Br Groups Research Articles

N27 Impact of Anaesthetic Nurse Scheduling Patterns on Resuscitation Outcomes after Painless Gastrointestinal Endoscopy in Patients with Inflammatory Bowel Disease

Abstract Background Nurse anesthetists in the post-anesthetic care unit (PACU) of the Gastrointestinal Endoscopy Center monitor and manage complications following endoscopy procedures. We examined the impact of nurse anesthetist scheduling patterns on resuscitation efficiency of inflammatory bowel disease (IBD) patients in the anesthesia recovery room after painless gastrointestinal endoscopy. Methods This was a retrospective analysis of IBD patients who underwent resuscitation following painless gastrointestinal endoscopy at a large tertiary care IBD clinic. Two anesthetic nurse practitioner scheduling models were compared: In 2022 (before-reform, BR), the scheduling model consisted of three anesthetic nurse practitioners (N1, N2, N3) with a nurse-to-resuscitation bed ratio of 1.5:1. In 2023 (after-reform, AR), the scheduling template was adjusted to reduce one N2 anesthesia nurse (nurse-to-resuscitation bed ratio of 1:1). The number of consultations, length of stay, complications, anesthesia nurses' satisfaction and patient satisfaction were compared between BR and AR groups. Results 211 and 246 patients with IBD were resuscitated in the PACU after painless gastrointestinal endoscopy in 2022 and 2023, respectively. The median length of stay in the PACU decreased significantly from 27.30 min (25.10–28.98) before the reform to 22.30 min (20.20–24.70) after the reform (p<0.001). There was no significant difference in the occurrence of complications following the implementation of the reform (hypoxemia, hypotension, nausea and vomiting, abdominal distension, pain, coughing, hypersomnia) (p=0.354). The anesthesia nurse practitioners were more satisfied with the reformed scheduling pattern, which mirrored the improved satisfaction among IBD patients. Conclusion The reformed anesthesia nurse scheduling model yielded improved resuscitation efficiency, reduced costs, and improved satisfaction of nurse anesthetists and IBD patients. Further studies are required to validate these findings.

Work Participation after Medical Rehabilitation due to Mental Disorders: Representative Analyses Using Routine Data of the German Pension Insurance

The particular relevance of mental disorders for society and the economy is highlighted in the context of work participation. Based on representative routine data from the pension insurance from 2017, the aim of the study was to describe a group of psychosomatic rehabilitation patients recruited on the basis of selected characteristics, examine the return to work (RTW) rates, to assess individual progression after rehabilitation and to identify possible influencing factors. Work participation was operationalized both as a monthly state up to 24 months after rehabilitation and as a rate of all people who were employed 12 or 24 months and the 3 preceding months (stable work participation). For the analysis of the influencing factors on stable work participation, multiple logistic regression models with stepwise inclusion were calculated separately for the rates after 12 and 24 months. A total of 122,623 data sets were included in the analysis (including depressive episode (DE): n=28,497, 23.2%, recurrent depressive disorders (RD): n=42,573, 34.7%; reaction to severe stress, and adjustment disorders (BR): n=19,122, 15.6%; dissociative disorders (AS): n=9,716, 7.9% and somatoform disorders (SO): n=8,564, 7.0%). The mean age was 50 years, 64% were female. There were different courses depending on the indication, with stable employment rates after 12 months of 69% in the BR group; 62% in the DE group; 61% in the SE group; 57% in RD up to 52% in the SO group. Factors influencing stable employment after one year were the duration of incapacity for work in the year before rehabilitation, the existence of an employment relationship and a high income. Since the relevant changes became apparent in the first six months after rehabilitation, further support services for people with mental illnesses after medical rehabilitation should ideally begin as early as possible after rehabilitation.

No Difference in Outcomes After Remplissage or Open Bankart Repair Plus Inferior Capsular Shift in Collision and Contact Athletes With Subcritical Glenoid Bone Loss ≤10% and Off-Track Hill-Sachs Lesion.

To compare functional outcomes, recurrence rate, range of motion (ROM), and return to sport between arthroscopic Bankart repair with remplissage (BR) and open Bankart repair with inferior capsular shift (OBICS) in contact and collision athletes with recurrent anterior shoulder instability. A prospective comparative cohort study of 90 patients separated into 2 study groups (OBICS and BR) of 45 collision and contact athletes each was conducted. All athletes had subcritical glenoid bone loss ≤10% and off-track Hill-Sach lesions. A minimum follow-up period of 5 years was established. Pre- and postoperative assessments of each group, as well as between them, were carried out. The Western Ontario Shoulder Instability Index score and the American Shoulder and Elbow Surgeons (ASES) scale were used to assess subjective outcomes. Recurrence rate, ROM, and return to sport were evaluated as objective outcomes. Significant differences were reported in the Western Ontario Shoulder Instability Index and ASES scores between preoperative and postoperative values in each group. There were no significant differences between the 2 groups (P= .68 and .28). Patient rates achieving the minimal clinically important difference and the patient-acceptable satisfactory state for ASES were 81.2% OBICS, 80% BR, and 78.6% and 76.5%, respectively. Although there was no significant difference between the 2 groups (P= .74), there were 3 dislocations (7.5%) in the OBICS group and 5 (12.5%) in the BR group. No significant differences in ROM were found between the 2 groups. However, significant differences in external rotation were reported in the BR group pre- compared with postoperatively (P= .03 and .04). We found no differences between the outcomes of the 2 groups. Depending on surgeon preference, BR or OBICS may be safely indicated in collision or contact athletes with subcritical glenoid bone loss ≤10% and off-track Hill-Sach lesions. Level II, prospective comparative study.

Continuous Flow Chemistry and Bayesian Optimization for Polymer-Functionalized Carbon Nanotube-Based Chemiresistive Methane Sensors.

We report the preparation of poly(ionic) polymer-wrapped single-walled carbon nanotube dispersions for chemiresistive methane (CH4) sensors with improved humidity tolerance. Single-walled CNTs (SWCNTs) were noncovalently functionalized by poly(4-vinylpyridine) (P4VP) with varied amounts of a poly(ethylene glycol) (PEG) moiety bearing a Br and terminal azide group (Br-R1). The quaternization of P4VP with Br-R1 was performed using continuous flow chemistry and Bayesian optimization-guided reaction selection. Polymers (PyBrR1) with different degrees of functionalization were used to disperse SWCNTs and subsequently incorporated into sensors containing a platinum complex as an aerobic oxidative catalyst with a polyoxometalate (POM) redox mediator to facilitate room-temperature CH4 sensing. As the degree of quaternization in the PyBrR1-CNT composites increased, improvements in response magnitude were observed, with nominally 10% quaternized PyBrR1 giving the largest response. Incorporation of PEG improved sensor stability at relative humidities between 57-90% versus sensors fabricated from CNT dispersions with unfunctionalized P4VP. Devices fabricated with these dispersions outperformed those prepared in situ under dry conditions, and exhibited greater stability at elevated humidities. The influence of Keggin-type POM character was also evaluated to identify alternative POMs for enhanced sensor performance at high humidity. In an effort to identify areas for further improvement in algorithm performance for polymer functionalization, a kinetically informed machine learning model was explored as a route to predict reactivity of pyridine units and alkyl bromides under flow conditions.

Efficacy and Comfort Level with the Non-Sliding Lingual Orthodontic Technique (BRIUS™) Versus Labial Full Fixed Appliances: A Pilot Randomized Controlled Clinical Trial.

Introduction: This pilot two-arm, parallel group, randomized clinical trial aimed to compare the efficacy of tooth movement and patient comfort during orthodontic leveling and alignment with the BRIUS™ lingual system (BR) versus labial full fixed appliances (LFFAs). Methods: Patients in the permanent dentition with mild to moderate crowding were recruited at the University at Buffalo and randomly assigned into the BR group (seven patients) or LFFAs group (six patients). The patients' dental arches were scanned before bonding (T1) and after 18 weeks (T2). Digital dental model superimpositions were performed to three-dimensionally evaluate tooth movement. Changes between T1 and T2 were measured in the x, y, and z planes. Little's Irregularity Index (LII) was also assessed at T1 and T2. An electronic questionnaire was completed daily for 7 days after T1 to evaluate the patients' comfort levels. Results: After 18 weeks, similar displacements were observed for all teeth in both groups except for the lower left second premolar (LL5) in the x-axis which showed greater displacement in the BR group (p = 0.016). Groups showed similar changes in LII. Discomfort during the first week after bonding was greater on the tongue in the BR group and on the lips and cheeks in the LFFAs group. Tongue discomfort caused by the BR lasted for around 3 days. Conclusion: The BR and LFFAs showed similar teeth displacements and therefore were equally effective at leveling and aligning teeth. LFFAs caused cheek- and lip-borne discomfort while the BR caused tongue-borne discomfort during the first week after bonding. Larger studies with longer follow-ups are needed to obtain more definitive results.

Occupational Exposure to Unburnt Tobacco Dust and Thyroid Function: A Case-Control Study

Beedi rolling is one of the most common home-based occupations used to meet daily expenses. The process of making beedis is mainly done by women, especially in rural areas. Due to a lack of awareness regarding safety measures, beedi-rolling women are exposed to toxic components present in unburnt tobacco dust. This exposure leads to many health complications among women beedi-rollers. In this study, we investigated how unburnt tobacco dust disrupts thyroid gland homeostasis by altering levels of thyroid hormone and TSH. We included 421 beedi rolling women (BR) and 426 control subjects (NBR) who were not exposed occupationally to any chemical agents. Levels of thyroid hormones (T3, T4) were analysed using competitive ELISA, and TSH levels were analysed using sandwich ELISA. Serum nicotine metabolites were analysed using LC-MS. We observed a statistically significant increase in the levels of T3, T4, anabasine, nornicotine, and cotinine in BR compared to the NBR group. Additionally, significantly lower TSH levels were observed in the BR group. However, the Correlation between nicotine metabolites, and hormones did not show a significant difference in the BR group. We conclude that prolonged exposure to unburnt tobacco dust must have disrupted thyroid function by altering the thyroid hormone, and TSH levels.

Diaminomethylation of Pyrazoles

AbstractWe studied the reaction of N‐alkyl(aryl)pyrazoles with silylformamidine 1 that exists in an equilibrium with its carbene form via migration of the trimethylsilyl group from the carbon to nitrogen atom. The carbene insertion proceeded at the C−H group in 5th position. N‐alkyl(aryl)pyrazoles featuring substituents such as Br, CN and NO2 group reacted readily affording the corresponding aminals. This approach allowed us to synthesize pyrazole dialdehyde and phosphine featuring a vicinal aldehyde group. The reaction does not require any catalyst. The insertion position was unambiguously confirmed by X‐ray analysis of an aminal and a set of derivatives. Aminals hydrolysis afforded the corresponding pyrazole carbaldehydes. Methanolysis of the aminals gave N‐methylimines of the pyrazolecarbaldehydes. Highly acidic nitro pyrazole instead of the insertion underwent silylation in 5th position.

FeCl3 induced sonochemical heteroarylation: Synthesis of meridianin alkaloid analogues for their in silico/in vitro evaluation against SIRT1

Meridianins A − G, the indole based marine alkaloids have displayed a diverse range of biological properties including anti-cancer / anti-tumour activities. Based on reported correlation between anticancer activities and SIRT1 inhibition, the meridianin alkaloid analogues were explored as possible inhibitors of SIRT1. The FeCl3 mediated regioselective heteroarylation under ultrasound irradiation was employed for the synthesis of this class of N-heterocycles. The methodology involved CC bond forming reaction between 2-amino-4-chloropyrimidine and indole to afford a library of desired compounds in varied yield depending on nature of substituent present on the reactant indole. Indeed the product yield was decreased when the NO2 or OH or two chloro groups were present on the indole ring. The usefulness of the current approach was demonstrated via functionalization of one of the synthesized compound i.e. Meridianin G under ultrasound. All the synthesized compounds were characterized by 1H and 13C NMR and MS spectral data. When docked into the SIRT1 in silico, promising interactions with this protein were noted for some of the meridianin analogues synthesized in addition to their probable selectivity towards SIRT1 over SIRT2. The common interacting residues of SIRT1 were found to be VAL412, PHE413, ILE347, ALA262, ILE411, HIS363, GLN345, ASN346, ILE270, PHE273 and PHE297. Indeed, the top four compounds e.g. 3b, 3c, 3d and 3f participated in H-bond interactions through their indole “NH” and the primary amino group with ASN346, HIS363 and VAL412 of SIRT1. Correlating the findings of in silico studies, these compounds showed promising inhibition of SIRT1 in vitro with IC50 ∼2.9–3.7 µM when 3f emerged as the best active molecule. The SAR (Structure-Activity-Relationship) analysis suggested high to good activities for the NO2, Cl, Br or MeO group at C-5 of indole ring (due to participation of these groups in H-bonding interaction as noted during the in silico docking studies) whereas a free NH moiety of the indole ring was essential for activity. The in silico and in vitro studies along with ADME predictions suggested that compound 3b, 3c, 3d and 3f could be of further pharmacological interest.

Compared the Effectiveness of Intraperitoneal Bupivacaine with Lung Recruitment Maneuver Versus Normal Saline with Lung Recruitment Maneuver in Reducing Shoulder Pain After Laparoscopic Surgery: A Double-Blind Randomized Controlled Trial.

Postoperative shoulder pain is one of the most common complications following laparoscopic surgery. Various interventions have been proposed to control this pain. The main objective of this comparative study was to determine the effects of intraperitoneal bupivacaine and normal saline infusion, in combination with lung recruitment maneuver (LRM), on shoulder pain following laparoscopic surgery. The present randomized controlled trial was conducted on 105 candidates for laparoscopic cholecystectomy referred to Imam Ali Hospital in Bojnurd, Iran, from November 2021 to June 2022. The patients were assigned to three groups using block randomization: BR (receiving 50 cc of 0.25% diluted intraperitoneal bupivacaine + LRM), NR (receiving 50 cc of intraperitoneal normal saline + LRM), and N (receiving 50 cc of intraperitoneal normal saline). Postoperative shoulder pain and surgical incision site pain were assessed using the Visual Analogue Scale (VAS) at recovery intervals of 4, 12, 24, and 48 hours after surgery. Additionally, the prevalence of nausea and vomiting, the first time of need for sedation, and the incidence of sedation overdose in the first 24 hours after surgery were investigated. The data were analyzed using one-way analyzed by one-way analysis of variance (ANOVA) with SPSS software at a significance level of 0.05. The findings showed no significant differences in demographic variables between the three groups. The range and mean score of shoulder pain based on VAS was 0 - 1 (0.3) in the BR group, 0 - 2 (1.4) in the NR group, and 1 - 3 (2.1) in the N group at 4 hours after surgery. The mean score of shoulder pain intensity in the BR group was lower compared to the NR and N groups during recovery time intervals at 4, 12, and 24 hours after surgery. This difference between groups was significant. There was also a statistically significant difference in the mean score of surgical incision site pain intensity and the first time of need for sedation between the three groups. The occurrence of side effects was not significant between the groups. Itching, bradycardia, and hypotension were not observed in any of the groups. The findings of this study showed that bupivacaine, along with LRM, is a safe method effective in relieving postoperative shoulder pain. It prolonged the first time of need for sedation and significantly reduced the incidence of shoulder pain.

Imaging the Area of Internal Limiting Membrane Peeling after Macular Hole Surgery.

Background: The aim of this study was to compare en-face optical coherence tomography (OCT) imaging and confocal scanning laser ophthalmoscopy (cSLO) imaging at different wavelengths to identify the internal limiting membrane (ILM) peeling area after primary surgery with vitrectomy and ILM peeling for macular hole (MH). Methods: In total, 50 eyes of 50 consecutive patients who underwent primary surgery with vitrectomy and ILM peeling for MH were studied. The true ILM rhexis based on intraoperative color fundus photography was compared to the presumed ILM rhexis identified by a blinded examiner using en-face OCT imaging and cSLO images at various wavelengths. To calculate the fraction of overlap (FoO), the common intersecting area and the total of both areas were measured. Results: The FoO for the measured areas was 0.93 ± 0.03 for en-face OCT, 0.76 ± 0.06 for blue reflectance (BR; 488 nm), 0.71 ± 0.09 for green reflectance (GR; 514 nm), 0.56 ± 0.07 for infrared reflectance (IR; 815 nm) and 0.73 ± 0.06 for multispectral (MS). The FoO in the en-face OCT group was significantly higher than in all other groups, whereas the FoO in the IR group was significantly lower compared to all other groups. No significant differences were observed in FoO among the MS, BR, and GR groups. In en-face OCT, there was no significant change in the ILM peeled area measured intraoperatively and postoperatively (8.37 ± 3.01 vs. 8.24 ± 2.81 mm2; p = 0.8145). Nasal-inferior foveal displacement was observed in 38 eyes (76%). Conclusions: En-face OCT imaging demonstrates reliable postoperative visualization of the ILM peeled area. Although the size of the ILM peeling remains stable after one month, our findings indicate a notable inferior-nasal shift of the overall ILM peeling area towards the optic disc.

Elevating Thermoelectric Performance by Compositing Dibromo-Substituted Thienoacene with SWCNTs.

Composites of organic small molecules (OSMs) and single-walled carbon nanotubes (SWCNTs) have drawn great attention as flexible thermoelectric (TE) materials in recent years. Here, we synthesized thieno[2',3':4,5]thieno[3,2-b]thieno[2,3-d]thiophene (TTA) and 2,6-dibromothieno[2',3':4,5]thieno[3,2-b]thieno[2,3-d]thiophene (TTA-2Br) and compounded them with SWCNTs, obtaining thermoelectric TTA/SWCNT and TTA-2Br/SWCNT composites. The introduction of the electron-withdrawing Br group was found to decrease the highest molecular orbital energy level and bandgap (Eg) of TTA-2Br. As a result, the Seebeck coefficient (S) and power factor (PF) of the OSM/SWCNT composite films were significantly improved. Moreover, suitable energy barrier between TTA-2Br and SWCNTs facilitates the energy filtering effect, which further enhances thermoelectric properties of the 40 wt % TTA-2Br/SWCNT composite film with optimum thermoelectric properties (PF = 242.59 ± 9.42 μW m-1 K-2 at room temperature), good thermal stability, and mechanical flexibility. In addition, the thermoelectric generator (TEG) prepared using 40 wt % TTA-2Br/SWCNT composite films and n-type SWCNT films can generate an output power of 102.8 ± 7.4 nW at a temperature difference of 20 °C. This work provides new insights into the preparation of OSM/SWCNT composites with significantly enhanced thermoelectric properties.

Tert-Butyl substituted aza-BODIPY-based bromides for phototherapy

Asymmetric mono - and dibromides aza-BODIPYs at 6-site were prepared. The singlet oxygen yield of monobromide MBr-azaBDP with the direct attachment of the –Br group at 6-site was higher than that of vinyl dibromide DBr-azaBDP. Self-assembled MBr-azaBDP-NPs with laser irradiation possessed a photothermal conversion capability. Monobromide MBr-azaBDP was discovered to be an effective PDT-PTT combined therapeutic agent and prospective candidate for tumor phototherapy by integrating tert-butyl free rotation and halogen substitution. However, comparing to MBr-azaBDP, DBr-azaBDP as a fluorescent dye possesses narrower full width at half maxima, higher molar extinction coefficient and fluorescence quantum yield.

Tuning structural and electronic properties of metal-organic framework 5 by metal substitution and linker functionalization.

The chemical flexibility of metal-organic frameworks (MOFs) offers an ideal platform to tune structure and composition for specific applications, from gas sensing to catalysis and from photoelectric conversion to energy storage. This variability gives rise to a large configurational space that can be efficiently explored using high-throughput computational methods. In this work, we investigate from first principles the structural and electronic properties of MOF-5 variants obtained by replacing Zn with Be, Mg, Cd, Ca, Sr, and Ba and by functionalizing the originally H-passivated linkers with CH3, NO2, Cl, Br, NH2, OH, and COOH groups. To build and analyze the resulting 56 structures, we employ density-functional theory calculations embedded in an in-house developed library for automatized calculations. Our findings reveal that structural properties are mainly defined by metal atoms and large functional groups, which distort the lattice and modify coordination. The formation energy is largely influenced by functionalization and enhanced by COOH and OH groups, which promote the formation of hydrogen bonds. The charge distribution within the linker is especially influenced by functional groups with electron-withdrawing properties, while the metal nodes play a minor role. Likewise, the bandgap size is crucially determined by ligand functionalization. The smallest gaps are found with NH2 and OH groups, which introduce localized orbitals at the top of the valence band. This characteristic makes these functionalizations particularly promising for the design of MOF-5 variants with enhanced gas uptake and sensing properties.

Introducing Br, K, and cyano group into carbon nitride for efficient photocatalytic hydrogen peroxide production then in situ tetracycline mineralization

In this work, Br, K-doped and cyano group-rich carbon nitride (CN) were prepared via pyrolysis of molten urea and 6-Bromopyridine-3-carbaldehyde, followed by re-calcination with potassium thiocyanate. The hydrogen peroxide (H2O2) evolution and in situ tetracycline (TC) mineralization performances of the prepared samples were studied. The optimal sample could produce 9127 μmol g–1 h–1 H2O2 from 10 vol% ethanol solution and air atmosphere, which was 10.9 times higher than that of pristine CN. With addition of 4 mg L–1 Fe2+ ions, 97.2% of TC (10 mg L–1) and 98.7% of total organic carbon were removed in 30 min under the actions of holes, hydroxyl and superoxide radicals. The high H2O2 yield and TC mineralization ratio were attributed to the increased light absorption, efficient electrons-holes separation, enhanced surface O2 adsorption (0.3878 mmol g−1), and accelerated conversion from Fe3+ to Fe2+ ions. Meanwhile, the system possessed good reusability in H2O2 evolution and TC removal. It is expected that this work can provide new ideas to design CN-based photo-Fenton system to treat wastewater.

Influence of Bioceramic Cements on the Quality of Obturation of the Immature Tooth: An In Vitro Microscopic and Tomographic Study.

The present in vitro study focuses on the filling ability of three different bioceramic cements with or without the addition of a bioceramic sealer in an open apex model on the marginal apical adaptation, tubule infiltrations, and void distributions as well as the interface between the cement and the sealer materials. To this end, sixty mandibular premolars were used. MTA-Biorep (BR), Biodentine (BD), and Well-Root Putty (WR) were used to obturate the open apex model with or without the addition of a bioceramic sealer, namely TotalFill® BC sealer™ (TF). A digital optical microscope and scanning electron microscope (SEM) were used to investigate the cement-dentin interface, marginal apical adaptation, and the material infiltration into the dentinal tubules. Micro-computed X-ray tomography and digital optical microscopy were used to investigate the cement-sealer interface. The results were analyzed by using the Kruskal-Wallis test. No significant difference was found between the groups for the marginal apical adaptation quality (p > 0.05). Good adaptation of the dentin-cement interface was found for all tested groups and the sealer was placed between the cement material and dentinal walls. All the groups demonstrated some infiltrations into the dentinal tubules at the coronal part except for the BR group. A good internal interface was found between the cement and the sealer with the presence of voids at the external interface. A larger number of voids were found in the case of the BD-TF group compared to each of the other two groups (p < 0.05). Within the limitations of the present in vitro study, all the groups demonstrated good marginal apical adaptation. The use of a sealer in an open apex does not guarantee good filling and, in addition, creates voids at the external interfaces with the dental walls when the premixed sealer is used with powder-liquid cement systems. The use of a premixed bioceramic cement could offer fewer complications than when a powder-liquid cement system is used.

Biceps Rerouting Regardless of a Biceps-Labral Lesion During Rotator Cuff Repair Results in Lower Retear Rates and Comparable Clinical Outcomes to Subpectoral Biceps Tenodesis

PurposeTo evaluate the radiographic and clinical outcomes when rerouting a pathologic biceps during arthroscopic rotator cuff repair, by comparing it with concomitant subpectoral biceps tenodesis. MethodsThis retrospective, historical cohort study was conducted with patients who underwent an arthroscopic repair of a full-thickness rotator cuff tear, with intraoperative confirmation of biceps pathology including partial tears, subluxation, pulley lesions, or type II superior labrum anterior to posterior (SLAP) lesions. Until May 2018, such patients were treated with concomitant subpectoral tenodesis (group SPBT). Afterward, biceps rerouting was done regardless of biceps pathology (group BR) without biceps or SLAP repair. Radiographic parameters, including fatty degeneration, acromiohumeral distance, Sugaya classification, and retears, were evaluated using preoperative and one-year postoperative MRI. Clinical evaluation with a minimum two-year follow-up included pain visual analogue scale, American Shoulder and Elbow Surgeons, Simple Shoulder Test, and Constant-Murley scores. Whether individual patients exceeded these scores' minimal clinically important difference was also determined. ResultsA total of 64 patients (group SPBT, 32; group BR, 32) were included in the final analysis. The duration of clinical follow-up was 36.2 ± 9.3 months in group SPBT and 29.4 ± 6.9 months in the BR group (P=0.002). Compared to group SPBT, group BR demonstrated a significantly lower retear rate (SPBT vs. BR: 34.4% vs. 12.5%, P=0.039). In the BR group, 8/32 (25%) patients demonstrated a postoperative LHBT tear. The four cuff retears in group BR only took place within these patients. Other postoperative radiographic and clinical outcomes were comparable between the groups. Within each group, significant postoperative improvements were demonstrated (P<0.05 for all clinical scores). ConclusionEven in the presence of a pathologic LHBT and/or a type II SLAP lesion, augmenting the rotator cuff repair with BR significantly reduced retear rates while achieving clinical scores comparable to SPBT in a minimum two-year follow-up.

Most Tibetan weedy barleys originated via recombination between Btr1 and Btr2 in domesticated barley

Tibetan weedy barleys reside at the edges of qingke (hulless barley) fields in Tibet (Xizang). The spikes of these weedy barleys contain or lack a brittle rachis, with either two- or six-rowed spikes and either hulled or hulless grains at maturity. Although the brittle rachis trait of Tibetan weedy barleys is similar to that of wild barley (Hordeum vulgare ssp. spontaneum Thell.), these plants share genetic similarity with domesticated barley. The origin of Tibetan weedy barleys continues to be debated. Here, we show that most Tibetan weedy barleys originated from cross-pollinated hybridization of domesticated barleys, followed by hybrid self-pollination and recombination between Non-brittle rachis 1 (btr1) and 2 (btr2). We discovered the specific genetic ancestry of these weedy barleys in South Asian accessions. Tibetan weedy barleys exhibit lower genetic diversity than wild and Chinese landraces/cultivars and share a close relationship with qingke, genetically differing from typical eastern and western barley populations. We classified Tibetan weedy barleys into two groups, brittle rachis (BR) and non-brittle rachis (NBR); these traits align with the haplotypes of the btr1 and btr2 genes. Whereas wild barleys carry haplotype combinations of Btr1 and Btr2, each showing lower proportions in a population, the recombinant haplotype BTR2H8+BTR1H24 is predominant in the BR group. Haplotype block analysis based on whole-genome sequencing revealed two recombination breakpoints, which are present in 80.6% and 16.8% of BR accessions according to marker-assisted analysis. Hybridization events between wild and domesticated barley were rarely detected. These findings support the notion that Tibetan weedy barleys originated via recombination between Btr1 and Btr2 in domesticated barley.

Total Synthesis of Dragmacidins G and H.

The total synthesis of dragmacidins G and H was achieved for the first time by employing nucleophilic aromatic substitution and site-selective cross-coupling reactions using appropriately functionalized pyrazines as substrates. The evaluation of antibacterial activities of dragmacidin G, dragmacidin H, and synthetic analogues against Staphylococcus aureus and the efflux pump-deficient Salmonella Typhimurium revealed that the presence of a Br group on the indole ring adjacent to the sulfide unit was important for increasing antibacterial activities.

An in vitro study measuring marginal gaps of inlay restorations fabricated from different CAD-CAM materials after thermocycling

BackgroundMany monolithic machined materials have been introduced and provided a suitable mechanical and physical properties for inlay restorations. However, there is shortage in the studies evaluating the marginal adaptation using these materials.PurposeThis study aimed to compare the effect of fabricating inlay restorations from 3 different CAD-CAM materials on marginal gaps before and after thermocycling.Materials and methodsSixty human premolars were randomly divided into 3 groups (n = 20) according to the material used: (e.max CAD, Ivoclar AG, Schaan, Liechtenstein), (HC, Shofu, Koyoto, Japan) and (Brilliant Crios, Coltene, Altstätten, Switzerland) (n = 20). A scanning electron microscope (SEM) (JSM- 6510 lv, JEOL, Tokyo, JAPAN) was used to for measuring the marginal gaps after cementation of inlay restorations. The magnification was adapted to 250x. Marginal gaps were revaluated with SEM after thermocycling. The temperatures of baths were 5 and 55 °C was applied for a total of 5000 cycles. All data were statistically analyzed by using ANCOVA to demonstrate if there were any statistically significant differences between the gap measures after thermocycling of the three independent (unrelated) groups. A Bonferroni adjustmen was used to perform post hoc analysis (α = 0.05).ResultsPost-intervention marginal gap was statistically significantly lower in group EX (110.8 μm) which was statistically significant compared with group SF (112.5 μm) (mean difference=-1.768, P = .007) and group BR (113 μm) (mean difference=-2.272, P = .001), however, in. comparing SF and BR groups, there was no significant difference (mean difference=-0.5, P = .770).ConclusionsThermocycling affected the marginal gaps of composite based restoration and resin-modified ceramics widely. However, it had a very small effect on glass ceramics marginal adaptation.Clinical implicationsThe marginal gaps of CAD-CAM inlays varied according to material used (ceramic based, combination, or resin based). Thermocycling has a minor effect on the marginal adaptation of lithium disilicate glass-ceramic inlays, where it affected the margin of resin-modified ceramic and composite based inlays greatly. Using lithium disilicate glass-ceramic might improve the clinical longevity of inlay restored teeth.

Zanubrutinib Plus Salvage Chemotherapy in Refractory/Relapsed Diffuse Large B-Cell Lymphoma Patients Non-Candidate for Autologous Stem Cell Transplantation: A Retrospective Study

Introduction ：Salvage chemotherapy followed by autologous stem cell transplantation (auto-SCT) is effective for relapsed or refractory DLBCL (R/R DLBCL). However, many patients are unable to undergo auto-SCT due to age, comorbidities, tolerance, economy and other factors. R/R DLBCL has poor clinical outcomes when treated with conventional salvage chemotherapy. Zanubrutinib, a selective Bruton's tyrosine kinase (BTK) inhibitor, has been shown to have modest antitumor activity in R/R DLBCL. Here we aimed to evaluate the efficacy and safety of Zanubrutinib plus salvage chemotherapy in autologous stem cell transplantation-ineligible R/R DLBCL patients. Methods: We retrospectively reviewed R/R DLBCL patients who were administered with Zanubrutinib 160mg*bid plus BR （Bendamustine 90mg/㎡*d1-2+Rituximab 375mg/㎡*d0）or R2 （Lenalidomide 25mg* d1-21 +Rituximab 375mg/㎡*d0）in our center between January, 2019 and July, 2023. Results: 49 R/R DLBCL patients were enrolled,including 30 patients in the Zanubrutinib plus BR group(ZBR)and19 patients in the Zanubrutinib plus R2 group(ZR2). Median age at this study was 60 years (range, 33-80). The best overall response rate (ORR) was 57.1% and complete remission rate was 12.2%. The ORR of ZBR group and ZR2 group were 63.2% and 53.3%, respectively. The response rate was lower in elderly, patients with ≥4 line treatment, refractory patients, patients with TP53 mutations, or without MYD88 and CD79A/B mutations. TThere was a positive correlation between the number of treatment cycles and ORR. With a median follow-up of 22 months (range, 6-43), the median progression-free survival (PFS) was 6.0 months, and the overall survival (OS) was 21.0 months. For OS, univariate analysis suggested that the number of treatment cycles was an independent favorable prognostic factor for OS. In multivariate analysis, , relapsed patients had better OS compared with refractory patients, and response after treatment was an independent favorable factor for OS. The most common grade-3/4 adverse events were neutropenia (55.0%), thrombocytopenia (44.9%), and pneumonia (30.1%). Conclusion: Zanubrutinib combined with BR or R2 showed promising efficacy and acceptable safety in R/R DLBCL patients, which may be a potential treatment option for autologous stem cell transplantation-ineligible R/R DLBCL patients.