Cardioplastic Approach to Omental Flap Coverage for Severe Aortic Root Infections in the Opioid Era

Aortic root abscesses are severe sequelae of endocarditis that clinically manifest as life-threatening infection. As the opioid epidemic continues to yield a national crisis, the incidence and severity of this disease process have increased. Reconstruction of the aortic root is a challenging undertaking and carries the risk of recurrent infection. The omentum has an established reputation as a reliable flap in thoracic reconstruction, given its amorphous form and immunogenic properties, but it has not been utilized for aortic root infections. We present a novel indication for the omental flap using a cardioplastic approach in coverage of aortic root reconstruction. Four patients were treated with pedicled omental flap coverage after aortic root reconstruction. All patients had successful flap healing with no evidence of recurrent infection. This series demonstrates the technical feasibility and clinical utility for providing soft tissue coverage and antimicrobial protection when used in aortic root reconstruction

Calibration and Irradiation Study of the BGO Background Monitor for the BEAST II Experiment

Beam commissioning of the SuperKEKB collider began in 2016. The Beam Exorcism for A STable experiment II (BEAST II) project is particularly designed to measure the beam backgrounds around the interaction point of the SuperKEKB collider for the Belle II experiment. We develop a system using bismuth germanium oxide (BGO) crystals with optical fibers connecting to a multianode photomultiplier tube (MAPMT) and a field-programmable gate array (FPGA) embedded readout board for monitoring the real-time beam backgrounds in BEAST II. The overall radiation sensitivity of this system is estimated to be $(2.20\pm0.26)\times10^{-12}$ Gy/ADU (analog-to-digital unit) with the standard 10 m fibers for transmission and the MAPMT operating at 700 V. Our $\gamma$-ray irradiation study of the BGO system shows that the exposure of BGO crystals to $^{60}$Co $\gamma$-ray doses of 1 krad has led to immediate light output reductions of 25--40%, and the light outputs further drop by 30--45% after the crystals receive doses of 2--4 krad. Our findings agree with those of the previous studies on the radiation hard (RH) BGO crystals grown by the low thermal gradient Czochralski (LTG Cz) technology. The absolute dose from the BGO system is also consistent with the simulation, and is estimated to be about 1.18 times the equivalent dose. These results prove that the BGO system is able to monitor the background dose rate in real time under extreme high radiation conditions. This study concludes that the BGO system is reliable for the beam background study in BEAST II

Information theoretical analysis of two-party secret computation

Abstract. Privacy protection has become one of the most important issues in the information era. Consequently, many protocols have been developed to achieve the goal of accomplishing a computational task cooperatively without revealing the participants' private data. Practical protocols, however, do not guarantee perfect privacy protection, as some degree of privacy leakage is allowed so that resources can be used efficiently, e.g., the number of random bits required and the computation time. A metric for measuring the degree of information leakage based on an information theoretical framework was proposed i

Neoadjuvant anti-PD-1 immunotherapy promotes a survival benefit with intratumoral and systemic immune responses in recurrent glioblastoma.

Glioblastoma is the most common primary malignant brain tumor in adults and is associated with poor survival. The Ivy Foundation Early Phase Clinical Trials Consortium conducted a randomized, multi-institution clinical trial to evaluate immune responses and survival following neoadjuvant and/or adjuvant therapy with pembrolizumab in 35 patients with recurrent, surgically resectable glioblastoma. Patients who were randomized to receive neoadjuvant pembrolizumab, with continued adjuvant therapy following surgery, had significantly extended overall survival compared to patients that were randomized to receive adjuvant, post-surgical programmed cell death protein 1 (PD-1) blockade alone. Neoadjuvant PD-1 blockade was associated with upregulation of T cell- and interferon-γ-related gene expression, but downregulation of cell-cycle-related gene expression within the tumor, which was not seen in patients that received adjuvant therapy alone. Focal induction of programmed death-ligand 1 in the tumor microenvironment, enhanced clonal expansion of T cells, decreased PD-1 expression on peripheral blood T cells and a decreasing monocytic population was observed more frequently in the neoadjuvant group than in patients treated only in the adjuvant setting. These findings suggest that the neoadjuvant administration of PD-1 blockade enhances both the local and systemic antitumor immune response and may represent a more efficacious approach to the treatment of this uniformly lethal brain tumor

Suitability for salt-lick tourism: A preliminary assessment on the natural saltlicks at Segaliud-Lokan Forest Reserve, Sandakan, Sabah

The natural salt-licks are visited by various species of terrestrial mammals, hence ideal for mammal watching, although the suitability for salt-lick tourism is influenced by other factors. Preliminary research was conducted on the suitability of four natural salt-licks for mammal watching in Segaliud-Lokan Forest Reserve (SLFR), Sabah. The camera trapping survey and field assessment were conducted for eight months, and then the assessment criteria applied in this study included the lick accessibility, detection frequency, species richness, viewable activity sighting probability, reliability and visibility on the terrestrial mammals, at a given lick. A total of 12 different mammal species were recorded, where Sambar Deer, Bearded Pig, Banteng, and Bornean Orang-utan were determined as the main visitor species of this study. Among the four selected salt-licks, the rating score of SL50A (Score=1.71) was significantly lower than those of SL50B, SL56 and SL59 (Score=2.57 respectively, χ2 2=6.794, p=0.042), hence highlighting that SL50A was not suitable for conducting mammal watching activity, unlike the other three natural licks at SLFR. The assessment on the compatibility between the supply (mammalian physical availability) and demand (highly anticipated species) was excluded from this research, therefore emphasizing the need to fill up this particular research gap in the future

Long-Term Relations Among Prosocial-Media Use, Empathy, and Prosocial Behavior

Despite recent growth of research on the effects of prosocial media, processes underlying these effects are not well understood. Two studies explored theoretically relevant mediators and moderators of the effects of prosocial media on helping. Study 1 examined associations among prosocial- and violent-media use, empathy, and helping in samples from seven countries. Prosocial-media use was positively associated with helping. This effect was mediated by empathy and was similar across cultures. Study 2 explored longitudinal relations among prosocial-video-game use, violent-video-game use, empathy, and helping in a large sample of Singaporean children and adolescents measured three times across 2 years. Path analyses showed significant longitudinal effects of prosocial- and violent-video-game use on prosocial behavior through empathy. Latent-growth-curve modeling for the 2-year period revealed that change in video-game use significantly affected change in helping, and that this relationship was mediated by change in empathy

Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines

Diagnostic and therapeutic strategies for acute biliary inflammation/ infection (acute cholangitis and acute cholecystitis), according to severity grade, have not yet been established in the world. Therefore we formulated flowcharts for the management of acute biliary inflammation/ infection in accordance with severity grade. For mild (grade I) acute cholangitis, medical treatment may be sufficient/appropriate. For moderate (grade II) acute cholangitis, early biliary drainage should be performed. For severe (grade III) acute cholangitis, appropriate organ support such as ventilatory/circulatory management is required. After hemodynamic stabilization is achieved, urgent endoscopic or percutaneous transhepatic biliary drainage should be performed. For patients with acute cholangitis of any grade of severity, treatment for the underlying etiology, including endoscopic, percutaneous, or surgical treatment should be performed after the patient's general condition has improved. For patients with mild (grade I) cholecystitis, early laparoscopic cholecystectomy is the preferred treatment. For patients with moderate (grade II) acute cholecystitis, early laparoscopic or open cholecystectomy is preferred. In patients with extensive local inflammation, elective cholecystectomy is recommended after initial management with percutaneous gallbladder drainage and/or cholecystostomy. For the patient with severe (grade III) acute cholecystitis, multiorgan support is a critical part of management. Biliary peritonitis due to perforation of the gallbladder is an indication for urgent cholecystectomy and/or drainage. Delayed elective cholecystectomy may be performed after initial treatment with gallbladder drainage and improvement of the patient's general medical condition. © Springer-Verlag Tokyo 2007.published_or_final_versio

Kinetic roughening of surfaces: Derivation, solution and application of linear growth equations

We present a comprehensive analysis of a linear growth model, which combines the characteristic features of the Edwards--Wilkinson and noisy Mullins equations. This model can be derived from microscopics and it describes the relaxation and growth of surfaces under conditions where the nonlinearities can be neglected. We calculate in detail the surface width and various correlation functions characterizing the model. In particular, we study the crossover scaling of these functions between the two limits described by the combined equation. Also, we study the effect of colored and conserved noise on the growth exponents, and the effect of different initial conditions. The contribution of a rough substrate to the surface width is shown to decay universally as $w_i(0) (\xi_s/\xi(t))^{d/2}$, where $\xi(t) \sim t^{1/z}$ is the time--dependent correlation length associated with the growth process, $w_i(0)$ is the initial roughness and $\xi_s$ the correlation length of the substrate roughness, and $d$ is the surface dimensionality. As a second application, we compute the large distance asymptotics of the height correlation function and show that it differs qualitatively from the functional forms commonly used in the intepretation of scattering experiments.Comment: 28 pages with 4 PostScript figures, uses titlepage.sty; to appear in Phys. Rev.

GPIHBP1 expression in gliomas promotes utilization of lipoprotein-derived nutrients

GPIHBP1, a GPI-anchored protein of capillary endothelial cells, binds lipoprotein lipase (LPL) within the subendothelial spaces and shuttles it to the capillary lumen. The GPIHBP1-bound LPL is essential for the margination of triglyceride-rich lipoproteins (TRLs) along capillaries, allowing the lipolytic processing of TRLs to proceed. In peripheral tissues, the intravascular processing of TRLs by the GPIHBP1-LPL complex is crucial for generating lipid nutrients for adjacent parenchymal cells. GPIHBP1 is absent in capillaries of the brain, which uses glucose for fuel; however, GPIHBP1 is expressed in capillaries of mouse and human gliomas. Importantly, the GPIHBP1 in glioma capillaries captures locally produced LPL. We document, by NanoSIMS imaging, that TRLs marginate along glioma capillaries and that there is uptake of TRL-derived lipid nutrients by surrounding glioma cells. Thus, GPIHBP1 expression in gliomas facilitates TRL processing and provides a source of lipid nutrients for glioma cells