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Abstract Background Percutaneous transluminal angioplasty is the current standard treatment for arteriovenous fistula (AVF) stenosis. The mid- and long-term patency with plain balloon angioplasty (PBA) is however far from satisfactory. While paclitaxel-coated balloon angioplasty has been shown to be superior to PBA, concern over its safety profile has recently arisen after a reported possible increased mortality risk with a meta-analysis of large lower limb studies. An angioplasty balloon with a new type of drug coating, the sirolimus-coated balloon (SCB), has been proven to improve patency in the coronary arteries. However, its effect on AV access has yet to be studied. Methods/design This is an investigator-initiated, prospective, multicenter, double-blinded, randomized controlled clinical trial to assess the effectiveness of SCB compared to PBA in improving the patency of AVF after angioplasty. A total of 170 patients with mature AVF that requires PTA due to AVF dysfunction will be randomly assigned to treatment with a SCB or PBA at a 1:1 ratio, stratified by location of AVF and followed up for up to 1 year. The inclusion criteria include [1] adult patient aged 21 to 85 years who requires balloon angioplasty for dysfunctional arteriovenous fistula [2]; matured AVF, defined as being in use for at least 1 month prior to the angioplasty; and [3] successful angioplasty of the underlying stenosis with PBA, defined as less than 30% residual stenosis on digital subtraction angiography (DSA) and restoration of thrill in the AVF on clinical examination. The exclusion criteria include thrombosed or partially thrombosed access circuit at the time of treatment, presence of symptomatic or angiographically significant central vein stenosis that requires treatment with more than 30% residual stenosis post angioplasty, and existing stent placement within the AVF circuit. The primary endpoint of the study is access circuit primary patency at 6 months. The secondary endpoints are target lesion primary patency; access circuit-assisted primary patency; access circuit secondary patency at 3, 6, and 12 months; target lesion restenosis rate at 6 months; total number of interventions; complication rate; and cost-effectiveness. The trial is supported by Concept Medical. Discussion This study will evaluate the clinical efficacy and safety of SCB compared to PBA in the treatment of AVF stenosis in hemodialysis patients. Trial registration ClinicalTrials.gov NCT04409912 . Registered on 1 June 2020

A method of ultra high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) combined with modified QuEChERS purification technology was developed for the simultaneous determination of 25 veterinary medicine residues including four classes (sulfonamides, quinolones, chloramphenicols and amantidines) in chicken and egg. The samples were hydrolyzed by dilute hydrochloric acid, extracted by acetonitrile. Sodium chloride was added into the extracting solution to salt out. The acetonitrile was took out and degreased by n-hexanecyclohexane solution (1∶1,V/V) after stratification of acetonitrile and aqueous phase and concentrated to dry. The residues were dissolved with 0.2% formic acid ethyl acetate to remove the sodium chloride by filtrating and the filtrate was concentrated to dry again, then the sample was purified with a mixture of 30 mg of C18 and 60 mg PSA after adding 0.2% formic acid methanol. The target compounds were separated by ZORBAX C18 chromatography column (50 mm×2.1 mm×1.8 μm), the mass spectrometer data were acquired under multiple reaction monitoring (MRM) of positive and negative modes at the same time, and the residues were quantitated by isotope internal standard method. The results showed that the linear of 25 veterinary medicines is good in the range of 0.2~250 μg/L. The linear correlation coefficients are more than 0.99, and the detection limits are in the range of 0.1~0.9 μg/kg. The limits of quantification are 0.3~3.0 μg/kg. The average recoveries at three spiked levels (about 1, 5 and 20 folds of quantitative limits) are 79.5%~119% with the relative standard deviations of 0.9%~9.2%. The method is rapid,simple, accurate, sensitive and cheap, which is suitable for simultaneous determination of multiple vererinary medicine residues in eggs and chicken.

Study Design Retrospective cohort study. Purpose This study aims to analyze the relationship between body mass index (BMI) subjective patient-reported outcomes (PRO) after 1- and 2-level anterior cervical discectomy and fusion (ACDF). Overview of Literature The prevalence of cervical spondylosis and ACDF in expected to continue rising among the aging population of Asia. Moreover, the prevalence of obesity is also increasing. However, limited information is available about the mechanism by which BMI affects PRO after ACDF. Methods Total 878 patients underwent ACDF between 2000 and 2015. After excluding patients with previous cervical instrumentation, >2 levels fused, missing BMI measurement, or neoplastic/trauma indication for surgery, 535 patients were included. The PRO measures of the Neck Disability Index, Numerical Pain Rating Scale (NPRS) for Neck Pain, NPRS for Limb Pain, American Academy of Orthopaedic Surgeons–Neurogenic Symptom Score, and Japanese Orthopaedic Association myelopathy score were used. Patients were grouped based on their preoperative BMI, as per the World Health Organization guidelines for Asian populations. PRO scores were collected preoperatively, at 6 months postoperatively, and 2 years postoperatively. A generalized linear model was used to analyze the relationship of BMI category with the individual score, accounting for several factors that are likely to affect the outcomes. Results Total 19 (3.4%) were underweight, 155 (28.0%) were normal weight, 112 (20.3%) were overweight, and 267 (48.3%) were obese. Patients across all BMI categories experienced significant and similar improvements in their postoperative PRO scores. There were no significant differences in the preoperative, 6-month postoperative, and 2-year postoperative PRO scores of the groups. Rate of reoperation was highest in patients with grade II obesity at 8.07%; however, the difference was not statistically significant. Conclusions Irrespective of the BMI, all patients exhibited similar satisfactory outcomes following ACDF. The results support surgery in all subgroups of patients with symptomatic nerve compression in the cervical spine.

Background: Inflammation and oxidation stress are key factors in the mechanism of acute lung injury (ALI). Therefore, suppression of the inflammatory response and oxidative stress could be a potential strategy to treat lipopolysaccharide (LPS)-induced ALI. Ginsenoside Rd (Rd), a natural Ginseng extract, alleviates inflammation and oxidative stress in several diseases such as Alzheimer's disease and cerebral ischemia, but its effect on ALI is still unclear. Aims and Objectives: To explore the protective effect of Rd on LPS-induced ALI and explored associated mechanisms. Materials and Methods: Mice were divided into five groups: A sham-operated group, a LPS-induced ALI group, and three LPS groups pretreated with Rd doses of 20, 40, and 80 mg/kg, respectively. The pathological changes of lung, collagen deposition, pulmonary edema, inflammatory cytokine, oxidative stress and the expression levels of TLR4 and NF-κB were detected. Results: The oral administration of Rd dose dependently attenuated histopathologic changes in the lung, lung edema, pulmonary collagen deposition, protein concentration in bronchoalveolar lavage fluid (BALF), myeloperoxidase (MPO) activity, and inflammatory cell infiltration. In addition, Rd suppressed the LPS-induced inflammatory cytokines tumor necrosis factor-α, interleukin (IL)-6, and IL-1 β in BALF. The productions of oxidative stress-related enzymes (catalase, superoxide dismutase, and glutathione peroxidase) in lung tissue were significantly upregulated by Rd administration. However, malondialdehyde and pulmonary MPO activity was reduced in the Rd-pretreated groups when compared with LPS-induced ALI group. Rd treatment also dose dependently suppressed LPS-induced NF-κB activation and TLR4 expression. Conclusion: Overall, these findings provide evidence that Rd pretreatment inhibits LPS-induced ALI through anti-inflammatory and antioxidative actions, suggesting that it could be a promising protective drug for LPS-induced ALI.

Music genre classification is significant to users and digital platforms. To enhance the classification accuracy, this study proposes a hybrid model based on VMD-IWOA-XGBOOST for music genre classification. First, the audio signals are transformed into numerical or symbolic data, and the crucial features are selected using the maximal information coefficient (MIC) method. Second, an improved whale optimization algorithm (IWOA) is proposed for parameter optimization. Third, the inner patterns of these selected features are extracted by IWOA-optimized variational mode decomposition (VMD). Lastly, all features are put into the IWOA-optimized extreme gradient boosting (XGBOOST) classifier. To verify the effectiveness of the proposed model, two open music datasets are used, i.e., GTZAN and Bangla. The experimental results illustrate that the proposed hybrid model achieves better performance than the other models in terms of five evaluation criteria. [ABSTRACT FROM AUTHOR]

Abstract Background Nonfusion fixation is an effective way to treat lumbar degeneration. In the present study, we analyzed the clinical effects and radiographic outcomes of the Isobar TTL system used to treat two-segment lumbar degenerative disease. Method Forty-one patients diagnosed with two-segment lumbar degenerative disease underwent surgical implantation of the Isobar TTL dynamic stabilization system (n = 20) or a rigid system (n = 21) from January 2013 to June 2017. The mean follow-up time was 23.6 (range 15–37) months. Clinical results were evaluated with the Oswestry Disability Index (ODI), modified Macnab criteria, and the visual analog score (VAS). Radiographic evaluations included the height of the intervertebral space and the range of motion (ROM) of the treated and adjacent segments. The intervertebral disc signal was classified using the modified Pfirrmann grading system and the University of California at Los Angeles (UCLA) system. Results The clinical results, including the ODI and VAS, showed that there was significant improvement in the two groups after implantation and that the difference between the two groups was not significant. In addition, the clinical efficacy indicated by the modified Macnab criteria for the two groups was similar. Radiological outcomes included the height of the intervertebral space, lumbar mobility, and intervertebral disc signal. The height of the intervertebral space of the upper adjacent segment L2/3 in the rigid group was significantly lower than that in the Isobar TTL group at the last follow-up. Furthermore, the number of ROMs of the fixed-segment L3/4 in the Isobar TTL group was significantly less than that before implantation, suggesting that the fixed-segment ROMs in the Isobar TTL group were limited. In addition, the ROM of the upper adjacent segment L2/3 in the last follow-up of the rigid group increased significantly, while that of the Isobar TTL group did not change after implantation. Finally, the incidence of adjacent-segment degeneration (ASD) was significantly greater in the rigid group than in the Isobar TTL group according to the UCLA system. Conclusion The Isobar TTL system can be clinically effective for treating two-segment lumbar degenerative disease. Compared with rigid fixation, the Isobar TTL system yielded better radiographic outcomes and maintained the mobility of the treated segments with less impact on the proximal adjacent segment.

Noble-metal-free catalysts often show stability issues in acidic media due to structural degradation. Here authors show that phase-mixed engineering of cobalt diselenide electrocatalysts can enable greater covalency of Co-Se bonds and improve robustness for catalyzing hydrogen evolution in acid.

Hypoxia induces cellular oxidative stress that is associated with neurodegenerative diseases. HPN (4'-hydroxyl-2-substituted phenyl nitronyl nitroxide), a stable nitronyl nitroxide, has excellent free radical scavenging properties. The purpose of this study was to investigate the protective effects of HPN on hypoxia-induced damage inPC12 cells. It was shown that HPN significantly attenuated hypoxia-induced loss of cell viability, release of lactate dehydrogenase (LDH), and morphological changes in PC12 cells. Moreover, hypoxic PC12 cells had increased levels of reactive oxygen species (ROS), malondialdehyde (MDA), and expression of HIF-1[alpha] and VEGF, but had reduced levels of superoxide dismutase (SOD) and catalase (CAT), and HPN reversed these changes. HPN also inhibited hypoxia-induced cell apoptosis via suppressing the expression of Bax, cytochrome c, and caspase-3, and inducing the expression of Bcl-2. These results indicate that the protective effects of HPN on hypoxia-induced damage in PC12 cells is associated with the suppression of hypoxia-induced oxidative stress and cell apoptosis. HPN could be a promising candidate for the development of a novel neuroprotective agent. Key words: nitronyl nitroxide, hypoxia, PC12 cells, oxidative stress, apoptosis. L'hypoxie provoque un stress oxydant cellulaire qui est associe aux maladies neurodegeneratives. Le 4'-hydroxyl-2-phenyl nitronyl-nitroxyde substitue (HPN), un nitronyl-nitroxyde stable, presente une excellente activite de piegeur de radicaux libres. L'objectif de cette etude consistait a examiner les effets protecteurs du HPN sur le dommage induit aux cellules PC12 par l'hypoxie. Il s'est avere que le HPN attenuait significativement la perte de viabilite cellulaire, la liberation de LDH et les changements morphologiques induits par l'hypoxie chez les cellules PC12. De plus, les cellules PC12 hypox-iques presentaient une elevation des contenus en derives reactifs de l'oxygene (DRO) et en malonaldehyde (MDA), ainsi que de l'expression de HIF-1[alpha] et du VEGF, mais une diminution de la superoxyde dismutase (SOD) et de la catalase (CAT), alors que le HPN pouvait renverser ces changements. Le HPN inhibait aussi l'apoptose induite par l'hypoxie en reprimant l'expression de Bax, du cytochrome c et de la caspase-3 et en induisant l'expression de Bcl-2. Ces resultats indiquent que la protection conferee par le HPN envers les dommages provoques par l'hypoxie chez les cellules PC12 est associee a la suppression du stress oxydant et de l'apoptose induits par l'hypoxie. Le HPN pourrait constituer un candidat prometteur dans le cadre du developpement d'un nouvel agent neuroprotecteur. [Traduit par la Redaction] Mots-cles: nitronyl-nitroxyde, hypoxie, cellules PC12, stress oxydant, apoptose., Introduction Oxygen ([O.sub.2]) is essential for aerobic organisms to produce energy (Majmundar et al. 2010). When the supply of oxygen does not meet demand from the cells, this leads to [...]