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Colonic intramuscular interstitial cells of Cajal (ICC-IM) are associated with cholinergic varicosities, suggesting a role in mediating excitatory neurotransmission. Ca2+ release in ICC-IM activates Ano1, a Ca2+ -activated Cl- conductance, causing tissue depolarization and increased smooth muscle excitability. We employed Ca2+ imaging of colonic ICC-IM in situ, using mice expressing GCaMP6f in ICC to evaluate ICC-IM responses to excitatory neurotransmission. Expression of muscarinic type 2, 3 (M2 , M3 ), and NK1 receptors were enriched in ICC-IM. NK1 receptor agonists had minimal effects on ICC-IM, whereas neostigmine and carbachol increased Ca2+ transients. These effects were reversed by DAU 5884 (M3 receptor antagonist) but not AF-DX 116 (M2 receptor antagonist). Electrical field stimulation (EFS) in the presence of L-NNA and MRS 2500 enhanced ICC-IM Ca2+ transients. Responses were blocked by atropine or DAU 5884, but not AF-DX 116. ICC-IM responses to EFS were ablated by inhibiting Ca2+ stores with cyclopiazonic acid and reduced by inhibiting Ca2+ influx via Orai channels. Contractions induced by EFS were reduced by an Ano1 channel antagonist, abolished by DAU 5884, and unaffected by AF-DX 116. Colonic ICC-IM receive excitatory inputs from cholinergic neurons via M3 receptor activation. Enhancing ICC-IM Ca2+ release and Ano1 activation contributes to excitatory responses of colonic muscles.The emergency department (ED) is a commonly utilized healthcare setting for many Americans when unexpected health challenges arise. Though vital, the ED is viewed as an expensive site of care, especially for conditions that could be managed in less resource-intensive settings. Prior estimates have suggested that a sizable proportion of ED visits are for low-acuity complaints that could be treated in cheaper alternatives, such as urgent care (UC) centers or retail clinics. Over the past decade, these alternatives to the ED for unexpected, low-acuity visits have rapidly emerged in the market. Policymakers and payers have shown enthusiasm to redirect low-acuity ED patients towards these alternatives given the proposed dual benefits of reducing crowded ED volumes and overall healthcare costs.Together with high conductivity, high flexibility is an important property required for the next generation organic electronic components. Both properties are difficult to achieve together especially when the components are crystalline due to the intrinsic high brittleness of organic molecular crystals. We report an organic radical crystal system that has both high flexibility and high conductivity. The crystal consists of 9,10-bis(phenylethynyl)anthracene radical cation ( BPEA ·+ ) units, and shows flexibility under pressure with high conductivity in ambient condition exhibiting average conductivity of 2.68 S cm -1 when normal linear shape, as well as 2.43 S cm -1 when bent. The structural analysis reveals that both a short π-π distance (3.290 Å) between BPEA ·+ units that are aligned along the crystal length direction, and the presence of PF 6 - counter ions induce flexiblity and high electircal conductivity.Objective Grief reactions in bereaved caregivers of cancer patients have been identified individually as distinct prolonged grief disorder (PGD)- and major depressive disorder (MDD)-symptom trajectories, but no research has examined whether patterns of change (trajectories) for PGD and MDD symptoms synchronize during bereavement. We conducted a secondary analysis study to investigate the construct distinctiveness of PGD and MDD by simultaneously identifying and examining similarities and differences between bereaved caregivers' PGD- and depressive-symptom trajectories from immediately postloss through 2 years later. Methods PGD and depressive symptoms were measured for 849 cancer patients' caregivers over their first 2 years of bereavement using 11 grief-symptom items of the Prolonged Grief-13 scale (PG-11) and the Center for Epidemiologic Studies-Depression (CES-D) scale, respectively. PGD- and depressive-symptom trajectories were identified using latent class growth analysis with continuous latent-class indreserved.Introducing amines/ammonia into lignin cracking will allow novel bond cleavage pathways. Herein, a method of amines/ammonia-mediated bond cleavage in oxidized lignin β-O-4 models was studied using a copper catalyst at room temperature, demonstrating the effect of the amine source on the selectivity of products. For primary and secondary aliphatic amines, lignin ketone models underwent oxidative Cα -Cβ bond cleavage and Cα -N bond formation to generate aromatic amides. For ammonia, the competition between oxygen and ammonia determined the selectivity between Cα -N and Cβ -N bond formation, generating amides and α-keto amides, respectively. For tertiary amines, the lignin models underwent oxidative Cα -Cβ bond cleavage to benzoic acids. Control experiments indicated that amines act as nucleophiles attacking at the Cα or Cβ position of the oxidized β-O-4 linkage to be cleaved. This study represents a novel example that the breakage of oxidized lignin model can be regulated by amines with a copper catalyst.Background The superficial circumflex iliac artery perforator (SCIP) flap cannot be used for coverage of large defects. We introduce a novel flap design to overcome the SCIP flap's size limitation. Methods Data of patients who underwent coverage of defects exceeding 113 cm2 (12 × 12 cm) using combined flaps composed of an SCIP flap and either a superficial inferior epigastric artery (SIEA) flap or a deep inferior epigastric artery perforator (DIEP) flap from September 2015 to September 2019 were retrospectively reviewed. After elevation of the SCIP flap, the SIEA was dissected. If the diameter of the SIEA was smaller than 0.5 mm, a DIEP included in the flap design was identified. For minimal donor site morbidity, the DIEP dissection was limited to its takeoff point from the deep inferior epigastric artery (DIEA), and a small T-portion of the DIEA was harvested. Results Six patients met inclusion criteria. The average defect size was 18.5 ± 2.3 × 15.7 ± 3.7 cm, and all defects were sufficiently covered. The mean dimensions of the SCIP flap, the SIEA flap, and the DIEP flap were 18.5 ± 2.5 × 7.5 ± 1.0 cm, 15.5 ± 2.1 × 6.6 ± 1.6 cm, and 17.5 ± 2.1 × 6.5 ± 0.7 cm, respectively. All flaps survived completely with no healing complications, and no donor site complications were observed. The SCIP flap was combined with the SIEA flap in four cases and with the DIEP flap in two cases. The average follow-up period was 12.7 ± 6.7 months. The final outcome was satisfactory in all cases. Conclusion Large defects (up to 20 × 20 cm) can be covered with minimal donor site morbidity, with primary closure, by combining either the SIEA or the DIEP flap with the SCIP flap.Many studies have reported a positive association between lower socioeconomic status (SES) and higher head and neck cancer (HNC) risk. Fewer studies have examined the impact of SES on the association between alcohol or cigarette use and HNC risk. The current case-control study (1,104 HNC cases and 1,363 controls) investigated the influence of education, a SES indicator, on the association between HNC and the use of alcohol, cigarettes, or betel quids in Taiwan, a country with universal health care. Our results showed a larger increase in HNC risk associated with alcohol among those with lower educational level (odds ratio (OR) = 2.07, 95% confidence interval (CI) 1.53-2.80) than those with higher educational level (OR = 1.38, 95% CI 1.04-1.85) (heterogeneity-p = 0.03). Educational level had an influence on the association between alcohol use and HNC risk among those with genetic susceptibility (ALDH2-deficient) to the carcinogenic effect of alcohol. The association between cigarette or betel quid use and HNC risk was similar between the high and the low educational groups. National policies and social interventions have led to the decline in the prevalences of cigarette and betel quid users in Taiwan. In contrast, due the lack of adequate alcohol control policies, alcohol consumption in Taiwan has continued to rise. A higher impact of alcohol on HNC risk among lower SES individuals even with universal health care could be the result of insufficient alcohol control policies in Taiwan.Over the past decades, teaching and learning within the discipline of anatomy has undergone significant changes. Some of these changes are due to a reduction in the number of teaching hours, while others are related to advancements in technology. Faced with these many choices for change, it can be difficult for faculty to decide on which new developments in anatomical education need or indeed can be integrated into their course to enhance student learning. This paper presents the Universal Design for Learning (UDL) framework - an informed, evidence-based and robust approach to underpin new course design and pedagogical reform in anatomy education. Universal design for learning is not a theory but a framework grounded in cognitive neuroscience that focuses on engaging multiple brain networks. The guidelines for UDL are organized into three core principles (1) provide multiple means of representation, (2) provide multiple means of action and expression, and (3) provide multiple means of engagement. The learning space within the anatomy laboratory provides an excellent opportunity in which to apply this framework. This article also describes current trends employed in the teaching of anatomy. The principles of UDL are then outlined, followed by a description of how UDL approaches have been applied in the design and delivery of anatomy practical teaching to first year medical students at University College Cork. Future implications for this work are a consideration and investigation of how a course designed with the principles of UDL at its heart ultimately benefits student learning.Background Recently, macro-focused ultrasound (MFU) has become a popular noninvasive esthetic treatment for facial laxity. However, there are no studies done that evaluated the use of MFU with a 2.0 mm transducer for upper facial lifting. Aims To evaluate the efficacy and safety of MFU with a 2.0 mm transducer in the treatment of upper facial laxity in Thai patients. Methods This was a prospective, evaluator-blinded pilot study with 34 Thai patients diagnosed with mild to moderate facial laxity. Patients were treated with a single session of MFU with 2.0 mm transducer at the forehead, lateral and just below the eye area. Bafilomycin A1 Primary outcome was the clinical improvement of upper facial laxity graded by 2 blinded dermatologists at baseline, 1-week, 1-, 3-, and 6-month follow-up. Objective measurements including eyebrow height, upper facial volume, and textural irregularities were evaluated. Patients' self-assessment scores and adverse effects were also recorded. Results Out of 34 patients, 27 (79.4%) attended all follow-ups. Clinical improvement of upper facial laxity was observed as early as 1-week follow-up. Eyebrow height elevation was significantly increased at every follow-up (P = .000) with an average of 1.22 mm at 6-month follow-up. Wrinkles improved significantly at 1-week and 6-month follow-up (P = .002 and P = .010, respectively). Skin roughness showed significant improvement at 6-month follow-up (P = .004). Majority of the patients (53.6%) reported marked improvement at 3-month follow-up. No serious adverse event was noted. Conclusion Macro-focused ultrasound is a safe and effective treatment for upper facial laxity and skin textural irregularities in patients with mild to moderate degree of laxity.
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