Three (two unilateral and one bilateral) tissue expander infections required removal of the expander and delayed reconstruction with a latissimus dorsi flap, whereas one patient with chronic pain and capsular contracture required a muscle-sparing transverse rectus abdominis myocutaneous for a unilateral implant failure., Conclusions: Although the risk of complications associated with preoperative radiation is well documented, physicians and patients should be cognizant of the increased risk of complications after mantle radiation as it represents a unique modality of radiation exposure.

Introduction: Mastectomy skin flap necrosis is a significant problem in the autologous breast reconstruction. The necrosis may create unsightly scarring, produce contour irregularities, and deform the breast mound. This may lead to a poor reconstruction and patient satisfaction. Most importantly, the development and treatment of mastectomy skin flap necrosis can delay further oncologic treatment.We performed a retrospective chart review of all patients undergoing autologous breast reconstruction in the past 5 years to examine our incidence and treatment of mastectomy skin flap necrosis. We then used these data to create a management algorithm for mastectomy skin flap necrosis. The goals of this algorithm were as follows: (1) to not delay further oncologic treatment, (2) to expedite the healing time while minimizing patient risk, and (3) to create an aesthetically pleasing breast reconstruction., Materials and Methods: A retrospective chart review from 2008 to 2013 was performed of all autologous breast reconstruction at our institution. We then analyzed our data and patient outcomes and developed a treatment algorithm., Results: We identified 204 patients who underwent autologous free flap breast reconstruction that was performed by the senior author (G.K.L.). Our incidence of mastectomy skin necrosis was 30%. There was no delay in adjuvant oncologic treatment for any of our patients. The development of mastectomy skin necrosis was significant for patients with diabetes (P=0.03), current tobacco use (P=0.04), and body mass index (P=0.01). The time for wound healing was prolonged in patients with a high body mass index (P=0.04). Regression analysis of wound size showed full-thickness wounds greater than 6 cm benefited from operative closure., Conclusions: Our incidence of mastectomy skin necrosis was 30%. Despite our high incidence mastectomy skin necrosis, we had no delays in adjuvant oncologic treatment. Retrospective data analysis allowed us to then develop a management algorithm for mastectomy skin necrosis. We feel it is advantageous to the patient and the reconstructive outcome to heal the breast wounds in the acute phase (within 3 weeks); and with regression analysis, we found full-thickness wounds greater than 6 cm benefit from operative intervention. Finally, patients requiring adjuvant oncologic treatment should be healed as quickly as possible so they may continue on with their oncologic care.

Introduction: Modern surgical training has placed a larger focus on procedural competency base training for surgical specialties. Although various simulators are in existence to teach laparoscopic skills, plastic surgery has a paucity of surgical training models., Methods and Materials: We developed a low-cost teaching model for the steps and techniques required in the deep inferior epigastric perforator flap and assessed the utility of this model with the resident surgeons using presurvey and postsurvey., Results: A total of 13 residents participated in the surgical skill exercise. The residents felt this exercise increased their proficiency in the steps and techniques required for a deep inferior epigastric perforator flap harvest [4 (0.4)]., Conclusions: Overall, residents felt this exercise should be included in the postgraduate years 1 and 2 educational curriculum.

Vascular remodeling of distal pulmonary arterioles that promotes abnormal pulmonary vascular reactivity is a central mechanism in the pathogenesis of pulmonary arterial hypertension (PAH). In selected patients, invasive pulmonary vasoreactivity testing performed in the cardiac catheterization laboratory with inhaled nitric oxide, epoprostenol, or adenosine is useful for PAH diagnosis, risk stratification, and assessing patient appropriateness for PAH-specific treatment(s). Limited accessibility to inhaled nitric oxide and a suboptimal test sensitivity profile reported for adenosine has contributed to the selection of epoprostenol for pulmonary vasoreactivity testing in some pulmonary hypertension referral centers. However, standardized procedural protocols for administrating epoprostenol for this purpose are largely unavailable to the practicing clinical community. The current work aims to bridge this gap by providing a stepwise procedure for the safe administration of clinically indicated intravenous epoprostenol during pulmonary vasoreactivity testing.

Purpose: A retrospective review of a single institution's 20-year experience of complications and reoperation rates after surgery for primary craniosynostosis correction., Methodology: A retrospective chart review of all patients (n = 376) undergoing primary surgery for craniosynostosis was conducted. The charts were analyzed for diagnosis, sex, syndromic involvement, age at operation, type of fixation, complications, and reoperations. Complications were defined as any event requiring prolonged hospitalization or readmission secondary to the surgical procedure, reoperation, or mortality. Reoperative rates were classified into major (e.g., repeat craniotomy, cranioplasty) or minor (e.g., hardware removal, wound closure)., Results: After excluding patients for length of follow-up less than 6 months (n = 23), inadequate verification of all data (n = 21), and prior neurosurgical craniectomy (n = 18), a total of 314 patients were identified. The percentage of patients with complications and reoperations was 39.2% (n = 123). The rates of major reoperation (n = 72), minor reoperation (n = 41), and various complications (n = 10) were 22.9%, 13.1%, and 3.2%, respectively. No mortalities were identified., Conclusions: Differing types of fixation, diagnosis of syndrome, and multiple-suture craniosynostosis were statistically correlated to increased reoperative rates. Age at initial operation and sex were not correlated to increased reoperative rates. Finally, this institution's complication and reoperative rates compare with other published results.

To date, there have been no quantitative in vivo assessments of contrast volumes and injection rates using modern high flow catheters during coronary angiography. Contrast volumes (n = 554), injection durations (n = 563), and injection rates (n = 498) were collected during 88 cardiac catheterizations. With increasing cathetersize (6, 7, and 8 French), injection volume increased (P < 0.0001), duration decreased (P < 0.0001), and rate increased (P < 0.0001). Compared with injections into the right coronary artery, left coronary artery injections were larger (7.1 +/- 0.1 cc vs. 4.8 +/- 0.1 cc, p < 0.0001), longer (3.6 +/- 0.05 sec vs 3.0 +/- 0.07 sec, P < 0.0001) and faster (2.1 +/- 0.04 cc/sec vs. 1.7 +/- 0.06 cc/sec, P < 0.0001). Patients with a significant stenosis in the left main or proximal right coronary artery received less contrast (P < 0.0001) more slowly (P < 0.0001) over a similar duration of injection (P = NS). When collaterals arose from the injected artery, angiographers injected more contrast (P < 0.001) over a longer period (P < 0.0001) more slowly (P < 0.0001). Catheter size and the injected vessel's location and anatomy significantly affect coronary catheterization injection technique.