Laparoscopic Sacral Colpopexy: A Proposed Technique

This case report describes a laparoscopic sacral colpopexy using Mersilene mesh in a patient with complete vaginal vault prolapse. Mersilene mesh was placed as a hammock between the vaginal apex and the anterior surface of the sacrum, using intracorporeal needles and an extracorporeal knot tying technique. Minor modifications are made from the traditional abdominal approach, because the patient had previously undergone a pelvic lymphadenectomy and vaginal cuff radiation for a stage IB grade 1 adenocarcinoma of the endometrium

Differential Pharmacological Actions of Methadone and Buprenorphine in Human Embryonic Kidney 293 Cells Coexpressing Human μ-Opioid and Opioid Receptor-Like 1 Receptors

Methadone and buprenorphine are used in maintenance therapy for heroin addicts. In this study, we compared their effects on adenylate cyclase (AC) activity in human embryonic kidney (HEK) 293 cells stably overexpressing human μ-opioid receptor (MOR) and nociceptin/opioid receptor-like 1 receptor (ORL1) simultaneously. After acute exposure, methadone inhibited AC activity; however, buprenorphine induced compromised AC inhibition. When naloxone was introduced after 30 min incubation with methadone, the AC activity was enhanced. This was not observed in the case of buprenorphine. Enhancement of the AC activity was more significant when the incubation lasted for 4 h, and prolonged exposure to buprenorphine elevated the AC activity as well. The removal of methadone and buprenorphine by washing also obtained similar AC superactivation as that revealed by naloxone challenge. The study demonstrated that methadone and buprenorphine exert initially different yet eventually convergent adaptive changes of AC activity in cells coexpressing human MOR and ORL1 receptors

The Performance of Non-Redundant Striping in a SSA Disk Array

An increasingly popular method of improving I/O performance is by distributing data across multiple disks in parallel. This organization of data is called striping, and a group of disks organized in this manner is called a disk array. This work investigates the performance of striping data in an array of Serial Storage Architecture (SSA) disks connected in a loop topology

US Department of Agriculture and global biogenome initatives: policy challenges and opportunities

Biodiversity research is seeing unprecedented global collaboration with initiatives such as the Earth BioGenome Project, an effort to sequence all known eukaryotic life, and Genesys, a global database for sharing crop genetic resources. However, as in other disciplines, public funding and policy for scientific research in agriculture tend to follow national borders even when science and its collaborations do not. In addition, agriculture is similar to biomedicine in having significant private investment in research and development where competition could inhibit sharing. It would seem that significant challenges lie ahead for making progress on ambitious global initiatives at least where agricultural samples, collections, and data are concerned. In this talk we will review several activities at the United States Department of Agriculture that illustrate how policy and infrastructure can overcome difficulties. For example, recent policies for openness of publicly-funded research products and adoption of FAIR data principles even for private or proprietary data hold promise and have elevated the importance of data infrastructure. The US Department of Agriculture's Agricultural Research Service (ARS) launched its Ag100Pest contribution to the Earth BioGenome Project, including the use of the i5K Workspace@NAL platform for its sequenced and annotated genomes. The GRIN Global platform supports not just USDA germplasm data management but a growing network of plant and animal researchers and collections around the world. The Ag Data Commons provides standardized metadata and machine-readable data dictionaries to the publicly accessible products of these and other USDA-funded efforts. It is teaming with the ARS high performance computing system SCINet to explore cost-effective public access to big data storage for agricultural data and models. Finally, many of these efforts extend and contribute back to widely used open source software systems. While challenges remain in coordinating and sustaining these efforts with international stakeholders, engagement with groups like AgBioData, the Research Data Alliance (RDA) Interest Group on Agricultural Data, and the Global Open Data for Agriculture and Nutrition coalition will continue to bear fruit (pun intended). We seek similar engagement with the broader biodiversity data community in order to ensure that policy and infrastructure investments result in maximum mutual benefit

Differences in Outcomes Based on Sex for Pediatric Patients Undergoing Pyloromyotomy

BackgroundMales and females are known to have varied responses to medical interventions. Our study aimed to determine the effect of sex on surgical outcomes after pyloromyotomy.Materials and methodsUsing the Kids' Inpatient Database for the years 2003-2012, we performed a serial, cross-sectional analysis of a nationally representative sample of all patients aged <1 y who underwent pyloromyotomy for hypertrophic pyloric stenosis. The primary predictor of interest was sex. Outcomes included mortality, in-hospital complications, cost, and length of stay. Regression models were adjusted by race, age group, comorbidity, complications, and whether operation was performed on the day of admission with region and year fixed effects.ResultsOf 48,834 weighted operations, 81.8% were in males and 18.2% were in females. The most common reported race was white (47.3%) and most of the patients were ≥29 days old (72.5%). There was no difference in the odds of postoperative complications, but females had a significantly longer length of stay (incidence rate ratio, 1.28; 95% confidence interval [95% CI], 1.18-1.39; P ≤ 0.01), higher cost (5%, 95% CI, 1.02-1.08; P ≤ 0.01), and higher odds of mortality (odds ratio, 3.26; 95% CI, 1.52-6.98; P ≤ 0.01).ConclusionsOur study demonstrated that females had worse outcomes after pyloromyotomy compared with males. These findings are striking and are important to consider when treating either sex to help set physician and family expectations perioperatively. Further studies are needed to determine why such differences exist and to develop targeted treatment strategies for both females and males with pyloric stenosis