Increased γ-Aminobutyric Acid Content of Germinated Brown Rice Produced in Membrane Reactor.

RESEARCH BACKGROUND: Rice germination is a natural approach to enhance the physical and functional properties of brown rice. Thus, the aim of this study is to investigate the influence of different germination methods on functional properties of germinated brown rice and evaluate the process feasibility. EXPERIMENTAL APPROACH: Brown rice of IPB 3S variety was germinated with three different methods: (i) complete soaking without water replacement, (ii) complete soaking with water replacement every six hours, and (iii) complete soaking with continuous washing in the developed membrane-facilitated soaking reactor. RESULTS AND CONCLUSIONS: The application of the membrane reactor for producing germinated brown rice maintained the pH of the soaking solution relatively constant (i.e. 6.8-7.0). This indicated the circumvention of natural fermentation during brown rice germination. Moreover, the mass fraction of γ-aminobutyric acid in germinated brown rice produced in the membrane reactor was about 4.5-fold higher (169.2 mg/100 mg) than in ungerminated brown rice (36.82 mg/100 mg), and also higher than that of the other two soaking methods. The γ-oryzanol mass fractions and the antioxidant capacity expressed as ascorbic acid equivalents of germinated brown rice obtained with the three soaking methods varied from 32 to 38 mg/100 mg and 18 to 28 mg/100 g, respectively. Within this study, germination could also slightly reduce the transition temperatures of germinated brown rice starch gelatinization (t o=73-74 °C, t p=76-77 °C and t c=~80 °C, where t o, t p and t c are onset, peak and conclusion (final) temperatures). In conclusion, the production of germinated brown rice in the membrane reactor could enhance its γ-aminobutyric acid mass fraction and reduce wastewater production and is therefore considered more feasible. NOVELTY AND SCIENTIFIC CONTRIBUTION: This study demonstrates the feasibility of germinated brown rice production using a membrane-facilitated soaking reactor with enhancement of bioactive compound content, especially γ-aminobutyric acid, and minimised wastewater production.

Priorities in coronary artery bypass grafting: Is midterm survival more dependent on completeness of revascularization or multiple arterial grafts?

OBJECTIVE: Both completeness of revascularization and multiple arterial grafts (multiple arterial coronary artery bypass grafting) have been associated with increased midterm survival after coronary artery bypass grafting. The purpose of this study was to evaluate the relative impact of completeness of revascularization and multiple arterial coronary artery bypass grafting on midterm survival after coronary artery bypass grafting. METHODS: A retrospective review of 17,411 isolated, primary coronary artery bypass grafting operations from January 2002 to June 2016 at a US academic institution was performed. Patients were divided into groups based on complete or incomplete revascularization and number of arterial grafts. Inverse probability of treatment weighting based on the generalized propensity score was performed to minimize imbalance in preoperative characteristics. Between-group differences in outcomes were assessed using multivariable logistic and Cox regression analyses, incorporating the propensity score weights. RESULTS: Patients undergoing multiple arterial coronary artery bypass grafting in this study were younger, had fewer comorbid conditions, and had lower incidence of left main stenosis compared with patients undergoing single-arterial coronary artery bypass grafting. Short-term perioperative outcomes were similar between groups once propensity score weighting was used to minimize between-group differences in preoperative variables. Median follow-up in the entire population was 630 days, but was 1366 days in the cohort with data available from the Social Security Death Index. Multiple arterial coronary artery bypass grafting was protective for midterm survival compared with single arterial coronary artery bypass grafting, regardless of complete or incomplete revascularization or strategy (multiple arterial complete revascularization vs single-arterial complete revascularization: hazard ratio, 0.82; 95% confidence interval, 0.69-0.97; P = .02; multiple arterial incomplete revascularization vs single-arterial incomplete revascularization: hazard ratio, 0.70; 95% confidence interval, 0.53-0.90; P = .007). CONCLUSIONS: After controlling for preoperative comorbidities, multiple arterial coronary artery bypass grafting provides a modest midterm survival benefit over single-arterial coronary artery bypass grafting irrespective of completeness of revascularization, suggesting that when forced to choose, surgeons may elect to pursue multiple arterial conduits.

Hyperlipidemia does not affect development of elastase-induced abdominal aortic aneurysm in mice.

BACKGROUND AND AIMS: Hyperlipidemia is a suggested risk factor for abdominal aortic aneurysm (AAA). However, whether hyperlipidemia is causally involved in AAA progression remains elusive. Here, we tested the hypothesis that hyperlipidemia aggravates AAA formation in the widely used porcine pancreatic elastase (PPE) model of AAA in mice with varying levels of plasma lipids. METHODS: Prior to PPE-surgery, 8-week-old male C57BL/6J mice (n = 32) received 1·1011 viral genomes of rAAV8-D377Y-mPcsk9 or control rAAV8 via the tail vein. Mice were fed either western type diet or regular chow. At baseline and during the 28 days following PPE-surgery, mice underwent weekly ultrasonic assessment of AAA progression. Experiments were repeated using Apolipoprotein E knockout (ApoE-/-) mice (n = 7) and wildtype C57BL/6J mice (n = 5). RESULTS: At sacrifice, maximal intergroup plasma cholesterol and non-HDL/HDL ratio differences were >5-fold and >20-fold, respectively. AAA diameters expanded to 150% of baseline, but no intergroup differences were detected. This was verified in an independent experiment comparing 8-week-old male ApoE-/- mice with wildtype mice. Histological evaluation of experimental AAA lesions revealed accumulated lipid in neointimal and medial layers, and analysis of human AAA lesions (n = 5) obtained from open repair showed medial lipid deposition. CONCLUSIONS: In summary, we find that lipid deposition in the aortic wall is a feature of PPE-induced AAA in mice as well as human AAA lesions. Despite, our data do not support the hypothesis that hyperlipidemia contributes to AAA progression.

Bullying and undermining behaviours in surgery: A qualitative study of surgical trainee experiences in the United Kingdom (UK) & Republic of Ireland (ROI).

BACKGROUND: Bullying and undermining (B/U) behaviours are documented in the international surgical workplace. This study is the largest assessment of prevalence of B/U behaviours within UK & ROI surgical training to date. MATERIALS AND METHODS: UK & ROI surgical trainees were electronically surveyed in July 2017. The survey was open for one month and sent to all registered trainees at Core and Specialty level by the Joint Committee on Surgical Training (JCST) along with email and social media dissemination by the Association of Surgeons in Training (ASiT) and the British Orthopaedic Trainees Association (BOTA). A consensus session on the topic was conducted at the ASiT Conference in Edinburgh in March 2018. Standards for reporting of Qualitative Research were followed. RESULTS: 1412 responses were received (26.6% response rate). All training regions, grades and specialties were represented. 60% of trainees (n = 837) reported witnessing or experiencing B/U behaviours in the surgical workplace. The most common reports related to sexism; 42% (n = 568) reported witnessing or experiencing sexist language/attitudes in the workplace. This was reported more by female respondents (66% compared to 27% male). 21% (n = 291) and 13% (n = 180) reported witnessing or personally experiencing racist and homophobic language or attitudes respectively. Consultants were identified as the most frequent perpetrators. The surgical wards or theatres were the most frequently reported areas that trainees either witnessed or experienced B/U behaviours. Of those trainees who had reported a personal experience of B/U behaviours (n = 344), 20% described their experiences of reporting as negative or very negative. 48.1% of respondents felt that surgery as a whole had a moderate, high or very high degree of a concern about B/U behaviours. CONCLUSION: B/U behaviours are prevalent in the surgical domain. Urgent action is required to eradicate this unacceptable behaviour. A cross-specialty, intercollegiate response is required to tackle this issue and improve the working culture in surgery for all.

Consensus recommendations on balancing educational opportunities and service provision in surgical training: Association of Surgeons in Training Delphi qualitative study.

BACKGROUND: Ensuring the highest quality of surgical training remains a challenge as demands on health service provision rise. This study aimed to explore the differences and potential conflicts between service provision and dedicated training activity provided by surgical trainees, and recommend solutions. METHODS: Participants were drawn from the Association of Surgeons in Training (ASiT) national council. Nominal Group Technique (NGT) was employed by members of the ASiT executive addressing 3 key domains (1) defining differences between training and service tasks, (2) impact of service-provision on training and (3) ways to improve training. A two-round Delphi process was conducted via electronic survey to ASiT council. Consensus was considered achieved for any statement where 80% or more of respondents indicated agreement. RESULTS: 47 statements were generated through NGT which were put to the Delphi process. Consensus was reached on a total of 24/47 statements. Educational or training tasks were identified as being activities which progressed a trainee's skill set, could be tailored to a trainee's own ability, and involved acting as a trainer to more junior colleagues. The negative impact of excess service provision included training quality, trainee mental health, and surgical trainee recruitment. Potential measures to improve training included increasing hospital staffing and resources, protected training times, trainee-specific or competency-based learning and training or incentivising trainers. CONCLUSION: This trainee-based study provides several consensus recommendations on the characteristics that define surgical training and how a balance between service provision and training can potentially be achieved. Policy makers and health systems may be guided by these to ensure high quality training and a satisfied workforce.

Ischemic Injury-Induced CaMKIIδ and CaMKIIγ Confer Neuroprotection Through the NF-κB Signaling Pathway.

Ca2+/calmodulin-dependent protein kinase II (CaMKII) has long been implicated in neuronal injury caused by acute ischemia/reperfusion (I/R). However, its precise role and regulatory mechanisms remain obscure. Here, we investigated the role of the CaMKII family in neuronal survival during I/R. Our data indicated that CAMK2D/CaMKIIδ and CAMK2G/CaMKIIγ were selectively upregulated in a time-dependent manner at both transcriptional and protein levels after acute ischemia. Overexpression of CaMKIIδ promoted neuronal survival, while their depletion exacerbated ischemic neuronal death. Similar to CaMKIIδ, knockdown of CAMKIIγ resulted in significant neuronal death after I/R. We further identified CaMKIIδ2 as the subtype that is selectively induced by I/R in primary neurons. The induction of CaMKIIδ was controlled in part by a pair of long non-coding RNAs (lncRNAs), C2dat1 and C2dat2. C2dat2, similar to C2dat1, was upregulated by I/R and cooperated with C2dat1 to modulate CaMKIIδ expression. Knockdown of C2dat1/2 blocked OGD/R-induced CaMKIIδ expression and decreased neuronal survival but did not affect the levels of CaMKIIγ, indicating specific targeting of CAMK2D by C2dat1/2. Mechanistically, I/R-induced CaMKIIδ and CaMKIIγ caused the upregulation of IKKα/ß and further activation of the NF-κB signaling pathway to protect neurons from ischemic damage. Genetically, downregulating p65 subunit of NF-κB in mice increased I/R-induced neuronal death by blocking the activity of CaMKII/IKK/IκBα/NF-κB signaling axis. In summary, CaMKIIδ and CaMKIIγ are novel I/R-induced genes that promote neuronal survival during ischemic injury. The upregulation of these CaMKII kinases led to activation of the NF-κB signaling pathway, which protects neurons from ischemic damage.

Single-Shot Readout of Hole Spins in Ge.

The strong atomistic spin-orbit coupling of holes makes single-shot spin readout measurements difficult because it reduces the spin lifetimes. By integrating the charge sensor into a high bandwidth radio frequency reflectometry setup, we were able to demonstrate single-shot readout of a germanium quantum dot hole spin and measure the spin lifetime. Hole spin relaxation times of about 90 µs at 500 mT are reported, with a total readout visibility of about 70%. By analyzing separately the spin-to-charge conversion and charge readout fidelities, we have obtained insight into the processes limiting the visibilities of hole spins. The analyses suggest that high hole visibilities are feasible at realistic experimental conditions, underlying the potential of hole spins for the realization of viable qubit devices.

Cost-utility analysis for bariatric surgery compared with usual care for the treatment of obesity in Australia.

BACKGROUND: The uptake of bariatric surgery in Australia has been hampered by the lack of funding and lack of evidence on relative value for money. OBJECTIVES: To determine the cost-effectiveness of adjustable gastric banding (AGB), Roux-En-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) versus usual care (UC). SETTING: Perspective of the Australian public healthcare system. METHODS: A Markov model was constructed to simulate the costs and outcomes for 4 approaches to managing obesity. The base-case was a 30-year-old Australian female with a body-mass index>35. Subgroup analysis was conducted to account for the effect of diabetes as well as various differences in cohort characteristics. Uncertainty was characterised by one-way and probabilistic sensitivity analyses. RESULTS: All bariatric surgeries were effective. The incremental cost-effectiveness ratios were similar at $24,454 for AGB, $22,645 for RYGB, and $27,523 for SG, compared with UC. At a willingness to pay threshold of $70,000 per quality-adjusted life year, the probabilities of being cost-effective were 64%, 75%, and 71% for AGB, RYGB, and SG, respectively. Subgroup analysis showed that bariatric procedures are less cost-effective for older cohorts. For those with diabetes, all the procedures were dominant in comparison with UC. CONCLUSION: This model shows that all bariatric procedures are a cost-effective treatment for the management of obese patients. When given to a subgroup with diabetes, bariatric interventions become cost-saving.

Role of microRNAs on Blood Brain Barrier Dysfunction in Vascular Cognitive Impairment.

BACKGROUND: Dementia cases are increasing as the population ages, leading to increased financial costs. Several neuronal diseases including ischemic and hemorrhagic stroke involve cerebrovascular injury or pathophysiology. Cerebrovascular injury is closely tied to blood brain barrier (BBB) disruption. Many studies have shown a significant association between BBB dysfunction and neurological diseases. Therefore, an understanding of the molecular mechanisms which regulate BBB permeability and disruption is essential for establishing future therapeutic strategies to alter dementia disease progression related to cerebrovascular injury, so-called vascular cognitive impairment (VCI). microRNAs (miRs) are small non-coding RNAs that regulate gene expression through targeting of mRNA transcripts. miRs have been implicated in the development and progression of various illnesses, including vascular disease. However, the role of miRs in BBB breakdown or permeability and VCI development has not yet been well clarified. METHOD: Research content related to the origins of VCI and the role of the BBB in pathologic development and therapeutic targeting are reviewed, including current relevant animal models. We draw from the published literature regarding microRNA candidates that are associated with modulation of BBB structure and function. RESULTS: In this review, we summarize the current knowledge about VCI, explore the potential role of miRs in BBB breakdown and VCI progression, and identify potential candidate miRs for development of new treatment strategies. CONCLUSION: miRs constitute a promising novel avenue as future therapeutic options for alteration of both BBB permeability and development of VCI.

Hypotonic swelling promotes nitric oxide release in cardiac ventricular myocytes: impact on swelling-induced negative inotropic effect.

AIMS: Cardiomyocyte swelling occurs in multiple pathological situations and has been associated with contractile dysfunction, cell death, and enhanced propensity to arrhythmias. We investigate whether hypotonic swelling promotes nitric oxide (NO) release in cardiomyocytes, and whether it impacts on swelling-induced contractile dysfunction. METHODS AND RESULTS: Superfusing rat cardiomyocytes with a hypotonic solution (HS; 217 mOsm), increased cell volume, reduced myocyte contraction and Ca(2+) transient, and increased NO-sensitive 4-amino-5-methylamino-2',7'-difluorofluorescein diacetate (DAF-FM) fluorescence. When cells were exposed to HS + 2.5 mM of the NO synthase inhibitor l-NAME, cell swelling occurred in the absence of NO release. Swelling-induced NO release was also prevented by the nitric oxide synthase 1 (NOS1) inhibitor, nitroguanidine, and significantly reduced in NOS1 knockout mice. Additionally, colchicine (inhibitor of microtubule polymerization) prevented the increase in DAF-FM fluorescence induced by HS, indicating that microtubule integrity is necessary for swelling-induced NO release. The swelling-induced negative inotropic effect was exacerbated in the presence of either l-NAME, nitroguandine, the guanylate cyclase inhibitor, ODQ, or the PKG inhibitor, KT5823, suggesting that NOS1-derived NO provides contractile support via a cGMP/PKG-dependent mechanism. Indeed, ODQ reduced Ca(2+) wave velocity and both ODQ and KT5823 reduced the HS-induced increment in ryanodine receptor (RyR2, Ser2808) phosphorylation, suggesting that in this context, cGMP/PKG may contribute to preserve contractile function by enhancing sarcoplasmic reticulum Ca(2+) release. CONCLUSIONS: Our findings suggest a novel mechanism for NO release in cardiomyocytes with putative pathophysiological relevance determined, at least in part, by its capability to reduce the extent of contractile dysfunction associated with hypotonic swelling.

Transorganellar complementation redefines the biochemical continuity of endoplasmic reticulum and chloroplasts.

Tocopherols are nonpolar compounds synthesized and localized in plastids but whose genetic elimination specifically impacts fatty acid desaturation in the endoplasmic reticulum (ER), suggesting a direct interaction with ER-resident enzymes. To functionally probe for such interactions, we developed transorganellar complementation, where mutated pathway activities in one organelle are experimentally tested for substrate accessibility and complementation by active enzymes retargeted to a companion organelle. Mutations disrupting three plastid-resident activities in tocopherol and carotenoid synthesis were complemented from the ER in this fashion, demonstrating transorganellar access to at least seven nonpolar, plastid envelope-localized substrates from the lumen of the ER, likely through plastid:ER membrane interaction domains. The ability of enzymes in either organelle to access shared, nonpolar plastid metabolite pools redefines our understanding of the biochemical continuity of the ER and chloroplast with profound implications for the integration and regulation of organelle-spanning pathways that synthesize nonpolar metabolites in plants.

Smoker-nonsmoker differences in neural response to smoking-related and affective cues: an fMRI investigation.

Smoking may sensitize brain systems to smoking cues while desensitizing systems to naturalistic rewards. This study examined smoker-nonsmoker differences in functional magnetic resonance imaging (fMRI) blood oxygen level dependent (BOLD) response to smoking-related and emotional images. Smokers, relative to nonsmokers, exhibited greater reactivity to smoking and decreased reactivity to emotional cues in the left middle frontal gyrus.

Disassembling glancing angle deposited films for high-throughput, single-post growth scaling measurements.

With growing interest in nanostructured thin films produced by glancing angle deposition (GLAD), it becomes increasingly important to understand their overall growth mechanics and nanocolumn structure. We present a new method of isolating the individual nanocolumns of GLAD films, facilitating automated measurement of their broadening profiles. Data collected for α = 81° TiO2 vertical nanocolumns deposited across a range of substrate rotation rates demonstrates that these rates influence growth scaling parameters. Further, individual posts were found in each case that violate predicted Kardar-Parisi-Zhang growth scaling limits. The technique's current iteration is comparable to existing techniques in speed: though data were studied from 10,756 individual objects, the majority could not be confidently used in subsequent analysis. Further refinement may allow high-throughput automated film characterization and permit close examination of subtle growth trends, potentially enhancing control over GLAD film broadening and morphology.

Blind rage? Heightened anger is associated with altered amygdala responses to masked and unmasked fearful faces.

We investigated anger-related variability in the BOLD fMRI response to crude/masked and detailed/unmasked fearful faces. Anger expression positively covaried with amygdala activation to crude fear, while trait anger negatively covaried with amygdala responses to detailed fear. This differential processing may trigger aggression without the subsequent inhibition associated with distress cues.

Distal humerus internal fixation: a biomechanical comparison of 90° and parallel constructs.

The optimal plating configuration for open reduction and internal fixation of complex distal humerus fractures is controversial. We evaluated cyclic fatigue performance and biomechanical stiffness in a cadaveric model of distal humerus fractures: precontoured nonlocking parallel plates versus a 90° nonlocking construct. A paired design was used, and 8 matched pairs of cadaveric arms were evaluated for bone density and plated. An osteotomy gap was created to simulate comminution, and constructs were randomized to anteroposterior, mediolateral, and torsional stiffness testing. Finally, 350 N was applied cyclically until deformation was permanent, Although there was a trend toward more stiffness of the parallel construct in anteroposterior, mediolateral, and torsional testing, it was not significant (P>.05). Likewise, there was no significant difference in number of cycles to failure (P>.05). Given these results, we suggest that it is reasonable to use a 90° construct or a parallel construct for internal fixation of distal humerus fractures. However, our findings are consistent with a trend in the biomechanical literature supporting use of a parallel construct.

The fluorescence of thyroid tissue.

OBJECTIVE: To investigate the fluorescent characteristics of different thyroid tissues. STUDY DESIGN: Fresh ex vivo thyroid tissue was surfaced scanned with a fluorescence spectrophotometer. Resultant spectra were evaluated via interpeak ratios. RESULTS: Interpeak ratios of all histologies were found to be significantly different from each other (P < 0.001). The diagnostic sensitivity and specificity of fluorescent spectroscopy was 86% and 91% for thyroid nodule capsule, 78% and 59% for papillary thyroid carcinoma, and 82% and 63% for normal thyroid, respectively. CONCLUSION: Fluorescent spectroscopy can been used to identify significant differences in the fluorescent characteristics of various thyroid histologies. SIGNIFICANCE: This study is the first investigation of the fluorescence of thyroid tissue. The diagnostic ability of fluorescent spectrometry may allow it to be used as a localization aid for fine needle aspiration, using optical fiber probes. Further investigations may enhance the sensitivity and specificity of fluorescent spectrometry allowing it to replace or compliment fine needle aspiration. EBM RATING: B-3.