The relationship between systemic inflammation and stoma formation following anterior resection for rectal cancer: a cross-sectional study

Introduction: There is evidence that temporary defunctioning stoma formation in patients undergoing anterior resection reduces the risk of anastomotic leakage. The aim of the present study was to investigate the relationship between stoma formation, the postoperative systemic inflammatory response and complications following anterior resection for rectal cancer. Methods: Data was recorded prospectively for patients who underwent anterior resection for histologically proven rectal cancer, from 2008 to 2015 at a single centre, n = 167. Patients had routine preoperative and postoperative blood sampling including serum C-reactive protein (CRP). Postoperative complications including anastomotic leakage were recorded. Results: Of the 167 patients, the majority were male (61%) and over 65 years old (56%) with node negative disease (60%). 36 patients (22%) underwent preoperative neoadjuvant treatment. 100 patients (60%) had a stoma formed at the time of surgery. Stoma formation was significantly associated with male sex (69% vs. 50%, p = 0.017), neoadjuvant chemoradiotherapy (30% vs 9%, p = 0.001) and open surgery (71% vs. 55%, p = 0.040). Of those 100 patients who had a stoma formed, 80 had it reversed. Permanent stoma was significantly associated with increasing age (p = 0.011), exceeding the established CRP threshold of 150 mg/L on postoperative day 4 (67% vs 37%, p = 0.039), higher incidence of postoperative complications (76% vs 47%, p = 0.035), anastomotic leakage (24% vs 2%, p = 0.003) and higher Clavien Dindo score (p = 0.036). Conclusions: There was no significant association between stoma formation during anterior resection and the postoperative systemic inflammatory response. However, in these patients both the postoperative systemic inflammatory response and complications were associated with permanent stoma

Bond option pricing under the CKLS model

Consider the European call option written on a zero coupon bond. Suppose the call option has maturity T and strike price K while the bond has maturity S T . We propose a numerical method for evaluating the call option price under the Chan, Karolyi, Longstaff and Sanders (CKLS) model in which the increment of the short rate over a time interval of length dt , apart from being independent and stationary, is having the quadratic-normal distribution with mean zero and variance dt. The key steps in the numerical procedure include (i) the discretization of the CKLS model; (ii) the quadratic approximation of the time-T bond price as a function of the short rate rT at time T; and (iii) the application of recursive formulas to find the moments of r(t+dt) given the value of r(t). The numerical results thus found show that the option price decreases as the parameter in the CKLS model increases, and the variation of the option price is slight when the underlying distribution of the increment departs from the normal distribution

Effects of Solder Temperature on Pin Through-Hole during Wave Soldering: Thermal-Fluid Structure Interaction Analysis

An efficient simulation technique was proposed to examine the thermal-fluid structure interaction in the effects of solder temperature on pin through-hole during wave soldering. This study investigated the capillary flow behavior as well as the displacement, temperature distribution, and von Mises stress of a pin passed through a solder material. A single pin throughhole connector mounted on a printed circuit board (PCB) was simulated using a 3D model solved by FLUENT. The ABAQUS solver was employed to analyze the pin structure at solder temperatures of 456.15 K (183∘C)

Mechanisms Of Fracturing In Structures Built From Topologically Interlocked Blocks

Failure of materials is in many cases associated with initiation and subsequent propagation of macroscopic fractures. Consequently, in order to increase the strength, one needs to inhibit either crack initiation or propagation. The principle of topological interlocking provides a unique opportunity to construct materials and structures in which both routes of the strength increase can be realised. Materials and structures built on the basis of this principle consist of many elements which are hold together by the special geometry of their shape, together with an external constrain. The absence of the binder phase between the elements allows the interfaces to arrest macroscopic crack propagation. In addition, with sufficiently small size of the elements an increase in local strength and, possibly, in the stress for crack initiation can be achieved by capitalising on the size effect. Furthermore, the ability of some interlocking structures to tolerate missing elements can serve to prevent the avalanche-type failure initiated by failure of one of the elements. In this paper, experimental results and a theoretical analysis with regard to this possibility are presented

Doing Biopolitics Differently? Radical Potential in the Post-2015 MDG and SDG Debates

Post print On institutional repository or subject-based repository after a 18 months embargo, withdraw

Self-assembly of quantum dots: effect of neighbor islands on the wetting in coherent Stranski-Krastanov growth

The wetting of the homogeneously strained wetting layer by dislocation-free three-dimensional islands belonging to an array has been studied. The array has been simulated as a chain of islands in 1+1 dimensions. It is found that the wetting depends on the density of the array, the size distribution and the shape of the neighbor islands. Implications for the self-assembly of quantum dots grown in the coherent Stranski-Krastanov mode are discussed.Comment: 4 pages, 6 figures, accepted version, minor change

Nrf2 Expression Is Regulated by Epigenetic Mechanisms in Prostate Cancer of TRAMP Mice

Nuclear factor-erythroid 2 p45-related factor 2 (Nrf2) is a transcription factor which regulates the expression of many cytoprotective genes. In the present study, we found that the expression of Nrf2 was suppressed in prostate tumor of the Transgenic Adenocarcinoma of Mouse Prostate (TRAMP) mice. Similarly, the expression of Nrf2 and the induction of NQO1 were also substantially suppressed in tumorigenic TRAMP C1 cells but not in non-tumorigenic TRAMP C3 cells. Examination of the promoter region of the mouse Nrf2 gene identified a CpG island, which was methylated at specific CpG sites in prostate TRAMP tumor and in TRAMP C1 cells but not in normal prostate or TRAMP C3 cells, as shown by bisulfite genomic sequencing. Reporter assays indicated that methylation of these CpG sites dramatically inhibited the transcriptional activity of the Nrf2 promoter. Chromatin immunopreceipitation (ChIP) assays revealed increased binding of the methyl-CpG-binding protein 2 (MBD2) and trimethyl-histone H3 (Lys9) proteins to these CpG sites in the TRAMP C1 cells as compared to TRAMP C3 cells. In contrast, the binding of RNA Pol II and acetylated histone H3 to the Nrf2 promoter was decreased. Furthermore, treatment of TRAMP C1 cells with DNA methyltransferase (DNMT) inhibitor 5-aza-2′-deoxycytidine (5-aza) and histone deacetylase (HDAC) inhibitor trichostatin A (TSA) restored the expression of Nrf2 as well as the induction of NQO1 in TRAMP C1 cells. Taken together, these results indicate that the expression of Nrf2 is suppressed epigenetically by promoter methylation associated with MBD2 and histone modifications in the prostate tumor of TRAMP mice. Our present findings reveal a novel mechanism by which Nrf2 expression is suppressed in TRAMP prostate tumor, shed new light on the role of Nrf2 in carcinogenesis and provide potential new directions for the detection and prevention of prostate cancer

Water Network Optimization with Wastewater Regeneration Models

The conventional water network synthesis approach greatly simplifies wastewater treatment units by using fixed recoveries, creating a gap for their applicability to industrial processes. This work describes a unifying approach combining various technologies capable of removing all the major types of contaminants through the use of more realistic models. The following improvements are made over the typical superstructure-based water network models. First, unit-specific shortcut models are developed in place of the fixed contaminant removal model to describe contaminant mass transfer in wastewater treatment units. Shortcut wastewater treatment cost functions are also incorporated into the model. In addition, uncertainty in mass load of contaminants is considered to account for the range of operating conditions. Furthermore, the superstructure is modified to accommodate realistic potential structures. We present a modified Lagrangean-based decomposition algorithm in order to solve the resulting nonconvex mixed-integer nonlinear programming (MINLP) problem efficiently. Several examples are presented to illustrate the effectiveness and limitations of the algorithm for obtaining the global optimal solutions.The authors would like to acknowledge financial support from the National Science Foundation for financial support under grant CBET-1437668, the program “Estancias de movilidad en el extranjero “Jose Castillejo” para jóvenes doctores” (JC2011-0051) of the Spanish Ministerio de Educación, and from the University of Alicante (GRE11-19)

In silico transcriptional regulation and functional analysis of dengue shock syndrome associated SNPs in PLCE1 and MICB genes

YesSingle nucleotide polymorphisms (SNPs) in PLCE1 and MICB genes increase risk for the development of dengue shock syndrome (DSS). We used Bioinformatics tools to predict alterations at the transcriptional and posttranslational levels driven by PLCE1 and MICB SNPs associated with DSS. Functional and phenotypic analysis conducted to determine deleterious SNPs and impact of amino acid substitution on the structure and function of proteins identified rs2274223 (H1619R) as deleterious to protein coding as it induces structural change in the C2 domain of PLCε, with the mutant residue more positively charged than the wild-type residue (RMSD score, 1.75 Å).Moreover, rs2274223 condenses the chromatinrepressing PLCε expression in DSS. Briefly, this study presents the impact of a single nucleotide transition at SNPs associated with DSS on differential protein binding patterns with PLCE1 and MICB genes and on protein structure modification and their possible role in the pathogenesis of DSS

Coronary artery calcification – distribution, extent and 1-year outcomes in patients with low to intermediate pre-test probability of coronary artery disease.

Background: Coronary artery calcium (CAC) is an established marker to predict major cardiovascular events (MACE), and has incremental value over traditional risk factors (CVRF). CAC is widely available, easily reproducible, and used in nearly all coronary computed tomography angiography (CCTA) assessment protocols for coronary artery disease (CAD). The distribution and extent of CAC, and its prognostic implications in local Malaysian patients with low to intermediate pre-test probability (LI-PTP) of CAD had not been established. Objectives: We aimed to establish the distribution, extent and prognostic implications of CAC in patients without known CAD, but with LI-PTP of CAD, undergoing CCTA for chest pain evaluation. Methods: Clinical information was obtained from consecutive patients who underwent CAC and CCTA examination from January 2020 to January 2021 at a single public access tertiary referral centre. The primary outcomes were the distribution and extent of CAC, and its relationship with MACE at 1 year. Results: Of 499 consecutive patients, 7 were excluded due to high PTP. CAC was present in 172/492 (35%). Within this group, 74/172 (41.3%) had CAC score of 1-100 (mild), 75/172 (42.4%) had a CAC of 101- 400 (moderate), 23/172 (13.4%) had CAC of >400 (high). 136 had suspected significant CAD and was offered conventional coronary angiography (CCA). 91/492 underwent CCA, and 38 were found to have significant CAD. Of those found to have significant CAD, 7/38 (18.4%) had CAC of zero, 8/38 (21.1%) had mild CAC, 12/38 (31.6%) moderate, and 11/38 (30%) high CAC. Severe CAC was associated with a higher rate of revascularization 11/23 (47.8%), compared to those with zero 7/320 (2.2%), mild 8/74 (10.8%) and moderate 12/75 (16%) CAC. Predictors of high CAC were age, male gender, and presence of cardiovascular disease risk factors. Of the 492 patients, 230 patients completed 1 year follow-up, and from this, 1 patient had a MACE. Conclusion In patients with LI-PTP risk of CAD, CAC was seen in approximately one third of our cohort. In the group with high CAC, a higher proportion required coronary revascularization, but MACE remained low at 1 year