Primary peritoneal drainage in neonates with necrotizing enterocolitis associated with congenital heart disease: a single experience in a Brazilian tertiary center.

Necrotizing enterocolitis (NEC) is a common condition in preterm infants. The risk factors that contribute to NEC include asphyxia, apnea, hypotension, sepsis, and congenital heart diseases (CHD). The objective of this study was to evaluate the association between the treatment (surgery or drainage) and unfavorable outcomes in neonates with NEC and congenital heart diseases (NEC+CHD). A 19-year retrospective cohort study was conducted (2000-2019). Inclusion criterion was NEC Bell II stage. Exclusion criteria were associated malformation or genetic syndrome and those who did not undergo echocardiography or had a Bell I diagnosis. We included 100 neonates: NEC (n=52) and NEC+CHD (n=48). The groups were subdivided into NEC patients undergoing surgery (NECS, n=31), NEC patients undergoing peritoneal drainage (NECD, n=19), NEC+CHD patients undergoing surgery (NECCAS, n=21), and NEC+CHD patients who were drained (NECCAD, n=29). Multivariate analysis was performed to estimate the relative risk of death and the length of stay. Covariates were birth weight and gestational age. The group characteristics were similar. The adjusted relative risk of death was higher in the drainage groups [NECD (Adj RR=2.70 (95%CI: 1.47; 4.97) and NECCAD (Adj RR=1.97 (95%CI: 1.08; 3.61)], and they had the shortest time to death: NECD=8.72 (95%CI: 3.10; 24.54) and NECCAD=5.32 (95%CI: 1.95; 14.44). We concluded that performing primary peritoneal drainage in neonates with or without CHD did not improve the number of days of life, did not decrease the risk of death, and was associated with a higher mortality in newborns with NEC and clinical instability.

Primary peritoneal drainage in neonates with necrotizing enterocolitis associated with congenital heart disease: a single experience in a Brazilian tertiary center

Necrotizing enterocolitis (NEC) is a common condition in preterm infants. The risk factors that contribute to NEC include asphyxia, apnea, hypotension, sepsis, and congenital heart diseases (CHD). The objective of this study was to evaluate the association between the treatment (surgery or drainage) and unfavorable outcomes in neonates with NEC and congenital heart diseases (NEC+CHD). A 19-year retrospective cohort study was conducted (2000-2019). Inclusion criterion was NEC Bell II stage. Exclusion criteria were associated malformation or genetic syndrome and those who did not undergo echocardiography or had a Bell I diagnosis. We included 100 neonates: NEC (n=52) and NEC+CHD (n=48). The groups were subdivided into NEC patients undergoing surgery (NECS, n=31), NEC patients undergoing peritoneal drainage (NECD, n=19), NEC+CHD patients undergoing surgery (NECCAS, n=21), and NEC+CHD patients who were drained (NECCAD, n=29). Multivariate analysis was performed to estimate the relative risk of death and the length of stay. Covariates were birth weight and gestational age. The group characteristics were similar. The adjusted relative risk of death was higher in the drainage groups [NECD (Adj RR=2.70 (95%CI: 1.47; 4.97) and NECCAD (Adj RR=1.97 (95%CI: 1.08; 3.61)], and they had the shortest time to death: NECD=8.72 (95%CI: 3.10; 24.54) and NECCAD=5.32 (95%CI: 1.95; 14.44). We concluded that performing primary peritoneal drainage in neonates with or without CHD did not improve the number of days of life, did not decrease the risk of death, and was associated with a higher mortality in newborns with NEC and clinical instability.

Maternal administration of cannabidiol promotes an anti-inflammatory effect on the intestinal wall in a gastroschisis rat model.

Gastroschisis (GS) is an abdominal wall defect that results in histological and morphological changes leading to intestinal motility perturbation and impaired absorption of nutrients. Due to its anti-inflammatory, antioxidant, and neuroprotective effects, cannabidiol (CBD) has been used as a therapeutic agent in many diseases. Our aim was to test the effect of maternal CBD in the intestine of an experimental model of GS. Pregnant rats were treated over 3 days with CBD (30 mg/kg) after the surgical induction of GS (day 18.5 of gestation) and compared to controls. Fetuses were divided into 4 groups: 1) control (C); 2) C+CBD (CCBD); 3) gastroschisis (G), and 4) G+CBD (GCBD). On day 21.5 of gestation, the fetuses were harvested and evaluated for: a) body weight (BW), intestinal weight (IW), and IW/BW ratio; b) histometric analysis of the intestinal wall; c) immunohistochemically analysis of inflammation (iNOS) and nitrite/nitrate level. BW: GCBD was lower than CCBD (P<0.005), IW and IW/BW ratio: GCBD was smaller than G (P<0.005), GCBD presented lower thickness in all parameters compared to G (P<0.005), iNOS and nitrite/nitrate were lower concentration in GCBD than to G (P<0.005). Maternal use of CBD had a beneficial effect on the intestinal loops of GS with decreased nitrite/nitrate and iNOS expression.

Space- and time-resolved resistive measurements of liquid metal wall thickness.

In a fusion reactor internally coated with liquid metal, it will be important to diagnose the thickness of the liquid at various locations in the vessel, as a function of time, and possibly respond to counteract undesired bulging or depletion. The electrical conductance between electrodes immersed in the liquid metal can be used as a simple proxy for the local thickness. Here a matrix of electrodes is shown to provide spatially and temporally resolved measurements of liquid metal thickness in the absence of plasma. First a theory is developed for m × n electrodes, and then it is experimentally demonstrated for 3 × 1 electrodes, as the liquid stands still or is agitated by means of a shaker. The experiments were carried out with Galinstan, but are easily extended to lithium or other liquid metals.

Onion-peeling inversion of stellarator images.

An onion-peeling technique is developed for inferring the emissivity profile of a stellarator plasma from a two-dimensional image acquired through a CCD or CMOS camera. Each pixel in the image is treated as an integral of emission along a particular line-of-sight. Additionally, the flux surfaces in the plasma are partitioned into discrete layers, each of which is assumed to have uniform emissivity. If the topology of the flux surfaces is known, this construction permits the development of a system of linear equations that can be solved for the emissivity of each layer. We present initial results of this method applied to wide-angle visible images of the Columbia Neutral Torus (CNT) stellarator plasma.

Avoiding Tokamak Disruptions by Applying Static Magnetic Fields That Align Locked Modes with Stabilizing Wave-Driven Currents.

Nonrotating ("locked") magnetic islands often lead to complete losses of confinement in tokamak plasmas, called major disruptions. Here locked islands were suppressed for the first time, by a combination of applied three-dimensional magnetic fields and injected millimeter waves. The applied fields were used to control the phase of locking and so align the island O point with the region where the injected waves generated noninductive currents. This resulted in stabilization of the locked island, disruption avoidance, recovery of high confinement, and high pressure, in accordance with the expected dependencies upon wave power and relative phase between the O point and driven current.

High aspect ratio PS-b-PMMA block copolymer masks for lithographic applications.

The control of the self-assembly (SA) process and nanostructure orientation in diblock copolymer (DBC) thick films is a crucial technological issue. Perpendicular orientation of the nanostructures in symmetric and asymmetric poly(styrene)-b-poly(methyl methacrylate) (PS-b-PMMA) block copolymer films obtained by means of simple thermal treatments was demonstrated to occur in well-defined thickness windows featuring modest maximum values, thus resulting in low aspect ratio (h/d < 2) of the final lithographic mask. In this manuscript, the thickness window corresponding to the perpendicular orientation of the cylindrical structures in asymmetric DBC is investigated at high temperatures (190 °C ≤ T ≤ 310 °C) using a rapid thermal processing machine. A systematic study of the annealing conditions (temperature and time) of asymmetric PS-b-PMMA (Mn = 67.1, polydispersity index = 1.09) films, with thicknesses ranging from 10 to 400 nm, allowed ordered patterns, with a maximum value of orientational correlation length of 350 nm, to be obtained for film thicknesses up to 200 nm. The complete propagation of the cylindrical structures through the whole film thickness in a high aspect ratio PS template (h/d ≈ 7) is probed by lift-off process. Si nanopillars are obtained having the same lateral ordering and characteristic dimensions of the DBC lithographic mask as further confirmed by grazing-incidence small-angle X-ray scattering experiments.

Effects of consumption of whole grain foods rich in lignans in healthy postmenopausal women with moderate serum cholesterol: a pilot study.

This study aims at investigating the effect of an experimental period of intake of whole grain foods rich in lignans as part of an habitual diet on the plasma and urinary excretion of enterolignans, the biomarkers of lipid metabolism and the immunological and antioxidant status in a group of postmenopausal women with moderate serum cholesterol. A randomized double-blind crossover study was completed on 13 subjects in 12-weeks after protocol approval of an ethical committee. The subjects consumed whole grain foods high in lignans (30 g/d of breakfast cereals or biscuits, etc., 80 g/d of whole grain pasta) or refined grain foods for 4 weeks, separated by a 2-weeks wash-out period. A modest hypocholesterolemic effect (p < 0.05) of the whole grain diet was observed and the intake of whole grain products rich in lignans was also associated with an increase in urinary enterodiol excretion (p < 0.05).

IS2-mediated overexpression of kfoC in E. coli K4 increases chondroitin-like capsular polysaccharide production.

Transposons are developing molecular tools commonly used for several applications: one of these is the delivery of genes into microorganisms. These mobile genetic elements are characterised by two repeated insertion sequences that flank a sequence encoding one or more orfs for a specific transposase that moves these sequences to other DNA sites. In the present paper, the IS2 transposon of Escherichia coli K4 was modified in vitro by replacing the sequence coding for the transposase with that of the kfoC gene that codes for chondroitin polymerase. KfoC is responsible for the polymerisation of the bacterial capsular polysaccharide whose structure is analogous to that of chondroitin sulphate, a glycosaminoglycan with established and emerging biomedical applications. The recombinant construct was stably integrated into the genome of E. coli K4 by exploiting the transposase from endogenous copies of IS2 in the E. coli chromosome. A significant improvement of the polysaccharide production was observed, resulting in 80 % higher titres in 2.5-L fed-batch cultivations and up to 3.5 g/L in 22-L fed-batch cultures.

Multi-pole multi-zero frequency-independent phase-shifter.

A multi-pole, multi-zero design allowed realizing a "true" phase-shifter (not time-delayer) of flat frequency-response over more than three decades (30 Hz-100 kHz), which can be extended to higher frequencies or broader bands thanks to a modular design. Frequency-dependent optimization of a single resistance made also the gain flat to within few percents. The frequency-independent phase-shifter presented can find application in any experiment in which an action needs to be taken (e.g., a measurement needs to be performed) at a fixed phase-delay relative to an event, regardless of how rapidly the system rotates or oscillates.

Oblique electron-cyclotron-emission radial and phase detector of rotating magnetic islands applied to alignment and modulation of electron-cyclotron-current-drive for neoclassical tearing mode stabilization.

A two channel oblique electron cyclotron emission (ECE) radiometer was installed on the DIII-D tokamak and interfaced to four gyrotrons. Oblique ECE was used to toroidally and radially localize rotating magnetic islands and so assist their electron cyclotron current drive (ECCD) stabilization. In particular, after manipulations operated by the interfacing analogue circuit, the oblique ECE signals directly modulated the current drive in synch with the island rotation and in phase with the island O-point, for a more efficient stabilization. Apart from the different toroidal location, the diagnostic view is identical to the ECCD launch direction, which greatly simplified the real-time use of the signals. In fact, a simple toroidal extrapolation was sufficient to lock the modulation to the O-point phase. This was accomplished by a specially designed phase shifter of nearly flat response over the 1-7 kHz range. Moreover, correlation analysis of two channels slightly above and below the ECCD frequency allowed checking the radial alignment to the island, based on the fact that for satisfactory alignment the two signals are out of phase.

Evolution of the millimeter-wave collective Thomson scattering system of the high-field tokamak Frascati Tokamak Upgrade.

We first describe the improved receiving system of the diagnostic experiment of millimeter-wave collective Thomson scattering being run on the Frascati Tokamak Upgrade (FTU), and then discuss some peculiar problems and new operating procedures related to the investigation of strong anomalous spectra of nonthermal origin, many-orders-of-magnitude stronger than the ion thermal feature merged in them, systematically observed in the experimentation, and finally ascribed to a perturbation of the gyrotron that generates the probing beam. Arguments in favor of a more general valence of the solutions actuated for the specific case of FTU are finally given.

Complex chimeras to map ligand binding sites of GPCRs.

Family 1a GPCRs are thought to bind small molecule ligands in a pocket comprising sequences from non-contiguous transmembrane helices. In this study, receptor-ligand binding determinants were defined by building a series of complex chimeras where multiple sequences were exchanged between related G-protein coupled receptors. Regions of P2Y(1), P2Y(2) and BLT(1) predicted to interact with nucleotide and leukotriene ligands were identified and receptors were engineered within their transmembrane helices to transpose the ligand binding site of one receptor on to another receptor. Ligand-induced activation of chimeras was compared with wild-type receptor activation in a yeast reporter gene assay. Binding of ligand to a P2Y(2)/BLT(1) chimera confirmed that the ligand binding determinants of BLT(1) are located in the upper regions of the helices and extracellular loops of this receptor and that they had been successfully transferred to a receptor that normally binds unrelated ligands.

Electron-Bernstein-wave current drive in an overdense plasma at the Wendelstein 7-AS stellarator.

Electron-Bernstein-wave (EBW) current drive in an overdense plasma was demonstrated at the Wendelstein 7-AS stellarator for the first time. The EBWs were generated by O-X-B mode conversion. The relatively high current drive efficiency was consistent with theoretical predictions. The experiments provided first investigations of EBW phase space interaction for wave refractive indices much larger than unity.

Tollip, a new component of the IL-1RI pathway, links IRAK to the IL-1 receptor.

Interleukin-1 (IL-1) is a proinflammatory cytokine that elicits its pleiotropic effects through activation of the transcription factors NF-kappaB and AP-1. Binding of IL-1 to its receptor results in rapid assembly of a membrane-proximal signalling complex that consists of two different receptor chains (IL-1Rs), IL-1RI and IL-1RAcP, the adaptor protein MyD88, the serine/threonine kinase IRAK and a new protein, which we have named Tollip. Here we show that, before IL-1beta treatment, Tollip is present in a complex with IRAK, and that recruitment of Tollip-IRAK complexes to the activated receptor complex occurs through association of Tollip with IL-1RAcP. Co-recruited MyD88 then triggers IRAK autophosphorylation, which in turn leads to rapid dissociation of IRAK from Tollip (and IL-1Rs). As overexpression of Tollip results in impaired NF-kappaB activation, we conclude that Tollip is an important constituent of the IL-1R signalling pathway.

Impact of a stimulant-focused enhanced program on the outcome of alcohol- and/or stimulant-dependent men.

BACKGROUND: The approaches to the treatment of most forms of substance dependence are similar. It is not clear whether specific treatment components need to be added to address specific substances. This study asks two questions: What is the impact of a more intense drug treatment program, and do different substance problems require different treatment interventions? METHODS: The 383 veterans included in this study represent two groups of consecutive inpatient male admissions with current alcohol dependence and/or dependence on amphetamines or cocaine at the inpatient Alcohol and Drug Treatment Program of the Veterans Affairs San Diego Healthcare System. All were interviewed at intake by trained interviewers using a standardized semistructured assessment instrument, and a resource person interview also was conducted with 85% of them. The first group of men received the Standard Treatment Program (STP), whereas the second group received the Enhanced Treatment Program (ETP). The latter included an addition of 10 hr per week of intense treatment aimed at stimulants, including two newly developed manual-driven groups (Relapse Prevention and Interpersonal Counseling), each of which met twice a week. RESULTS: The patient follow-up was 92% at 3 months and 83% at 12 months. Abstinence from substances of abuse for ETP and STP were 63% vs. 49% at 3 months and 43% vs. 24% at 12 months. Logistic regressions demonstrated that treatment type continued to predict outcome even in the context of other potentially predictive variables. CONCLUSIONS: Despite the ETP emphasis on stimulants, both alcohol- and stimulant-dependent men appeared to benefit, suggesting a generic improvement in substance use.

Overexpression of an enzymically inactive interleukin-1-receptor-associated kinase activates nuclear factor-kappaB.

Upon interleukin 1 (IL-1) stimulation, the IL-1-receptor (IL-1R)-associated kinase (IRAK) is rapidly recruited to the IL-1R complex and undergoes phosphorylation. Here we demonstrate that recombinant wild-type IRAK (IRAK-WT), but not a kinase-defective mutant with Asp340 replaced by an asparagine residue (IRAK-Asp340Asn), is highly phosphorylated and is capable of auto-phosphorylation in vitro. Overexpression of both IRAK-WT and IRAK-Asp340Asn caused activation of nuclear factor kappaB, suggesting that the kinase activity of IRAK is not required outside of the IL-1R complex.

Cutaneous larva migrans infection in the pediatric foot. A review and two case reports.

Cutaneous larva migrans is the result of infestation of human skin by helminth larvae, which burrow through the epidermis. This route of infestation makes the foot a typical site for origination of this infection. Children, who frequently play barefoot in locations where the most common of the helminth larvae, the dog and cat hookworms, are endemic, are at particular risk for this disorder. This article reviews the differential diagnosis of cutaneous larva migrans and current concepts in management. Two cases of related children who presented to their pediatricians with this condition are reported.

Cutaneous larva migrans infection in the pediatric foot: a review and two case reports

Cutaneous larva migrans is the result of infestation of human skin by helminth larvae, which burrow through the epidermis. This route of infestation makes the foot a typical site for origination of this infection. Children, who frequently play barefoot in locations where the most common the helminth larvae, the dog and cat hookworms, are endemic, are at particular risk of this disorder. This article reviews the differential diagnosis of cutaneous larva migrans and current concepts in management. Two cases of related children who presented to their pediatricians with this condition are reported(AU)