The structure and innervation of the sphincters in the large intestine of the domestic duck (Anas platyrhynchos)

(1) The aim of the thesis was to investigate the presence of anatomical sphinc¬ ters at the ileo-caeco-rectal junction and recto-coprodeal junction of the large intestine of birds using the domestic duck ( Anas platyrhynchos ) as the subject(2) The methods used to study the anatomy of the digestive tract sphincters, the evidence for the existence of sphincters in the large intestine of birds, and the anatomical evidence for the existence of sphincters at the gastro-oesophageal, gastro-duodenal, and ileo-caecal junctions of mammals were outlined.(3) The detailed objectives were as follows. (a) To study the arrangement of the muscle at the ileo-caeco-rectal junction and recto-coprodeal junction using light and transmission electron microscopy and, in the case of the ileo-caeco-rectal junction, by the construction of 3-D models of the circular muscle and by scanning electron microscopy. (b) To study the ultrastructure of the muscle cell at the junctions and to provide quantitative data on their size by estimating the length and volume. (c) To study the ultrastructure of the nerve bundles at the junctions and to provide quantitative data on the number of nerve bundles and axon profiles in the circular muscle layer.(4) The arrangement of the muscle at the ileo-caeco-rectal and recto-coprodeal junctions was investigated in adult birds by means of gross observations, light microscopy and reconstruction models. (a) The muscle layers in the wall of the terminal part of the ileum consisted of four closely apposed layers including the inner longitudinal layer, the inner circular layer, the outer circular layer and the outer longitudinal layer. (b) The muscle in the wall of the caeca and rectum consisted of three layers including the muscularis mucosae ( inner longitudinal muscle layer ), the circular muscle layer and the outer longitudinal muscle layer. The inner portion of the circular muscle layer was found to be absent in the large intestine. (c) The muscle layer in the ileal papilla was composed only of the musculario mucosae and the circular layer, the outer longitudinal muscle layer being absent. There was no evidence for the existence of cells which were characteristic of the inner portion of the circular layer. The muscle layers around the caecal orifice consisted of the muscularis mucosae, the circular layer and the longitudinal layer. (d) The muscularis mucosae in the terminal part of the ileum was thickened at the base of the ileal papilla and was continuous laterally with the muscularis mucosae of the caeca. At the base of each caecum it was thickened and became continuous medially with the muscularis mucosae of the papilla and laterally with the muscularis mucosae of the rectum. At the recto-coprodeal junction the muscularis mucosae was slightly thickened and became continuous distally with the muscularis mucosae of the coprodeum. (e) The longitudinal muscle of the ileum did not extend into the ileal papilla. Immediately proximal to the base of the papilla it was thickened and became continuous caudally with the longitudinal muscle of the rectum. At the base of each caecum the longitudinal muscle was thickened and became continuous caudally with the longitudinal muscle of the rectum. The longitudinal muscle of the recto-coprodeal junction was not thickened. It was continuous caudally with the longitudinal muscle of the coprodeum. (f) The circular muscle of the terminal part of the ileum was massively thickened at the base of the ileal papilla forming a thick muscular ring, the ileal sphincter. The circular muscle of the caeca was thickened forming muscular rings at the caecal orifices, the right and left caecal sphincters. These three muscular rings were continuous. The circular muscle layer in the caudal part of the rectum was slightly thickened 1-2 mm cranial to the recto-coprodeal junc¬ tion forming an obliquely orientated sphincter.(5) The ultrastructure of the muscle cells was investigated in adult birds, by means of transmission electron microscope. (a) The ultrastructure of the muscle cells was basically similar to the struc¬ ture of the mammalian visceral muscle cells. The main part of the cell was occupied by three different types of myofilaments. Dense bodies were scattered throughout the cytoplasm among the myofilaments and associated with the thin myofilaments. Dense bands were wide and attached to large areas of the cell membrane. The plasma membrane of the cell was lined with numerous regular vesicles, the caveolae. Smooth endoplasmic reticulum was observed in the form of long tubules or as a lace-like network. Other cytoplasmic contents included free ribosomes, rough endoplasmic reticulum, microtubules and centrioles. (b) Two types of intercellular junction were identified. The gap junctions (nexuses) were found mainly in the circular muscle layer of the junction regions whilst the intermediate junctions were formed between the dense bands of cy¬ toplasm of adjacent cells. (c) These findings were discussed in relation to the available ultrastructural information of the muscle cells in the chicken and other classes of vertebrates.(6) The size of the muscle cells in three adult birds was calculated by estimating their length and volume using the stereological method of Gabella ( 1976 ). (a) The longest muscle cells at the ileo-caeco-rectal junction occurred in the circular muscle layer at the base of the ileal papilla and around the caecal ori¬ fices. The muscle cells at the base of the ileal papilla were tended to belonger than those in the ileum and rectum 5 mm from the junction.The muscle cells around the caecal orifice were longer than those in the caecum and rectum 5 mm from the junction. At the recto-coprodeal junction the muscle cells in the circular layer were evidently longer than those in the rectum and coprodeum 5 mm from the junction. (b) The largest volume of the muscle cells occurred at the junctional regions of the large intestine. The muscle cells at the base of the ileal papilla had an apparently larger volume than those in the ileum and rectum 5 mm from the ileo-caeco-rectal junction. The muscle cells around the caecal orifices had a generally larger volume than those in the caecum and rectum 5 mm from the junction. The muscle cells at the recto-coprodeal junction had a somewhat larger volume than those in the rectum and coprodeum 5 mm from the junction. (c) The differences in the cell length and volume between the sphincter and non-sphincter regions were discussed and compared with similar data in other vertebrates.(7) The distribution and the ultrastructure of the nerve bundles in the muscle layers was investigated in adult birds by means of the transmission electron microscope. (a) Nerve bundles and vesiculated axon profiles were distributed mainly throughout the circular muscle layer and were rarely seen in the inner and outer longitudinal layers. (b) Numerous nerve bundles, the plexus muscularis profundus, were observed in the connective tissue between the inner and outer portions of the circular muscle in the terminal part of the ileum. (c) Small and large axon profiles were identified. Small axon profiles contained mainly microtubules and neurofilaments, whilst large profiles contained mainly granular and agranular vesicles. Three types of axon profile terminals were described. The first type of profile contained predominantly agranular vesicles and was probably cholinergic. The second type of axon contained small granular vesicles and a varying number of agranular vesicles and was probably adrenergic. The third type of profile contained mainly large granular vesicles and many agranular vesicles and was probably peptidergic. (d) The non-neuronal cells were Schwann cells, interstitial cells and fibrob¬ lasts. Schwann cells gave rise to many long, thin processes which ensheathed many axons. Some structural differences between the interstitial cells and fibroblasts were observed. (e) These observations were discussed in the light of the available ultrastructural information in other classes of vertebrates.(8) The density of innervation in the circular muscle of the junctional regions was estimated in ten adult birds by counting the number of nerve bundles and axon profiles, and the percentage of vesiculated axon profiles per approximately 1000 muscle cells. (a) The muscular rings at the base of the ileal papilla and around the caecal orifices were more innervated than the non-thickened circular muscle of the ileum, caecum and rectum 5 mm from the ileo-caeco-rectal junction. The innervation of the circular muscle at the recto-coprodeal junction was denser than the innervation of the circular muscle in the rectum and coprodeum 5 mm from the junction. (b) The total number of axon profiles was greater at the base of the ileal papilla and around the caecal orifices than in the circular muscle of the ileum, caecum and rectum 5 mm from the junction. At the recto-coprodeal junction the total number of axon profiles was also greater at the junction than in the rectum and coprodeum 5 mm from the junction. (c) The number of vesiculated axon profiles and their percentage of the total number of axon profiles was significantly greater in the circular muscle at the base of the ileal papilla and around the caecal orifice than in the circular muscle of the ileum, caecum and rectum 5 mm from the junction. At the recto-coprodeal junction the number of the vesiculated axon profiles and their percentage was also significantly greater than in the rectum and coprodeum 5 mm from the junction. (d) The innervation of the thickened rings at the base of the ileal papilla and around the caecal orifices was significantly denser and contained more vesiculated axon profiles than in the ileum, caecum and rectum 5 mm from the junction. At the recto-coprodeal junction the innervation of the circular muscle was also significantly denser and contained more vesiculated axons than in the circular muscle of the rectum and coprodeum 5 mm from the junction.(9) The discussion of the present observations in relation to the available information on sphincter function and intestinal motility shows the need for physiological studies on the junctional regions of the avian large intestine

Correction to: the role of the complement system in traumatic brain injury: a review

Abstract After publication of the article [1], it was brought to our attention that Tables 1 and 2 were missing from the final manuscript, These tables can be seen below and have now been added to the revised version of the article

Long-term clinical outcomes of percutaneous coronary intervention in saphenous vein grafts in a low to middle-income country

Background: Revascularization of saphenous vein grafts (SVGs) is challenging and debated for the last few decades. The percutaneous revascularization of SVGs was reported to have poorer long-term outcomes than native coronary artery revascularization.Purpose: We aim to study the peri-procedural complications and long-term outcomes of the percutaneous revascularization of SVGs in a low-middle-income country.Methods: In this retrospective study, we included 110 patients who underwent percutaneous revascularization from January 2011 to March 2020 and followed them retrospectively for long-term outcomes and major adverse cardiovascular events.Results: The mean age was 71 ±9, and 81% were male. The most common reason for the presentation was non-ST segment elevation myocardial infarction (NSTEMI) (46%). The mean follow-up period of the study was 48±27 months. The most common comorbidity was hypertension (86%). A drug-eluting stent (80%) was placed in most of the patients, followed by a bare-metal stent (BMS) (14%) and percutaneous balloon angioplasty (POBA) (6%). We did not find any significant difference in major adverse cardiac events (MACE) (P=0.48), target vessel revascularization (TVR) (p=0.69), and target lesion revascularization (TLR) (p=0.54) with drug-eluting stent (DES) as compared to either BMS or POBA. The mean period from coronary artery bypass grafting (CABG) to SVG percutaneous coronary intervention (PCI) was 15± 5.5 years. Multivariate Cox regression analysis showed that an acute coronary syndrome (ACS) event, stroke, and female sex were independently associated with MACE.Conclusion: The long-term outcomes of SVG PCI are not affected by the types of stents. Female gender, ACS, and stroke are the independent predictors of MACE after SVG PCI, and statin therapy has a positive impact on the long-term outcomes of SVG PCI

Random forest models for motorcycle accident prediction using naturalistic driving based big data

Motorcycle accident studies usually rely upon data collected from road accidents collected through questionnaire surveys/police reports including characteristics of motorcycle riders and contextual data such as road environment. The present study utilizes big data, in the form of vehicle trajectory patterns collected through GPS, coupled with self-reported road accident information along with motorcycle rider characteristics to predict the likelihood of involvement of a motorcyclist in an accident. Random Forest-based machine learning algorithm is employed by taking inputs based on a variety of features derived from trajectory data. These features are mobility-based features, acceleration event-based features, aggressive overtaking event-based features and motorcyclists socio-economic features. Additionally, the relative importance of features is also determined which shows that aggressive overtaking event-based features have more impact on motorcycle accidents as compared to other categories of features. The developed model is useful in identifying risky motorcyclists and implementing safety measures focused towards them

Prediction Model for Construction Cost and Duration in Jordan

Risk is mitigated in the course of reliable prediction. A probabilistic model is proposed to predict the risk effects on time and cost of construction projects. Project managers and consultants can use the model in estimating project cost and duration based on historic data. Statistical regression models and sample tests are developed using real data of 140 projects. The research objective is to develop a model to predict project cost and duration based on historic data of similar projects. The model result can be used by project managers in the planning phase to validate the schedule critical path time and project budget. Research methodology is steered per the following progression: i) Conduct nonparametric test for project cost and time performance. ii) Develop generic multiple-regression models to predict project cost and duration using historic performance data. iii) The percent prediction error is statistically analyzed; and found to be substantial; thus, iv) Custom multiple regression models are developed for each project type to obtain statistically reliable results. In conclusion, the 95% point estimation of error margin= ±0.035%. Therefore, at a probability of 95%, the proposed model predicts the project cost and duration with a precision of ±0.035% of the mean cost and time

In silico elucidation of potential drug target sites of the Thumb Index Fold Protein, Wnt-8b

Purpose: The involvement of Wnt-8b in Wnt signaling pathway leads to various  cancers. The purpose of this study was to determine the therapeutic compounds from the available library by targeting Wnt-8b using molecular docking analyses.Methods: Threading and comparative modeling approaches were employed to predict the 3D structure of Wnt-8b. Sixty-eight models were evaluated using molprobity, ERRAT and rampage evaluation tools and the model having 82.456 % overall quality value was selected for further analyses. The acyl group was added to the suitable model to satisfy the hydrophobic nature of the Wnt-8b. Literature-derivedcompounds were selected for comparative molecular docking studies using GOLD, AutoDock and AutoDock Vina. Furthermore, docked complexes were analyzed and visualized using Chimera and Ligplot.Results: The compound ZINC04029462 exhibited high binding potential with Wnt-8b and palmitoleic acid and was found common among top 20 compounds of each tool. His-183, Val-185, Ser-186, Gly-187, Ser-188 and Thr-190 residues commonly interacted with compounds and palmitoleic acid and considered as potential interacting residues.Conclusion: Common interacting residues from top 20 compounds of each tool suggest that these compounds may be utilized to inhibit aberrant expression of Wnt-8b. The common inhibitor ZINC04029462 may act as a lead compound for further drug designing against Wnt family.Keywords: Wnt-8b, Cancer, Homology modeling, Molecular docking, AutoDoc

China-Pakistan Economic Corridor: News Framing in Political, Strategic, and Economic Perspectives in Print Media of Pakistan

The treatment, image, and issues related to CPEC become significant when this venture is considered a game-changer for the Pakistani economy. This study analyzes the CPEC coverage in Pakistan's highly circulated English newspaper, Daily Dawn, and The News. The quantitative content analysis technique is employed for this study from April 2015 to December 2019. This study aims to explore how news contents of selected newspapers portray the image of CPEC and the treatment of selected newspapers toward this project. The theoretical foundation of this study work under the Grunig models of Public Relations. The findings of this study reveal that both newspapers portray a positive image of CPEC. The primary focus of the news content of selected newspapers is information regarding the economic and political aspects of this project, while inadequate significance is given to strategic, social, and legal aspects. Moreover, from Grunig’s models' perspective, major public relations practices worked under the public information and press agent mode

High CD44 immunoexpression correlates with poor overall survival: Assessing the role of cancer stem cell markers in oral squamous cell carcinoma patients from the high-risk population of Pakistan

Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the Pakistani population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells, called cancer stem cells (CSCs), are responsible for tumour progression, treatment resistance, and metastasis, which leads to a poor prognosis. This study investigated the impact of CSC markers expression on overall survival (OS) and disease-free survival (DFS) of OSCC patients. Materials and Methods. Immunohistochemistry was used to evaluate CD44, CD133, L1CAM, and SOX2 expression in a well-characterized cohort of 100 Pakistani patients with primary treatment naïve OSCC. The immunoreactivity for each marker was correlated with patient clinicopathologic characteristics, oral cancer risk chewing habits, and survival. The minimum follow-up time for all patients was five years, and survival estimates were calculated using the Kaplan-Meier method and Cox proportional hazards model. Results. In this cohort of 100 patients, there were 57 males and 43 females. The median OS and DFS time durations observed were 64 and 52.5 months, respectively. Positive expression for CD44, CD133, L1CAM, and SOX2 was observed in 33%, 23%, 41%, and 63% of patients. High CD44 expression correlated with decreased OS (P=0.047) but did not influence DFS. However, CD133, L1CAM, and SOX2 had no effect on either OS or DFS. Tonsils, nodal involvement, and AJCC stage were independent predictors of worse OS and DFS both. Conclusion. Of the CSC markers investigated here, only CD44 was a predictor for poor OS. CD44 was also associated with advanced AJCC and T stages. Interestingly, CD133 was significantly lower in patients who habitually consumed oral cancer risk factors

Spatial clustering of emergency department visits by asthmatic children in an urban area: south-western Detroit, Michigan

Objective This ecological study evaluates the correlation of asthma clusters with outdoor air pollution, race, and household income in South-western Detroit, Michigan. Design To attain this objective (1) a geographic information aystem (GIS) is utilized to evaluate the relationships between rates of emergency department (ED) admissions for asthma, race, and socio-economic status at the neighborhood block group level of analysis; (2) cluster statistical analyses are performed using Geomed software; and (3) the asthma risk from industrial air pollution was evaluated with windrose data and Screen3 air pollution model. Sample Data from five major hospitals with ED admissions of asthma patients (code 493), aged 0–15 years, are used to select a region of analysis with good geographical representation based on the catchment areas of hospitals in the study. A total of 2067 of the reported cases between 1 January 1993 and 30 June 1998, are successfully geocoded to a map, generating a no-match rate of 8.4%. Data on racial characteristics, population density, and household income levels are obtained from neighborhood block groups in the 1990 census report. Locations of major polluting industries within the study area are obtained from the Toxics Release Inventory. Results Spatial analysis identified a local asthma cluster roughly 2 km east (the predominant downwind direction) of the second and third largest air polluters (in terms of tonnage) in Wayne County. Evaluation of the industrial pollution with a focused cluster test, Screen3 air pollution model, and windrose figures, displayed weak association between ED asthma admissions and estimated levels of outdoor air pollution from these two facilities. The neighborhood block groups in the local asthma cluster are more closely correlated with high proportions of African Americans and low median household income. Implications for practice This study illustrates the strengths and weaknesses of GIS in the public health arena. It highlights the difficulty of disentangling the effects of exposure to outdoor air pollutants and socio-economic factors on ED asthmatics (reflecting asthma severity) among an urban population. This study also illustrates the need for population-based, as opposed to hospital-based, asthma data, and the need for block-groups, as opposed to zip codes, as a spatial unit of analysis in the evaluation and analysis of asthma-related risk factors.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73994/1/j.1467-0658.2001.00143.x.pd

Total parotidectomy under local anesthesia: A novel technique

Parotidectomy is a common procedure usually done for a parotid mass necessitating a histological diagnosis. Operation is normally performed under General anesthesia with a nerve stimulator to facilitate facial nerve stimulation. We describe a new technique with reports of three cases, making total parotidectomy under local anesthesia possible. The ascending cervical branch of cervical plexus and the auriculotemporal nerve were anesthetized by bupivacaine 0.25% (2mg/kg) and lignocaine with adrenaline 7 mg/kg. Effective onset of anesthesia was within 15-25 minutes and the operations lasted between 2-3 hours without any complications. This offers advantage in high-risk patients where general anesthesia is contraindicated. The facial nerve can be easily identified with on command movements by the patient rendering the use of nerve stimulator or injection of the dye superfluous. This technique makes total parotidectomy an outpatient procedure and facilitates an early discharge