Kinetic and Mutagenic Evidence for the Role of Histidine Residues in the Lycopersicon esculentum 1-Aminocyclopropane-1-carboxylic acid Oxidase

The ACCO gene from Lycopersicon esculentum (tomato) has been cloned into the expression vector PT7-7. The highly expressed protein was recovered in the form of inclusion bodies. ACCO is inactivated by diethyl pyrocarbonate (DEPC) with a second-order rate constant of 170 M −1 min −1 . The pH–inactivation rate data imply the involvement of an amino acid residue with a p K value of 6.05. The difference UV spectrum of the the DEPC-inactivated versus native ACCO showed a single peak at 242 nm indicating the modification of histidine residues. The inactivation was reversed by the addition of hydroxylamine to the DEPC-inactivated ACCO. Substrate/cofactor protection studies indicate that both iron and ACC bind near the active site, which contains histidine residues. Four histidines of ACCO were individually mutated to alanine and glycine. H39A is catalytically active, while H177A, H177G, H211A, H211G, H234A, and H234G are basically inactive. The results indicate that histidine residues 177, 211, and 234 may serve as ligands for the active-site iron of ACCO and/or may play some important structural or catalytic role.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45083/1/10930_2004_Article_409396.pd

Influence of blended powders on properties of ultra-high strength fibre reinforced self compacting concrete subjected to elevated temperatures

Ultra-High Strength Fibre Reinforced Self Compacting Concrete (UHSFRSCC) is in great demand for use in construction projects around the globe. Unless fillers are utilized in this concrete, its production will come at an excessive environmental cost due to the high Carbon footprint of Portland cement. A gap in the published literature was identified, where quaternary mixes, containing Portland cement with three fillers, incorporating fibres, and achieving ultra high strength, were not cited. In this study ternary and quaternary mixes were designed and produced, satisfying the European Guidelines for SCC, with compressive strengths exceeding 115 MPa. Some mixes had compressive strengths between 125 – 150 MPa, which were not previously reported in the literature. The mixes contained Silica Fume (SF), Metakaolin (MK), Limestone powder (LS) as partial Portland cement replacement and quartz powder (QP) as partial sand replacement. Basalt Fibres were added to reinforce the matrix. Compressive & tensile strength of the mixes along with UPV, sorptivity, absorption and SEM Micro-structure features were studied at ambient temperature and after the samples were exposed to either 200 or 300 oC; since the behavior of HSC at elevated temperature is always a cause for concern. The active and inert fillers exhibited a synergic behavior at all temperature conditions. The mix containing: 15% SF, 5% MK, 20% LS and 34% QP achieved the best performance. Compressive and splitting tensile strength improve by 10% and 17% while sorptivity and absorption decline by 40% and 29% respectively at ambient temperature. Residual compressive strength improved by 10% and 19% while, residual splitting tensile strength significantly increases by 21% and 28% after exposure to elevated temperatures 200°C and 300°C respectively. Meanwhile, residual sorptivity decreases by 39% and 38% after exposure to these elevated temperatures. Microstructure properties supported and agreed with the mechanical and permeation characteristics results. The results will contribute to the development of UHSFRSCC in hot weather countries

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Punching shear behaviour of RC flat slabs incorporating recycled coarse aggregates and crumb rubber

This paper presents experimental, analytical and numerical investigations to evaluate the punching shear strength of concrete slabs incorporating a combination of recycled coarse aggregate (RCA) and crumb rubber (CR). Therefore, twelve different concrete mixes were designed with various substitution ratios of RCA and CR as a partial replacement of natural coarse aggregate (NCA) and fine aggregate (FA), respectively. Four substitution ratios of RCA (0%, 25%, 50% and 100%) by NCA and three substitution ratios of CR (0%, 10% and 20%) by FA were considered. Twelve simply supported two-way RC slabs with dimensions of 1000 × 1000 × 100 mm were cast and tested. The experimental programme was divided into two stages. The first and second stages were respectively conducted to evaluate the mechanical properties and the punching shear behaviour of concrete slabs incorporating a combination of RCA and CR. Experimental results show that the combination of RCA and CR negatively affects the mechanical properties of concrete. The substitution ratios of rubber content had a more significant effect on the reduction of the concrete strengths than the RCA content. The punching shear strength, stiffness and toughness of RC slabs incorporating RCA and CR decreased with increasing CR and RCA contents. Based on the experimental results, a combination of 25% RCA and 10% CR is the optimum substitution ratios that can be used on the concrete mixture, as it has a minor effect on the punching shear strength of concrete slab. The predictions of five approaches, namely ACI 318–2014, ECP 203, Euro −2, BS8110 and CSA A23.3, were compared with the experimental results. Finally, nonlinear element analysis (ANSYS) was conducted to verify the experimental results with numerical ones.This paper presents experimental, analytical and numerical investigations to evaluate the punching shear strength of concrete slabs incorporating a combination of recycled coarse aggregate (RCA) and crumb rubber (CR). Therefore, twelve different concrete mixes were designed with various substitution ratios of RCA and CR as a partial replacement of natural coarse aggregate (NCA) and fine aggregate (FA), respectively. Four substitution ratios of RCA (0%, 25%, 50% and 100%) by NCA and three substitution ratios of CR (0%, 10% and 20%) by FA were considered. Twelve simply supported two-way RC slabs with dimensions of 1000 × 1000 × 100 mm were cast and tested. The experimental programme was divided into two stages. The first and second stages were respectively conducted to evaluate the mechanical properties and the punching shear behaviour of concrete slabs incorporating a combination of RCA and CR. Experimental results show that the combination of RCA and CR negatively affects the mechanical properties of concrete. The substitution ratios of rubber content had a more significant effect on the reduction of the concrete strengths than the RCA content. The punching shear strength, stiffness and toughness of RC slabs incorporating RCA and CR decreased with increasing CR and RCA contents. Based on the experimental results, a combination of 25% RCA and 10% CR is the optimum substitution ratios that can be used on the concrete mixture, as it has a minor effect on the punching shear strength of concrete slab. The predictions of five approaches, namely ACI 318–2014, ECP 203, Euro −2, BS8110 and CSA A23.3, were compared with the experimental results. Finally, nonlinear element analysis (ANSYS) was conducted to verify the experimental results with numerical ones