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The coronavirus disease 2019 (COVID-19) pandemic has sparked interest in telemedicine, resulting in an increase in neurosurgical publications focused on it. We summarize this new literature to evaluate telemedicine applications to neurosurgery.A systematic literature review was performed in accordance with the PRISMA guidelines by searching PubMed, Embase, and Scopus for journal articles published after January 1, 2020. All journal articles that included data after the start of COVID-19 and evaluated any aspect of telemedicine relevant to outpatient neurosurgical visits were included. The premise and key findings of each included study were extracted, as well as patient and provider satisfaction with and preference for telemedicine.Thirty-seven articles met the inclusion criteria. Four studies proposed and evaluated a remote neurologic examination. Two studies reported similar postvisit outcomes between remote and in-person visits. Twenty-four studies reported a combination of patient and provider opinions toward telemedicine. Of 9834 patients and 116 providers, 82.4% and 65.2% were satisfied overall with telemedicine, respectively. Of 3526 patients and 168 providers, 57.0% and 66.5% preferred telemedicine to in-person visits, respectively.Overall, most patients and providers have a high opinion of telemedicine for outpatient visits, and increasing evidence suggests that remote visits yield favorable clinical outcomes. The high rates of patient and provider satisfaction and preference may be considered for further adoption of remote neurosurgical visits beyond the COVID-19 era.

A sophisticated finite element analysis (FEA) method for modeling interior permanent magnet (IPM) electric motors is presented. Based on this method, a coupled structural-acoustic analysis procedure was developed to simulate the motor dyno vibroacoustic responses with improved accuracy and reliability for NVH (noise, vibration, and harshness) behavior prediction over a wide range of torques and frequencies under the operational electromagnetic forces. The proposed motor modeling and analysis method is detail-oriented with high fidelity in modeling the structure and complex material representation. To effectively deal with the motor stator core constructed with large numbers of electromagnetic laminae, the unit-cell approach was employed to derive the core material properties by homogenizing the laminated core as an equivalent orthotropic material. Meanwhile, the windings were modeled by capturing the precise geometry for accuracy improvement. Additionally, the method facilitates modeling the varnish fill details between the core, linings, and the windings, such as bonded locations, area coverage, and fill rate. Guidelines pertinent to FEA modeling of motor components related to element type selection, mesh size determination, acoustic domain definition, and structure-acoustic interface connection are also provided. The stator analysis model was first correlated with the free-free modes and frequency response functions (FRF) obtained from the vibrometer test before being incorporated into the motor dyno system to simulate the radiated noise for critical motor whine orders and other NVH-related behavior. Finally, the simulated results were verified against motor dyno test data over a wide range of torque and frequency. This high-fidelity motor model can further be used for advanced studies in objectively assessing the influence of airgap eccentricity, rotor skew configuration, stator attachment architecture, etc., on motor NVH behavior.

Anterior cervical diskectomy and fusion (ACDF) is a highly successful procedure to treat spinal cord or nerve root compression; however, complications can still occur. With advancements in imaging, 3-dimensional (3D) reconstruction allows real-time instrument tracking in a surgical field relative to the patient's anatomy. Here, we compare plate positioning and short-term outcomes when using 3D navigation to fluoroscopy in ACDF for degenerative spine disease.All ACDFs for cervical spondylosis performed by 6 surgeons at a single center between 2010 and 2018 were included. ACDFs were divided into those performed using 3D navigation or fluoroscopy. Records were assessed for patient demographics, American Society of Anesthesiology score, number of operated interspaces, operative time, length of stay, perioperative complications, and 90-day readmissions. Postoperative images were reviewed for lateral and angular plate deviations.A total of 193 ACDFs performed with 3D navigation and 728 performed with fluoroscopy were included. After controlling for demographics and surgical characteristics, using 3D navigation was associated with less lateral plate deviation (P = 0.048) and longer operative times per interspace (P0.001) but was not associated with angular plate deviation (P = 0.724), length of stay (P = 0.393), perioperative complications (P = 0.844), and 90-day readmissions (P = 0.539).Using 3D navigation in ACDF for degenerative disease is associated with slightly more midline plate positioning and comparable short-term outcomes as using fluoroscopy and can be a suitable alternative. Advantages of using this technology, such as improved visualization of anatomy, should be weighed against disadvantages, such as increased operative time, on a per-patient basis.

Planning and executing motor behaviors requires coordinated neural activity among multiple cortical and subcortical regions of the brain. Phase-amplitude coupling between the high-gamma band amplitude and the phase of low frequency oscillations (theta, alpha, beta) has been proposed to reflect neural communication, as has synchronization of low-gamma oscillations. However, coupling between low-gamma and high-gamma bands has not been investigated. Here, we measured phase-amplitude coupling between low- and high-gamma in monkeys performing a reaching task and in humans either performing finger movements or speaking words aloud. We found significant coupling between low-gamma phase and high-gamma amplitude in multiple sensorimotor and premotor cortices of both species during all tasks. This coupling modulated with the onset of movement. These findings suggest that interactions between the low and high gamma bands are markers of network dynamics related to movement and speech generation.

Stroke is a prominent and financially burdensome disease. Lacunar strokes are traditionally attributed to small vessel disease rather than cardioemboli, which typically occlude larger arteries. Thus, the benefit of screening for potential sources of cardioemboli in lacunar stroke patients is unclear. We evaluated the clinical utility of the transthoracic echocardiogram performed in patients with lacunar strokes.A single-center retrospective analysis of ischemic stroke patients from January 2013 through December 2017 was performed. Brain magnetic resonance imaging was used to select patients with a single lacunar infarct. Patients presenting with acute symptoms of cardiac disease or an abnormal electrocardiogram were excluded. Transthoracic echocardiogram results were reviewed, and their utility in decision-making was evaluated.Of the 442 patients at our institution diagnosed with ischemic stroke during the inclusion period, 89 met inclusion criteria. Transthoracic echocardiogram detected a patent foramen ovale in 5.6% of patients, mitral annular calcification in 9.0% of patients, and abnormal wall motion in 4.5% of patients. For all patients, there were no findings that prompted anticoagulation, antibiotic, or surgical intervention. The cost of an inpatient transthoracic echocardiogram is $4100, resulting in $364,900 in unnecessary health care spending.Transthoracic echocardiogram appears to have minimal therapeutic value in most patients with lacunar strokes. In stroke patients with no acute symptoms of cardiac disease and a normal electrocardiogram, it may be reasonable to forgo the transthoracic echocardiogram if the brain magnetic resonance imaging shows an isolated lacunar infarct.

Background Neurosurgeons are frequently consulted for traumatic brain injuries (TBIs) resulting in intracranial hemorrhage (ICH). After inpatient confirmation of hemorrhage stability, outpatient head computed tomography (CT) is often performed to assess for hemorrhage resolution. Our objective was to assess the practice patterns and clinical utility of routine outpatient head CT scans for patients with mild TBI (mTBI). Materials and Methods A retrospective review was performed on all adult mTBI patients with ICH who presented to a level I trauma center over a 4-year period. A combination of the patient’s initial clinical evaluation and CT findings was used to identify mTBI patients at low risk for neurologic deterioration and neurosurgical intervention. Findings from the outpatient follow-up clinical evaluation and head CT were assessed. Patients without outpatient follow-up within 3 months were excluded. Results Forty-nine patients met inclusion criteria for the study. Thirty-two had an outpatient head CT before their follow-up appointment. Twenty-one patients had at least 1 neurologic finding at the earliest follow-up appointment. All patients except those with a subdural hematoma (SDH) had smaller or resolving ICH on outpatient CT scans. Seven patients with an SDH had unchanged or expanded hemorrhage on outpatient imaging, 2 of whom had traumatic brain injury−related hospitalizations and 1 of whom underwent neurosurgical intervention due to an enlarging SDH. Conclusions Routine outpatient head CT scans before follow-up for low-risk mTBI patients without an SDH appears to have limited clinical utility. In low-risk mTBI patients with an SDH, obtaining an outpatient head CT is reasonable to monitor for resolution.

While neurosurgeons are experienced in treating penetrating brain injuries (PBIs) in civilian settings, much less is known about management and outcomes of PBIs in military settings.A systematic review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Data extracted included surgical management, age, gender, location/type of injury, initial Glasgow Coma Scale (GCS) score, and outcomes. The primary outcomes were last reported Glasgow Outcome Score (GOS) and mortality. The secondary outcomes included central nervous system infections, seizures, and cerebrospinal fluid leak/fistula. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used for outcome analysis.Twelve studies with 1738 patients treated for PBIs in military settings were included. The weighted mean age was 27.8 years, 86.7% were male, and 64.3% underwent neurosurgical intervention. Most patients (64.3%) presented with a GCS score8, while 31.0% presented in a coma (GCS score8). Over a median last follow-up time of 9 months, 68.6% achieved a favorable (GOS = 4-5) outcome and 34.2% achieved a poor (GCS score = 1-3) outcome. The overall mortality was 18.0%. A meta-analysis was performed using 5 of 12 studies to evaluate the effect of the presenting GCS score on primary outcomes. Patients with an initial GCS score8 had statistically significant lower odds of a favorable (GOS = 4-5) outcome (OR: 0.03; 95% CI: 0.00-0.19; P: 0.000) and higher odds of mortality (OR: 28.46; 95% CI: 8.62-94; P: 0.000) than patients with an initial GCS score8. The pooled rates of central nervous system infection, seizures, and cerebrospinal fluid leak/fistula were 13.8%, 13.2%, and 5.4%, respectively.In this first systematic review and meta-analysis of outcomes following combat-related PBIs, a GCS score8 at presentation was found to be an important predictor of a favorable GOS and decreased mortality.

Spinal synovial cysts are acquired, fluid-filled lesions of the facet joint that most commonly occur in the lumbar spine. They are thought to arise from degenerative changes and to result from segmental instability. Although the treatment of these lesions has been studied, the long-term implications and effects of the different strategies for surgical intervention (i.e., decompression and fusion vs. decompression alone) have not yet been elucidated or established.Using an all-payer database with 53 million patient records (MARINER-53), patients with a diagnosis of lumbar synovial cysts were identified. Patients who had undergone lumbar fusion versus laminectomy were matched 1:1 using binomial and gaussian logistic regression models to evaluate the need for future lumbar surgery within 5 years after their index procedure.No statistically significant differences were noted between the 5-year rates of subsequent intervention, additional laminectomy, or fusion among patients who had undergone index decompression and fusion (n = 51; 10.5%) versus decompression alone (n = 43; 8.8%; P = 0.39). Furthermore, no significant differences were found in the odds of intervention type after index decompression and fusion versus decompression alone (subsequent laminectomy: odds ratio, 0.59; 95% confidence interval, 0.32-1.09; subsequent fusion: odds ratio, 1.14; 95% confidence interval, 0.64-2.02).Patient-specific factors and surgeon-patient-shared decision-making should be used when planning interventions for these lesions. However, synovial cysts might not require a fusion procedure for presumed instability. Further investigation is required, using randomized and prospective studies, to further evaluate the effective treatment of this entity.

Arm movement kinematics may provide a more sensitive way to assess neurorehabilitation outcomes than existing metrics. However, measuring arm kinematics in people with stroke can be challenging for traditional optical tracking systems due to non-ideal environments, expense, and difficulty performing required calibration. Here, we present two open-source methods, one using inertial measurement units (IMUs) and another using virtual reality (Vive) sensors, for accurate measurements of wrist position with respect to the shoulder during reaching movements in people with stroke. We assessed the accuracy of each method during a 3D reaching task. We also demonstrated each method’s ability to track two metrics derived from kinematics-sweep area and smoothness-in people with chronic stroke. We computed correlation coefficients between the kinematics estimated by each method when appropriate. Compared to a traditional optical tracking system, both methods accurately tracked the wrist during reaching, with mean signed errors of 0.09 ± 1.81 cm and 0.48 ± 1.58 cm for the IMUs and Vive, respectively. Furthermore, both methods’ estimated kinematics were highly correlated with each other (p

OBJECTIVE Foramen magnum meningiomas (FMMs) pose a unique challenge given their intimate anatomical relationship with the craniovertebral junction. While resection has been studied extensively, much less has been reported about the use of stereotactic radiosurgery (SRS) for FMMs. This study includes what is to the authors’ knowledge the first systematic review in the literature that summarizes patient and treatment characteristics and synthesizes outcomes following SRS for FMMs. METHODS A retrospective chart review was conducted at a single major academic institution, and a systematic review was performed according to PRISMA guidelines. The initial search on the PubMed and Scopus databases yielded 530 results. Key data extracted from both databases included Karnofsky Performance Status (KPS) score and neurological deficits at presentation, tumor location, treatment indication, target volume, single versus multiple fractions, marginal and maximum doses, isodose line, clinical and radiographic follow-up times, and primary (clinical stability and local control at last follow-up) and secondary (mortality, adverse radiation events, time to regression, progression-free survival) outcomes. RESULTS The study patients included 9 patients from the authors’ institution and 165 patients across 4 studies who received SRS for FMMs. The weighted median age at treatment was 60.2 years, and 73.9% of patients were female. Common presenting symptoms included headache (33.9%), dizziness/ataxia (29.7%), cranial nerve deficit(s) (27.9%), numbness (22.4%), weakness (15.2%), and hydrocephalus (4.2%). Lateral/ventrolateral (64.2%) was the most common tumor location. SRS was utilized as the primary therapy in 63.6% of patients and as salvage (21.8%) or adjuvant (14.5%) therapy for the rest of the patients. Most patients (91.5%) were treated with a single fraction. A tumor with a weighted median target volume of 2.9 cm3 was treated with a weighted median marginal dose, maximum dose, and isodose line of 12.9 Gy, 22.8 Gy, and 58%, respectively. Clinical stability and local control at last follow-up were achieved in 98.8% and 97.0% of patients, respectively. Only one possible adverse radiation event occurred, and no mortality directly related to the tumor or SRS was reported. CONCLUSIONS In this retrospective analysis and systematic review, the authors demonstrate SRS to be an effective and safe treatment option for carefully selected patients with FMMs.

International audience; An electron or electron-positron beam streaming through a plasma is notoriously prone to microinstabilities. For a dilute ultrarelativistic infinite beam, the dominant instability is a mixed mode between longitudinal two-stream and transverse filamentation modes, with a phase velocity oblique to the beam velocity. A spatiotemporal theory describing the linear growth of this oblique mixed instability is proposed which predicts that spatiotemporal effects generally prevail for finite-length beams, leading to a significantly slower instability evolution than in the usually assumed purely temporal regime. These results are accurately supported by particle-in-cell (PIC) simulations. Furthermore, we show that the self-focusing dynamics caused by the plasma wakefields driven by finite-width beams can compete with the oblique instability. Analyzed through PIC simulations, the interplay of these two processes in realistic systems bears important implications for upcoming accelerator experiments on ultrarelativistic beam-plasma interactions.

BackgroundStroke is the leading cause of long-term disability in the United States, often resulting in upper extremity (UE) motor impairment. Most existing outcome metrics of UE function in rehabilitation are insensitive to change or subject to observer bias. There is growing interest in using movement kinematics to measure UE motor function, since they can provide high-resolution, quantitative measurements. However, measuring arm kinematics in stroke survivors, particularly in the hospital or clinic, can be challenging for traditional optical tracking systems due to non-ideal environments, expense, and a limited ability to perform required calibration poses. The aim of this study was to develop a general framework for accurate measurements of wrist position during reaching movements in people with stroke using relatively inexpensive wearable sensors.MethodsWe developed and presented two methods, one using inertial measurement units (IMUs) and using virtual reality (Vive) sensors, that practically estimate wrist position with respect to the shoulder. We then assessed the estimation accuracies of each method during a 3D reaching task by using a Vicon motion capture system. We also demonstrated each methods ability to track two kinematic metrics, sweep area and smoothness, in chronic stroke survivors. We computed Pearson correlation coefficients when appropriate.ResultsCompared to a traditional optical system, both systems tracked with high accuracy during 3D reaching, with mean absolute errors of 1.00 ± 0.80 cm and 1.09 ± 0.51 cm for the IMU and Vive, respectively. Furthermore, both methods’ estimated kinematics highly agreed with each other (p < 0.01).ConclusionsThese methods may be useful for developing kinematic metrics to evaluate stroke rehabilitation outcomes in both laboratory and clinical environments.Trial RegistrationThe clinical trial (ClinicalTrial.gov ID: NCT03401762) was registered on January 17, 2018 (https://clinicaltrials.gov/ct2/show/NCT03401762) and posted on January 1, 2018. The trial is scheduled to be completed by August 2023. The trial was updated on December 2, 2020 and is currently recruiting.

PURPOSE: Megestrol acetate is a synthetic progestogen used to treat some cancers and cancer-associated cachexia, but its potential interactions with other drugs are not well known. This study aims to determine the regulation of drug metabolizing enzymes by megestrol acetate. METHODS: Primary human hepatocytes were treated and analyzed by PCR array to identify genes involved in drug metabolism that are impacted by megestrol acetate. P450 3A4 (CYP3A4) reporter gene assay and HPLC analyses of nifedipine metabolites were used to determine CYP3A4 gene expression and activities. Competitive ligand binding assay was used to determine the affinity of megestrol acetate toward human pregnane x receptor (hPXR). Electrophoretic mobility shift assay and mammalian two hybrid assay were used to determine the mechanism of megestrol to activate hPXR. RESULTS: The levels and activities of CYP3A4 were significantly induced (> 4-folds) by megestrol acetate in human hepatocytes and HepG2 cells. Megestrol treatment induced CYP3A4 through the activation of hPXR, a ligand-activated transcription factor that plays a role in drug metabolism and transport. Other tested nuclear receptors showed no response. The mechanism studies showed that megestrol activated hPXR by binding to the ligand binding domain (LBD) of hPXR and increasing the recruitment of the cofactors such as steroid receptor cofactor (SRC-1). CONCLUSION: The results suggest that megestrol acetate is a specific inducer of CYP3A4 mediated by hPXR and therefore has the potential to cause drug interactions, especially in the co-administration with drugs that are substrates of CYP3A4.

Summary In this study, we report a test result of deep Seafloor Massive Sulfide (SMS) deposits exploration at the Longqi hydrothermal field on the ultraslow-spreading Southwest Indian Ridge (SWIR) by using transient electromagnetic method (TEM). The TEM dataset was acquired during the 30th cruise of the China Ocean Mineral Resources R & D Association (COMRA). Conductivity profile has been obtained through 2D inversion of TEM data, and high conductivity anomalies under the seafloor covered by the profile was consistent with the hydrothermal venting sites. Combined with the geochemical and hydrothermal anomalies, it is suggested that the conductive anomalies are attributed to SMS deposits and that the TEM is helpful for exploration and characterization of SMS deposits at hydrothermal fields.

OBJECTIVE Tuberous sclerosis complex (TSC) is an autosomal dominant, multisystem neurocutaneous disorder associated with cortical tubers, brain lesions seen in nearly all patients with TSC, which are frequently epileptogenic. Seizures are often the earliest clinical manifestation of TSC, leading to epilepsy in over 70% of patients. Medical management with antiepileptic drugs constitutes early therapy, but over 50% develop medically refractory epilepsy, necessitating surgical evaluation and treatment. The objective of this study was to summarize the literature and report seizure outcomes following surgical treatment for TSC-associated epilepsy. METHODS A systematic literature review was performed in accordance with the PRISMA guidelines. The PubMed and Embase databases were searched for journal articles reporting seizure outcomes following epilepsy surgery in TSC patients. Included studies were placed into one of two groups based on the surgical technique used. Excellent and worthwhile seizure reductions were defined for each group as outcomes and extracted from each study. RESULTS A total of 46 studies were included. Forty of these studies reported seizure outcomes following any combination of resection, disconnection, and ablation on a collective 1157 patients. Excellent and worthwhile seizure reductions were achieved in 59% (683/1157) and 85% (450/528) of patients, respectively. Six of these studies reported seizure outcomes following treatment with neuromodulation. Excellent and worthwhile seizure reductions were achieved in 34% (24/70) and 76% (53/70) of patients, respectively. CONCLUSIONS Surgery effectively controls seizures in select patients with TSC-associated epilepsy, but outcomes vary. Further understanding of TSC-associated epilepsy, improving localization strategies, and emerging surgical techniques represent promising avenues for improving surgical outcomes.

Background Patients with congestive heart failure (CHF) are vulnerable to contrast-induced acute kidney injury (CI-AKI), but few prediction models are currently available. Objectives We aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography. Methods A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. The endpoint was CI-AKI defined as serum creatinine elevation of ≥0.3 mg/dL or 50% from baseline within the first 48–72 hours following the procedure. Predictors for the nomogram were selected by multivariable logistic regression with a stepwise approach. The discriminative power was assessed using the area under the receiver operating characteristic (ROC) curve and was compared with the classic Mehran score in the validation cohort. Calibration was assessed using the Hosmer–Lemeshow test and 1000 bootstrap samples. Results The incidence of CI-AKI was 9.06% (n=170) in the total sample, 8.64% (n=109) in the development cohort and 9.92% (n=61) in the validation cohort (p=0.367). The simple nomogram including four predictors (age, intra-aortic balloon pump, acute myocardial infarction and chronic kidney disease) demonstrated a similar predictive power as the Mehran score (area under the curve: 0.80 vs 0.75, p=0.061), as well as a well-fitted calibration curve. Conclusions The present simple nomogram including four predictors is a simple and reliable tool to identify CHF patients at risk of CI-AKI, whereas further external validations are needed. Figure 1 Funding Acknowledgement Type of funding source: None

International audience; Deep-sea polymetallic sulfides associated with hydrothermal systems are considered a potential viable resource for base and precious metals. The Southwest Indian Ridge (SWIR, Indian Ocean) hosts active and inactive hydrothermal systems. Inactive hydrothermal fields are more abundant than active fields but are difficult to remotely characterize. We report a deep-sea self-potential investigation to locate inactive ore deposits at the Yuhuang hydrothermal field on the ultraslow-spreading SWIR. A horizontal array of six nonpolarizing AgCl electrodes are attached to a deep-towed transient electromagnetic system to record the electrical field at a height of 40 m above the seafloor. The observed electrical field strength near a previously recognized sulfide deposits (verified by drilling) reaches an amplitude of 0.5 mV/m. Negative self-potential anomalies (~−27 mV) were observed by integrating the measured electrical field. The high electrical conductivities (up to 12 S/m) of sulfide samples measured in the laboratory and the oxidized sulfides recovered from the surface of the deposit suggest that the self-potential anomalies are due to sulfide mineralization and corrosion of the polymetallic sulfides. Inversion of the self-potential data reveals a localized body with a thickness of~65 m, which is interpreted as the Yuhuang ore deposit. Our field data demonstrate that the self-potential method is a useful exploration method to identify and image seafloor massive sulfide deposits hosted in inactive hydrothermal fields at mid-ocean ridges.

Growing evidence indicates that calcium-dependent protein kinases (CDPKs) are involved in many aspects of plant’s growth, development and responses to biotic and abiotic stresses. Previous researchers reported AtCDPK1 gene used as a positive regulator in salt and drought stress signaling. This study aimed to increase transgenic potatoes’ (Solanum tuberosum L. cv. Favorita) tolerance to the drought and osmotic stresses. Transgenic potato plants expressing AtCDPK1 gene under the control of the cauliflower mosaic virus (CaMV) 35S promoter (referred to as T-plants) were successfully generated through Agrobacterium-mediated transformation. Two representative transgenic T6 and T25 lines were evaluated for enhanced tolerance to drought and osmotic stresses. The survival rates of transgenic lines T6 and T25 (67 and 54%, respectively) were higher than that of wild type (WT) plants (25%) after the drought stress. After 15 days of PEG stress, the survival rate of T6 was 45.68%, whereas that of the WT line was approximately 20%. The survival rate of transgenic lines was very higher than that of WT after 15 days of PEG stress. The content of proline and malondialdehyde (MDA) were clear difference between control and transgenic lines after the drought and osmotic stresses. After the 24 h osmotic treatment, content of proline in transgenic plants was very higher than that of the control, enhanced 26%, reached an extremely significant level (P < 0.05). MDA content in transgenic plants was lower than the control in the same period, while the biggest difference appeared at 24 h (P < 0.05), and MDA content of transgenic plants reduced 28% than the control. qRT-PCR proves that relative expressions of StP5CS and StProDH genes in the transgenic lines both increased in early period, and then decreased after PEG 6000 stress. These results suggested that enhanced AtCDPK1 expression affected the transcription of stress-associated genes and the content of proline and MDA in transgenic plants, which leads to improved tolerance ability in transgenic potatoes.

Cervical cancer is one of the gynecologic tumors in the world. The main aim of this study was to elucidate the functional role of MFI2 in cervical cancer and provide novel insight into biomarkers and therapeutic strategies for cervical cancer.The relative expression level of MFI2 was examined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Cell counting kit-8 (CCK-8) assay was involved to determine the ability of cell proliferation. Flow cytometric analysis was performed to detect cell apoptosis. Transwell assay and Matrigel assay were involved to determine cell migration and invasion. Expressions of protein kinase B (AKT), phosphorylated-AKT (p-AKT), B-cell lymphoma-2 (BCL2), and BCL2-Associated X (Bax) protein levels were detected in Western blotting. Transfected cells were used to perform tumor xenograft formation assay.Our research validated that MFI2 was up-regulated in cervical cancer by qRT-PCR. Through CCK-8 assay, flow cytometric analysis, transwell assay, and Matrigel assay, we verified that MFI2 can promote cell proliferation, cell metastasis and inhibit cell apoptosis in cervical cancer. Subsequently, we used Western blotting assay to determine the alteration of protein expression of p-AKT, BCL2, and Bax. The results indicated that MFI2 may exert its function by regulating phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway. In tumor xenograft formation assay, up-regulated MFI2 accelerated tumor formation.Current research elucidated that MFI2 promoted cell proliferation, cell metastasis and inhibited cell apoptosis in cervical cancer by regulating the PI3K/AKT signaling pathway. Our results may provide a novel insight into finding new therapeutic targets and biomarkers for cervical cancer.

Objective Intracranial hemorrhage (ICH) is frequently found on computed tomography (CT) after mild traumatic brain injury (mTBI) prompting transfer to centers with neurosurgical coverage and repeat imaging to confirm hemorrhage stability. Studies suggest routine repeat imaging has little utility in patients with minimal ICH, no anticoagulant/antiplatelet use, and no neurological decline. Additionally, it is unclear which mTBI patients benefit from transfer for neurosurgery consultation. The authors sought to assess the clinical utility and cost effectiveness of routine repeat head CTs and transfer to tertiary centers in patients with low-risk, mTBI. Methods Retrospective evaluation of patients receiving a neurosurgical consultation for TBI during a 4-year period was performed at a level 1 trauma center. Patients were stratified according to risk for neurosurgical intervention based on their initial clinical evaluation and head CT. Only patients with low-risk, mTBI were included. Results Of 531 patients, 119 met inclusion criteria. Eighty-eight (74.0 %) received two or more CTs. Direct cost of repeat imaging was $273,374. Thirty-seven (31.1 %) were transferred to our facility from hospitals without neurosurgical coverage, costing $61,384. No patient had neurosurgical intervention or mTBI-related in-hospital mortality despite enlarging ICH on repeat CT in three patients. Two patients had mTBI related 30-day readmission for seizure without ICH expansion. Conclusion Routine repeat head CT or transfer of low-risk, mTBI patients to a tertiary center did not result in neurosurgical intervention. Serial neurological examinations may be a safe, cost-effective alternative to repeat imaging for select mTBI patients. A large prospective analysis is warranted for further evaluation.

Fluorescence imaging signal is severely limited by the quantum efficiency and emission wavelength. To overcome these challenges, novel NIR-emitting K5NdLi2F10 nanoparticles under NIR excitation was introduced as fluorescence imaging probe for the first time. The photostability of K5NdLi2F10 nanoparticles in the water, phosphate buffer saline, fetal bovine serum and living mice was investigated. The fluorescence signal was detected with depths of 3.5 and 2.0 cm in phantom and pork tissue, respectively. Fluorescence spectrum with a significant signal-to-background ratio of 10:1 was captured in living mice. Moreover, clear NIR images were virtualized for the living mice after intravenous injection. The imaging ability of nanoparticles in tumor-beard mice were evaluated, the enrichment of K5NdLi2F10 nanoparticles in tumor site due to the enhanced permeability and retention effect was confirmed. The systematic studies of toxicity, bio-distribution and in-vivo dynamic imaging suggest that these materials give high biocompatibility and low toxicity. These NIR-emitting nanoparticles with high quantum efficiency, high penetration and low toxicity might facilitate tumor identification in deep tissues more sensitively.

Numerous compounds, including weak bases (e.g., glucosamine, ethylenediamine, and pyridine) and weak acids (e.g., bicarbonate, acetate, propionate, and butyrate), were found to inhibit the catalysis of cephalosporin C acylase (CCA), which is a recombinant enzyme expressed in E. coli. Additionally, the protective effect of the inhibitors on free and immobilized CCA against heat treatment was investigated. The inhibitors were added to increase recovery of the activity of the enzyme immobilized by covalent attachment to an epoxy support. The activities of immobilized CCA obtained in the presence of acetate or bicarbonate were 99.2±2.5 U g–1 and 94.1±3.0 U g–1, respectively, which were 31.7 % and 25 % higher, respectively, than that of the control. In addition, the immobilized CCA exhibited improved thermostability. The half-life of immobilized CCA obtained in the presence of acetate or bicarbonate increased by 190 % and 120 %, respectively, compared to that of immobilized CCA obtained in the absence of an inhibitor. This work is licensed under a Creative Commons Attribution 4.0 International License.

Growing evidences indicate that calcium-dependent protein kinases (CDPKs) are involved in many aspects of plant’s growth, development and responses to biotic and abiotic stresses. However, the biological roles of most CDPKs remain unclear. Here we report that CDPK1 is induced by infection with both virulent and avirulent Pseudomonas syringae strains. To understand the biological function of CDPK1, we analyzed phenotypes of the T-DNA insertion line (cpk10) which did not express the CDPK1 gene. The cpk10 mutant exhibited deduced expression of the defense-related genes PR1, PR2, and AIG1 following inoculation with the avirulent pathogen Pst AvrRpt2. In addition, the CDPK1 gene was found to be expressed in guard cells and the cpk10 mutant showed alteration in stomata closure after Pst DC3000 infection. We also found that expression of CDPK1 is induced by plant hormones salicylic acid, methyl jasmonate, and abscisic acid. These results indicate that CDPK1 may be involved in plant defense response.