Discovery of the small molecular inhibitors against sclerostin loop3 as potential anti-osteoporosis agents by structural based virtual screening and molecular design

Sclerostin is a secreted glycoprotein that expresses predominantly in osteocytes and inhibits bone formation by antagonizing the Wnt/β-catenin signaling pathway, and the loop3 region of sclerostin has recently discovered as a novel therapeutic target for bone anabolic treatment without increasing cardiovascular risk. Herein, we used a structural based virtual screening to search for small molecular inhibitors selectively targeting sclerostin loop3. A novel natural product hit ZINC4228235 (THFA) was identified as the sclerostin loop3-selective inhibitor with a Kd value of 42.43 nM against sclerostin loop3. The simplification and derivation of THFA using molecular modeling-guided modification allowed the discovery of an effective and loop3-selective small molecular inhibitor, compound (4-(3-acetamidoprop-1-yn-1-yl)benzoyl)glycine (AACA), with improved binding affinity (Kd = 15.4 nM) compared to the hit THFA. Further in-vitro experiment revealed that compound AACA could attenuate the suppressive effect of transfected sclerostin on Wnt signaling and bone formation. These results make AACA as a potential candidate for development of anti-osteoporosis agents without increasing cardiovascular risk.

Effect of a selective personality-targeted prevention program on 7-year illicit substance related outcomes: A secondary analysis of a cluster randomized controlled trial

BACKGROUND

This study evaluated the efficacy of the selective personality-targeted PreVenture program in reducing cannabis and stimulant use over a 7-year period spanning adolescence and early adulthood.

METHODS

A cluster randomized controlled trial was conducted in 14 Australian schools. Schools were randomized to PreVenture, a brief personality-targeted selective intervention, comprising two 90-minute facilitator-led sessions delivered one week apart, or a control group (health education as usual). Only students who scored highly on one of four personality traits (anxiety sensitivity, negative thinking, impulsivity, sensation seeking) were included. Students completed online self-report questionnaires between 2012 and 2019: at baseline; post-intervention; 1-, 2-, 3-, 5.5- and 7-years post-baseline. Outcomes were past 6-months cannabis use, stimulant use (MDMA, methamphetamine or amphetamine) and cannabis-related harms.

RESULTS

The sample comprised 438 adolescents (Mage=13.4 years; SD=0.47) at baseline. Retention ranged from 51% to 79% over the 7-years. Compared to controls, the PreVenture group had significantly reduced odds of annual cannabis-related harms (OR=0.78, 95% CI=0.65-0.92). However, there were no significant group differences in the growth of cannabis use (OR=0.84, 95% CI=0.69-1.02) or stimulant use (OR=1.07, 95% CI=0.91-1.25) over the 7-year period.

CONCLUSIONS

PreVenture was effective in slowing the growth of cannabis-related harms over time, however owing to missing data over the 7-year trial, replication trials may be warranted to better understand the impact of the PreVenture intervention on cannabis and stimulant use among young Australians. Alternative implementation strategies, such as delivering the intervention in later adolescence and/or providing booster sessions, may be beneficial.

Selective Autophagy of Macromolecular Complexes: What Does It Take to be Taken?

Proteins are known to perform an astonishing array of functions thanks to their ability to cooperate and modulate each other's properties. Inside cells, proteins can assemble into large multi-subunit complexes to carry out complex cellular functions. The correct assembly and maintenance of the functional state of macromolecular protein complexes is crucial for human health. Failure to do so leads to loss of function and potential accumulation of harmful materials, which is associated with a variety of human diseases such as neurodegeneration and cancer. Autophagy engulfs cytosolic material in autophagosomes, and therefore is best suited to eliminate intact macromolecular complexes without disassembling them, which could interfere with de novo assembly. In this review, we discuss the role of autophagy in the selective degradation of macromolecular complexes. We highlight the current state of knowledge for different macromolecular complexes and their selective autophagic degradation. We emphasize the gaps in our understanding of what it takes for these large macromolecular complexes to be degraded and point to future work that may shed light on the regulation of the selective degradation of macromolecular complexes by autophagy.

Revisiting the Percentage of K-12 Students in Need of Preventive Interventions in Schools in a "Peri-COVID" Era: Implications for the Implementation of Tiered Programming

As the public health framework has been implemented in schools through multi-tiered systems of support, as in Positive Behavioral Interventions and Supports (PBIS), a prominent interpretation has been that 80% of students will benefit from universal or Tier 1 schoolwide behavior support, around 15% will require added selective or Tier 2 targeted support, and 5% will require the more intensive selective or Tier 3 intervention. The PBIS framework also emphasizes the use of tiered logic, with strengthened efforts at the universal and selective levels when student behavioral or mental health needs exceed expected levels. The prediction that 5% of students will require indicated support was based mostly on students at risk for discipline encounters (i.e., office discipline referral data) and, more recently, systematic screening data, but this percentage remains an interpretation of the public health framework. Further, epidemiologic data over the past decade show that rates of childhood mental health disorders have risen and are even higher now as schools struggle to recover from the COVID-19 pandemic-much higher than 15% and 5% for selective and indicated levels. Thus, we believe it is time to revisit projections of the number of students in need of Tier 2 and Tier 3 support. In this position paper, we review the evidence for escalating youth mental health needs and discuss the implications for the tiered prevention framework in schools. We describe strategies to expand the availability of preventive intervention supports beyond Tier 1 efforts and conclude with recommendations for practice, policy, and research in this peri-COVID recovery era.

Utilization of 3D evaluation for assessing selective caries removal practice in pre-clinical dental students: a pilot study

BACKGROUND

Practicing and assessment of selective caries removal techniques in dental students remain challenges in many dental schools. The aim of this study was to utilize a 3D assessment technique, within a designated acceptable range of deviation, to evaluate the tendency of dental students in performing selective caries removal (SCR). The correlation between 3D assessment results and the conventional rubric rated by an instructor was also determined.

METHODS

Fifth-year dental students (n = 61) performed the SCR task on 3D-printed teeth containing simulated deep caries lesions in occlusal and proximal surfaces. One instructor assessed the results using a conventional analytic rubric. The excavated teeth were additionally evaluated using 3D analysis software with the designated acceptable range of deviations (± 0.5 mm) from the standard cavities. The average root mean square (RMS) value, representing the deviation between student-prepared cavities and the predefined standard cavities, was recorded. A tendency towards over-excavation was defined for RMS values > 0.5 mm, and towards under-excavation for RMS values < 0.5 mm.

RESULTS

The mean (min-max) of RMS was 0.27 (0.18-0.40) for occlusal and 0.29 (0.20-0.57)for proximal cavities. A tendency of dental students toward over-excavation was observed in both occlusal (74%) and proximal cavities (87%). There was a moderate negative correlation between the RMS values and the traditional rubric scores for both occlusal (R2 = 0.148, P = 0.002) and proximal cavities (R2 = 0.107, P = 0.010).

CONCLUSIONS

The 3D evaluation technique effectively revealed specific tendencies in dental students' caries removal skills. The integration of computerized assessments with traditional methods could potentially assist the instructors in delivering more objective and specific feedback to students. Further research is encouraged to investigate the impact of this assessment technique on improving student performance in selective caries removal skills.

Safety and efficacy of modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension

BACKGROUND

Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension (LSPH). The hemorrhage is fatal and requires safe and effective interventions.

AIM

To evaluate the clinical safety and efficacy of modified endoscopic ultrasound (EUS)-guided selective N-butyl-2-cyanoacrylate (NBC) injections for gastric variceal hemorrhage in LSPH.

METHODS

A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted. Preoperative EUS evaluations were performed. Enrolled patients were divided into modified and conventional groups according to the NBC injection technique. The final selection of NBC injection technique depended on the patients' preferences and clinical status. The technical and clinical success rates, operation time, NBC doses, perioperative complications, postoperative hospital stay, and recurrent bleeding rates were analyzed, respectively.

RESULTS

A total of 27 patients were enrolled. No statistically significant differences were observed between the two groups regarding baseline characteristics. In comparison to patients in the conventional group, patients in the modified group demonstrated significantly reduced NBC doses (2.0 ± 0.6 mL vs 3.1 ± 1.0 mL; P = 0.004) and increased endoscopic operation time (71.9 ± 11.9 min vs 22.5 ± 6.7 min; P < 0.001). Meanwhile, the two groups had no significant difference in the technical and clinical success rates, perioperative complications, postoperative hospital stay, and recurrent bleeding rates.

CONCLUSION

Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage, with advantages of reduced injection dose and no radiation risk. Drawbacks were time consumption and technical challenge.

Redox Reorganization: Aluminium Promoted 1,5-Hydride Shifts Allow the Controlled Synthesis of Multisubstituted Cyclohexenes

An efficient synthesis of cyclohexenes has been achieved from easily accessible tetrahydropyrans via a tandem 1,5-hydride shift-aldol condensation. We discovered that readily available aluminium reagents, e.g. Al2 O3 or Al(Ot Bu)3 are essential for this process, promoting the 1,5-hydride shift with complete regio- and enantiospecificity (in stark contrast to results obtained under basic conditions). The mild conditions, coupled with multiple methods available to access the tetrahydropyran starting materials makes this a versatile method with exceptional functional group tolerance. A wide range of cyclohexenes (>40 examples) have been prepared, many in enantiopure form, showing our ability to selectively install a substituent at each position around the newly forged cyclohexene ring. Experimental and computational studies revealed that aluminium serves a dual role in facilitating the hydride shift, activating both the alkoxide nucleophile and the electrophilic carbonyl group.

Recent research of BTK inhibitors: Methods of structural design, pharmacological activities, manmade derivatives and structure-activity relationship

Protein kinases constitute the largest group within the kinase family, and mutations and translocations of protein kinases due to genetic alterations are intimately linked to the pathogenesis of numerous diseases. Bruton's tyrosine kinase (BTK) is a member of the protein kinases and plays a pivotal role in the development and function of B cells. BTK belongs to the tyrosine TEC family. The aberrant activation of BTK is closely associated with the pathogenesis of B-cell lymphoma. Consequently, BTK has always been a critical target for treating hematological malignancies. To date, two generations of small-molecule covalent irreversible BTK inhibitors have been employed to treat malignant B-cell tumors, and have exhibited clinical efficacy in hitherto refractory diseases. However, these drugs are covalent BTK inhibitors, which inevitably lead to drug resistance after prolonged use, resulting in poor tolerance in patients. The third-generation non-covalent BTK inhibitor Pirtobrutinib has obtained approval for marketing in the United States, thereby circumventing drug resistance caused by C481 mutation. Currently, enhancing safety and tolerance constitutes the primary issue in developing novel BTK inhibitors. This article systematically summarizes recently discovered covalent and non-covalent BTK inhibitors and classifies them according to their structures. This article also provides a detailed discussion of binding modes, structural features, pharmacological activities, advantages and limitations of typical compounds within each structure type, providing valuable references and insights for developing safer, more effective and more targeted BTK inhibitors in future studies.

Selective recovery of Cu(II) from strongly acidic wastewater by zinc dimethyldithiocarbamate: Affecting factors, efficiency and mechanism

The selective recovery of copper from strongly acidic wastewater containing mixed metal ions remains a significant challenge. In this study, a novel reagent zinc dimethyldithiocarbamate (Zn(DMDC)₂) was developed for the selective removal of Cu(II). The removal efficiency of Cu(II) reached 99.6% after 120 min reaction at 30°C when the mole ratio Zn(DMDC)₂/Cu(II) was 1:1. The mechanism investigation indicates that the Cu(DMDC)₂ products formed as a result of the displacement of Zn(II) from the added Zn(DMDC)₂ by Cu(II) in wastewater, due to the formation of stronger coordination bonds between Cu(II) and the dithiocarbamate groups of Zn(DMDC)₂. Subsequently, we put forward an innovative process of resource recovery for strongly acidic wastewater. Firstly, the selective removal of Cu(II) from actual wastewater using Zn(DMDC)₂, with a removal efficiency of 99.7%. Secondly, high-value CuO was recovered by calcining the Cu(DMDC)₂ at 800°C, with a copper recovery efficiency of 98.3%. Moreover, the residual As(III) and Cd(II) were removed by introducing H₂S gas, and the purified acidic wastewater was used to dissolve ZnO for preparation of valuable ZnSO₄·H₂O. The total economic benefit of resource recovery is estimated to be 11.54 $/m³. Accordingly, this study provides a new route for the resource recovery of the treatment of copper-containing acidic wastewater.

A review of hydrogen chloride removal from calcium- and sodium-based sorbents

With the steady progress of ultra-low emissions in various industries, the management of unconventional pollutants is gradually attracting attention. A such unconventional pollutant that negatively affects many different processes and pieces of equipment is hydrogen chloride (HCl). Although it has strong advantages and potential in the treatment of industrial waste gas and synthesis gas, the process technology of removing HCl by calcium- and sodium-based alkaline powder has not yet been thoroughly studied. The impact of reaction factors on the dechlorination of calcium- and sodium-based sorbents is reviewed, including temperature, particle size, and water form. The most recent developments in sodium- and calcium-based sorbents for capturing hydrogen chloride were presented, and the dechlorination capabilities of various sorbents were contrasted. In the low-temperature range, sodium-based sorbents had a stronger dechlorination impact than calcium-based sorbents. Surface chemical reactions and product layer diffusion between solid sorbents and gases are crucial mechanisms. Meanwhile, the effect of the competitive behavior of SO₂ and CO₂ with HCl on the dechlorination performance has been taken into account. The mechanism and necessity of selective hydrogen chloride removal are also provided and discussed, and future research directions are pointed out to provide the theoretical basis and technical reference for future industrial practical applications.

PSS functionalized and stabilized carbon nanodots for specific sensing of iron in biological medium

Carbon Quantum Dots (CQDs) are already emerged as an excellent sensing element for its exceptional behavior in fluorescence, biocompatibility, and water dispersibility. However, its poor stability, selectivity and reproducibility in complex medium still be a big problem for its practical application. To overcome this, in the work, we have developed a new type of carbon quantum dot-PSS fluorescent nanocomposites which has been used for specific Fe³⁺ detection. The polystyrene sulfonate (PSS) polymer not only stabilize the QDs but also produces specific sites for Fe³⁺ to make a co-ordinate complex via Fe³⁺-SO3. The detection limit is calculated as low as 1 ppm which is adequate for measuring Fe³⁺ in blood or water samples. The mechanism of the quenching is very specific towards the Fe³⁺ ion due to the presence of PSS which makes the sensor selective among other metal ions and possible interferences. The rapid process of sensing, simple instrumentation, and excellent performances in presence of 1 % BSA and serum samples indicates the possible application for diagnostic usage in near future.

New triazole-attached quinoxalines selectively recognize the telomeric multimeric G-quadruplexes and inhibit breast cancer cell growth

The telomeric 3'-overhang had potential to form into higher-order structures termed multimeric G-quadruplexes (G4s), which may mainly exist in telomeres, representing an attractive drug target for development of anticancer agents with few side effects. However, only a few molecules that selectively bind to multimeric G4s have been found by random screening, which means a lot of room for improvement. In this study, we raised a feasible strategy to design small-molecule ligands with possible selectivity to multimeric G4s, and then synthesized a focused library of multi-aryl compounds by attaching triazole rings to the quinoxaline skeleton. Among them, QTR-3 was identified as the most promising selective ligand that may bind at the G4-G4 interface, which accordingly stabilized multimeric G4s and induced DNA damage in telomeric region, thereby leading to cell cycle arrest and apoptosis. Notably, QTR-3 showed more significant inhibition on breast cancer cells against normal mammary cells.

Listening to two speakers: Capacity and tradeoffs in neural speech tracking during Selective and Distributed Attention

Speech comprehension is severely compromised when several people talk at once, due to limited perceptual and cognitive resources. In such circumstances, top-down attention mechanisms can actively prioritize processing of task-relevant speech. However, behavioral and neural evidence suggest that this selection is not exclusive, and the system may have sufficient capacity to process additional speech input as well. Here we used a data-driven approach to contrast two opposing hypotheses regarding the system's capacity to co-represent competing speech: Can the brain represent two speakers equally or is the system fundamentally limited, resulting in tradeoffs between them? Neural activity was measured using magnetoencephalography (MEG) as human participants heard concurrent speech narratives and engaged in two tasks: Selective Attention, where only one speaker was task-relevant and Distributed Attention, where both speakers were equally relevant. Analysis of neural speech-tracking revealed that both tasks engaged a similar network of brain regions involved in auditory processing, attentional control and speech processing. Interestingly, during both Selective and Distributed Attention the neural representation of competing speech showed a bias towards one speaker. This is in line with proposed 'bottlenecks' for co-representation of concurrent speech and suggests that good performance on distributed attention tasks may be achieved by toggling attention between speakers over time.

Echocardiographic Evaluation of His Bundle Pacing in Patients with Prolonged PR Intervals

Background

Patients with PR intervals >240ms have atrio-ventricular (AV) dyssynchrony, which can increase risk of atrial fibrillation and all-cause mortality. When requiring pacing, long AV delays (AVDs) have been programmed to avoid ventricular dyssychrony. His bundle pacing (HBP) may provide improved AV synchrony in patients with prolonged PR.

Methods

10 patients with sinus node dysfunction and prolonged PR who received HBP were studied. Real-time echocardiographic was performed with 3 pacemaker modes (RV septal, non-selective HBP, and selective HBP) using the following pacemaker settings: control (no ventricular pacing), pacing with AVD of 180ms, 150ms, 120ms, 100ms, and 70ms. Echocardiographic Doppler measurements: EA/RR, >40% = AV synchrony; E/e', <8 = normal left atrial pressure; pulmonic-to-aortic pre-ejection time difference, <40ms = interventricular synchrony; septal-to-lateral wall activation time difference, <56ms = intraventricular synchrony; and LVOT VTI. Unpaired T test was used to evaluate for significance. Exclusion criteria: persistent atrial fibrillation, second-degree AV block.

Results

Compared to control programming, HBP showed a 31.5% increase in EA/RR time, a decrease in E/e' of 26.9%, and an increase in the LVOT VTI of 21.3%. Compared to RV septal pacing, there was a similar increase in LVOT VTI. These findings met statistical significance and were considered optimal based on Doppler echocardiography findings primarily at AVDs of 150ms and 120ms. Comparisons between selective and non-selective pacing were not significantly different.

Conclusion

Compared to controls and RV septal pacing, physiologic His bundle pacing was shown to increase markers of AV synchrony and LV stroke volume while maintaining ventricular synchrony.

Luminescent Pyrene-based Schiff base Receptor for Hazardous Mercury(II) Detection Demonstrated by Cell Imaging and Test Strip

Qualitative and quantitative analysis of mercury at concentration levels as low as parts per billion (ppb) is a basic and practical concern. The vast majority of research in this field has centered on the development of potent chemosensor to monitor mercuric (Hg²⁺) ions. Mercury exists in three oxidation states, + 2, + 1 and 0, all of which are highly poisonous. In this study, (N¹E,N²E)-N¹,N²-bis(pyrene-1-ylmethylene)benzene-1,2-diamine (PAPM), a novel photoluminescent sensor based on pyrene platform was synthesized. Over the tested metal ions (Cd²⁺, Co²⁺, Cu²⁺, Mg²⁺, Mn²⁺, Ni²⁺, K⁺, Na⁺, Zn²⁺, Sr²⁺, Pb²⁺, Al³⁺, Cr³⁺ and Fe³⁺) the sensor responds only to Hg²⁺ by showing high selectivity and sensitivity. After treatment with mercuric ions at room temperature, the luminescence intensity of probe was quenched at 456 nm. The quenching of fluorescence intensity of probe upon addition of mercury is due to the effect of "turn-off" chelation enhanced quenching (CHEQ) by the formation of 1:1 complex. The ESI-MS spectrum and the Job's experimental results confirm the formation of 1:1 complex between PAPM and Hg²⁺. The detection limit and association constant of sensor for mercury is computed using fluorescence titration data and were found to be 9.0 × 10^-8 M and 1.29 × 10⁵ M^-1 respectively. The practical application of sensor towards recognition of mercury(II) ions was explored through economically viable test strips and also using cell imaging studies.

Isolated main thoracic curve fusion in idiopathic scoliosis: optimizing radiographic outcomes using lumbar modifiers to guide correction

PURPOSE

Does differential correction of main thoracic curve (MTC) and instrumented LIV angulation based on lumbar modifiers affect radiographic outcomes, and can preoperative supine AP radiograph be used to guide correction for optimal final radiographic alignment.

METHODS

Retrospective analysis of idiopathic scoliosis patients who underwent selective thoracic fusions (LIV T11-L1) for Lenke 1 and 2 curve patterns, < 18 years of age. 2-year minimum follow-up. Optimal outcome meant LIV + 1 of < 5 degrees disk-wedging and C7-CSVL < 2 cm. 82 patients met inclusion criteria (70% female), mean age 14.1 years.

RESULTS

24 patients were A modifier, 21 B modifier, and 37 C modifier. There were 52 optimal and 30 suboptimal outcomes. LIV was not associated with outcome (p = 0.08). For optimal outcomes, A modifiers' MTC improved 65%, B modifiers 65%, and C modifiers 59%. C modifiers' MTC correction was less than A modifiers (p = 0.03) but equivalent to B modifiers' (p = 0.10). A modifiers' LIV + 1 tilt improved 65%, B modifiers 64%, and C modifiers 56%. C modifiers' instrumented LIV angulation was greater than A modifiers' (p < 0.01) but equivalent to B modifiers' (p = 0.06). Preoperative supine LIV + 1 tilt was 16^o in optimal outcomes and 15° in suboptimal outcomes. Instrumented LIV angulation was 9° for both. The correction between preoperative LIV + 1 tilt and instrumented LIV angulation was not significantly different between groups (p = 0.67).

CONCLUSION

Differential MTC and LIV tilt correction based on lumbar modifier may be a valid goal. Optimizing radiographic outcome by matching instrumented LIV angulation to preoperative supine LIV + 1 tilt could not be proven.

LEVEL OF EVIDENCE

IV.

Development of potent and selective degraders of PI5P4Kγ

Phosphatidylinositol 5-phosphate 4-kinases (PI5P4Ks), a family of three members in mammals (α, β and γ), have emerged as potential therapeutic targets due to their role in regulating many important cellular signaling pathways. In comparison to the PI5P4Kα and PI5P4Kβ, which usually have similar expression profiles across cancer cells, PI5P4Kγ exhibits distinct expression patterns, and pathological functions for PI5P4Kγ have been proposed in the context of cancer and neurodegenerative diseases. PI5P4Kγ has very low kinase activity and has been proposed to inhibit the PI4P5Ks through scaffolding function, providing a rationale for developing a selective PI5P4Kγ degrader. Here, we report the development and characterization of JWZ-1-80, a first-in-class PI5P4Kγ degrader. JWZ-1-80 potently degrades PI5P4Kγ via the ubiquitin-proteasome system and exhibits proteome-wide selectivity and is therefore a useful tool compound for further dissecting the biological functions of PI5P4Kγ.

Design, synthesis and biological evaluation of novel tumor hypoxia-activated EGFR tyrosine kinase inhibitors

Hypoxia is widespread in solid tumors, such as NSCLC, and has become a very attractive target. On the basis of AZD9291 scaffold, novel hypoxia-targeted EGFR inhibitors without the acrylamide warhead but containing hypoxic reductive activation groups were described. Among them, compound JT21 exhibited impressive inhibitory activity (IC₅₀ = 23 nM) against EGFR^L858R/T790M and displayed about 21-fold inhibitory activity decrease against EGFR^wt. Under hypoxia, JT21 exhibited more significant proliferation inhibitory activities against H1975 cells (IC₅₀ = 7.39 ± 2.20 nM) and HCC827 cells (IC₅₀ = 5.88 ± 0.85 nM) than that of AZD9291, which was about 5 times more effective than normoxia activities. Meanwhile, the weak inhibition effects on A549 and BEAS-2B cells suggested JT21 might be a selective inhibitor for EGFR mutations with low toxicity. Furthermore, JT21 could induce apoptosis of H1975 cells under hypoxia and showed good bio-reductive property.

Selective versus non-selective NSAIDs as prophylaxis for heterotopic ossification following hip arthroplasty: a meta-analysis

Background

Some patients have demonstrated evidence of heterotopic ossification (HO) following total hip arthroplasty (THA). Selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) are used as prophylaxis for HO following THA. This meta-analysis compared selective versus non-selective NSAIDs as prophylaxis for HO following THA.

Material and methods

The present study was conducted according to the PRISMA 2020 guidelines. All the clinical investigations comparing selective versus non-selective NSAIDs as prophylaxis for HO following THA were accessed in February 2022. An assessment of the methodological quality and statistical analyses were performed through the risk of bias summary tool of the Review Manager 5.3 software (Cochrane Collaboration, Copenhagen). The modified Brooker staging system was used to rate the efficacies of the interventions.

Results

Data from 8 studies and 1526 patients were collected. 60.8% were female. No difference was found in the sample size, mean age, and percentage of females between the two groups at baseline. No statistically significant difference was found between selective and non-selective NSAIDs in term of efficacy. 72% (1078 of 1502) of the patients were classified as Brooker 0, 21% (322 of 1502) as Brooker I, 5% (80 of 1502) as Brooker II, 1% (16 of 1502) as Brooker III, and 0.1% (2 of 1502) as Brooker IV.

Conclusion

Selective and non-selective NSAIDs were equally effective when used as prophylaxis for HO following THA.

Level of evidence

Level III, systematic review and meta-analysis.

Interactions among endogenous, exogenous, and agency-driven attentional selection mechanisms in interactive displays

Attentional selection is driven, in part, by a complex interplay between endogenous and exogenous cues. Recently, one's interactions with the physical world have also been shown to bias attention. Specifically, the sense of agency that arises when our actions cause predictable outcomes biases our attention toward those things which we control. We investigated how this agency-driven attentional bias interacts with simultaneously presented endogenous (words) and exogenous (color singletons) environmental cues. Participants controlled the movement of one object while others moved independently. In a subsequent search task, targets were either the previously controlled objects or not. Targets were also validly or invalidly cued. Both cue types influenced attention allocation. Endogenous cues and agency-driven attentional selection were independent and additive, indicating they are separable mechanisms of selection. In contrast, exogenous cues eliminated the effects of agency, indicating that perceptually salient environmental cues can override internally derived effects of agency. This is the first demonstration of a boundary condition on agency-driven selection.

Modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension: A case report

BACKGROUND

Left-sided portal hypertension (LSPH), also known as sinistral portal hypertension or regional portal hypertension, refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis. N-butyl-2-cyanoacrylate (NBC) has been widely used in the endoscopic hemostasis of portal hypertension, but adverse events including renal or pulmonary thromboembolism, mucosal necrosis and gastrointestinal (GI) bleeding may occur after treatment. Herein, we report successfully managing gastric variceal (GV) hemorrhage secondary to LSPH using modified endoscopic ultrasound (EUS)-guided selective NBC injections.

CASE SUMMARY

A 35-year-old man was referred to our hospital due to an upper GI hemorrhage. Gastroscopy revealed GV hemorrhage and computed tomography venography (CTV) confirmed LSPH. The patient requested endoscopic procedures and rejected surgical therapies including splenectomy. EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose. The "sandwich" method using undiluted NBC and hypertonic glucose was applied. No complications occurred. The patient was followed up regularly after discharge. Three months later, the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH. No recurrent GI hemorrhage was reported during this follow-up period.

CONCLUSION

EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.

Modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension: A case report

BACKGROUND

Left-sided portal hypertension (LSPH), also known as sinistral portal hypertension or regional portal hypertension, refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis. N-butyl-2-cyanoacrylate (NBC) has been widely used in the endoscopic hemostasis of portal hypertension, but adverse events including renal or pulmonary thromboembolism, mucosal necrosis and gastrointestinal (GI) bleeding may occur after treatment. Herein, we report successfully managing gastric variceal (GV) hemorrhage secondary to LSPH using modified endoscopic ultrasound (EUS)-guided selective NBC injections.

CASE SUMMARY

A 35-year-old man was referred to our hospital due to an upper GI hemorrhage. Gastroscopy revealed GV hemorrhage and computed tomography venography (CTV) confirmed LSPH. The patient requested endoscopic procedures and rejected surgical therapies including splenectomy. EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose. The "sandwich" method using undiluted NBC and hypertonic glucose was applied. No complications occurred. The patient was followed up regularly after discharge. Three months later, the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH. No recurrent GI hemorrhage was reported during this follow-up period.

CONCLUSION

EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.

Modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension: A case report

BACKGROUND

Left-sided portal hypertension (LSPH), also known as sinistral portal hypertension or regional portal hypertension, refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis. N-butyl-2-cyanoacrylate (NBC) has been widely used in the endoscopic hemostasis of portal hypertension, but adverse events including renal or pulmonary thromboembolism, mucosal necrosis and gastrointestinal (GI) bleeding may occur after treatment. Herein, we report successfully managing gastric variceal (GV) hemorrhage secondary to LSPH using modified endoscopic ultrasound (EUS)-guided selective NBC injections.

CASE SUMMARY

A 35-year-old man was referred to our hospital due to an upper GI hemorrhage. Gastroscopy revealed GV hemorrhage and computed tomography venography (CTV) confirmed LSPH. The patient requested endoscopic procedures and rejected surgical therapies including splenectomy. EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose. The "sandwich" method using undiluted NBC and hypertonic glucose was applied. No complications occurred. The patient was followed up regularly after discharge. Three months later, the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH. No recurrent GI hemorrhage was reported during this follow-up period.

CONCLUSION

EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.

Modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension: A case report

BACKGROUND

Left-sided portal hypertension (LSPH), also known as sinistral portal hypertension or regional portal hypertension, refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis. N-butyl-2-cyanoacrylate (NBC) has been widely used in the endoscopic hemostasis of portal hypertension, but adverse events including renal or pulmonary thromboembolism, mucosal necrosis and gastrointestinal (GI) bleeding may occur after treatment. Herein, we report successfully managing gastric variceal (GV) hemorrhage secondary to LSPH using modified endoscopic ultrasound (EUS)-guided selective NBC injections.

CASE SUMMARY

A 35-year-old man was referred to our hospital due to an upper GI hemorrhage. Gastroscopy revealed GV hemorrhage and computed tomography venography (CTV) confirmed LSPH. The patient requested endoscopic procedures and rejected surgical therapies including splenectomy. EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose. The "sandwich" method using undiluted NBC and hypertonic glucose was applied. No complications occurred. The patient was followed up regularly after discharge. Three months later, the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH. No recurrent GI hemorrhage was reported during this follow-up period.

CONCLUSION

EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.

Modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension: A case report

BACKGROUND

Left-sided portal hypertension (LSPH), also known as sinistral portal hypertension or regional portal hypertension, refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis. N-butyl-2-cyanoacrylate (NBC) has been widely used in the endoscopic hemostasis of portal hypertension, but adverse events including renal or pulmonary thromboembolism, mucosal necrosis and gastrointestinal (GI) bleeding may occur after treatment. Herein, we report successfully managing gastric variceal (GV) hemorrhage secondary to LSPH using modified endoscopic ultrasound (EUS)-guided selective NBC injections.

CASE SUMMARY

A 35-year-old man was referred to our hospital due to an upper GI hemorrhage. Gastroscopy revealed GV hemorrhage and computed tomography venography (CTV) confirmed LSPH. The patient requested endoscopic procedures and rejected surgical therapies including splenectomy. EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose. The "sandwich" method using undiluted NBC and hypertonic glucose was applied. No complications occurred. The patient was followed up regularly after discharge. Three months later, the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH. No recurrent GI hemorrhage was reported during this follow-up period.

CONCLUSION

EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.

Modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension: A case report

BACKGROUND

Left-sided portal hypertension (LSPH), also known as sinistral portal hypertension or regional portal hypertension, refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis. N-butyl-2-cyanoacrylate (NBC) has been widely used in the endoscopic hemostasis of portal hypertension, but adverse events including renal or pulmonary thromboembolism, mucosal necrosis and gastrointestinal (GI) bleeding may occur after treatment. Herein, we report successfully managing gastric variceal (GV) hemorrhage secondary to LSPH using modified endoscopic ultrasound (EUS)-guided selective NBC injections.

CASE SUMMARY

A 35-year-old man was referred to our hospital due to an upper GI hemorrhage. Gastroscopy revealed GV hemorrhage and computed tomography venography (CTV) confirmed LSPH. The patient requested endoscopic procedures and rejected surgical therapies including splenectomy. EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose. The "sandwich" method using undiluted NBC and hypertonic glucose was applied. No complications occurred. The patient was followed up regularly after discharge. Three months later, the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH. No recurrent GI hemorrhage was reported during this follow-up period.

CONCLUSION

EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.

Modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension: A case report

BACKGROUND

Left-sided portal hypertension (LSPH), also known as sinistral portal hypertension or regional portal hypertension, refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis. N-butyl-2-cyanoacrylate (NBC) has been widely used in the endoscopic hemostasis of portal hypertension, but adverse events including renal or pulmonary thromboembolism, mucosal necrosis and gastrointestinal (GI) bleeding may occur after treatment. Herein, we report successfully managing gastric variceal (GV) hemorrhage secondary to LSPH using modified endoscopic ultrasound (EUS)-guided selective NBC injections.

CASE SUMMARY

A 35-year-old man was referred to our hospital due to an upper GI hemorrhage. Gastroscopy revealed GV hemorrhage and computed tomography venography (CTV) confirmed LSPH. The patient requested endoscopic procedures and rejected surgical therapies including splenectomy. EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose. The “sandwich” method using undiluted NBC and hypertonic glucose was applied. No complications occurred. The patient was followed up regularly after discharge. Three months later, the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH. No recurrent GI hemorrhage was reported during this follow-up period.

CONCLUSION

EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.

Modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension: A case report

BACKGROUND

Left-sided portal hypertension (LSPH), also known as sinistral portal hypertension or regional portal hypertension, refers to extrahepatic portal hypertension caused by splenic vein obstruction or stenosis. N-butyl-2-cyanoacrylate (NBC) has been widely used in the endoscopic hemostasis of portal hypertension, but adverse events including renal or pulmonary thromboembolism, mucosal necrosis and gastrointestinal (GI) bleeding may occur after treatment. Herein, we report successfully managing gastric variceal (GV) hemorrhage secondary to LSPH using modified endoscopic ultrasound (EUS)-guided selective NBC injections.

CASE SUMMARY

A 35-year-old man was referred to our hospital due to an upper GI hemorrhage. Gastroscopy revealed GV hemorrhage and computed tomography venography (CTV) confirmed LSPH. The patient requested endoscopic procedures and rejected surgical therapies including splenectomy. EUS-guided selective NBC injections were performed and confluences of gastric varices were selected as the injection sites to reduce the injection dose. The "sandwich" method using undiluted NBC and hypertonic glucose was applied. No complications occurred. The patient was followed up regularly after discharge. Three months later, the follow-up gastroscopy revealed firm gastric submucosa with no sign of NBC expulsion and the follow-up CTV showed improvements in LSPH. No recurrent GI hemorrhage was reported during this follow-up period.

CONCLUSION

EUS-guided selective NBC injection may represent an effective and economical treatment for GV hemorrhage in patients with LSPH.

A post-functional Ti-based MOFs composite for selective removal of Pb (II) from water

Lead ions in water have notorious effects on humans and environment. It is important to design an adsorbent with high adsorption capacity and reproducibility for efficiently removing Pb (II)ions from polluted water. Here, a novel Ti-based MOFs material (BDB-MIL-125(Ti)@Fe₃O₄) was prepared by modifying NH₂-MIL-125(Ti) with sulfhydryl and amino groups. Due to the large number of active sites, the maximum Pb (II) adsorption capacity of BDB-MIL-125(Ti)@Fe₃O₄ was 710.79 mg/g at 25 °C and pH = 6 within 120 min corresponding to a maximum removal rate of 95.68%. The adsorbent also has extremely high selectivity and good cycling adsorption performance. The adsorption isotherms and kinetics agree with the Langmuir and the pseudo-second-order models, indicating that the process was chemisorption. Thermodynamic studies prove that spontaneous processes enhance Pb (II) adsorption at higher temperatures. DFT and FMOs calculations were used to discuss the adsorption mechanism. The sulfhydryl groups on the surface of organic ligands have a stronger affinity for Pb (II).

A ratiometric fluorescent probe for selective detection of thiophenol derivatives

Though a number of on-off or off-on fluorescent probes have been developed for the detection of thiophenol by using its unique recognition groups, such as 2, 4-dinitrophenyl ether, 2, 4-dinitrophenyl sulfonamide, and 2, 4-dinitrophenyl sulfonate, up to now, there are few probes that can detect thiophenol by the proportional fluorescence signal. We developed a ratiometric fluorescent probe with coumarin pyridine derivative as fluorophore and 2, 4-dinitrophenyl ether moiety as the sensing unit which could be used to detect thiophenol derivatives by the aromatic nucleophilic substitution reaction. This probe (CPBPN) displayed significant change in fluorescence ratio (256 fold) to result in a more reliable analysis by self-calibration and a relatively low detection limit of 24 nM toward 4-methylthiophenol (MTP) within 30 min to achieve more sensitivity. Besides, the probe was also applied to detect the presence of thiophenol derivatives in actual water samples and fluorescence imaging in living cells. The present work is of great importance for monitoring environmental pollutants and studying their biological function.

Discovery of a fluorescent, long chain-bridged bispurine that selectively targets the c-MYC G-quadruplex

G-quadruplexes (G4s) are special nucleic acid structures which are involved in the regulation of some key biological events like transcription and translation, which are now treated as promising therapeutic targets for cancers. Stabilizing the promoter G4 by small-molecule ligands can suppress the c-MYC oncogene transcription, thus inhibiting cancer cell proliferation. So far, targeting the very structure, a number of ligands have been reported. However, most of them showed unsatisfactory specificity to the c-MYC G4 over other G4s, resulting in uncertain side effects. In this contribution, we discovered a new class of bispurines bridged with flexible hydrocarbon chains, which presented somewhat selectivity to the c-MYC G4 possibly by adaptive binding, which then showed clear inhibition on the c-MYC expression rather than other G4-driven oncogenes. Moreover, these novel molecules had the potential to fluorescently label G4s. We believed that this study may shed light on the discovery of new functional small molecules targeting a specific G4 structure.

A clean process for selective recovery of copper from industrial wastewater by extraction-precipitation with p-tert-octyl phenoxy acetic acid

A novel method for the selective removal and recovery of copper ion from copper-containing wastewater by extraction-precipitation with p-tert-octyl phenoxy acetic acid as a precipitant is presented. The morphology, thermal stability and solubility of POAA were synthesized and characterized. Then the application of POAA to precipitate copper from simulated copper-containing wastewater was studied. The effects of some factors (i.e., time, pH, temperature, dosage of precipitant) on copper precipitation efficiency (P%) and water solubility of POAA were discussed. The extraction-precipitation mechanism of POAA and Cu²⁺ was investigated by slope analysis combined with SEM, EDS, XPS and IR spectra. The concentration and purity of copper from industrial wastewater increased from 100.2 mg/L to 27,916 mg/L and 13.71%-93.01% respectively, treating by the proposed extraction-precipitation. Moreover, POAA revealed good stability in the recycling processes. Extraction-precipitation strategy is simple, efficient and sustainable, which can effectively reduce the volume of sludge in the process of wastewater treatment and produce copper concentrated solution with industrial value, which has revealed application potential for the clean production of copper smelting enterprises.

Adsorption of uranium by chitosan/Chlorella pyrenoidosa composite adsorbent bearing phosphate ligand

In order to remove and recover uranium from acidic uranium-bearing wastewater in uranium mining and metallurgy. Herein, a novel chitosan/Chlorella pyrenoidosa composite adsorbent bearing phosphate ligand (CSP/CP) was designed and synthesized, demonstrating a high uranium adsorption capacity at a pH of 5 and excellent selectivity in an aqueous solution with eight coexisting ions. The CSP/CP exhibits a maximum adsorption capacity (1393.338 mg g^-1) and selectivity (Su = 80.53%) for uranium, which is higher than many reported adsorbents. Mechanism analysis shows that the surface of CSP/CP is rich in hydroxyl, amino, phosphate and carboxyl groups, resulting in an excellent three-dimensional structure with active sites for high-performance uranium adsorption; U(VI) is selectively bound via ion exchanges with -COOH and -OH and through surface complexation with NH₂ and PO. Furthermore, by desorption with 0.1 M Na₂CO₃ + 2% H₂O₂ at 318 K, CSP/CP can be recycled more than five times. It provides a new scientific basis for the preparation of high selectivity composite adsorbent by chitosan.

Selective photocatalytic reduction of selenate over TiO2 in the presence of nitrate and sulfate in mine-impacted water

Selenium contamination is a critical global issue across numerous industries. Industrial waters such as mine-impacted water (MIW) can contain toxic levels of selenate, in addition to varying concentrations of many different dissolved species from the underlying strata, such as sulfate, carbonate, nitrate, organic matter, and many dissolved metals. The removal of selenate from MIW is desired, due to selenate's acute and chronic toxicity in aquatic ecosystems at elevated concentrations. However, due to the complexity of the water matrix and the presence of many other dissolved constituents, this is often very challenging. In this study, we present for the first time the reduction of selenate in a real industrial wastewater, namely MIW, and reveal a significant advantage of photocatalytic reduction; the ability to selectively reduce selenate from >500 μg L^-1 to <2 μg L^-1 in the presence of the more energetically favourable electron acceptor, nitrate (250× molar concentration of selenate) and high concentrations of sulfate (1,940× molar concentration of selenate). The presence and impacts of sulfate, chloride, carbonate, and nitrate on the competitive adsorption and reduction of selenate on TiO₂ are thoroughly investigated for the first time, using formic acid as an electron hole scavenger. The electron transfer mechanism proposed follows TiO₂ conduction band electrons are responsible for the reduction of selenate to elemental Se (Se⁰) and both carbon dioxide radicals (CO₂^·-) and Se conduction band electrons are responsible for the further reduction of Se⁰ to hydrogen selenide (H₂Se).

Electrode for selective bromide removal in membrane capacitive deionisation

Due to the shortage of freshwater around the world, seawater is becoming an important water source. However, seawater contains a high concentration of bromide that can form harmful disinfection by-products during water disinfection. Therefore, the current seawater reverse osmosis (SWRO) has to adopt two-pass reverse osmosis (RO) configuration for effective bromide removal, increasing the overall desalination cost. In this study, a bromide selective composite electrode was developed for membrane capacitive deionisation (MCDI). The composite electrode was developed by coating a mixture of bromide selective resin and anion exchange polymer on the surface of the commercial activated carbon electrode, and its performance was compared to that of conventional carbon electrode. The results demonstrated that the composite electrode has ten times better bromide selectivity than the conventional carbon electrode. The study shows the potential application of MCDI for the selective removal of target ions from water sources and the potential for resource recovery through basic modification of commercial electrode.

Three-year study to evaluate an anthelmintic treatment regimen with reduced treatment frequency in horses on two study sites in Belgium

In the present study, an anthelmintic treatment regimen with reduced treatment frequency was evaluated in horses on two study sites in Belgium during three consecutive summer pasture seasons. Historically, the horses on both study sites were treated up to 6 times a year with ivermectin (IVM) or up to 4 times a year with moxidectin (MOX), and previous efficacy evaluations indicated a reduced egg reappearance period in some of the treated horses for both IVM (28 days) and MOX (42 days). In the present study, all horses were treated with IVM or MOX in the spring and in autumn. Faecal egg counts (FEC) were conducted every two weeks during the summer pasture season and whenever the individual FEC exceeded 250 eggs per gram of faeces, the specific horse was treated with pyrantel embonate. No increase in parasitic disease over the three-year period of the study was observed. The FEC data collected in the study as well as the age of the animals and local weather data were then imported into a cyathostomin life-cycle model, to evaluate long term effects of the newly applied treatment regimen on the selection pressure for anthelmintic resistance, and compare to the previous high frequency treatment regimen. The model simulations indicated that the whole-herd treatment regimen with at least 4 macrocyclic lactone treatments annually led 2-3 times faster resistance development than any of the alternative treatment regimens evaluated under the specific conditions of these two study sites. Further lowering the treatment frequency or applying even more selective treatments enhanced the delay in resistance development, but to a lesser extent.

Current Indications and Long-Term Outcomes of Surgical Portosystemic Shunts in Adults

BACKGROUND

Surgical portosystemic shunts are rare. We reviewed indications, operative details, and outcomes of patients undergoing surgical portosystemic shunt procedures.

METHODS

We retrospectively reviewed clinical data of consecutive patients between 1997 and 2018 from a single institution. Clinical characteristics and outcomes were compared between two groups: patients with portomesenteric venous thrombosis (PMVT) vs those with cirrhosis. Endpoints included 30-day mortality, shunt-related complications, patency, and survival.

RESULTS

There were 99 patients, 45 male and 54 female, with a mean age of 46 ± 18 years, enrolled in the study. There were 63 patients (63%) with PMVT and 36 patients (36%) with cirrhosis. Both groups had similar demographics, cardiovascular risk factors, and aneurysm extent, except for more diabetes among those with cirrhosis (p < 0.05). There were no significant differences in procedural metrics and intra-procedure complications between groups, except that patients with PMVT underwent more non-selective shunts than those with cirrhosis (63% vs. 30%, p < 0.001). There were two 30-day deaths (2%), with no difference in mortality and MAEs between groups. On univariate analysis, cholangiopathy and PMVT were associated with graft thrombosis (HR = 9.22, 95% CI 1.22-70.27) while race, smoking, cardiac comorbidity, type of operative shunt, configuration of the shunt, and use of conduit were not (p > 0.05). Patients with PMVT had significantly lower 1-, 5-, and 10-year primary (77%, 71%, and 71% vs. 97%, p = 0.009) and secondary patency (88%, 76%, and 72% vs. 96%, p = 0.027) compared with those with cirrhosis. The 1-, 5-, and 10-year survival rates were 94%, 84%, and 61% for patients with PMVT compared with 88%, 58%, and 26% for those with cirrhosis (non-adjusted HR 0.40, 95% CI 0.19-0.84, p = 0.01, age-adjusted HR 0.51, 95% CI 0.24-1.09, p = 0.08). The survival of patients with PMVT without liver disease trended higher than those with liver disease; however, when adjusted for age, the survival gap narrowed, and the difference was not statistically significant (p = 0.19), survival being lowest for those with PMVT and liver disease.

CONCLUSIONS

Surgical portosystemic shunts are safe and effective for symptom relief in selected patients with portal hypertension. The odds of graft thrombosis is 9 times higher in patients with PMVT. Overall survival is similar in patients with PMVT or cirrhosis.

Screening of Newborns and Infants for Developmental Dysplasia of the Hip: A Systematic Review

BACKGROUND

Developmental dysplasia of hip (DDH) is a common disorder of childhood and has a good prognosis when treated at an early age. In spite of being a significant concern, many children with DDH are not picked early and present late at walking age. In our country, it is presumed to be due to absence of a national policy for screening of DDH. Screening programmes including the combination of clinical and radiological methods in different ways have been suggested. However, the exact method of screening is controversial.

PURPOSE

To analyze effectiveness and cost-effectiveness of various screening methods for DDH.

STUDY DESIGN

Systematic review.

METHODS

This review was conducted in accordance with PRISMA guidelines. Medline database was explored for original case series and randomized clinical trials. Inclusion criteria were English language, screening for DDH in neonates, sample size more than 500, and studies with minimum duration of one year.

RESULTS

Thirty-four studies were selected to write the manuscript. This included 23 studies looking for effectiveness of a screening programme and 11 studies comparing various outcomes of different screening strategies. A trend favoring universal ultrasound screening was observed.

CONCLUSION

The literature supports universal ultrasound screening and has proved its cost-effectiveness. However, considering the logistic and financial challenges in our country, immediate implementation of universal ultrasound screening seems impractical. In the absence of any current guidelines for screening for DDH in India, we suggest professional organizations involved in the care of children and public health policy-makers to come together to develop national screening guidelines for DDH.

Improved selectivity for the determination of trinitrotoluene through reactive stage tandem ion mobility spectrometry and a quantitative measure of source-based suppression of ionization

A tandem ion mobility spectrometer was used to mobility isolate ions at the drift time for trinitrotoluene (TNT) in a first mobility stage, remove an interfering compound by ion decomposition in a middle reactive stage, and mobility characterize the remaining TNT ions in a second mobility stage. This sequential processing of ions provided decisive detection of TNT in the presence of an interfering peak differing from TNT in reduced mobility coefficient (K_o) by only 0.02 cm²/V. Even though ions of TNT (as M - 1)^- and the interfering compound were more than 90% convolved, TNT could be selectively detected with more than 95% decomposition of the interferent at 123 Td to an ion now separated by ΔK_o of 0.2 cm²/V from TNT. Ions for TNT were not decomposed in these electric fields though transmission efficiency was decreased by 20% through a wire grid assembly (the reactive stage). Although tandem ion mobility spectrometry with a reactive stage improves selectivity of measurement in the drift time dimension, the chemistry of ion formation in the ion source is affected still by ion suppression. Response to 1 ng TNT was decreased as much as 30% from 200 ng of interferent deposited on sample trap.

Discovery of potent and selective reversible Bruton's tyrosine kinase inhibitors

Bruton's tyrosine kinase (BTK) is a cytoplasmic, non-receptor tyrosine kinase member of the TEC family of tyrosine kinases. Pre-clinical and clinical data have shown that targeting BTK can be used for the treatment for B-cell disorders. Here we disclose the discovery of a novel imidazo[4,5-b]pyridine series of potent, selective reversible BTK inhibitors through a rational design approach. From a starting hit molecule 1, medicinal chemistry optimization led to the development of a lead compound 30, which exhibited 58 nM BTK inhibitory potency in human whole blood and high kinome selectivity. Additionally, the compound demonstrated favorable pharmacokinetics (PK), and showed potent dose-dependent efficacy in a rat CIA model.

The Combination of Food Approach and Food Avoidant Behaviors in Children with Autism Spectrum Disorder: "Selective Overeating"

Based on parent questionnaires, we demonstrate the presence of an eating pattern among children with autism spectrum disorder (ASD) that is characterized by both food selectivity and eating in the absence of hunger. Children with ASD were categorized as engaging in eating patterns of selective overeating, selective eating only, overeating only, or typical eating. Group differences were found in the areas of diet composition, body mass index, and behavioral flexibility. Both the selective overeating group and selective eating only group were prone to favor calorie-dense, nutrient-deficient diets as compared to other groups. Eating groups also presented with differing profiles of everyday behavioral flexibility. These results suggest that selective overeating in ASD may present unique challenges and require tailored interventions.

A fetal reduction from twin to singleton based on sonography and cell-free fetal DNA testing: A sequential approach to old pitfalls

OBJECTIVE

We examined the potential value of combining ultrasound and non-invasive prenatal screening (NIPS) of maternal blood to screen for major aneuploidies as an early approach before selective fetal reduction from twin pregnancy to singleton.

STUDY DESIGN

The sample was composed of pregnant women with di-chorionic di-amniotic twins who chose to undergo fetal reduction to singleton at 12-24 weeks of gestation. These women were asked to provide a blood sample for cell-free fetal DNA (cffDNA) testing prior to fetal reduction.

RESULTS

A total of 24 pregnant women with a twin pregnancy prior to fetal reduction to singleton were enrolled. There were 8 cases with structural anomalies (33.3%) in one twin that dictated fetal reduction. The proportion of patients who underwent selective fetal reduction for fetal abnormalities was larger than in several other studies. The NIPS identified 1 case of Trisomy 13 (4.2%). The other 15 cases (62.5%) had no structural or chromosomal anomalies. The decision to undergo elective reduction of twin pregnancy to singleton was made for social reasons or upon the parents' request. Given the 33% of structural anomalies in the cohort, a cost analysis indicated that this procedure was 6.6-fold less expensive (vs. 4.6-fold with 4% structural anomalies in other publications) than conducting invasive procedures for the entire cohort.

CONCLUSION

The findings suggest that an early anatomical scan and cffDNA can increase the overall safety margin and reduce interventional procedures before elective reduction of twin pregnancy to singleton. However, a larger cohort is needed to confirm these results.

A review on selective production of value-added chemicals via catalytic pyrolysis of lignocellulosic biomass

Increasing fossil fuel consumption and global warming has been driving the worldwide revolution towards renewable energy. Biomass is abundant and low-cost resource whereas it requires environmentally friendly and cost-effective conversion technique. Pyrolysis of biomass into valuable bio-oil has attracted much attention in the past decades due to its feasibility and huge commercial outlook. However, the complex chemical compositions and high water content in bio-oil greatly hinder the large-scale application and commercialization. Therefore, catalytic pyrolysis of biomass for selective production of specific chemicals will stand out as a unique pathway. This review aims to improve the understanding for the process by illustrating the chemistry of non-catalytic and catalytic pyrolysis of biomass at the temperatures ranging from 400 to 650 °C. The focus is to introduce recent progress about producing value-added hydrocarbons, phenols, anhydrosugars, and nitrogen-containing compounds from catalytic pyrolysis of biomass over zeolites, metal oxides, etc. via different reaction pathways including cracking, Diels-Alder/aromatization, ketonization/aldol condensation, and ammoniation. The potential challenges and future directions for this technique are discussed in deep.

The optimization of a novel selective antagonist for human M2 muscarinic acetylcholine receptor

Muscarinic acetylcholine receptors (mAChRs) comprise five distinct subtypes denoted M₁ to M₅. The antagonism of M₂ subtype could increase the release of acetylcholine from vesicles into the synaptic cleft and improve postsynaptic functions in the hippocampus via M₁ receptor activation, displaying therapeutic potentials for Alzheimer's disease. However, drug development for M₂ antagonists is still challenged among different receptor subtypes. In this study, by optimizing a scaffold from virtual screening, we synthesized two focused libraries and generated up to 50 derivatives. By measuring potency and binding selectivity, we discovered a novel M₂ antagonist, ligand 47, featuring submicromolar IC₅₀, high M₂/M₄ selectivity (~30-fold) and suitable lipophilicity (cLogP = 4.55). Further study with these compounds also illustrates the structure-activity relationship of this novel scaffold. Our study could not only provide novel lead structure, which was easy to synthesize, but also offer valuable information for further development of selective M₂ ligands.

Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis

Promotion of good mental health in young people is important. Our aim was to evaluate the consistency and magnitude of the efficacy of universal/selective interventions to promote good mental health. A systematic PRISMA/RIGHT-compliant meta-analysis (PROSPERO: CRD42018088708) search of Web of Science until 04/31/2019 identified original studies comparing the efficacy of universal/selective interventions for good mental health vs a control group, in samples with a mean age <35 years. Meta-analytical random-effects model, heterogeneity statistics, assessment of publication bias, study quality and sensitivity analyses investigated the efficacy (Hedges' g=effect size, ES) of universal/selective interventions to promote 14 good mental health outcomes defined a-priori. 276 studies were included (total participants: 159,508, 79,142 interventions and 80,366 controls), mean age=15.0 (SD=7.4); female=56.0%. There was a significant overall improvement in 10/13 good mental health outcome categories that could be meta-analysed: compared to controls, interventions significantly improved (in descending order of magnitude) mental health literacy (ES=0.685, p<0.001), emotions (ES=0.541, p<0.001), self-perceptions and values (ES=0.49, p<0.001), quality of life (ES=0.457, p=0.001), cognitive skills (ES=0.428, p<0.001), social skills (ES=0.371, p<0.001), physical health (ES=0.285, p<0.001), sexual health (ES=0.257, p=0.017), academic/occupational performance (ES=0.211, p<0.001) and attitude towards mental disorders (ES=0.177, p=0.006). Psychoeducation was the most effective intervention for promoting mental health literacy (ES=0.774, p<0.001) and cognitive skills (ES=1.153, p=0.03). Physical therapy, exercise and relaxation were more effective than psychoeducation and psychotherapy for promoting physical health (ES=0.498, p<0.001). In conclusion, several universal/selective interventions can be effective to promote good mental health in young people. Future research should consolidate and extend these findings.

Whole-genome resequencing provides insights into the evolution and divergence of the native domestic yaks of the Qinghai-Tibet Plateau

BACKGROUND

On the Qinghai-Tibet Plateau, known as the roof ridge of the world, the yak is a precious cattle species that has been indispensable to the human beings living in this high-altitude area. However, the origin of domestication, dispersal route, and the divergence of domestic yaks from different areas are poorly understood.

RESULTS

Here, we resequenced the genome of 91 domestic yak individuals from 31 populations and 1 wild yaks throughout China. Using a population genomics approach, we observed considerable genetic variation. Phylogenetic analysis suggested that the earliest domestications of yak occurred in the south-eastern QTP, followed by dispersal to the west QTP and northeast to SiChuang, Gansu, and Qinghai by two routes. Interestingly, we also found potential associations between the distribution of some breeds and historical trade routes such as the Silk Road and Tang-Tibet Ancient Road. Selective analysis identified 11 genes showing differentiation between domesticated and wild yaks and the potentially positively selected genes in each group were identified and compared among domesticated groups. We also detected an unbalanced pattern of introgression among domestic yak, wild yak, and Tibetan cattle.

CONCLUSIONS

Our research revealed population genetic evidence for three groups of domestic yaks. In addition to providing genomic evidence for the domestication history of yaks, we identified potential selected genes and introgression, which provide a theoretical basis and resources for the selective breeding of superior characters and high-quality yak.

Discovery of the first potent and selective αvβ5 integrin inhibitor based on an amide-containing core

Integrins α_vβ₅ and α_vβ₃ are closely related, proangiogenic members of the wider RGD-binding integrin family. Due to their high sequence homology, the development of α_vβ₅-selective compounds has remained elusive to synthetic and medicinal chemists. Herein, we describe a survey of SAR around a series of amide-containing 3-aryl-succinamic acid-based RGD mimetics. This resulted in the discovery of α,α,α-trifluorotolyl 12 which exhibits 800 × selectivity for α_vβ₅versus α_vβ₃ with a pyrrolidine amide linker that confers selectivity for α_vβ₅ by positioning a key aryl ring in the SDL of α_vβ₅ with good complementarity; binding in this mode is disfavoured in α_vβ₃ due to clashes with key residues in the β₃-subunit. Compound 12 exhibits selective inhibition by a cell adhesion assay, high passive permeability and solubility which enables potential use of this inhibitor as an α_vβ₅-selective in vitro tool compound.

Improved selective visualization of internal and external carotid artery in 4D-MR angiography based on super-selective pseudo-continuous arterial spin labeling combined with CENTRA-keyhole and view-sharing (4D-S-PACK)

PURPOSE

Four-dimensional magnetic resonance angiography (4D-MRA) based on super-selective pseudo-continuous arterial spin labeling, combined with Keyhole and View-sharing (4D-S-PACK) was introduced for scan-accelerated vessel-selective 4D-MRA. Label selectivity and visualization effectiveness were assessed.

METHODS

Nine healthy volunteers were included in the study. The label selectivity for the imaging of internal carotid artery (ICA) and external carotid artery (ECA) circulation was assessed qualitatively. The contrast-to-noise ratio (CNR) in 4D-S-PACK was measured in four middle cerebral artery (MCA) and superficial temporal artery (STA) segments and compared with that in contrast-inherent inflow-enhanced multi-phase angiography combined with the vessel-selective arterial spin labeling technique (CINEMA-select). Vessel-selective arterial visualization in 4D-S-PACK was assessed qualitatively in a patient with dural arteriovenous fistula and compared with digital subtraction angiography (DSA) and non-vessel selective 4D-PACK.

RESULTS

4D-S-PACK vessel selectivity was judged to be at a clinically acceptable level in all cases except one ECA-targeted label. The CNR was significantly higher using 4D-S-PACK compared with CINEMA-select in MCA and STA peripheral segments (p < 0.001). In patient examination, territorial flow visualization in feeding artery and draining vein circulation on 4D-S-PACK were comparable with that on DSA and the identification of such responsible vessels was easier on 4D-S-PACK than on 4D-PACK.

CONCLUSION

4D-S-PACK showed high vessel-selectivity and higher visualization effectiveness compared with CINEMA-select. One clinical case was performed and ICA and ECA territorial flow was successfully visualized separately, suggesting clinical usefulness.

Efficient removal of tylosin by nitrogen-doped mesoporous carbon nanospheres with tunable pore sizes

Efficient and selective removal of antibiotics from wastewater is quite important but challenging. In this work, the nitrogen-doped mesoporous carbon nanospheres (NMCN) with different pore size (from 2.67 to 4.62 nm) were successfully prepared by changing the hydrothermal condition, and their removal performance on tylosin was evaluated. The adsorption experimental data were fitted well with the pseudo-second-order kinetic model. Besides, Langmuir isotherm model could better describe the adsorption process. Notably, the NMCN with medium pore size (3.36 nm) exhibited the highest adsorption capacity (1333 mg g^-1), which was 24% and 14% higher than that of NMCNs with smaller and larger pore size, respectively. In order to study the adsorption mechanism, the mesoporous carbon nanospheres without N-doped was prepared, and the comparison of nitrogen adsorption-desorption isotherms was conducted. The result proved that in addition to the modified surface property, large specific surface area, and high pore volume, the pore size could precisely influence the adsorption performance of the proposed adsorbent. Furthermore, the proposed NMCN material possessed a selective adsorbing ability toward tylosin in the presence of tetracycline. Clearly, the NMCN was a promising alternative to be used as high efficient and selective adsorbent in practical environment pollution treatment, especially in large-size molecule adsorption.

Paying attention to speech: The role of working memory capacity and professional experience

Managing attention in multispeaker environments is a challenging feat that is critical for human performance. However, why some people are better than others in allocating attention appropriately remains highly unknown. Here, we investigated the contribution of two factors-working memory capacity (WMC) and professional experience-to performance on two different types of attention task: selective attention to one speaker and distributed attention among multiple concurrent speakers. We compared performance across three groups: individuals with low (n = 20) and high (n = 25) WMC, and aircraft pilots (n = 24), whose profession poses extremely high demands for both selective and distributed attention to speech. Results suggests that selective attention is highly effective, with good performance maintained under increasingly adverse conditions, whereas performance decreases substantially with the requirement to distribute attention among a larger number of speakers. Importantly, both types of attention benefit from higher WMC, suggesting reliance on some common capacity-limited resources. However, only selective attention was further improved in the pilots, pointing to its flexible and trainable nature, whereas distributed attention seems to suffer from more fixed and severe processing bottlenecks.