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Endophthalmitis is a serious complication of cataract surgery that occurs in thousands of patients each year. read more To decrease the incidence of post-operative endophthalmitis, many surgeons inject intracameral antibiotics (cefuroxime, moxifloxacin, and vancomycin) routinely at the conclusion of surgery. A large number of recently published retrospective studies and large database analyses have reported decreased endophthalmitis rates with routine antibiotic use, and the only prospective, multi-center, randomized trial performed by the European Society of Cataract and Refractive Surgery demonstrated that intracameral cefuroxime decreases the incidence of post-operative endophthalmitis. Routine cefuroxime use has become common in many European countries, whereas moxifloxacin is the most commonly used drug in India, and vancomycin use predominates in Australia. The decision regarding whether or not to use intracameral prophylaxis and the drug that is selected varies considerably throughout the world because of antibiotic availability and cost, and the spectrum of causative organisms. Adverse events due to intracameral antibiotics are infrequent, but complications such as hemorrhagic occlusive retinal vasculitis have been reported. link2 Because additional prospective, comparative trials have not been performed, a consensus regarding best practices to prevent post-operative endophthalmitis has not been reached. Additionally, many surgeons do not routinely use intracameral antibiotics because they believe them unnecessary with modern antiseptic techniques, small incision surgery, and shorter operating times. We discuss the most commonly used intracameral antibiotics, present the risks and potential benefits of this approach, and higlight challenges with drug compounding and safety. Stem cell aging contributes to aging-associated tissue degeneration and dysfunction. Recent studies reveal a mitochondrial metabolic checkpoint that regulates stem cell quiescence and maintenance, and dysregulation of the checkpoint leads to functional deterioration of aged stem cells. Here, we present the evidence supporting the mitochondrial metabolic checkpoint regulating stem cell aging and demonstrating the feasibility to target this checkpoint to reverse stem cell aging. We discuss the mechanisms by which mitochondrial stress leads to stem cell deterioration. We speculate the therapeutic potential of targeting the mitochondrial metabolic checkpoint for rejuvenating aged stem cells and improving aging tissue functions. BACKGROUND AND AIMS Artificial intelligence (AI), specifically deep learning, offers the potential to enhance the field of gastrointestinal endoscopy in areas ranging from lesion detection and classification, to quality metrics and documentation. Progress in this field will be measured by whether AI implementation can lead to improved patient outcomes and more-efficient clinical workflow for GI endoscopists. The aims of this article are to report the findings of a multidisciplinary group of experts focusing on issues in artificial intelligence research and applications related to gastroenterology and endoscopy, to review the current status of the field, and to produce recommendations for investigators developing and studying new AI technologies for gastroenterology. METHODS A multidisciplinary meeting was held on September 28, 2019, bringing together academic, industry, and regulatory experts in diverse fields including gastroenterology, computer and imaging sciences, machine learning, and computer vision, Fondpoints. Other threshold outcomes will be important, as well as clarity on iterative improvement of clinical systems. CONCLUSIONS Gastroenterology is a prime candidate for early adoption of AI. AI is rapidly moving from an experimental phase to a clinical implementation phase in gastroenterology. It is anticipated that the implementation of AI in gastroenterology over the next decade will have a significant and positive impact on patient care and clinical workflows. Ongoing collaboration among gastroenterologists, industry experts, and regulatory agencies will be important to ensure that progress is rapid and clinically meaningful. However, there are several constraints and areas that will benefit from further exploration, including potential clinical applications, implementation, structure and governance, role of gastroenterologists, and potential impact of AI in gastroenterology. link3 BACKGROUNDS AND AIMS New mucosal resective and ablative endoscopic procedures based on gastric cardiac remodeling to prevent reflux have appeared. We aimed to evaluate the feasibility of a new ablative technique named antireflux ablation therapy (ARAT), GERD control in patients without hiatal hernia. METHODS PPI-refractory GERD patients without hiatal hernia underwent ARAT between January 2016 and October 2019. GERD-HRQL, upper endoscopy, 24-hour pH monitoring and PPI use were documented at 3, 6, 12, 24, and 36 months after ARAT. RESULTS One hundred eight patients were included (61 male [56.5%]; median age 36.5 years [18-78]). ARAT was performed in all patients. At 36-month evaluation, 84 patients completed protocol. Median ARAT time was 35.5 minutes (22-51), and median circumference ablation was 300°(270°-320°). No major adverse events were found, and 14 out of 108 (12.9%) presented with stenosis that was responsive to balloon dilation in all cases ( less then 5 sessions). At 3-month evaluation, we found a decrease from 18.8 to 2.8 (P=0.001), 42.5 to 9.1 (P=0.001) and 36.5 to 10 (P=0.02), for AET (acid exposure time), DM and GERD-HRQL scores, respectively, and were maintained up to 36 months. Success (AET less then 4%) was achieved in 89% and 72.2% at 3 and 36 months respectively. Related factors at 36 months were as follows Pre-ARAT Hill type II (OR, 3.212; 95% CI, 1.431-5.951; P=0.033), post-ARAT 3-month Hill type I (OR, 4.101; 95% CI, 1.812-9.121; P=0.042) and AET less then 4 at 3 months (OR, 5.512; 95% CI, 1.451-7.621; P=0.021). CONCLUSIONS ARAT is a feasible, safe, and effective therapy at early- and mid-term for treatment of GERD in patients without sliding hiatal hernia. However, longer follow-up evaluations and randomized comparative studies are needed to clarify its real role. In this study, we investigated the protective role of Spirulina platensis-lipopolysaccharides (S-LPS) and low dose-ionizing radiation (LD-IR) against prolonged administration of high nicotine concentration that induced neurotoxicity in the rats' brain. Rats treated with nicotine for two months showed alterations in the oxidative stress markers (malondialdehyde (MDA), reduced glutathione (GSH) and oxidized glutathione disulfide (GSSG)), antioxidant enzymes (superoxide dismutase (SOD), catalase (Cat), glutathione enzymes (GPx and GST)) as well as several pro-inflammatory markers (Tumor Necrosis Factor-alpha (TNF-α), Interleukin-17 (IL-17), and Nuclear Factor-kappa B (NF-κB)), and induced apoptosis through Caspase-3 activity. Further, it upregulates the mRNA gene expression of cytochrome P450 enzymes (CYP2B1 and CYP2E1), Toll-Like Receptor 4 (TLR4), and Cyclin-dependent kinase 5 (CDK5). Furthermore, it upregulates Phospho-Tau (p-Tau) protein expression. Besides, it downregulates the alpha-7 nicotinic receptor (α7nAChR) mRNA expression accompanied by a decline in the calcium (Ca+2) level. S.LPS exhibited neuroprotective activity by counteracting the detrimental effects of chronic nicotine administration. LD-IR demonstrated comparable effects as S.LPS. Exposure of rats to LD-IR enhanced the neuroprotective effects of S.LPS against nicotine toxicity. The light microscopic examination of the brain tissues is in agreement with the biochemical investigations. In conclusion S.LPS and LD-IR mitigate the oxidative stress and impairment of rats' brain induced by nicotine. The active sites of metalloproteins may be mimicked by designing peptides that bind to their respective metal ions. Studying the binding of protein ligands to metal ions along with the associated structural changes is important in understanding metal uptake, transport and electron transfer functions of proteins. Copper-binding metalloprotein azurin is a 128-residue electron transfer protein with a redox-active copper cofactor. Here, we report the copper-binding associated spectroscopic and structural properties of peptide loops (11 and 13 residues) from the copper-binding site of azurin. These peptides develop a β-turn upon copper-binding with a 11 Cu2+peptide stoichiometry as seen in circular dichroism and exhibit electronic transitions centered at 340 nm and 540 nm. Further addition of copper develops a helical feature along with a shift in the absorption maxima to ~360 nm and ~580 nm at 21 Cu2+peptide stoichiometry, indicating stoichiometric dependence of copper-binding geometry. Mass spectrometry indicates the copper-binding to cysteine, histidine and methionine in the peptide with 11 stoichiometry, and interestingly, dimerization through a disulfide linkage at 21 stoichiometry, as observed previously for denatured azurin. Fluorescence quenching studies on peptides with tryptophan further confirm the copper-binding induced changes in the two peptides are bi-phasic. Epithelial mesenchymal transition (EMT) is a well-known and important step in metastasis and thus can be a key target in cancer treatment. Here, we tested the EMT inhibitory actions of Selaginella tamariscina and its active component, amentoflavone (AF). EMT was examined in vitro using wound-healing and invasion assays and by monitoring changes in the expression of the EMT-related proteins, E-cadherin, Snail, and Twist. Metastasis was examined in vivo using SCID mice injected with luciferase-labeled A549 cells. We confirmed that aqueous extracts of S. tamariscina (STE) and AF inhibited EMT in human cancer cell lines. We found that STE and AF at nontoxic concentrations exerted remarkable inhibitory effects on migration (wound healing assay) and invasion (Transwell assay) in tumor necrosis factor (TGF)-β-treated cancer cells. Western blotting and immunofluorescence imaging show that AF treatment also restored E-cadherin expression in these cells compared to cells treated with TGF-β only. Suppression of metastasis by AF was investigated by monitoring migration of tail-vein-injected, circulating A549-luc cells to the lungs in mice. After 3 wk, fewer nodules were observed in mice co-treated with AF compared with those treated with TGF-β only. Our findings indicate that STE and AF are promising EMT inhibitors and, ultimately, potentially potent antitumor agents. OBJECTIVES To examine the immediate and sustained effects of interventions for changing physical activity behavior in people with multiple sclerosis (MS), and explore factors that might moderate intervention effects on physical activity behavior (e.g., intervention type and duration, type of physical activity measurement, intensity of theory integration [degree of theory used in study design], and study quality). DATA SOURCES Systematic searches were conducted in four databases, including MEDLINE, CINAHL, PsychINFO, Google Scholar, in October 2017 and October 2018. Updated searches were conducted in September 2019 with two additional databases (Embase and Scopus) and enhanced search terms. STUDY SELECTION Studies were included that (1) incorporated a randomized controlled trial design of interventions that targeted change in physical activity behavior in adults with MS, namely, exercise training and behavioral intervention (alone and combined); (2) included self-reported and/or device-measured physical activity as an outcome; and (3) contained pre-post assessments.
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