Persistent Growth Research Articles

Multi-Area and Multi-Period Optimal Reactive Power Dispatch in Electric Power Systems

Factors such as persistent demand growth, expansion project delays, and the rising adoption of renewable energy sources highlight the importance of operating power systems within safe operational margins. The optimal reactive power dispatch (ORPD) seeks to find operating points that allow greater flexibility in reactive power reserves, thus ensuring the safe operation of power systems. The main contribution of this paper is a multi-area and multi-period ORPD (MA-MP-ORPD) model, which seeks the minimization of the voltage deviation in pilot nodes, the reactive power deviation of shunt elements, and the total reactive power generated, all taking into account the operational constraints for each area. The MA-MP-ORPD was implemented in the Python programming language using the Pyomo library; furthermore, the BONMIN solver was employed to solve this mixed-integer nonlinear programming problem. The problem was formulated from the standpoint of the system operator; therefore, it minimizes the variations of critical variables from the desired operative values; furthermore, the number of maneuvers of the reactive compensation elements was also minimized to preserve their lifetimes. The results obtained on IEEE test systems of 39 and 57 buses validated its applicability and effectiveness. The proposed approach allowed obtaining increases in the reactive power reserves of up to 59% and 62% for the 39- and 57-bus test systems, respectively, while ensuring acceptable operation values of the critical variables.

Spatiotemporal Characteristics Prediction and Driving Factors Analysis of NPP in Shanxi Province Covering the Period 2001–2020

The advent of a range of high-precision NPP products, including MODIS NPP, MOD17 NPP, and GIMMS NPP, has sparked growing interest in the study of Earth’s ecosystems. In order to enhance comprehension of ecosystem health, in order to facilitate the development of rational resource management and environmental conservation policies, this investigation employs the MOD17A3 dataset to analyze historical variations in Net Primary Productivity (NPP) within Shanxi Province from 2001 to 2020, while also exploring future trends. The Theil–Sen median trend analysis and Mann–Kendall test are commonly used methods for analyzing time series data, employed to study the spatiotemporal trends and variations in NPP. The Grey Wolf Optimization–Support Vector Machine (GWO–SVM) model combines optimization algorithms and machine learning methods, enhancing the predictive capacity of the model for future NPP time series changes. Conversely, the Hurst exponent utilizes historical NPP trends to assess the persistence characteristics of NPP and predict future spatial variations in NPP. This study additionally investigates the natural driving factors of NPP using the Geographic Detector approach. The key findings of this study are as follows. (1) Overall, NPP in Shanxi Province exhibits a fluctuating upward trend from 2001 to 2020, with an average value of 206.278 gCm−2a−1. Spatially, NPP exhibits a northwest–low and southeast–high pattern, with significant spatial heterogeneity and considerable variability. (2) The average Hurst exponent is 0.86, indicating a characteristic of strong persistence in growth in future NPP. Regions with strong or higher persistent growth account for 95.54% of the total area. (3) According to the CMIP6 climate scenarios, NPP is projected to gradually increase from 2025 to 2030. (4) The interactive effects between natural factors contribute more to NPP variations than individual factors, with the rainfall–elevation interaction having the highest contribution percentage.

The Future of European Beech in Northern Germany—Climate Change Vulnerability and Adaptation Potential

Earth’s forests are increasingly exposed to climate risks through climate change-related drought and heat waves. Here, we review the climate vulnerability of European beech (Fagus sylvatica), the most abundant tree species of Central Europe’s temperate forests, and its adaptation potential to a hotter and drier climate in northern Germany, close to the center of the species’ distribution range. About two-thirds of the studied beech forests show persistent negative growth trends of their dominant trees since the onset of rapid warming in the early 1980s, driven primarily by long-term deterioration of the climatic water balance (CWB) in summer and, locally, long-term decrease in June precipitation. Lower water storage capacity of the soil increases the climate sensitivity of growth. Even though beech populations of drier sub-regions reveal some acclimation to drought (reduced stomatal conductance, turgor loss point reduction, higher C allocation to roots), they are more climate-vulnerable than populations at moister sites, visible in larger growth decreases and greater CWB sensitivity of growth. Even though beech mortality is still lower in the study region than in other parts of Central Europe, our results identify beech forest regions with <350 mm growing-season precipitation as vulnerable to recent climate conditions, which refers to half of the study region. With further climate warming and aridification, most of northern Germany likely will become unfavorable for beech growth within the next tree generation, which suggests choosing in many production forests alternative, more drought- and heat-resistant timber species.

Comparison of Bovine- and Porcine-Derived Decellularized Biomaterials: Promising Platforms for Tissue Engineering Applications.

Animal-derived xenogeneic biomaterials utilized in different surgeries are promising for various applications in tissue engineering. However, tissue decellularization is necessary to attain a bioactive extracellular matrix (ECM) that can be safely transplanted. The main objective of the present study is to assess the structural integrity, biocompatibility, and potential use of various acellular biomaterials for tissue engineering applications. Hence, a bovine pericardium (BP), porcine pericardium (PP), and porcine tunica vaginalis (PTV) were decellularized using a Trypsin, Triton X (TX), and sodium dodecyl sulfate (SDS) (Trypsin + TX + SDS) protocol. The results reveal effective elimination of the cellular antigens with preservation of the ECM integrity confirmed via staining and electron microscopy. The elasticity of the decellularized PP (DPP) was markedly (p < 0.0001) increased. The tensile strength of DBP, and DPP was not affected after decellularization. All decellularized tissues were biocompatible with persistent growth of the adipose stem cells over 30 days. The staining confirmed cell adherence either to the peripheries of the materials or within their matrices. Moreover, the in vivo investigation confirmed the biocompatibility and degradability of the decellularized scaffolds. Conclusively, Trypsin + TX + SDS is a successful new protocol for tissue decellularization. Moreover, decellularized pericardia and tunica vaginalis are promising scaffolds for the engineering of different tissues with higher potential for the use of DPP in cardiovascular applications and DBP and DPTV in the reconstruction of higher-stress-bearing abdominal walls.

Financial Intermediation and Economic Growth: Evidence from Nepal

Purpose - This study aims to investigate the role of financial intermediation in Nepalese economic growth using time-series data over the period from 1974 to 2019. In order to establish the relationship, GDP per capita is used as a proxy for economic growth, while private sector credit, commercial bank assets, and the broad money supply serve as proxy measures of financial intermediation.&#x0D; Design/Methodology/Approach - To obtain empirical results, the Johansen test of co-integration, the vector error correction model, and the Granger causality test are applied.&#x0D; Findings - The results support finance-led growth in Nepal, implying that financial intermediation is positively associated with economic growth in the long run. A positive association with total trade was observed in the short run, but a negative effect was found in the long run. Granger causality tests indicate that the broad money supply and commercial bank assets are bidirectionally related to Nepal’s economic growth, while private sector credit is unidirectional.&#x0D; Research Implications - The findings suggest that if central bank authorities prioritized monetary policy tools, it may foster economic growth in Nepal in both the short- and long terms. In addition, for the persistent growth of the Nepalese economy, the banking sector should be reformed by employing more liberal policies. The study also suggests that policymakers should take immediate action to correct the direction of Nepalese foreign trade.

FROM DIAGNOSIS TO REHABILITATION: A UNICYSTIC AMELOBLASTOMA CASE REPORT

Ameloblastoma is considered the most common odontogenic tumor. It normally shows a slow and persistent growth, and is considered a locally aggressive neoplasm, affecting the posterior area of the mandible in most cases. This study aimed to report a case of unicystic ameloblastoma. A 21-year-old female patient reported a volume growing on the right size of her face, without other symptoms. Oral clinical examination showed an increase in the mandibular alveolar ridge region, covering the region of the right 1st and 2nd molars . An incisional biopsy was conducted and the anatomopathological analysis revealed a unicystic amelobastoma. A lesion decompression device was implanted. Two months after removing the decompression device, enucleation of the lesion and bone reconstruction with autogenous and xenogenous grafts were performed. Six months later, the patient began rehabilitation with implants, followed by the installation of prosthetic crowns. Ameloblastoma is considered the most common odontogenic tumor. It normally shows a slow and persistent growth, and is considered a locally aggressive neoplasm, affecting the posterior area of the mandible in most cases. This study aimed to report a case of unicystic ameloblastoma. A 21-year-old female patient reported a volume growing on the right size of her face, without other symptoms. Oral clinical examination showed an increase in the mandibular alveolar ridge region, covering the region of the right 1st and 2nd molars . An incisional biopsy was conducted and the anatomopathological analysis revealed a unicystic amelobastoma. A lesion decompression device was implanted. Two months after removing the decompression device, enucleation of the lesion and bone reconstruction with autogenous and xenogenous grafts were performed. Six months later, the patient began rehabilitation with implants, followed by the installation of prosthetic crowns.

Child Aflatoxin Exposure is Associated with Poor Child Growth Outcomes: A Prospective Cohort Study in Rural Malawi

BackgroundAflatoxin (AF) exposure is associated with child growth faltering in cross-sectional studies, with limited findings from longitudinal studies. ObjectivesTo evaluate the relationship between maternal AF B1-lysine adduct concentration, child AF B1-lysine adduct concentration, and child growth in the first 30 mo of life. MethodsAF B1-lysine adduct was measured in mother-child dyad plasma samples using isotope dilution mass spectrometry. Using linear regression, we assessed the relationship between AF B1-lysine adduct concentration and child weight, height, and head and mid-upper arm circumferences at 1 wk, 6, 12, 18, 24, and 30 mo of age. ResultsIn adjusted models, maternal prenatal AF B1-lysine adduct (pg/μL) was positively associated with newborn anthropometric outcomes; largest beta coefficients for associations between standardized values were for newborn weight-for-age z-score [β = 0.13; 95% confidence interval (CI): 0.02, 0.24; P < 0.05 and β = 0.11; 95% CI: 0.00, 0.22; P < 0.05 for second and third trimester AF, respectively]. Child AF B1-lysine adduct (pg/μL) at 6 mo was negatively associated with head circumference-for-age z-score at 6, 18, 24, and 30 mo, with beta coefficients ranging from β = –0.15; 95% CI: –0.28, –0.02 to β = –0.17; 95% CI: –0.31, –0.03; P < 0.05); 18-mo AF was negatively associated with anthropometric outcomes at 18, 24, and 30 mo, most consistently with length-for-age z-score (β = –0.18; 95% CI: –0.32, –0.04, β = –0.21; 95% CI: –0.35, –0.07, β = –0.18; 95% CI: –0.32, –0.03 at 18, 24 and 30 mo, respectively). ConclusionsChild AF exposure was associated with impaired child growth, but maternal AF exposure was not. Exposure during infancy was linked to persistent deficit in head circumference, implying reduced brain size lasting beyond the age of 2 years. Exposure at 18 mo was linked to persistent linear growth deficit. Further research should elucidate mechanisms through which AF affects child growth.

Drug-induced gingival enlargement – Oral implications for prescribing physicians

A male patient presented with a main complaint of persistent growth of the upper and lower gingiva that bled easily and resulted in an inability of maintaining proper oral hygiene. He reports that the growth of the gingiva started approximately three years prior to consultation in our clinic and is asymptomatic. His medical history revealed that he suffers from epilepsy and was being treated with a daily anticonvulsant, namely Phenytoin (100mg). Full-mouth non-surgical periodontal therapy was performed and supplemented with an adjunctive chlorhexidine mouth rinse as a chemical plaque control mechanism. Part of the systemic phaseof management of the patient, involved requesting the medical physician change the current epilepsy medication to Epilim®, which was benefi cial in contributing to the resolution of gingival enlargement. Signifi cant reduction in gingival infl ammation and enlargement were achieved with the non-surgical treatment.Corrective surgery therapy was performed to treat those areas of DIGE that had not resolved.

The Implications of Oxygen Dependent Chronic Obstructive Pulmonary Disease On Abdominal Aortic Aneurysm Sac Growth and Mortality Following Endovascular Aortic Aneurysm Repair

Chronic obstructive pulmonary disease (COPD) is a documented risk factor for abdominal aortic aneurysm (AAA) growth and rupture. However, little is known about the impact of COPD on AAA sac behavior after endovascular AAA repair (EVAR). Our objective was to determine the longitudinal association between COPD and sac remodeling after EVAR. All EVAR patients from 2010 to 2021 were identified within the Society of Vascular Surgery-Vascular Quality Initiative. Patients who expired within the first postoperative year or lacked follow-up data were excluded. The primary exposure was COPD severity (none, medically treated, and oxygen-dependent). The primary end point was sac growth after index EVAR. Secondary end points included mortality and reintervention. We used mixed-effects linear and logistic regression to assess the effects of COPD severity on sac remodeling with particular attention to control for the presence of endoleak. Cox-proportional hazards regression identified the predictors of mortality and reintervention. A total of 30,686 EVAR patients met inclusion criteria. The cohort had a mean age of 73 years with 18% female (n = 5519). A total of 24% had documented COPD (none 76% [n = 23,260], medically treated, 20% [n = 6057], oxygen-dependent 4% [n = 1369]), whereas 29% (n = 8803) were active smokers. Persistent sac growth was significantly associated with oxygen-dependent COPD (regression coefficient: +0.55, 95% confidence interval [CI]: 0.046-1.05; P = .03) after EVAR implantation; however, medically treated COPD was not (regression coefficient: −0.06, 95% CI: −0.322 to 0.199; P = .6). Notably, in adjusted analysis, patients with oxygen-dependent COPD did not experience increased reintervention rates (hazard ratio [HR]: 0.88, 95% CI: 0.8-1.02; P = .09), as they were vulnerable to significantly increased mortality (HR: 1.9, 95% CI: 1.74-2.12; P = .01) (Fig). Moreover, mortality was similar among patients irrespective of post-EVAR sac enlargement (HR: 1.2, 95% CI: 0.96-1.4; P = .13). As expected, the incidence of type 2 endoleak was greater among patients with documented sac growth of >5 mm irrespective of COPD severity (26% vs 10%, P < .0001), which also correlated with increased reintervention rates over time (22% vs 4%, P < .0001). Oxygen-dependent COPD was significantly associated with increased sac growth after EVAR. However, patients with oxygen-dependent COPD did not experience increased reinterventions, though this likely reflects the >2-fold risk of mortality within 2 years of their index EVAR. These findings underscore the importance of critical patient selection among those with severe COPD when considering EVAR and justify reserving repair for patients at greatest risk for AAA-related mortality.Fig 2View Large Image Figure ViewerDownload Hi-res image Download (PPT)Fig 3View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Organizational scaling: The role of knowledge spillovers in driving multinational enterprise persistent rapid growth

Based on insights from the spillover, international business, and knowledge management literatures, we study factors that enhance multinational enterprise (MNE) scaling and growth. Viewing MNEs and their employees as potentially rich knowledge sources, we draw attention to MNE-to-MNE knowledge spillover which fuel MNE scaling throughout organizations and employ panel data spanning 44,256 foreign and 21,246 domestic MNEs during 2004-2017. Our results show that (a) foreign MNEs benefit from depth and breadth of organizational knowledge spillover available in a geographic region, (b) domestic MNEs benefit from the depth of human capital knowledge spillover, and surprisingly, (c) domestic ownership hampers MNE scaling.

Microsurgical Resection of Vascular Malformations of the Upper Extremity.

The records of nine patients who presented with vascular malformations that circumferentially surrounded an artery in the upper limb were reviewed. The main indications for surgical intervention were pain or persistent growth. In each case, microsurgical technique using a microscope and microsurgical instruments was used to dissect the lesions free from the affected end arteries. Four digital arteries, three radial arteries, one brachial artery and one palmar arch were involved. There were six venous malformations, two fibro-adipose vascular anomalies, and one lymphatic malformation. There were no cases of distal ischemia, bleeding, or functional compromise. Two patients experienced delayed wound healing. After a minimum follow-up of 1 year, only one patient experienced a small area of recurrence but had no pain. Microsurgical dissection using a microscope and microsurgical instruments is a viable technique for resection of difficult vascular malformations that surround major arterial channels in the upper limb. This technique allows preservation of maximum blood supply while treating problematic lesions.

Abstract B037: Hit-finding by Cysteine-Scanning (HCS): A method for finding druggable pockets

Abstract Large-scale cancer sequencing efforts coupled with deep functional genomic interrogation of cancer models provides us an increasingly detailed view of the critical cancer drivers required for persistent growth and survival of cancer cells. Targeting such drivers has provided significant therapeutic benefit to patients across a wide range of cancers, yet progress has been, in large part, confined to the targeting of catalytic domains in kinases. To expand the reach of therapeutics into new classes of therapeutic targets, we need to identify and validate specific mechanisms and pockets to enable drug discovery. To enable this, we are developing a method called Hit-finding by Cysteine-Scanning (HCS) for identifying druggable pockets in proteins of interest. Here, we seek to couple the ability to create systematic variant libraries across proteins of interest with increasingly diverse covalent small molecule/fragment libraries. Thus, HCS involves screening pooled cysteine (cys)-variants against libraries of covalent compounds. To demonstrate the utility of this approach, we applied HCS to systematically screen 189 KRAS-G12D variants. We successfully purified KRAS cys-variant recombinant proteins in pools of seven or eight achieving coverage of 184/189 variants. KRAS variant pools were then screened against a pilot library of 47 covalent compounds with diverse reactivity detecting reactive variant-ligand pairs by intact LC-MS. This allowed us to quantify the accessibility and reactivity across the entire KRAS-G12D protein. The data confirmed the known SII-pocket in KRAS and revealed potentially novel ligand-bound conformations of oncogenic KRAS mutant proteins. In parallel, the same KRAS cys-variant library was generated as a barcoded library in a mammalian expression system. Upon screening this library in intact cells we observed that Sotorasib functionally inhibit the relevant KRAS SII-pocket cys-variants, enabling enrichment of these variants in a negative selection screen. Importantly, binding of a panel of SII-pocket compounds to variant H95C was found to be independent of the KRAS mutant context. Our results indicate that HCS could be a useful tool for the development of inhibitors for currently undruggable oncogenic KRAS mutants as well as potentially other drug targets. Citation Format: Laurens Moore van Tienen, Shadwa Bayoumi, Khaja Muneeruddin, Nancy Leymarie, David Kornfilt, Yuemin Bian, Devishi Kesar, Ruitong Li, Thomas Atack, Alexandra-Mariela Popa, Zuzana Jandova, Philipp Trollmann, Andreas Bergner, Klaus Rumpel, Dirk Kessler, William R. Sellers. Hit-finding by Cysteine-Scanning (HCS): A method for finding druggable pockets [abstract]. In: Proceedings of the AACR Special Conference: Targeting RAS; 2023 Mar 5-8; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Res 2023;21(5_Suppl):Abstract nr B037.

The proteasome regulator Rpn4 controls antifungal drug tolerance by coupling protein homeostasis with metabolic responses to drug stress.

Fungal pathogens overcome antifungal drug therapy by classic resistance mechanisms, such as increased efflux or changes to the drug target. However, even when a fungal strain is susceptible, trailing or persistent microbial growth in the presence of an antifungal drug can contribute to therapeutic failure. This trailing growth is caused by adaptive physiological changes that enable the growth of a subpopulation of fungal cells in high drug concentrations, in what is described as drug tolerance. Mechanistically, antifungal drug tolerance is incompletely understood. Here we report that the transcriptional activator Rpn4 is important for drug tolerance in the human fungal pathogen Candida albicans. Deletion of RPN4 eliminates tolerance to the commonly used antifungal drug fluconazole. We defined the mechanism and show that Rpn4 controls fluconazole tolerance via two target pathways. First, Rpn4 activates proteasome gene expression, which enables sufficient proteasome capacity to overcome fluconazole-induced proteotoxicity and the accumulation of ubiquitinated proteins targeted for degradation. Consistently, inhibition of the proteasome with MG132 eliminates fluconazole tolerance and resistance, and phenocopies the rpn4Δ/Δ mutant for loss of tolerance. Second, Rpn4 is required for wild type expression of the genes required for the synthesis of the membrane lipid ergosterol. Our data indicates that this function of Rpn4 is required for mitigating the inhibition of ergosterol biosynthesis by fluconazole. Based on our findings, we propose that Rpn4 is a central hub for fluconazole tolerance in C. albicans by coupling the regulation of protein homeostasis (proteostasis) and lipid metabolism to overcome drug-induced proteotoxicity and membrane stress.

PET-CT detection of local residual laryngeal carcinoma after definitive (chemo)radiotherapy

BackgroundPositron emission tomography and computed tomography (PET-CT) is currently recommended in evaluating the treatment response after (chemo)radiotherapy ([C]RT). In the larynx, post-treatment changes and physiological uptake make image interpretation more challenging compared to other head and neck sites. Previous research has not addressed imaging factors specifically in the larynx that would help in distinguishing the residual disease and explain the unique challenges of that anatomic area. The study cohorts are small and heterogenous. Our objective was to investigate the ability of PET-CT in diagnosing local residual laryngeal carcinoma, and to uncover imaging factors that could be used in differentiating the residual disease from post-treatment and physiological changes. In the same study cohort, we also aimed to uncover prognostic factors for local residual or recurrent disease.MethodsOur retrospective study cohort included 73 patients with T2-T4 laryngeal carcinoma undergoing (C)RT with curative intention, and post-treatment non-contrast-enhanced PET-CT at 2–6 months. Findings were compared between local residual and non-residual disease. Local residual disease was defined as a persistent tumor growth with no evidence of remission in between, confirmed by biopsy, and evident within 6 months from the end of RT. PET-CT was evaluated using a 3-step scale: negative, equivocal, and positive.ResultsNine (12%) had a local residual tumor and 11 (15%) developed local recurrence, based on the biopsy. The median follow-up of surviving patients was 64 months (range, 28–174). In univariate analysis, primary tumor diameter greater than 2.4 cm (median value), and vocal cord fixation were prognostic for local residual or recurrent disease. Sensitivity, specificity, PPV, and NPV were 100%, 75%, 36%, and 100%, respectively, when the equivocal interpretation was grouped with the positive interpretation. All local residuals, and 28% (18/64) non-residuals, had a primary tumor area SUVmax of over 4.0 (p < 0.001). CT showed a persistent mass at the primary tumor area in 56% of residuals, and in 23% of non-residuals (p > 0.05). By combining SUVmax>4.0 and mass, specificity improved to 91%.ConclusionsNPV of post-treatment PET-CT in laryngeal carcinoma is high, but equivocal and positive results have low PPV and require further diagnostics. All local residuals had SUVmax over 4.0. The combination of SUVmax over 4.0 and mass on CT increased specificity, but the sensitivity was low.

Physical and Technological Capital Efficiency for Profit Growth in Small and Medium Enterprises in Gauteng, South Africa: A Descriptive Qualitative Study

The increasing number of businesses closing down and the persistent slow growth of small and medium enterprises (SMEs) within the manufacturing sector is a serious concern globally, including in South Africa. The SMEs that are currently existing are operating below the required efficiency level. Physical and technological capital efficiency integrating manufacturing systematic planning, work study, standardisation and inventory management to improve the profit of SMEs in Gauteng South Africa is inadequate, which is a major concern. This study aimed to explore the physical and technological capital constraints affecting SMEs’ profit growth and develop the physical and technological capital efficiency adoption model merging manufacturing systematic planning, work study, standardisation and inventory management for SME profit growth in Gauteng. The study was qualitative, exploratory and descriptive in nature. Face-to-face interviews were conducted targeting 15 owners/managers amongst SMEs in Gauteng. The findings show the most common causes of slow profit growth, which involve poor material handling, unfavourable workplace layout, unscheduled machine maintenance, network challenges, failure to adhere to workplace standards, insufficient product and material recording systems and poor work methods and procedures. The study revealed major concerns for SMEs that required intervention for these enterprises to sustain their profit growth. Thus, the adoption of the model concerning the incorporation of physical and technological capital efficiency tools to advance manufacturing operations be considered as the contributing insight into the profit growth of SMEs in Gauteng. Thus, this study recommends that the government creates an enabling environment for the adoption of this model for SMEs.

Outcomes among Neonates after a Diagnosis of Persistent or Transient Fetal Growth Restriction Delivered at Term.

This study aimed to evaluate whether transient fetal growth restriction (FGR) that resolves prior to delivery confers a similar risk of neonatal morbidity as uncomplicated FGR that persists at term. This is a secondary analysis of a medical record abstraction study of singleton live-born pregnancies delivered at a tertiary care center between 2002 and 2013. Patients with fetuses that had either persistent or transient FGR and delivered at 38 weeks or later were included. Patients with abnormal umbilical artery Doppler studies were excluded. Persistent FGR was defined as estimated fetal weight (EFW) <10th percentile by gestational age from diagnosis through delivery. Transient FGR was defined as EFW <10th percentile on at least one ultrasound, but not on the last ultrasound prior to delivery. The primary outcome was a composite of neonatal morbidity: neonatal intensive care unit admission, Apgar's score <7 at 5 minutes, neonatal resuscitation, arterial cord pH <7.1, respiratory distress syndrome, transient tachypnea of the newborn, hypoglycemia, sepsis, or death. Baseline characteristics and obstetric and neonatal outcomes were compared using Wilcoxon's rank-sum and Fisher's exact test. Log binomial regression was used to adjust for confounders. Of 777 patients studied, 686 (88%) had persistent FGR and 91 (12%) had transient FGR. Patients with transient FGR were more likely to have a higher body mass index, gestational diabetes, diagnosed with FGR earlier in pregnancy, have spontaneous labor, and deliver at later gestational ages. There was no difference in the composite neonatal outcome (relative risk = 1.03, 95% confidence interval [CI] 0.72, 1.47) for transient versus persistent FGR after adjusting for confounders (adjusted relative risk = 0.79, 95% CI 0.54, 1.17). There were no differences in cesarean delivery or delivery complications between groups. Neonates born at term after transient FGR do not appear to have differences in composite morbidity compared with those where uncomplicated FGR persists at term. · No differences in neonatal outcomes in uncomplicated persistent versus transient FGR at term.. · Transient FGR pregnancies more likely to deliver at later gestational ages.. · No differences in mode of delivery or obstetric complications in persistent versus transient FGR at term..

Nanostructured Lipid Carriers in Chemotherapeutics: An Overview

Abstract: Cancer is a life-threatening disease that is associated with persistent tissue injury and uncontrolled cell growth. The treatments available to treat cancer are chemotherapy, surgery and radiation therapy. These treatments are used in combinations, while the most preferred treatment is chemotherapy. Because of the Non-specificity of anticancer drugs, they kill normal healthy cells along with cancer cells which lead to severe side effects. To minimize such limitations associated with conventional chemotherapy, nanostructured lipids carriers can be developed. These are nanocarriers consisting of a mixture of solid and liquid lipids along with surfactants. Lipids used in the formulation of NLCs are biocompatible and biodegradable. NLCs ensure high drug payload, less drug expulsion and more stability on storage. NLCs enhance the aqueous solubility of lipophilic anticancer drugs. Their surface modification can help to overcome drug resistance in cancer therapy. Controlled and targeted drug delivery of anticancer drugs can be possible by formulating them as NLCs. NLCs can play an important role in targeting anticancer drugs by different mechanisms. This review highlights types, formulation methods, characterization of nanostructured lipid carriers and strategies to achieve targeted release of anticancer drugs loaded in NLCs. Keywords: Cancer, Nanostructured lipid carriers, Drug targeting, Lipids, Anticancer drugs.

Embolization therapy for type 2 endoleaks after endovascular aortic aneurysm repair: imaging-based predictive factors and clinical outcomes on long-term follow-up

To evaluate the technical, radiological, and clinical outcomes after type 2 endoleak (T2EL) embolization in patients with a growing aneurysm sac after endovascular aortic aneurysm repair (EVAR). Additionally, to determine clinical and imaging-based factors for outcome prediction after embolization of a T2EL. A single-institution, retrospective analysis was performed of 60 patients who underwent a T2EL embolization procedure between September 2005 and August 2016 to treat a growing aneurysm sac diameter following EVAR. The patients' electronic medical records and all available pre- and post-embolization imaging were reviewed. Statistical analysis methods included logistic regression models for binary outcomes, proportional odds models for ordinal outcomes, and linear regression models for continuous outcomes. The Kaplan-Meier method was used to estimate the overall survival probability. Technical, radiological, and clinical success rates after T2EL embolization were 95% (n = 57), 26.7% (n = 16), and 76.7% (n = 46), respectively. Persistent aneurysm sac expansion was found in 31 patients (51.7%). Unsharp or blurred T2EL delineation on pre-interventional computed tomography (CT) was a predictive factor for a post-embolization persistent visible endoleak and persistent growth of the aneurysm sac (P = 0.025). Median survival after T2EL embolization was 5.35 years, with no difference observed between patients with persistent sac expansion compared with patients with stable or decreased sac diameter. Progression of the aneurysm sac diameter was observed in half the study patients, despite technically successful T2EL embolization. Unsharp or blurred T2EL delineation on pre-interventional CT seemed to be an imaging-based predictor for a persistent T2EL and progressive aneurysm sac growth after embolization.

Secondary Formation of Submicron and Supermicron Organic and Inorganic Aerosols in a Highly Polluted Urban Area

AbstractDifferent adverse health effects of submicron (PM1) and fine particles (PM2.5) may be attributed to their chemical differences, requiring a better understanding of size‐resolved composition. Herein, extensive online measurements were conducted across seasons in Beijing by two aerosol mass spectrometers, one of which alternately sampled PM1 and PM2.5. Source apportionment of organic aerosol (OA) indicated that traffic‐ and cooking‐related OA together accounted for ∼20%−30% of the OA mass in PM2.5, showing insignificant seasonal variations. Coal‐combustion and biomass‐burning‐related OA had minor contributions. The two secondary OA (SOA) factors together accounted for 59%−73% of the OA mass in PM2.5. The mass distributions of particulate components in PM1 and PM2.5 varied greatly across seasons. Secondary formation played a key role in particle size growth during cold seasons. During severe hazes with high aerosol liquid water content (ALWC), the supermicron mass fraction (MF1−2.5) of secondary components reached ∼40%−50% while those for primary OA remained at ∼20%. Heterogeneous uptake, aqueous processing, and dissolution likely all contributed to the enhanced concentration of secondary components, and the former two were perhaps more important. The increase of MF1−2.5 for secondary components with increasing ALWC in spring was less than that in winter, possibly due to the shorter duration of stagnant conditions limiting secondary formation. Early autumn showed higher MF1−2.5 values than cold seasons with insignificant changes as ALWC varied, plausibly explained by intensive new particle formation hindering persistent particle growth. Our results highlight the importance of heterogeneous uptake and aqueous processing in distributing SOA in supermicron mode in polluted areas.

A timeline of tumour-associated macrophage biology.

Tumour progression is modulated by the local microenvironment. This environment is populated by many immune cells, of which macrophages are among the most abundant. Clinical correlative data and a plethora of preclinical studies in mouse models of cancers have shown that tumour-associated macrophages (TAMs) play a cancer-promoting role. Within the primary tumour, TAMs promote tumour cell invasion and intravasation and tumour stem cell viability and induce angiogenesis. At the metastatic site, metastasis-associated macrophages promote extravasation, tumour cell survival and persistent growth, as well as maintain tumour cell dormancy in some contexts. In both the primary and metastatic sites, TAMs are suppressive to the activities of cytotoxic T and natural killer cells that have the potential to eradicate tumours. Such activities suggest that TAMs will be a major target for therapeutic intervention. In this Perspective article, we chronologically explore the evolution of our understanding of TAM biology put into the context of major enabling advances in macrophage biology.