Thermal damage to the skin from 8.2 and 95 GHz microwave exposures in swine.

A study of burn thresholds from superficially penetrating radio-frequency (RF) energy at 8.2 and 95 GHz for swine skin was conducted. The study determined the thresholds for superficial, partial-thickness, and full-thickness burn severities after 5 seconds of exposure at power densities of 4-30 W/cm2and 2-15 W/cm2at 8.2 and 95 GHz, respectively. There were significant differences in he burn thresholds at the different severities between the two frequencies due to the large difference in energy penetration depths. Biopsies were collected from each burn site at 1, 24, 72, and 168 hr post exposure. Each sample was assessed by a burn pathologist against 20 histological factors to characterize the damage resulting from these RF overexposures. A one-dimensional, layered digital phantom that utilized realistic values for dielectric and thermal properties was used to explain some observed thresholds. The results of the heating and cooling response of the animal model and histology scores of each exposure are provided to enhance future efforts at simulation of RF overexposures and to establish damage thresholds.

Mid- to long-term results of SuPerLap single-port treatment in inguinal hernia. / Resultados a medio-largo plazo del tratamiento monopuerto SuPerLap de la hernia inguinal.

INTRODUCTION: Laparoscopic treatment of inguinal hernia is gaining popularity in many hospitals, but the use of working channel scopes is not as widely extended. We present our long-term experience with the SuPerLap (laparoscopic-assisted percutaneous suture) technique described by Rosell et al.(1) for epigastric hernia repair in the percutaneous, single-port treatment of inguinal hernia using working channel scopes. MATERIALS AND METHODS: A retrospective analysis of a series of male patients with congenital inguinal hernia undergoing surgery from February 2017 to December 2020 was carried out. A 5 mm-0º pleuroscope with a 3.5 mm working channel, a 20 G epidural needle, a 36 cm/3.5 mm laparoscopic Maryland dissector, and 3-0 polypropylene and polyester sutures were used. RESULTS: 384 inguinal hernia repairs using the SuPerLap technique were performed in 295 male patients - 206 unilateral repairs and 89 bilateral repairs. In 24 bilateral cases (26.95%), preoperative diagnosis had been unilateral. Mean age was two years (2 weeks-13 years). Mean operating time was 14 minutes (6-50 min) for unilateral repair, and 27 minutes (14-80 min) for bilateral repair. There were two cases of epigastric vessel damage, and one case of early recurrence in a newborn, who successfully underwent re-intervention using the SuPerLap technique. No late complications were recorded after a mean follow-up of 1-36 months. CONCLUSIONS: Working channel scopes using the SuPerLap technique avoid additional ports in inguinal hernia repair. They allow for excellent functional results, without visible scars, and minimize spermatic cord manipulation. Laparoscopy allows previously undiagnosed defects to be concomitantly treated.

INTRODUCCION: La laparoscopia en el tratamiento de la hernia inguinal está cada vez más presente en muchos hospitales. El uso de ópticas con canal de trabajo no está tan extendido. Se presenta la experiencia a largo plazo en la aplicación de la técnica SuPerLap (sutura percutánea laparoasistida) propuesta por Rosell y cols.(1) para la reparación de hernias epigástricas en el tratamiento monopuerto, percutáneo de las hernias inguinales mediante el uso de ópticas con canal de trabajo. MATERIAL Y METODO: Serie quirúrgica de hernia inguinal congénita en varones (febrero de 2017-diciembre de 2020). Se utilizó: pleuroscopio de 5 mm-0º con canal de trabajo de 3,5 mm; aguja epidural 20 G; suturas de polipropileno y poliéster 3/0; disector Maryland laparoscópico (36 cm-3,5 mm). RESULTADOS: Se realizaron 384 herniorrafias inguinales según técnica SuPerLap en 295 varones (206 unilaterales, 89 bilaterales). En 24 casos bilaterales (26,95%) el diagnóstico preoperatorio fue unilateral. La edad media fue de dos años (2 semanas-13 años). El tiempo medio quirúrgico fue 14 minutos (6-50 min) en unilaterales, 27 (14-80 min) en bilaterales. Hubo dos casos de lesión de vasos epigástricos y una recidiva precoz en un neonato, reintervenido satisfactoriamente mediante técnica SuPerLap. En un seguimiento de 1-36 meses no hubo complicaciones tardías. CONCLUSIONES: El uso de ópticas con canal de trabajo según técnica SuPerLap posibilita prescindir de puertos adicionales en el tratamiento de la hernia inguinal. Permite resultados funcionales comparables y cirugía sin cicatrices visibles. Minimiza la manipulación del cordón espermático. La laparoscopia permite el tratamiento concomitante de defectos no diagnosticados previamente.

Resultados a medio-largo plazo del tratamiento monopuerto SuPerLap de la hernia inguinal / Mid- to long-term results of SuPerLap single-port treatment in inguinal hernia

Objetivos: La laparoscopia en el tratamiento de la hernia inguinalestá cada vez más presente en muchos hospitales. El uso de ópticas concanal de trabajo no está tan extendido. Se presenta la experiencia a largoplazo en la aplicación de la técnica SuPerLap (sutura percutánea lapa-roasistida) propuesta por Rosell y cols.(1) para la reparación de herniasepigástricas en el tratamiento monopuerto, percutáneo de las herniasinguinales mediante el uso de ópticas con canal de trabajo.Material y método: Serie quirúrgica de hernia inguinal congénitaen varones (febrero de 2017-diciembre de 2020). Se utilizó: pleuroscopiode 5 mm-0º con canal de trabajo de 3,5 mm; aguja epidural 20 G; suturasde polipropileno y poliéster 3/0; disector Maryland laparoscópico (36cm-3,5 mm).Resultados: Se realizaron 384 herniorrafias inguinales según técnicaSuPerLap en 295 varones (206 unilaterales, 89 bilaterales). En 24 casosbilaterales (26,95%) el diagnóstico preoperatorio fue unilateral. La edadmedia fue de dos años (2 semanas-13 años). El tiempo medio quirúrgicofue 14 minutos (6-50 min) en unilaterales, 27 (14-80 min) en bilaterales.Hubo dos casos de lesión de vasos epigástricos y una recidiva precoz enun neonato, reintervenido satisfactoriamente mediante técnica SuPer-Lap. En un seguimiento de 1-36 meses no hubo complicaciones tardías.Conclusiones: El uso de ópticas con canal de trabajo según técnicaSuPerLap posibilita prescindir de puertos adicionales en el tratamientode la hernia inguinal. Permite resultados funcionales comparables ycirugía sin cicatrices visibles. Minimiza la manipulación del cordónespermático. La laparoscopia permite el tratamiento concomitante dedefectos no diagnosticados previamente.

Introduction: Laparoscopic treatment of inguinal hernia is gainingpopularity in many hospitals, but the use of working channel scopes isnot as widely extended. We present our long-term experience with theSuPerLap (laparoscopic-assisted percutaneous suture) technique de-scribed by Rosell et al.(1) for epigastric hernia repair in the percutaneous,single-port treatment of inguinal hernia using working channel scopes.Materials and methods: A retrospective analysis of a series ofmale patients with congenital inguinal hernia undergoing surgery fromFebruary 2017 to December 2020 was carried out. A 5 mm-0º pleuro-scope with a 3.5 mm working channel, a 20 G epidural needle, a 36cm/3.5 mm laparoscopic Maryland dissector, and 3-0 polypropyleneand polyester sutures were used.Results: 384 inguinal hernia repairs using the SuPerLap techniquewere performed in 295 male patients – 206 unilateral repairs and 89bilateral repairs. In 24 bilateral cases (26.95%), preoperative diagnosishad been unilateral. Mean age was two years (2 weeks-13 years). Meanoperating time was 14 minutes (6-50 min) for unilateral repair, and27 minutes (14-80 min) for bilateral repair. There were two cases ofepigastric vessel damage, and one case of early recurrence in a new-born, who successfully underwent re-intervention using the SuPerLaptechnique. No late complications were recorded after a mean follow-upof 1-36 months.Conclusions: Working channel scopes using the SuPerLap tech-nique avoid additional ports in inguinal hernia repair. They allow forexcellent functional results, without visible scars, and minimize sper-matic cord manipulation. Laparoscopy allows previously undiagnoseddefects to be concomitantly treated.

Correction to: Alterations in bacterial communities, SCFA and biomarkers in an elderly HIV-positive and HIV-negative population in western Mexico.

An amendment to this paper has been published and can be accessed via the original article.

Alterations in bacterial communities, SCFA and biomarkers in an elderly HIV-positive and HIV-negative population in western Mexico.

BACKGROUND: The study of stool microbiota has taken great relevance in the last years, given its role in the maintenance of the intestinal metabolic, physiological, and immunological homeostasis, as well as, its effect over HIV biomarkers levels such as CD4/CD8 ratio, high sensitivity C-Reactive Protein (hs-CRP), related to poor outcomes (rapid progression to AIDS). Several efforts have been made to characterize the gut microbiome. In HIV infection, most of the studies report the presence of a dysbiotic pattern; however, few of them have made an approach in elderly HIV-positive subjects despite the fact that nowadays this subgroup is rising. In this study, we compared the composition of faecal microbiota, Short Chain Fatty Acids (SCFAs), and systemic biomarkers between elderly HIV-positive and HIV-negative subjects. METHODS: A cross-sectional study with 18 HIV-negative controls and 20 HIV-positive patients. The quantification of Bacteroidetes, Firmicutes, Proteobacteria, Actinobacteria, Lactobacillus, Enterobacteriaceae, Bifidobacterium, Escherichia coli, Clostridium leptum, Clostridium coccoides was performed in faecal samples by qPCR. The analysis was performed by calculating the ΔCq of each microorganism using 16S rDNA as a reference gene. Faecal SCFAs were measured by HPLC. The hs-CRP and sCD14 were performed by ELISA. RESULTS: An increase in the Firmicutes/Bacteroidetes ratio, coupled with a significant increase in the proteobacteria phylum was detected in HIV-positive subjects. In contrast, a decrease in the Clostridium leptum group was observed. Nevertheless, these elderly HIV-positive patients showed higher levels of total SCFAs mainly by an augmented propionic acid values, compared to HIV-negative subjects. Whereas high levels of hs-CRP were positively correlated with sCD14 in the HIV-positive group. CONCLUSIONS: Alterations in bacterial communities reveals a dysbiotic state related to an unbalance of faecal SCFAs. Therefore, these intestinal conditions might drive an increase of poor prognostic biomarkers in elderly HIV-positive subjects.

A hybrid mathematical modeling approach of the metabolic fate of a fluorescent sphingolipid analogue to predict cancer chemosensitivity.

Sphingolipid (SL) metabolism is a complex biological system that produces and transforms ceramides and other molecules able to modulate other cellular processes, including survival or death pathways key to cell fate decisions. This signaling pathway integrates several types of stress signals, including chemotherapy, into changes in the activity of its metabolic enzymes, altering thereby the cellular composition of bioactive SLs. Therefore, the SL pathway is a promising sensor of chemosensitivity in cancer and a target hub to overcome resistance. However, there is still a gap in our understanding of how chemotherapeutic drugs can disturb the SL pathway in order to control cellular fate. We propose to bridge this gap by a systems biology approach to integrate i) a dynamic model of SL analogue (BODIPY-FL fluorescent-sphingomyelin analogue, SM-BOD) metabolism, ii) a Gaussian mixture model (GMM) of the fluorescence features to identify how the SL pathway senses the effect of chemotherapy and iii) a fuzzy logic model (FLM) to associate SL composition with cell viability by semi-quantitative rules. Altogether, this hybrid model approach was able to predict the cell viability of double experimental perturbations with chemotherapy, indicating that the SL pathway is a promising sensor to design strategies to overcome drug resistance in cancer.

Long-range quantitative PCR for determining inactivation of adenovirus 2 by ultraviolet light.

AIMS: An extra-long-range quantitative PCR (LR-qPCR) method was developed for estimating genome damage to adenovirus 2 caused by UV irradiation. The objective was to use LR-qPCR as a rapid method to determine adenovirus UV inactivation. METHODS: The LR-qPCR consisted of two steps: a long-range PCR (up to 10 kb fragment) and a real-time, quantitative (q) PCR for quantifying the products of the first PCR. We evaluated LR-qPCR with adenovirus irradiated with medium-pressure (MP, polychromatic emission) and low-pressure (LP, 254 nm) mercury vapour lamps and compared results with cell culture infectivity. RESULTS: Using LR-qPCR, a fragment of 6 kb estimated DNA damage in a linear relationship to doses between 0 and 20 mJ cm(-2) , and a 1-kb fragment related linearly to doses between 20 and 100 mJ cm(-2) . The LR-qPCR results for the 6-kb fragment were similar to infectivity assays results for adenovirus exposed to MP UV. For adenovirus irradiated with LP lamps, LR-qPCR results for the shorter fragment size (1 kb) were similar to reduction in viral infectivity. No difference was observed between 10 and 6 kb LR-qPCR results. CONCLUSION: The LR-qPCR can be used as a tool for estimating DNA damage caused by UV in adenovirus. The LR-qPCR results were related to reduction in viral infectivity. SIGNIFICANCE AND IMPACT OF THE STUDY: The use of LR-qPCR to determine DNA damage and estimate inactivation of adenovirus 2 from UV disinfection allows for same-day results compared with >7 days required for cell culture. This accelerates adenovirus inactivation results for the water industry where adenovirus is used as a representative virus for crediting UV systems. This PCR approach provides a framework that can be used for other viral viability assays using the inhibition of amplification of viral nucleic acid after pretreatments, such as propidium monoazide, and for cellular biology studies of DNA damage.

A simple and novel method for recovering adenovirus 41 in small volumes of source water.

AIM: A new procedure was developed to recover adenovirus 41 in small volumes (1 l) of water samples based on adsorption, elution and evaporation. METHODS AND RESULTS: One litre of source water seeded with adenovirus 41 was adjusted to pH 3·5 and filtered using a large pore size (8·0 µm) negatively charged membrane filter (SCWP, 47 mm diameter, made of mixed-cellulose esters). Then, the filter was eluted using 4 ml of 1·5% beef extract plus 0·75% glycerol (pH 9·0). The eluate was reconcentrated to 0·1 ml or less volumes through evaporation assisted with air flow and heating at 55°C. Recovery of adenovirus 41 reached 55% under tested conditions and reduced filtration time by 85% in contrast to the widely used small pore size filter (0·45 µm pore size, 47 mm diameter). Reconcentration by evaporation achieved approx. 86·8% recovery from source water in approx. 1 h at no cost. CONCLUSION: The virus concentration method developed in this study is simple and cost-effective and can be used to efficiently recover adenovirus 41 from turbid water samples. SIGNIFICANCE AND IMPACT OF THE STUDY: The procedure developed can be applied to detect adenovirus 41 in source water within hours of sampling. In addition, this is the first application of evaporation to concentrate viruses in water samples.

Evaluation of positively charged alumina nanofibre cartridge filters for the primary concentration of noroviruses, adenoviruses and male-specific coliphages from seawater.

AIM: To evaluate the electropositive, alumina nanofibre (NanoCeram) cartridge filter as a primary concentration method for recovering adenovirus, norovirus and male-specific coliphages from natural seawater. METHODS AND RESULTS: Viruses were concentrated from 40 l of natural seawater using a NanoCeram cartridge filter and eluted from the filter either by soaking the filter in eluent or by recirculating the eluent continuously through the filter using a peristaltic pump. The elution solution consisted of 3% beef extract and 0.1 mol l(-1) of glycine. The method using a peristaltic pump was more effective in removing the viruses from the filter. High recoveries of norovirus and male-specific coliphages (>96%) but not adenovirus (<3%) were observed from seawater. High adsorption to the filter was observed for adenovirus and male-specific coliphages (>98%). The adsorption and recovery of adenovirus and male-specific coliphages were also determined for fresh finished water and source water. CONCLUSION: The NanoCeram cartridge filter was an effective primary concentration method for the concentration of norovirus and male-specific coliphages from natural seawater, but not for adenovirus, in spite of the high adsorption of adenovirus to the filter. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrates that NanoCeram cartridge filter is an effective primary method for concentrating noroviruses and male-specific coliphages from seawater, thereby simplifying collection and processing of water samples for virus recovery.

[Usefulness of contrast-enhanced ultrasonography in daily clinical practice: a multicenter study in Spain]. / Utilidad de la ecografía con contraste en la práctica clínica diaria. Estudio multicéntrico español CEUS.

OBJECTIVES: We aimed to determine whether the use of ultrasonographic contrast agents improves the diagnostic performance of ultrasonography (US). MATERIAL AND METHODS: We carried out a prospective multicenter study in 42 hospitals. We included 1786 patients with inconclusive US; 84.9% of the inconclusive studies were abdominal US (including studies of the liver, kidneys, spleen, and other sites), 6.2% were studies of the peripheral vessels, 4.3% were breast studies, and 4.6% were other studies. We evaluated the type of contrast-enhanced US (color Doppler or contrast-specific method), type of contrast agent, dose and number of doses, and type of administration (bolus or infusion). We evaluated whether the findings at contrast-enhanced US improved the diagnostic performance of unenhanced US and whether they enabled a conclusive diagnosis to be reached. RESULTS: The contrast agent SonoVue was used in 99.9% of the studies; a single dose of contrast agent was used in 84.8%, and the contrast agent was administered in bolus in 98.5%. Contrast-enhanced US improved the diagnostic performance in 91.6% of cases and enabled the conclusive diagnosis in 69.2%. The best diagnostic performance was obtained in the supraaortic trunks, where a definitive diagnosis was reached in 95.4% of cases, followed by the abdominal area, with a conclusive diagnosis in 72.6% of cases. CONCLUSIONS: The use of contrast-enhanced US significantly improved the diagnostic performance of US and enabled a conclusive diagnosis in most cases.

Thermoluminescence properties of undoped and Dy3+ doped ZrO2 nanophosphor under beta-ray irradiation.

The thermoluminescence (TL) of undoped and Dy3+ doped ZrO2 nanocrystals under beta-ray irradiation is reported. The TL glow curves are the result of the overlapping of four TL peaks produced partly by the intrinsic defect of highly asymmetrical monoclinic structure and partly due to defects produced during the synthesis process. The introduction of dopant ions induces changes in the glow curve due to the enhancement of high temperature peaks intensity. The results show that both undoped and doped ZrO2 nanocrystalline phosphor present good TL efficiency as well as good dose response which qualify them as a potential beta-ray dosimeter.

The impact of HIV on chronic kidney disease outcomes.

Chronic kidney disease (CKD) is a known complication of the human immunodeficiency virus (HIV) but outcomes among HIV-infected patients with kidney disease are unknown. We studied a national sample of 202,927 patients with CKD (stage 3 or higher) for death, end-stage renal disease (ESRD) and the mean annual rate of decline in estimated glomerular filtration rate (eGFR) over a median period of 3.8 years. Within this sample, 0.3% of the patients were diagnosed with HIV, 43.5% were diabetic, whereas the remainder had neither disease. In this national CKD cohort, HIV-infected black patients were at higher risk of death, a similar risk for ESRD and loss of eGFR than black patients with diabetes. HIV-infected white patients experienced higher rates of death but a lower risk of ESRD than their counterparts with diabetes. Our results highlight a need to study mortality and mechanisms of ESRD in the HIV infected population.

When to refer patients with chronic kidney disease for vascular access surgery: should age be a consideration?

To determine whether age should inform our approach toward permanent vascular access placement in patients with chronic kidney disease, we conducted a retrospective cohort study among 11 290 non-dialysis patients with an estimated glomerular filtration rate (eGFR) <25 ml/min/1.73 m(2) based on 2000-2001 outpatient creatinine measurements in the Department of Veterans Affairs. For each age group, we examined the percentage of patients that had and had not received a permanent access by 1 year after cohort entry, and the percentage in each of these groups that died, started dialysis, or survived without dialysis. We also modeled the number of unnecessary procedures that would have occurred in theoretical scenarios based on existing vascular access guidelines. The mean eGFR was 17.7 ml/min/1.73 m(2) at cohort entry. Twenty-five percent (n=2870) of patients initiated dialysis within a year of cohort entry. Among these, only 39% (n=1104) had undergone surgery to place a permanent access beforehand. As compared with younger patients, older patients were less likely to undergo permanent access surgery, but also less likely to start dialysis. In all theoretical scenarios examined, older patients would have been more likely than younger patients to receive unnecessary procedures. If all patients had been referred for permanent access surgery at cohort entry, the ratio of unnecessary to necessary procedures after 2 years of follow-up would have been 5:1 for patients aged 85-100 years but only 0.5:1 for those aged 18-44 years. Currently recommended approaches to permanent access placement based on a single threshold level of renal function for patients of all ages are not appropriate.

Dialysis and kidney transplantation among patients living in rural areas of the United States.

Although one-fifth of the United States population is rural, little is known about the characteristics and outcomes of rural dialysis patients. We measured the association of rural residence with patient characteristics, survival, and time to transplant among 552,279 patients who initiated dialysis between January 1, 1995 and December 31, 2002 and survived more than 90 days. We also examined the characteristics of 4363 Medicare-certified dialysis facilities by degree of rurality. Compared with urban patients, rural dialysis patients were older, less racially diverse with a higher prevalence of most co-morbid conditions. Hemodialysis was the dominant modality in both urban and rural areas, although the use of peritoneal dialysis was more frequent in rural areas. Survival and time to transplant differed by racial-ethnic group. Most notably, despite slightly better survival associated with rural vs urban residence among black populations, black populations living in rural areas were less likely to be transplanted than their urban counterparts (and than any other group examined). Compared with urban facilities, rural facilities are smaller, less likely to be for profit or owned by a large chain. Nonetheless, rural facilities perform at least as well as urban facilities based on standard performance measures. Despite more frequent use of peritoneal dialysis among rural patients, rural facilities were markedly less likely to offer peritoneal dialysis or home hemodialysis training than urban facilities. Rural black patients (most of whom live in the south) should be targeted in policies to reduce racial disparities in access to transplant. Further studies are needed to determine whether rural dialysis patients have adequate access to home-based therapies.

Bidirectional fusion of the heart-forming fields in the developing chick embryo.

It is generally thought that the early pre-tubular chick heart is formed by fusion of the anterior or cephalic limits of the paired cardiogenic fields. However, this study shows that the heart fields initially fuse at their midpoint to form a transitory "butterfly"-shaped, cardiogenic structure. Fusion then progresses bi-directionally along the longitudinal axis in both cranial and caudal directions. Using in vivo labeling, we demonstrate that cells along the ventral fusion line are highly motile, crossing future primitive segments. We found that mesoderm cells migrated cephalically from the unfused tips of the anterior/cephalic wings into the head mesenchyme in the region that has been called the secondary heart field. Perturbing the anterior/cranial fusion results in formation of a bi-conal heart. A theoretical role of the ventral fusion line acting as a "heart organizer" and its role in cardia bifida is discussed.