Notes

Robot-assisted pancreatoduodenectomy with the fordi Vinci Xi: could the price involving innovative technological innovation always be counteract by specialized medical advantages? A case-matched expense examination vs . available method.
Eyes with tilted disc (TD) had significantly lower peripapillary vessel density (pVD) and lower long-term measurement reproducibility in optical coherence tomography angiography (OCTA). After adjusting for confounding factors, disc tilt still contributed to the reduction of pVD in most sectors.

The purpose of this study was to investigate the effect of optic disc tilt on the measurement of sectoral pVD by OCTA and on the long-term measurement reproducibility.

This retrospective observational case-control study included 70 healthy eyes. Average and 8-sector pVDs and peripapillary retinal nerve fiber layer (pRNFL) thicknesses were obtained from OCTA at 2 visits at 1-year intervals. The disc tilt was quantified by ovality ratio (the longest/shortest disc diameter) on fundus photography, with a TD defined as an ovality ratio ≥1.3. pVD and pRNFL thickness of each sector were compared in the TD and nontilted disc (NTD) groups. Long-term reproducibility was assessed by the intraclass correlation coefficients (ICCs) for both groups. Factors associated with pVD were evaluated by univariable and multivariable linear regression analyses.

Thirty-five eyes each had TD and NTD. Average pVD was lower in the TD than in the NTD group (47.0%±3.5% vs. 51.7%±2.8%, P <0.001), as were pVDs in all 8 sectors. The long-term reproducibilities of average and sectoral pVD measurements were lower in the TD (ICC 0.46-0.83) than in the NTD (ICC 0.67-0.96) group. Disc tilt was significantly associated with pVD in average and all sectors except for nasal inferior sector after adjusting for axial length, pRNFL thickness, and signal strength index of OCTA image.

OCTA-measured pVD and the long-term reproducibility were lower in eyes with TD than NTD. These findings should be considered when interpreting OCTA-measured pVD.
OCTA-measured pVD and the long-term reproducibility were lower in eyes with TD than NTD. These findings should be considered when interpreting OCTA-measured pVD.
We examined the safety and efficacy of the open conjunctiva ab externo approach for XEN45 gel stent implantation. There was a significant reduction in intraocular pressure (IOP) and number of glaucoma medications at 12 months follow-up.

This study aims to determine the safety and efficacy of the open conjunctiva ab externo approach to XEN45 stent implantation.

Retrospective chart review of all patients between July 2018 and March 2020 who underwent XEN45 implantation. IOP and the number of glaucoma medications were measured at the preoperative, 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperative appointments. The primary outcome of this study is the number of cases achieving complete success at 12 months postoperatively.

Forty-four eyes of 44 patients were included. Mean preoperative IOP was 26.2±8.7mmHg on 3.2±0.7 IOP-lowering medications. At 12 months postoperative, mean IOP was 18.9±9.1mmHg (n=35, P <0.0001; mean reduction of 27.9%) on 0.9±1.4 (n=35, P <0.0001) IOP-lowerinction in 48.6% of glaucoma cases within the first year. The most common adverse events included the need for additional glaucoma surgery (excluding needling procedures), transient hypotony, and bleb leak.
To compare the pattern of vascular density and structural damage in primary open angle glaucoma (POAG) with primary angle closure glaucoma (PACG) using optical coherence tomography (OCT) and OCT angiography (OCTA) in the optic nerve head, circumpapillary, and macular regions, respectively.

One hundred thirty-one eyes of 82 patients (53 eyes with PACG and 78 eyes with POAG) were enrolled in this study. The patients underwent complete ophthalmic examination, Bruch membrane opening minimum rim width, circumpapillay retinal nerve fiber layer (cpRNFL), and macular ganglion cell complex (GCC) measurements and vascular density determination of the peripapillary and macular area with OCT and OCTA. A linear mixed model was used for the statistical analysis.

There was no significant difference between the 2 groups in terms of age ( P =0.94) and visual field mean deviation ( P =0.78). Female-to-male ratio was higher in PACG patients than the POAG group ( P =0.02), and AL was shorter in PACG eyes ( P <0.001). cpRNFL and GCC were not different between the 2 groups (all P values>0.05, except for nasal segment cpRNFL). Vessel densities in the peripapillary and macular areas were comparable between the 2 groups (all P values>0.05). Although Bruch membrane opening minimum rim width was thicker in PACG eyes on univariate analysis, the multivariable analysis showed no significant difference between the 2 groups ( P >0.05).

PACG and POAG eyes with similar visual field damages have comparable structural damage patterns in the peripapillary and inner macular thickness and vessel density measurements.
PACG and POAG eyes with similar visual field damages have comparable structural damage patterns in the peripapillary and inner macular thickness and vessel density measurements.
Identifying the severity of neonatal respiratory distress (RD) is essential, so that resources can be appropriately allocated. We assessed the ability of nurses to grade neonatal RD in a low-resource setting before and after they were trained to use a dedicated scoring tool.

The study was conducted in the Special Care Unit of St Luke Wolisso Hospital, Ethiopia. Ten nurses reviewed nine local video recordings and graded neonatal RD without a standardised method, which was current practice, and then after they were trained to use the Silverman and Andersen score. The data were analysed using the McNemar test and Cohen's kappa.

Training increased the identification of mild RD from 63% to 93% (p=0.008) and moderate RD from 40% to 73% (p=0.03). Severe RD was 93% before and 90% after training (p=0.99). Overall, the agreement improved from kappa 0.59 to 0.84, mainly by reducing the overestimation of milder degrees of RD.

Being trained on how to use the Silverman and Andersen score improved the ability of nurses to identify mild and moderate neonatal RD. This improvement has the potential to optimise the use of equipment, staff and time.
Being trained on how to use the Silverman and Andersen score improved the ability of nurses to identify mild and moderate neonatal RD. This improvement has the potential to optimise the use of equipment, staff and time.Identification of the authentic active species of cluster catalysis is rather challenging, and direct structural evidence is quite valuable and difficult to obtain. Two "isostructural" clusters, Ag25Cu4Cl6(dppb)6(PhC≡C)12(SO3CF3)3 (1) and Ag25Cu4Cl6H8(dppb)6(PhC≡C)12(SO3CF3)3 (2H) (dppb is 1,4-bis(diphenylphosphine)butane), have been successfully isolated and structurally characterized. Both these clusters have a centered icosahedron Ag13 core with the same peripheral composition and structure. Zolinza The only difference is that 2H has eight hydrides but 1 has none, that is, the kernels are Ag135+ and Ag13H85+ in 1 and 2H, respectively. The catalytic reduction of 4-nitrophenol (4-NP) to 4-aminophenol (4-AP) as a model reaction is assessed with the two clusters. Cluster 2H is very active with 100% yield within 2 h, whereas 1 shows a very low conversion (∼8%) under the same conditions. Interestingly, high catalytic activity was observed when 1 was converted to 2H with the oxidation of H2O2 under catalytic conditions. The unprecedented transformation of a reduced nanocluster to an Ag(I)Cu(I) bimetallic cluster compound provides an excellent platform to determine the real active cluster in terms of metal cluster catalysis. The present work presents clear structural evidence that the catalytic performance of metal nanoclusters can be modulated by properly regulating the oxidation state of their constituted metal atoms.Immunometabolism has recently emerged as a field of study examining the intersection between immunology and metabolism. Studies in this area have yielded new findings on the roles of a diverse range of metabolic pathways and metabolites, which have been found to control many aspects of T-cell biology, including cell differentiation, function and fate. A particularly important finding has been the discovery that to meet the energy requirements associated with their proliferation, activation and specific functions, T cells switch their metabolic signatures during differentiation. For example, whereas the induction of de novo fatty acid biosynthesis and fatty acid uptake programs are required for antigen-stimulation-induced proliferation and differentiation of effector T cells, fatty acid catabolism via β-oxidation is essential for the generation of memory T cells and the differentiation of regulatory T cells. In this review, we discuss recent advances in our understanding of the metabolism in different stages of T cells and how fatty acid metabolism in these cells controls their specific functions.One strategy to prepare phase-separated co-assembly is to use the existing assembly as a platform to architect structures. For this purpose, the edge of a sheet or tube-shaped molecular assembly, which is less hydrophilic than the bulk region can become a starting point to build assembly units to realize more complex structures. In this study, we succeeded in preparing rod-shaped nanocapsules with previously unachieved sealing efficiency (>99%) by fine-tuning the properties of cationic amphiphilic polypeptides to seal the ends of neutral charge nanotubes. In addition, we demonstrated the nanocapsule's reversible responsiveness to salt. In high salt concentrations, a decrease in electrostatic repulsion between cationic polypeptides caused tearing and shrinking of the nanocapsule's sealing dome, which resulted in an opened nanotube. On the other hand, when salt was removed, the electrostatic repulsion among the cationic peptides localizing on the edge of opened nanocapsules was recovered, and the sealing membrane swelled up like an accordion to create a distance between the peptides, resulting in the restoration of the seal.Carbon dots (CDs) have aroused widespread interest in the construction of room-temperature phosphorescent (RTP) materials. However, it is a great challenge to obtain simultaneous multicolor long-wavelength RTP emission and excellent stability in CD-based RTP materials. Herein, a novel and universal "CDs-in-YOHF" strategy is proposed to generate multicolor and long-wavelength RTP by confining various CDs in the Y(OH)xF3-x (YOHF) matrix. The mechanism of the triplet emission of CDs is related to the space confinement, the formation of hydrogen bonds and C-F bonds, and the electron-withdrawing fluorine atoms. Remarkably, the RTP lifetime of orange-emissive CDs-o@YOHF is the longest among the reported single-CD-matrix composites for emission above 570 nm. Furthermore, CDs-o@YOHF exhibited higher RTP performance at long wavelength in comparison to CDs-o@matrix (matrix = PVA, PU, urea, silica). The resulting CDs@YOHF shows excellent photostability, thermostability, chemical stability, and temporal stability, which is rather favorable for information security, especially in a complex environment.Supported catalysts have exhibited excellent performance in various reactions. However, the rational design of supported catalysts with high activity and certain selectivity remains a great challenge because of the complicated interfacial effects. Using recently emerged two-dimensional materials supported dual-atom catalysts (DACs@2D) as a prototype, we propose a simple and universal descriptor based on inherent atomic properties (electronegativity, electron type, and number), which can well evaluate the complicated interfacial effects on the electrochemical reduction reactions (i.e., CO2, O2, and N2 reduction reactions). Based on this descriptor, activity and selectivity trends in CO2 reduction reaction are successfully elucidated, in good agreement with available experimental data. Moreover, several potential catalysts with superior activity and selectivity for target products are predicted, such as CuCr/g-C3N4 for CH4 and CuSn/N-BN for HCOOH. More importantly, this descriptor can also be extended to evaluate the activity of DACs@2D for O2 and N2 reduction reactions, with very small errors between the prediction and reported experimental/computational results.
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