Complete Collapse Research Articles

INFECTED MEDIASTINAL MATURE TERATOMA

TOPIC: Disorders of the Mediastinum TYPE: Medical Student/Resident Case Reports INTRODUCTION: Mature teratoma, a benign germ-cell tumor, commonly presents in the ovaries. Extragonadal manifestation is uncommon and rarely occurs with superimposed infection. We present a unique case of extragonadal teratoma found in the mediastinum complicated by infection. CASE PRESENTATION: A 24-year-old male with a history of asthma presented with a 3-day history of dyspnea and right rib pain radiating into the center of his chest. He reported a 30-pound weight loss in the preceding 3 months. He denied tobacco, alcohol, or recreational drug use. He previously worked as a coal miner but is now working in coastal drilling. He was afebrile and normotensive but had an oxygen saturation of 93% on room air. On examination, he had right upper lobe rhonchi with absent breath sounds in the right basilar region. Chest imaging showed complete collapse of the right middle and lower lobes, large loculated right pleural effusion within the anterior right lung base, and heterogeneity with rim enhancing fluid collection, which was suggestive of empyema. The patient had leukocytosis of 16.6k with neutrophil predominance of 14.18k. The patient was started on empiric intravenous antibiotics with vancomycin, ceftriaxone, and metronidazole. He underwent video-assisted thoracoscopic surgery with cystic mass resection from the pericardial surface and anterior surface of right lower lobe, 1600 milliliters of purulent fluid drainage, and decortication of right middle and lower lobes. Frozen section showed squamous and glandular cells. Pathology showed keratinized skin with granulation tissue, acute and chronic inflammation, and giant cell reaction consistent with infected mature teratoma. Pleural fluid's gram stain revealed 2+ PMNs and no growth in aerobic, anerobic, fungus, or AFB cultures. The patient was de-escalated to amoxicillin-clavulanate for a 14-day course and clinically improved. DISCUSSION: This case demonstrates a rare presentation of extragonadal mature teratoma in the mediastinum. Mediastinal teratomas occur from 20 to 40 years old with clinical symptoms of cough, chest pain, trichoptysis, and fever. Possible complications are infection, rupture, malignant transformation, and paraneoplastic anti-N-methyl-D-aspartate receptor (anti-NMDA receptor) associated limbic encephalitis. Infected mature teratomas are uncommon. Reported infectious organisms include Salmonella enterica, Escherichia coli, Mycoplasma pneumonia, Staphylococcus aureus, Staphylococcus agalactiae, and Haemophilus influenza. Proposed pathogenesis is due to the release of proteolytic enzymes from pancreatic and/or intestinal mucosal tissues in the tumor leading to inflammation and eventual infection. CONCLUSIONS: Teratoma rarely presents with superimposed infection, which may be complicated by rupture. Definitive management is surgical excision of teratoma and antibiotic targeting the organism. REFERENCE #1: Lee WL, Yen MS, Tseng JY, Yu KW, Wang PH. Mature teratoma with secondary infection: case report. Changgeng Yi Xue Za Zhi. 1999 Jun;22(2):339-43. PMID: 10493045. REFERENCE #2: Li C, Lin F, Liu C, Hai Y, Liu L. Intrapulmonary teratoma misdiagnosed as aspergilloma. Thorac Cancer. 2018;9(2):328-329. doi:10.1111/1759-7714.12566 REFERENCE #3: Tian Z, Liu H, Li S, et al. Surgical treatment of benign mediastinal teratoma: summary of experience of 108 cases. J Cardiothorac Surg. 2020;15(1):36. Published 2020 Feb 17. doi:10.1186/s13019-020-1075- DISCLOSURES: No relevant relationships by Ashley Anselene, source=Web Response No relevant relationships by Asma Balobaid, source=Web Response No relevant relationships by Shu Xian Lee, source=Web Response No relevant relationships by Rebecca Reece, source=Web Response

Characterization of Microstructure, Chemical, and Physical Properties of Delignified and Densified Poplar Wood.

Wood is an attractive and inherently sustainable alternative to many conventional materials. Recent research on improving wood mechanical strength emphasizes wood densification through the partial removal of lignin and hemicelluloses, therefore the chemical and physical properties of delignified and densified wood require further investigation. In this study, poplar wood samples were subjected to alkali and maleic acid hydrotropic delignification with varying degrees of lignin and hemicellulose removal followed by hot pressing, and the microstructure, chemical properties, and dimensional stability of densified wood through delignification were evaluated. The results showed that the complete wood cell collapse was observed near the surface of all the delignified wood blocks, as well as some micro-cracks in the cell walls. The chemical analysis indicated that delignification occurred mainly near the surface of the wood blocks and enhanced hydrogen bonding among the aligned cellulose fibers. For dimensional stability, the set recovery decreased with the increase in alkali dosage, and the considerable fixation of compressive deformation was obtained by a post-densification hydrothermal treatment at 180 °C. These results have demonstrated that the densified wood with delignification can be easily fabricated using the proposed method, and the densified wood exhibited great potential to be used as a sustainable material.

Strategic Pause on the National Libyan Education Reform Plan: Insights & Enhanced Tactics

Primarily based on the strategic pillars presented in the essential plan titled: "National Libyan Public Education Reform: Entire Transformative Strategies 2020–2026" (Published: November 2017), which proposed comprehensive bases for reforming Libyan public education as a reflection on the problems that the whole Libyan public/private education system have faced due to still-existing circumstances. It divided the entire reform strategy into six years of definite procedures designed to solve the revealed problems through gradual, ongoing actions. This essential plan was followed by a detailed executive paper on the same reverence plan titled "Contextualizing the First Two Years of the Libyan Education Reform Proposed Strategies (2020–2026): Targeted Candidates and Reflective Activities" (Published: May 2018), which explained in detail the projected (Phase I) actions of the first two years of the plan. (Phase II) of applying such a plan was explained in a paper titled "Employing the Subsequent Four Years of the Libyan Education Reform Strategy: Administrations and Contributors" (Published: January 2019), which extensively described the four executive years of the reform strategy with considerations to the constitutional laws or the existing educational regulations in the country.This associated project aimed to obtain a deeper understanding and awareness of the consequences and variables resulting from the remaining state instability for over (10) years (2011-2021) in general, and from (2017-2021) in particular, along with an assessment of the impacts of the coronavirus (COVID-19) on the whole educational system in Libya. This comprehensive work is a result of (16) months of field qualitative study (&), which predominantly depended on the pillars of the suggested plan to professionally determine whether the projected National Reform Plan for the entire Libyan education system is still valuable to apply, or if it needs to be modified, developed, or even changed in some of its aspects or in one/all its phases. The significance of obtaining this field work emerged after the increase of great challenges that revealed problems faced by/facing the entire State of Libya: for instance, the effects of civil wars, a prolonged time of sharp institutional division (East and West), and a tremendous deficit (damage) in most education infrastructures and interferences, in addition to the almost non-existence of QAs, CPD, research, technology, and teaching facilities inside public schools, universities, and even in the vocational sector. This is in addition to the deep effects of the continued lack of a clear policy of education and the approximate non-existence of a clear and authentic Vision, Mission, and Goals (VMG) or sequenced tactics of leadership and lifelong learning for educators, inspectors, social workers, education administrators, TAs, and university lecturers, etc.This field study uncovered profound problems in the entire Libyan education system, which might lead to a complete collapse or major failures if it remains as it is now. It also re-verified the still-valued proposed National Libyan Public Education Reform (NLPER) strategy in combination with contemporary innovative concepts, added stakeholders, and developed tactical leadership philosophies and active crisis management techniques, all to be contained in a developed (7) years of reform strategy and tactics instead of the (6) suggested years, which will immediately take place (the updated Reform Plan) as a response to the findings of this study.

Ovarian inguinal hernia \u2013 a possibility in MURCS syndrome

BackgroundInguinal hernia containing ovary and fallopian tube can be found in paediatric population and is a rare finding in women of reproductive age group. Most of the cases are associated with congenital abnormalities of the female genital tract.Case presentationA 20 year old female presented with right reducible inguinal hernia, primary amenorrhea and normal secondary sexual characteristics. Clinical examination revealed scoliosis with convexity towards left side, prominence of left rib cage with Sprengel deformity and right sided heart sounds. Ultrasound of the inguinal swelling revealed right ovary within the hernial sac, Chest X-ray revealed right lung collapse and dextrocardia. Further Magnetic resonance imaging (MRI) of pelvis revealed inguinal hernia with right ovary as its content, normal left ovary and absent uterus. Computed tomography (CT) revealed complete collapse of right lung with compensatory left lung hyperinflation and absent right kidney. Karyotyping of the patient was normal, 46XX. A diagnosis of MURCS syndrome with right ovarian hernia was made. The hernia was surgically managed with repositioning of ovary and fallopian tube into the pelvis.DiscussionOvary in inguinal hernia is rare in women of reproductive age group. MRKH syndrome, a mullerian duct anomaly, is the congenital aplasia of uterus and upper two-thirds of vagina in a female with normal ovaries, fallopian tube, secondary sexual characteristics and 46XX karyotype. MURCS is a subtype of MRKH type 2 having mullerian duct agenesis with renal, cardiac, muscular & vertebral defects. General physical examination and primary investigations if yields abnormal findings; the patient must undergo an array of investigations to rule out MRKH/MURCS, or other congenital abnormality. Early diagnosis is essential to prevent its incarceration or torsion. The primary treatment of ovary in inguinal hernia is repositioning the ovary and fallopian tube back to pelvis to preserve fertility and repair of inguinal hernia. A multidisciplinary team is required to deal with various abnormalities present in a patient with MURCS.

The legality of Lebanese banks’ restrictions on deposits: Between challenges and practice

For almost two years, Lebanon has been suffering from a severe economic downturn, the worst since the end of the civil war (1975–90). This has led to a complete financial collapse, with significant material losses incurred by the Lebanese Central Bank (BDL). It has also fuelled protests against the rampant corruption plaguing the country. Since the beginning of the banking crisis in Lebanon characterized by a lack of liquidity and the cessation of banks from dealing in US dollars, the risks surrounding deposits belonging to residents and non-residents, as well to foreigners, have emerged. This exacerbated the absence of procedures to determine the fate of deposits and the applicable legislation that protects these deposits. This article examines the resulting imbalances in the financial paradigm and demonstrates the illegality of actions or restrictions taken by banks. Consequently, this article explores the means to protect depositors’ rights and the legal steps followed by depositors to retrieve their money or at least to save what is left of it.

Theoretical Simulation and Discussion on Fusion Process of Hollow Core Fiber

The hole collapse of hollow core fiber fusion is a key difficulty in sensor fabrication. In this paper, the hollow core fiber fusion is theoretically analyzed and optimized. The heat conduction and deformation of fiber are simulated by COMSOL software. The fiber temperature distribution at fusion area are discussed at different fusion time. Then the deformation value and fiber melting time with different heat flux are simulated and discussed. The deformation value and time value both showed decreasing trend with bigger heat flux. Although it is difficult to get zero deformation value, even if at fiber melting temperature, the fusion deformation can be effectively controlled at some scale. For typical 1% hole diameter deformation scale, the heat flux value should be more than 1.00505×107 W/m2. Considering the small contact surface between hollow core fiber and common fiber end, for getting sufficient fusion, we still simulated the required time of 1% deformation scale with different heat flux, which can give us more fusion parameters choice. Fusion can be continued after fiber melting temperature until getting 1% deformation control value, which can supply enough time for good and firm fusion. The time difference between melting temperature and 1% hole diameter deformation is simulated. According to the simulated curves, 1.5×107 W/m2 heat flux, with 0.02436 s time difference, may be a good choice for hollow core fiber fusion by typical parameters. It is interesting that some report showed complete collapse is helpful to improve mode-coupling efficiency. For investigating this situation, the required heat flux and fusion time simulation are also operated and analyzed. The simulation and discussion in this paper gave deep understanding and some reference advice for optimizing hollow core fiber fusion.

A highly specific Serratia-infecting T7-like phage inhibits biofilm formation in two different genera of the Enterobacteriaceae family

Due to the emergence of multidrug-resistant bacteria, bacteriophages have become a viable alternative in controlling bacterial growth or biofilm formation. Biofilm is formed by extracellular polymeric substances (EPS) and is one of the factors responsible for increasing bacterial resistance. Bacteriophages have been studied as a bacterial control agent by use of phage enzymes or due to their bactericidal activities. A specific phage against Serratia marcescens was isolated in this work and was evaluated its biological and genomic aspects. The object of this study was UFV01, a bacteriophage belonging to the Podoviridae family, genus Teseptimavirus (group of lytic viruses), specific to the species S. marcescens, which may be related to several amino acid substitutions in the virus tail fibers. Despite this high specificity, the phage reduced the biofilm formation of several Escherichia coli strains without infecting them. UFV01 presents a relationship with phages of the genus Teseptimavirus, although it does not infect any of the E. coli strains evaluated, as these others do. All the characteristics make the phage an interesting alternative in biofilm control in hospital environments since small breaks in the biofilm matrix can lead to a complete collapse.

Upper airway collapse characteristics in adult patients with OSA and previous tonsillectomy.

To analyze upper airway (UA) collapse patterns through drug-induced sleep endoscopy (DISE) in adult patients withobstructive sleep apnea (OSA) who previously underwent tonsillectomy. This was a retrospective study on patients withOSA who underwent DISE between June 1, 2013 and July 30, 2017 at Stanford Hospital. Subjects who had prior tonsillectomy history were classified into the tonsil0 group, whereas others were classified into the tonsil1 and tonsil2/3/4 group based on tonsil grade. UA collapse characteristics were recorded and analyzed among groups according to Velum, Oropharynx, Tongue base and Epiglottis (VOTE) classification. A total of 205 individuals were included, 38 in tonsil0 group, 104 in tonsil1 and 63 in tonsil2/3/4. The tonsil0 group had a higher percentage of anterior-posterior (AP) velum (58%) and tongue base (45%) collapse compared with the tonsil2/3/4 group (22%, P = 0.0003 and 22%, P = 0.02, respectively) but less oropharyngeal lateral wall collapses (29% vs 53%, P = 0.02). Most of the tonsil0 group (70%) showed multi-sites collapse pattern, the percentage of combined obstruction in both palatopharyngeal and hypopharyngeal region was higher (50% vs 29%, P = 0.03). The difference of velum complete AP collapse remained significant after adjusting for age and BMI (Odds Ratio = 0.33, 95% CI 0.12-0.86, P = 0.02). No significant differences were found between the tonsil0 and tonsil1 groups. Compared with individuals with larger tonsils (grade 2 to 4), those with previous tonsillectomy and OSA were susceptible to the velum AP configuration collapse. Diversity of multi-sites obstruction and combined collapse in both palatopharyngeal and hypopharyngeal level was the main characteristic.

Concentric vs Anteroposterior-Laterolateral Collapse of the Soft Palate in Patients With Obstructive Sleep Apnea.

The presence of complete concentric collapse of the soft palate (CCCp) during drug-induced sleep endoscopy (DISE) has important therapeutic consequences. However, CCCp may present in various, sometimes doubtful, ways due to the complex anatomy of the upper airway. Herein, we aimed to characterize these doubtful variants by reviewing the DISE recordings of patients with obstructive sleep apnea (n = 332). We observed in some individuals that the soft palate collapsed in an anteroposterior-laterolateral (AP-LL) way, producing a polygonal shape that was distinct from CCCp. Patients with this collapse pattern (n = 29) had a smaller neck circumference and less severe obstructive sleep apnea than patients with CCCp (n = 68). The majority of patients with AP-LL collapse (n = 19) were originally diagnosed with CCCp. Based on these findings, AP-LL collapse of the soft palate might represent a distinct DISE phenotype that is easily confounded with CCCp.

Combined extracorporeal membrane oxygenation and microaxial pump-when left ventricular preload is too low to unload in cardiogenic shock.

PurposeSevere cardiogenic shock is the major driver of mortality on cardiologic intensive care units. Novel therapeutic options like extracorporeal membrane oxygenation (ECMO) or the combination of ECMO and a percutaneous microaxial pump like Impella CP (ECMELLA) are promising Options. Here we want to focus on the question what happens when left ventricular preload is too low to unload in cardiogenic shock in patients with ECMELLA and this aspect is illustrated by transesophageal echocardiography.MethodsWe detail a case of a 43‐year‐old active smoker who was admitted for acute myocardial infarction causing severe cardiogenic shock and who was finally treated with ECMELLA. Transesophageal echocardiography is used to illustrate what happens when left ventricle (LV) preload is too low to unload.ResultsTransesophageal echocardiography demonstrates complete collapse of LV and LA as consequence of increased but still low flow rate of the coaxial pump.ConclusionNovel therapeutic options like ECMO and percutaneous microaxial pumps like Impella CP, 5.0 or the combination of both (ECMELLA), are promising options. Whether these approaches reduce mortality has to be evaluated in urgently needed randomized trials but results will not be available in the next few years.

Numerical analysis of a clad portal frame structure tested to destruction

A full-scale steel portal frame structure, explicitly designed to utilize stressed skin action, was tested to destruction in the early 1970′s. At this time, it was not possible to perform any detailed analysis of such structures; however, using modern computational techniques, detailed Finite Element Models (FEMs) have now been developed. These FEMs show an excellent agreement with the reported test results, including following the nonlinear behaviour to complete collapse. The validated model was then extrapolated into a multi-bay portal structure of more realistic length, and the effect of cladding on the strength and flexibility of the frames was established under both vertical and horizonal loading. Under a distributed vertical load, the cladding initially had little influence although, once the internal frames reached a complete collapse mechanism, the cladding prevented structural collapse until the cladding also failed. However, under horizontal load, the coupling between frames was significant, particularly in the multi-bay case, leading to high forces in the cladding and the structure/cladding interface. The tested frame was stocky and low rise, typical of its time. Today, with taller, more flexible modern frames, stiffer and potentially less robust cladding systems will resist an even more significant proportion of the horizontal load; a warning to the construction industry that parasitic diaphragm action should not be ignored.

Post-Operative Sleep Endoscopy with Target-Controlled Infusion After Palatopharyngoplasty for Obstructive Sleep Apnea: Anatomical and Polysomnographic Outcomes.

IntroductionThe findings of drug-induced sleep endoscopy (DISE) are not always correlated with the outcome of upper airway surgery for obstructive sleep apnea (OSA), and whether multilevel surgery is truly required in treating multilevel obstruction identified in preoperative DISE remains an issue. We attempted to compare DISE findings before and after palatopharyngoplasty in patients with OSA because changes in DISE may be beneficial to better understand polysomnographic and anatomical outcomes.MethodsThis was a prospective cohort study for 34 patients with moderate to severe OSA who underwent palatopharyngoplasty at a tertiary care center from 2016 to 2018. We recorded the patients’ demographic characteristics, procedures, and surgical outcomes and compared the preoperative and postoperative DISE staging patterns.ResultsThe apnea-hypopnea index (AHI) values of 34 adults improved significantly after surgery (40.6 ± 23.3 versus 25.6 ± 20.6, P < 0.001). The majority of patients, 26/34, had preoperative complete concentric collapse at the velum, and for most (20/26, 77%) there was a change of the collapse pattern into anteroposterior collapse postoperatively. Patients with postoperative velar collapse had higher follow-up AHI values than those who without (27.8 ± 21.9 versus 15.2 ± 7.7, P = 0.023). Patients with preoperative complete tongue base collapse had higher follow-up AHI values than did those with no or partial collapse (40.6 ± 21.0 versus 21.0 ± 18.6, P = 0.017). Patients with postoperative complete tongue base collapse also had higher follow-up AHI values than the others (42.7 ± 22.1 versus 18.5 ± 15.4, P = 0.001).ConclusionPalatopharyngoplasty could change the collapse pattern at the velum in most patients. Preoperative and postoperative complete tongue base collapse and postoperative velar collapse identified in TCI-DISE were associated with relatively poor outcomes.

Patient Satisfaction Following Primary Total Knee Arthroplasty: Contributing Factors.

The reported dissatisfaction rate after primary total knee arthroplasty (TKA) ranges between 15% and 25%. The purpose of this article is to perform a narrative review of the literature with the aim of answering the following question: What are the main factors contributing to patient dissatisfaction after TKA? A review of the literature was performed on patient satisfaction after TKA. The search engines used were MedLine (PubMed) and the Cochrane Library. The keywords used were "TKA" and "satisfaction". The main reported preoperative factors positively contributing to patient satisfaction were the following: fulfilment of preoperative expectations, preoperative complete joint space collapse, increasing patellar and lateral compartment osteophyte size, and TKA communication checklist. The principal preoperative factors negatively contributing to patient satisfaction included female sex, comorbidities, and Hispanic race. The chief perioperative factor positively contributing to patient satisfaction was cosmetic closure, whereas the fundamental perioperative factors negatively contributing to patient satisfaction included joint laxity, anterior tibial component slope, and greater femoral component valgus angle. The principal postoperative factors positively contributing to patient satisfaction were the following: ameliorated walking distance, improved range of motion, and improvements in pain. The most important postoperative factors negatively contributing to patient satisfaction included poor postoperative knee stability and soft-tissue balance, functional limitation, surgical complication and reoperation, staff or quality of care issues, and increased stiffness.

The ‘Norway Model’ for a Privileged Partnership Between the EU and Turkey

Even though no one has officially declared the halt of Turkey’s EU accession process, Ankara’s membership negotiations have effectively been stalled over the past few years. Neither Brussels nor Ankara wants a complete collapse of bilateral ties which are strong, multifaceted and complex as well as beneficial for both Turkey and the EU. In fact, as suggested by some observers, Turkey and the EU are not stuck with full membership as the only option going forward. The two sides can modify the relationship toward building a privileged partnership based upon one of the external differentiated integration models. The “Norway model” of integration with the EU might be a feasible option for Turkey and the EU considering the fact that the two sides have already come to an agreement to upgrade their Customs Union. This paper analyses the Norway model for an alternative path to the Turkish-EU relations comparing the model with the status quo as well as with the proposed scenarios for the updated Customs Union by the European Commission.

Combinatorial Use of Bexarotene Plus ATRA for the Treatment of Acute Myeloid Leukemia

Aim: All-trans retinoic acid (ATRA) results in high response rates in acute promyelocytic leukemia (APL), but has not had a significant impact on non-APL forms of acute myeloid leukemia (AML), even though retinoic acid receptors have been implicated in hematopoietic maturation and self-renewal. RXRs bind as heterodimers with RARs, and are expressed at higher levels in AML cells than are RARs. We sought to determine whether natural RXR ligands exist in primary leukemia cells, whether RXR ligands might augment or inhibit leukemic cell growth, and whether RXRs might be rational targets for AML therapeutics.Background: Retinoid receptors are nuclear hormone receptors, induced during terminal myeloid maturation with highest expressed in M4 and M5 AML. Retinoids serve as intracellular messengers and are activating ligands for the retinoic acid receptors (RAR) and retinoid X receptors (RXR).Methods: We developed an in vivo reporter assay that measures intracellular, activating nuclear receptor ligands in mouse bone marrow cells. We generated transgenic mice with GFP regulated by a UAS promoter. The yeast Gal4 transcription factor recognizes UAS promoter sequences. When a fusion of the Gal4-DNA binding domain (DBD) and a retinoid receptor ligand-binding domain (LBD) is expressed in UAS-GFP bone marrow cells, and an activating ligand is present, the cells express GFP. Leukemia was generated in bone marrow cells from these mice and from Mx1-Cre x Rxrαfl/fl x Rxrβfl/fl mice using MSCV-MLL-AF9 retrovirus.Results: We found that intermediate levels of RXRA ligands are present in mouse MLL-AF9 leukemia cells in vivo. To determine if activation of RXRA is required for MLL-AF9 cell growth, we transduced MSCV-MLL-AF9 retrovirus into bone marrow cells from Mx1-Cre+ x Rxrαfl/fl x Rxrβfl/fl mice and transplanted these into recipient mice. Mx1-Cre is “leaky.” Without external activation of Mx1-Cre (i.e. without pIpC treatment) we found that all subsequent leukemias were associated with deleted (“floxed out”) Rxra and Rxrb alleles, suggesting that the deleted allele was positively selected for. In secondary transplants, we found that MLL-AF9 leukemias with deleted Rxrα and Rxrβ were associated with shorter survival when compared with MLL-AF9 leukemias with wild type Rxrα and Rxrβ, suggesting that naturally occurring RXR ligands suppressed leukemic growth. To determine if pharmacologic activation of retinoid receptors could inhibit MLL-AF9 cell growth, we treated MLL-AF9 cells ex vivo with ATRA and bexarotene. We found that ATRA modestly inhibited growth, and this effect reached a plateau at 62 nM (this may partially explain the limited clinical efficacy of ATRA in non-APL AML) (see Figure). In contrast, the EC50 of bexarotene was 125 nM and the EC50 decreased to 54 nM when bexarotene was combined with 62 nM ATRA. Higher doses of ATRA decreased the bexarotene EC50 further to 43 nM and resulted in near complete culture collapse. Finally, to determine whether combination bexarotene and ATRA inhibited cell growth by inducing differentiation or apoptosis, we examined cytomorphology, cell division by Celltrace Violet staining (similar to CFSE), and Annexin V. Unexpectedly, we observed no evidence of differentiation, but rather increased Annexin V associated with ATRA and bexarotene-induced growth arrest.Conclusion: RXRs act as tumor suppressors in MLL-AF9 murine leukemia cells in vivo, and the activation of RXR/RAR heterodimers with bexarotene and all-trans retinoic acid leads to synergistic apoptosis and growth arrest. Additional experiments are now being performed to test the efficacy of this dug combination in vivo and assess their potential use in elderly relapsed/refractory AML. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Collapse of fresh foam concrete: Mechanisms and influencing parameters

This study assesses the influence of rheology and density on the collapse behaviour of mechanically foamed fresh aerated concrete. The collapse mechanism was studied under two conditions of varying interstitial paste's rheology and varying foam content. Adequate yield stress in the interstitial cement paste (critical yield stress) is crucial to achieve stability, below which the foam concrete displays partial or complete collapse. However, higher yield stresses may affect the hardened properties, thus an optimum range is important. Besides, this critical yield stress decreases with the foam content, leading to enhanced stability at lower densities. The critical yield stress to prevent collapse was then experimentally determined and compared against the yield stresses required to prevent the rising of bubbles (buoyancy) and the flow of interstitial paste through the foam network (drainage). This comparison showed that the experimentally determined critical yield stress to prevent foam collapse agrees well with the drainage-based stability criteria.

Another thermophilic "Miocene survivor" from the Italian Pliocene: A geologically young occurrence of the pelagic eagle ray Aetobatus in the Euro-Mediterranean region

Aetobatus (Myliobatiformes: Aetobatidae) is a living genus of eagle rays that occurs in shallow-marine, tropical and subtropical environments of the Atlantic, Pacific, and Indian Oceans. Nowadays, Aetobatus does not inhabit the cool- to warm-temperate European and Mediterranean waters, though it is known from this broad region by virtue of several fossil teeth ranging chronostratigraphically from the lower Palaeogene to the upper Neogene. The present paper reports on a fossil aetobatid tooth discovered in mid-Pliocene (upper Zanclean to lower Piacenzian, 3.82-3.19 Ma) marine deposits exposed in the vicinities of Certaldo (Tuscany, Italy) and identified as belonging to †Aetobatus cf. cappettai. This specimen comprises the youngest occurrence of Aetobatus along the coasts of mainland Europe; furthermore, together with previous finds from roughly coeval deposits of Mallorca (Balearic Islands, Spain), it represents the most recent record of this genus in the whole Euro-Mediterranean region. In light of the environmental preferences of extant Aetobatus spp., our discovery suggests palaeoenvironmental conditions favourable to the persistence of tropical/subtropical taxa of "Miocene survivors" along the Pliocene coasts of Tuscany. In addition, it raises the question of whether or not the Messinian Salinity Crisis really resulted in the complete collapse of the Mediterranean marine biota and in the subsequent recolonisation of the Mediterranean Basin from the adjoining Atlantic waters and/or scattered marginal intrabasinal refugia at the beginning of the Pliocene. The possibility of Aetobatus recolonising the Mediterranean Sea through the Suez Canal in the near future is discussed.

ANALYSIS AND COMPARATIVE STUDIES OF SOFTWARE PENETRATION TESTING METHODS

Information security is one of the most important components in any organization. The disclosure of this information can lead not only to material losses, but also to the loss of the reputation and image of the company, which ultimately, in some cases, can lead to its complete collapse. Therefore, in order to avoid these consequences, it is necessary to analyze the security and reliability of information processing systems. One of the most effective ways to do this is through the use of "penetration testing" methods. The results obtained. The section provides software vulnerabilities analysis. The most frequently used types of attacks and intrusions by cyber intruders are highlighted. In contrast to this, methods comparative analysis for identifying software vulnerabilities was carried out. It is concluded that it is advisable to improve the methods for identifying vulnerabilities through the recommendations complex use taking into account the existing security risks of software tools, the features of modern methodologies and software development tools, as well as the modern software penetration testing methods capabilities.

Deep Learning Pitfall: Impact of Novel Ultrasound Equipment Introduction on Algorithm Performance and the Realities of Domain Adaptation.

To test deep learning (DL) algorithm performance repercussions by introducing novel ultrasound equipment into a clinical setting. Researchers introduced prospectively obtained inferior vena cava (IVC) videos from a similar patient population using novel ultrasound equipment to challenge a previously validated DL algorithm (trained on a common point of care ultrasound [POCUS] machine) to assess IVC collapse. Twenty-one new videos were obtained for each novel ultrasound machine. The videos were analyzed for complete collapse by the algorithm and by 2 blinded POCUS experts. Cohen's kappa was calculated for agreement between the 2 POCUS experts and DL algorithm. Previous testing showed substantial agreement between algorithm and experts with Cohen's kappa of 0.78 (95% CI 0.49-1.0) and 0.66 (95% CI 0.31-1.0) on new patient data using, the same ultrasound equipment. Challenged with higher image quality (IQ) POCUS cart ultrasound videos, algorithm performance declined with kappa values of 0.31 (95% CI 0.19-0.81) and 0.39 (95% CI 0.11-0.89), showing fair agreement. Algorithm performance plummeted on a lower IQ, smartphone device with a kappa value of -0.09 (95% CI -0.95 to 0.76) and 0.09 (95% CI -0.65 to 0.82), respectively, showing less agreement than would be expected by chance. Two POCUS experts had near perfect agreement with a kappa value of 0.88 (95% CI 0.64-1.0) regarding IVC collapse. Performance of this previously validated DL algorithm worsened when faced with ultrasound studies from 2 novel ultrasound machines. Performance was much worse on images from a lower IQ hand-held device than from a superior cart-based device.

Durability of cement stones in injection wells

Cement stone is the weakest component of the wells, it is easily destroyed when working inside the casing and is vulnerable to the action of most formation fluids. In injection wells, under the action of water injected into the reservoir, intensive leaching of the cement stone occurs, which leads to its complete degradation after several years of well operation. The consequence of this is the injection of fluid into other formations and increased corrosion of the casings. Analysis of the field experience of injection wells showed that inter-reservoir crossflows result in cement stone complete collapse in 4-6 years, while in production wells it retained its properties after 20 years.&#x0D; Theoretical consideration of the leaching corrosion process made it possible to determine the main directions of reducing the corrosion rate, aimed at improving the structural characteristics of cement stone. Among these, a decrease in the initial water-content and optimization of the porous structure should be optimized.&#x0D; Analysis of the loads acting on the cement sheath in wells showed that during perforation, hydraulic fracturing and well drilling for deepening, the stresses arising in the cement stone exceed its strength characteristics. Therefore, it is advisable to use reinforced and self-healing cements to minimize these negative effects.