Renal Cell Carcinoma with IVC Thrombus Extending up to Right Atrium and Triple Vessel Coronary Artery Disease - One-stage uro-cardiac Procedure: A case Report

Introduction: The aim of this report is to prove the possibility of simultaneous difficult cardiac and urologic operation. Important point to make in our report concerns the fact that the oncologic treatment was not delayed despite severe heart disease. There is also an advantage in avoiding second operation and hence anesthesiaCase Presentation: A 72 year old male presented to us with right renal mass lesion with tumour thrombus extending up to right atrium. He had undergone Percutaneous Transluminal Coronary Angioplasty 5 years ago and had two coronary stents in situ. Coronary angiography revealed triple vessel coronary re obstruction. After proper planning he underwent right radical nephrectomy with tumour thombectomy along with Coronary Artery Bypass Grafting in the same sitting.Conclusion: One-stage cardiac and uro-oncologic operation can be a safe and beneficial procedure, if performed in selected patients

Expression of A152T human tau causes age-dependent neuronal dysfunction and loss in transgenic mice.

A152T-variant human tau (hTau-A152T) increases risk for tauopathies, including Alzheimer's disease. Comparing mice with regulatable expression of hTau-A152T or wild-type hTau (hTau-WT), we find age-dependent neuronal loss, cognitive impairments, and spontaneous nonconvulsive epileptiform activity primarily in hTau-A152T mice. However, overexpression of either hTau species enhances neuronal responses to electrical stimulation of synaptic inputs and to an epileptogenic chemical. hTau-A152T mice have higher hTau protein/mRNA ratios in brain, suggesting that A152T increases production or decreases clearance of hTau protein. Despite their functional abnormalities, aging hTau-A152T mice show no evidence for accumulation of insoluble tau aggregates, suggesting that their dysfunctions are caused by soluble tau. In human amyloid precursor protein (hAPP) transgenic mice, co-expression of hTau-A152T enhances risk of early death and epileptic activity, suggesting copathogenic interactions between hTau-A152T and amyloid-β peptides or other hAPP metabolites. Thus, the A152T substitution may augment risk for neurodegenerative diseases by increasing hTau protein levels, promoting network hyperexcitability, and synergizing with the adverse effects of other pathogenic factors

A mammalian enhancer trap resource for discovering and manipulating neuronal cell types

There is a continuing need for driver strains to enable cell-type-specific manipulation in the nervous system. Each cell type expresses a unique set of genes, and recapitulating expression of marker genes by BAC transgenesis or knock-in has generated useful transgenic mouse lines. However, since genes are often expressed in many cell types, many of these lines have relatively broad expression patterns. We report an alternative transgenic approach capturing distal enhancers for more focused expression. We identified an enhancer trap probe often producing restricted reporter expression and developed efficient enhancer trap screening with the PiggyBac transposon. We established more than 200 lines and found many lines that label small subsets of neurons in brain substructures, including known and novel cell types. Images and other information about each line are available online (enhancertrap.bio.brandeis.edu)

Taking stock of 10 years of published research on the ASHA programme: Examining India’s national community health worker programme from a health systems perspective

Background: As India’s accredited social health activist (ASHA) community health worker (CHW) programme enters its second decade, we take stock of the research undertaken and whether it examines the health systems interfaces required to sustain the programme at scale. Methods: We systematically searched three databases for articles on ASHAs published between 2005 and 2016. Articles that met the inclusion criteria underwent analysis using an inductive CHW–health systems interface framework. Results: A total of 122 academic articles were identified (56 quantitative, 29 mixed methods, 28 qualitative, and 9 commentary or synthesis); 44 articles reported on special interventions and 78 on the routine ASHA program. Findings on special interventions were overwhelmingly positive, with few negative or mixed results. In contrast, 55% of articles on the routine ASHA programme showed mixed findings and 23% negative, with few indicating overall positive findings, reflecting broader system constraints. Over half the articles had a health system perspective, including almost all those on general ASHA work, but only a third of those with a health condition focus. The most extensively researched health systems topics were ASHA performance, training and capacity-building, with very little research done on programme financing and reporting, ASHA grievance redressal or peer communication. Research tended to be descriptive, with fewer influence, explanatory or exploratory articles, and no predictive or emancipatory studies. Indian institutions and authors led and partnered on most of the research, wrote all the critical commentaries, and published more studies with negative results. Conclusion: Published work on ASHAs highlights a range of small-scale innovations, but also showcases the challenges faced by a programme at massive scale, situated in the broader health system. As the programme continues to evolve, critical comparative research that constructively feeds back into programme reforms is needed, particularly related to governance, intersectoral linkages, ASHA solidarity, and community capacity to provide support and oversight

A prospective study to compare changes in male sexual function following holmium laser enucleation of prostate versus transurethral resection of prostate

Introduction: Transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP), both are considered standard endosurgical treatment of benign prostatic hyperplasia (BPH). Many studies have evaluated changes in sexual function following treatment of BPH. However, data are sparse on comparative study between the two standard options of the treatment of BPH. Aim: The aim of this study was to compare changes in sexual function following HoLEP versus TURP using the International Index of Erectile Function-15 (IIEF-15) questionnaire. Materials and Methods: A prospective study carried out for 4 years from May 2013 to April 2017. All patients with bothersome lower urinary tract symptoms due to BPH, who got admitted to the hospital for surgical management, were enrolled for the study and they underwent either HoLEP or TURP. Postoperatively, they were followed for 6 months at 1-, 3-, and 6-month interval. Main Outcome Measures: Statistical testing was conducted with the Statistical Package for the Social Science system version 17.0. Continuous variables are presented as mean ± standard deviation, and categorical variables are presented as absolute numbers and percentage. The comparison of normally distributed continuous variables between the groups was performed using Student's t- test. For within the groups, paired t-test was used at 1 month, 3 months, and 6 months from the baseline. Results: All the five domains of sexual function based on the IIEF-15 questionnaire remained significantly low at 6-month postsurgery in both the groups. Conclusions: By comparing the changes in sexual function between HoLEP and TURP group at the end of our study (6 months), we found no difference between the groups with regard to erectile function or overall sexual function as assessed by total IIEF-15 score

Erratum to Antiresonant ring interferometry as a sensitive technique for measuring nonlinear optical properties of thin films

There is a critical need for a simple technique for the accurate measurement of weak optical nonlinearities such as the nonlinear coefficients of thin films. We discuss the experimental set-up and provide a realistic analysis for a sensitive and single beam technique based on an antiresonant ring interferometer for measuring nonlinear optical coefficients in thin films. The technique was benchmarked using toluene and its superiority was demonstrated by measuring the effective nonlinear absorption coefficient of a 1.3 μm thick CdS film, which could not be detected using standard techniques such as z-scan. We show that this technique can, in principle, be used for films with thickness down to the nanometer.© Elsevie

Antiresonant ring interferometry as a sensitive technique for measuring nonlinear optical properties of thin films

There is a critical need for a simple technique for the accurate measurement of weak optical nonlinearities such as the nonlinear coefficients of thin films. We discuss the experimental set-up and provide a realistic analysis for a sensitive and single beam technique based on an antiresonant ring interferometer for measuring nonlinear optical coefficients in thin films. The technique was benchmarked using toluene and its superiority was demonstrated by measuring the effective nonlinear absorption coefficient of a 1.3 μm thick CdS film, which could not be detected using standard techniques such as z-scan. We show that this technique can, in principle, be used for films with thickness down to the nanometer regime.© Elsevie

Observation of hexagonal (4H) phase in nanocrystalline silver

We report the observation of an unusual hexagonal (4H) phase in silver nanoparticles deposited by high-pressure dc magnetron sputtering. X-ray-diffraction and transmission electron microscopy studies clearly reveal the presence of a hexagonal 4H phase in the silver nanoparticles in addition to the cubic 3C phase— which is the equilibrium crystal structure for bulk silver. The smaller the average particle size, the larger was the volume fraction of the 4H phase. The hexagonal phase can be made to revert to the usual cubic structure by heating the nanocrystalline sample and allowing the grains to grow. This rare hexagonal phase had previously been observed only in certain mineral deposits. We show that there is a size-induced stabilization of this phase in nanocrystalline silver below ≈30 nm