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This cave dwelling sponge species harbors a distinctive microbiome composition of potential taxonomic and metabolic novelties that may be linked to its ecological success in such extreme environments. © FEMS 2020.INTRODUCTION The ocular trauma score (OTS) is a widely used predictive tool in determining the visual prognosis of ocular injuries. Intraocular-foreign-body (IOFB)-type injuries comprise the leading type of open-globe injuries (OGI) in ocular combat injuries. However, there are scarce reports evaluating the efficacy of OTS in IOFB-type injuries. Only one study is available that explored the validity of OTS in combat-related IOFB injuries with a limited number of eyes. The aim of this study is to confirm the predictive value of OTS in lethal-weapon (LW)-related OGI with IOFB. MATERIAL AND METHODS The charts of 488 patients with IOFB-type-eye injuries between January 1998 and January 2018 were analyzed. Only the LW-related ocular injuries were included. Baseline details (patient demographics, surgeries, OTS categories, and visual acuity [VA]) were recorded. To test the validity of OTS, Fischer exact test was used to compare the likelihood of the final VAs for every OTS subgroups between OTS study group and this failed to predict visual outcome in first three OTS categories in this study. Therefore, OTS appears to be verified only in better (OTS categories 4 and 5) categories. © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail [email protected] The purpose of the present study was to evaluate the prognostic value of a systemic immune-inflammation index (SII) and the relationship between SII and the effectiveness of postoperative treatment in patients with non-small cell lung cancer (NSCLC). METHODS A total of 538 patients diagnosed with NSCLC who had undergone curative surgery were retrospectively enrolled in the study. Clinicopathologic and laboratory variables were collected. SII was defined as neutrophil × platelet/lymphocyte counts. Both univariate and multivariate analyses were performed to analyze the prognostic value of these factors. RESULTS The preoperative SII level was associated with sex, smoking history, histological type, lesion type, resection type, pathological stage, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), fibrinogen and bone metastasis (P less then 0.05). The univariate and multivariate analyses revealed that SII was an independent prognostic factor for disease-free survival (DFS, P=0.033) and overall survival (OS, P=0.020). Furthermore, the prognostic value of SII was also verified regardless of the histological type and pathological stage. The subgroup analysis demonstrated that patients with a high SII may benefit from adjuvant therapy (P=0.024 for DFS and P=0.012 for OS). CONCLUSION An increased preoperative SII may independently predict the poor DFS and OS in patients with resectable NSCLC. SII may help select NSCLC patients who might benefit from adjuvant chemotherapy. © 2020 The Author(s).INTRODUCTION Noncombat injuries ("injuries") greatly impact soldier health and United States (U.S.) Army readiness; they are the leading cause of outpatient medical encounters (more than two million annually) among active component (AC) soldiers. Noncombat musculoskeletal injuries ("MSKIs") may account for nearly 60% of soldiers' limited duty days and 65% of soldiers who cannot deploy for medical reasons. Injuries primarily affect readiness through increased limited duty days, decreased deployability rates, and increased medical separation rates. MSKIs are also responsible for exorbitant medical costs to the U.S. government, including service-connected disability compensation. A significant subset of soldiers develops chronic pain or long-term disability after injury; this may increase their risk for chronic disease or secondary health deficits potentially associated with MSKIs. The authors will review trends in U.S. Army MSKI rates, summarize MSKI readiness-related impacts, and highlight the importance of stalth and U.S. Army readiness. MSKIs also figure prominently in medical disability discharges and long-term, service-connected disability costs. MSKI patterns and trends vary between trainees and soldiers in operational units and among military occupations and types of operational units. Coordinated injury surveillance efforts are needed to provide standardized metrics and accurately measure temporal changes in injury rates. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2020. This work is written by US Government employees and is in the public domain in the US.INTRODUCTION Treatment approaches for mild traumatic brain injury (mTBI) have evolved to focus on active and targeted therapies, but the effect of compliance with therapy has not been investigated. The purpose of this study was to examine the role of patient compliance with prescribed therapies on clinical outcomes following mTBI. MATERIALS AND METHODS Participants were aged 18-60 years with chronic (ie, 6+ months) mTBI symptoms who were previously recalcitrant (n = 66). Participants were diagnosed with a vestibular disorder and were prescribed vestibular and exertion therapies. Participants were instructed to continue the exercise regimen during the 6-month treatment phase at home. Participant compliance was evaluated by clinicians at patients' follow up visit as (1) high, (2) moderate, or (3) low compliance based on patient report and clinician interview. High-compliance was compared to a combined low- and moderate-compliance group on the outcomes using a 2 (group) × 2 (time) analysis of variance. RESULTS 39 of the 66 (59%) participants with vestibular disorder returned for a 6-month evaluation and were included in the analyses. Of these 39 participants, 16 (41%) were high-compliance (36.7 ± 10.9 years, 18.8% female), 17 (44%) were moderate-compliance (32.5 ± 5.5 years, 23.5% female), and 6 (15%) were low-compliance (32.7 ± 3.3 years, 0% female). CONCLUSION High compliance significantly reduced total Vestibular/Ocular Motor Screening scores compared to low/middle compliance (P = .005). Post-Concussion Symptom Scale was reduced by 48% and dizziness symptoms reduced by 31% in the high-compliance cohort. High compliance with prescribed exertion/vestibular rehabilitation therapies enhanced clinical outcomes for previously recalcitrant patients with chronic mTBI-related vestibular disorders. © The Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail [email protected] To construct and analyze tumor-infiltrating immune cell and ceRNA (competitive endogenous RNA) networks in metastatic adrenal cortical carcinoma (ACC). METHODS A ceRNA network was established to identify the ceRNAs involved in metastasis of ACC based on 92 samples from TCGA, including 18 cases of metastasis and 74 cases of non-metastatic primary tumors. And the algorithm "cell type identification by estimating relative subsets of RNA transcripts (CIBERSORT)" was used to quantify the proportion of immune cells in ACC. In addition, predictive nomograms based on the types of important immune cells or ceRNAs were constructed to predict ACC prognosis. Moreover, we evaluated the relationships between metastatic ACC-specific immune cells and ceRNA networks to identify the potential immune gene characteristics. RESULTS Ten prognostic biomarkers were identified as key members of the ceRNA network and three tumor-infiltrating immune cells were identified by CIBERSORT algorithm. Some important co-expression patterns between immune cells and ceRNAs network indicate significant correlation between Macrophages M0 and hsa-miR-130b-3p (P less then 0.001), Macrophages M0 and H2AFX (P = 0.003). CONCLUSIONS The present study inferred that the metastasis-related ceRNAs of H2AFX, hsa-miR-130b-3p and Macrophages M0 might play important roles in ACC metastasis. © 2020 The Author(s).Diabetic cardiac fibrosis increases ventricular stiffness and facilitates the occurrence of diastolic dysfunction. Retinoid X receptor (RXR) plays an important role in cardiac development and has been implicated in cardiovascular diseases. In the present study, we investigated the effects of RXR agonist treatment on streptozotocin (STZ)-induced diabetic cardiomyopathy (DCM) and the underlying mechanism. Sprague-Dawley (SD) rats induced by STZ injection were treated with either RXR agonist bexarotene (Bex) or vehicle alone. Echocardiography was performed to determine cardiac structure and function. Cardiac fibroblasts (CFs) were treated with high glucose (HG) with or without the indicated concentration of Bex or the RXR ligand 9-cis-retinoic acid (9-cis-RA). The protein abundance levels were measured along with collagen, body weight (BW), blood biochemical indexes and transforming growth factor-β (TGF-β) levels. The effects of RXRα down-regulation by RXRα small interfering RNA (siRNA) were examined. The results showed that bexarotene treatment resulted in amelioration of left ventricular dysfunction by inhibiting cardiomyocyte apoptosis and myocardial fibrosis. Immunoblot with heart tissue homogenates from diabetic rats revealed that bexarotene activated liver kinase B1 (LKB1) signaling and inhibited p70 ribosomal protein S6 kinase (p70S6K). The increased collagen levels in the heart tissues of DCM rats were reduced by bexarotene treatment. Treatment of CFs with HG resulted in significantly reduced LKB1 activity and increased p70S6K activity. RXRα mediated the antagonism of 9-cis-RA on HG-induced LKB1/p70S6K activation changes in vitro. Our findings suggest that RXR agonist ameliorates STZ-induced DCM by inhibiting myocardial fibrosis via modulation of the LKB1/p70S6K signaling pathway. RXR agonists may serve as novel therapeutic agents for the treatment of DCM. Mitapivat © 2020 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.BACKGROUND User fee exemption for maternal healthcare services was introduced with a focus on providing free maternal health services, including caesarean sections (CS), in Nigeria. This policy has had a positive impact on access to facility-based delivery; however, the extent to which inequality in access to CS exists in the context of user fee exemption is unclear. The objective of this study was to examine inequalities in access to birth by CS 5 y after the implementation of the user fee exemption policy. METHODS Data were obtained from 1227 women who gave birth between 2011 and 2015 and were selected using cluster random sampling between May and August 2016 from two of the six main regions of the country. Adjusted and unadjusted binary logistic regression models were performed. RESULTS An overall CS rate of 6.1% was found, but varied by income, education and place of residence. Women who earned a monthly income of ≤20 000 naira (US$150) were 50% less likely to have a birth by CS compared with those who earned more. Compared with women who were educated to the tertiary level, women who had a secondary education or less were 51% less likely to give birth by CS. CONCLUSIONS This study shows that inequality in access to CS persists despite the implementation of free maternal healthcare services. © The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
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