Bacterial nanocellulose-clay film as an eco-friendly sorbent for superior pollutants removal from aqueous solutions.

The persistent water treatment and separation challenge necessitates innovative and sustainable advances to tackle conventional and emerging contaminants in the aquatic environment effectively. Therefore, a unique three-dimensional (3D) network composite film (BNC-KC) comprised of bacterial nanocellulose (BNC) incorporated nano-kaolinite clay particles (KC) was successfully synthesized via an in-situ approach. The microscopic characterization of BNC-KC revealed an effective integration of KC within the 3D matrix of BNC. The investigated mechanical properties of BNC-KC demonstrated a better performance compared to BNC. Thereafter, the sorption performance of BNC-KC films towards basic blue 9 dye (Bb9) and norfloxacin (NFX) antibiotic from water was investigated. The maximum sorption capacities of BNC-KC for Bb9 and NFX were 127.64 and 101.68 mg/g, respectively. Mechanistic studies showed that electrostatic interactions, multi-layered sorption, and 3D structure are pivotal in the NFX/Bb9 sorption process. The intricate architecture of BNC-KC effectively traps molecules within the interlayer spaces, significantly increasing sorption efficiency. The distinctive structural configuration of BNC-KC films effectively addressed the challenges of post-water treatment separation while concurrently mitigating waste generation. The environmental evaluation, engineering, and economic feasibility of BNC-KC are also discussed. The cost estimation assessment of BNC-KC revealed the potential to remove NFX and Bb9 from water at an economically viable cost.

Minimalist transcatheter aortic valve replacement misses paravalvular regurgitation: Incidence and echocardiographic distribution of missed paravalvular regurgitation.

BACKGROUND: Paravalvular regurgitation (PVR) may be missed intraoperatively with transthoracic echocardiography (TTE) guided minimalist TAVR. We sought to determine the incidence and echocardiographic distribution of PVR missed on intra-op TTE, but detected on predischarge TTE. METHODS: From July 2015 to 2020, 475 patients with symptomatic severe native aortic stenosis underwent TTE-guided minimalist TAVR. Missed PVR was defined as predischarge PVR that was ≥1 grade higher than the corresponding intra-op PVR severity. PVR was classified as anterior or posterior on the four standard TTE views; parasternal short-axis (PSAX), parasternal long-axis (PLAX), apical 3-chamber (A3C), and 5-chamber (A5C). Location-specific risk of missed PVR was then determined. RESULTS: Mild or greater PVR was seen in 55 (11.5%) cases intra-op and 91 (19.1%) at predischarge, with no severe PVR. Among the 91 patients with ≥mild predischarge PVR, missed PVR was present in 42 (46.2%). Compared to the corresponding anterior jets, missed PVR rate was significantly higher for posterior jets in PLAX (62.5% vs. 25.0%, p = 0.005), A5C (56.9% vs. 25.0%, p = 0.009), PSAX (66.7% vs. 24.3%, 0.001), but not A3C (58.5% vs. 40.0%, p = 0.28). CONCLUSIONS: Intraoperative TTE-guided minimalist TAVR either misses nearly half of ≥mild PVR or underestimates PVR by ≥1 grade when compared to predischarge TTE. Posterior PVR jets are more likely to be missed. Transesophageal echo guidance may help minimize missing PVR. Further studies are warranted.

Callus cell and explants regeneration, glucose, mineral, antioxidant and flavonoid content development using broccoli root tip and leaf cutting in vitro.

The study was conducted to evaluate the root, shoot and leaf callus cell regeneration and its biochemical properties like antioxidant, carbohydrate, pigment and mineral content from broccoli root, shoot and leaf cutting in vitro. An in vitro factorial experiment was carried out based on a Completely Randomized Design (CRD) with 5 replicates in tissue culture applying different IBA (0.25, 0.5, 1.0, 1.5, 2.0, 2.5, 3.0 and 3.5 mg/l) and BAP (1 mg/l) concentrations using broccoli root tip and leaf cutting. The results showed that a higher callus weight was found in the cultured leaf cutting than in root tip cutting in the concentration of 1.0, 1.5 & 2.0 mg/l IBA + 1.0 mg/l BAP combination. The highest callus weight was found in the cultured leaf cutting than root tips cutting at the concentration of 1.5mg/l IBA+1.0 mg/l BAP. Furthermore, the highest inverted sugar and glucose, chlorophyll and nutrient content (K+, NO3- & Ca++), total phenol, flavonoid and total antioxidant were found in the concentration of 1.5mg/l IBA+1.0 mg/l BAP combination in both broccoli leaf and root cutting. The results seemed that it was best to use the combination of the IBA and BAP in the concentration of 1.0-2.0 mg/l and 1mg/l to regenerate root, leaf and callus cell proliferation of broccoli from the root tip and leaf cutting.

Seedless okra pod, chlorophyll, vitamin C and mineral content development using plant growth regulator in vitro and in vivo culture.

Vegetables are rich in vitamins, minerals and dietary fiber that keep a significant role in the functioning of the human body to refrain human health benefits. The experiment was carried out to investigate the effect of different concentrations of IAA on the seedless pod, chlorophyll, vitamin and mineral content of okra as human health benefits. The innovative seed soaking method of application using 0, 25, 50, 100 & 200 mg/l of IAA concentrations was used in okra before germination and cultured in vitro and in vivo. The lower concentrations (25 and 50 mg/l) of IAA significantly increased the pod setting compared to the higher concentration (100 and 200 mg/l). The higher concentration (100 and 200 mg/l) had lower fruit settings than the lower concentration (25 &50) had higher fruit settings. The higher pod size was obtained in the concentration of 100 & 200 mg/l of IAA (34.18 cm²) as compared to the control and other concentrations. In addition, the highest soluble solid content was obtained by 100 and 200 mg/l of IAA concentration as compared to the other concentrations. The maximum vitamin C was found in the concentration of 100 mg/l of IAA as compared to the control and other concentrations. Moreover, higher mineral contents like K, Ca, Mg, Na and Fe were found in 100 & 200 mg/l of IAA. The higher concentrations (100 and 200 mg/l) of IAA greatly increased the seedless okra percentage as compared to the lower concentration. It seemed that 100 and 200 mg/l concentration IAA was a better concentration for mineral content and seedless okra production as compared to the other concentrations.

Calcium released by osteoclastic resorption stimulates autocrine/paracrine activities in local osteogenic cells to promote coupled bone formation.

A major cause of osteoporosis is impaired coupled bone formation. Mechanistically, both osteoclast-derived and bone-derived growth factors have been previously implicated. Here, we hypothesize that the release of bone calcium during osteoclastic bone resorption is essential for coupled bone formation. Osteoclastic resorption increases interstitial fluid calcium locally from the normal 1.8 mM up to 5 mM. MC3T3-E1 osteoprogenitor cells, cultured in a 3.6 mM calcium medium, demonstrated that calcium signaling stimulated osteogenic cell proliferation, differentiation, and migration. Calcium channel knockdown studies implicated calcium channels, Cav1.2, store-operated calcium entry (SOCE), and calcium-sensing receptor (CaSR) in regulating bone cell anabolic activities. MC3T3-E1 cells cultured in a 3.6 mM calcium medium expressed increased gene expression of Wnt signaling and growth factors platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and bone morphogenic protein-2 (BMP 2). Our coupling model of bone formation, the receptor activator of nuclear factor-κΒ ligand (RANKL)-treated mouse calvaria, confirmed the role of calcium signaling in coupled bone formation by exhibiting increased gene expression for osterix and osteocalcin. Critically, dual immunocytochemistry showed that RANKL treatment increased osterix-positive cells and increased fluorescence intensity of Cav1.2 and CaSR protein expression per osterix-positive cell. The above data established that calcium released by osteoclasts contributed to the regulation of coupled bone formation. CRISPR/Cas-9 knockout of Cav1.2 in osteoprogenitor cells cultured in basal calcium medium caused a >80% decrease in the expression of downstream osteogenic genes, emphasizing the large magnitude of the effect of calcium signaling. Thus, calcium signaling is a major regulator of coupled bone formation.

Intracellular virus sensor MDA5 mutation develops autoimmune myocarditis and nephritis.

Mutations in IFIH1 gene encoding viral RNA sensor MDA5 have been reported responsible for many interferonopathies, including Aicardi-Goutières syndrome (AGS) and monogenic lupus, however, the pathological link between IFIH1 mutations and various autoimmune symptoms remains unclear. Here, we generated transgenic mice expressing human MDA5 R779H mutant (R779H Tg), reported in AGS and monogenic lupus patient. Mice spontaneously developed myocarditis and nephritis with upregulation of type I IFNs in the major organs. R779H Tg Mavs-/- and R779H Tg Ifnar-/- showed no phenotypes, indicating direct MDA5-signaling pathway involvement. Rag-2 deficiency and bone marrow cells transfer from wild type to adult mice did not prevent myocarditis development, while mice with cardiomyocyte-specific expression of hMDA5 R779H showed cardiomegaly and high expression of inflammatory cytokines. Taken together, our study clarifies that type I IFNs production and chemokines from cardiomyocytes starts in neonatal period and is critical for the development of myocarditis. Activated lymphocytes and auto-antibodies exacerbate the pathogenesis but are dispensable for the onset.

Evaluation of microbial air quality and aerosol distribution in a large dental clinic.

PURPOSE: To evaluate the microbial air quality during dental clinical procedures in a large clinical setting with increasing patient capacity. METHODS: This was a single-center, observational study design evaluating the microbial air quality and aerosol distribution during normal clinical sessions at 5% (sessions 1 and 2) and at > 50% (session 3) treatment capacity of dental aerosol generating procedures. Sessions 1 and 2 were evaluated on the same day with a 30-minute fallow time between the sessions. Session 3 was evaluated on a separate day. For each session, passive air-sampling technique was performed for three collection periods: baseline, treatment, and post-treatment. Blood agar plates were collected and incubated at 37°C for 48 hours. Colonies were counted using an automatic colony counter. Mean colony forming units (CFU) per plate were converted to CFU/m²/h. RESULTS: Kruskal Wallis test was performed to compare the mean CFU/m²/h between the clinic sessions. Statistically significant differences were observed between sessions 1 and 2 (P< 0.05), but not between sessions 2 and 3 (P> 0.05). Combining all clinical sessions, the mean CFU/m²/h were 977 (baseline), 873 (treatment), and 1,631 (post-treatment) for the collection periods. A decrease-to-increase CFU/m²/h trend was observed from baseline to treatment, and from treatment to post-treatment that was observed for all clinic sessions and was irrespective to treatment capacity. Higher amounts of CFU/m²/h were found near the air exhaust outlets for all three clinic sessions. Microbial aerosol distribution is most likely due to the positions and power levels of the air inlets and outlets, and to a lesser extent with patient treatment capacity. CLINICAL SIGNIFICANCE: Dental clinics should be designed and optimized to minimize the risk of airborne transmissions. The results of this study emphasize the need to evaluate dental clinic ventilation systems.

YAP1/TEAD1 upregulate platelet-derived growth factor receptor beta to promote vascular smooth muscle cell proliferation and neointima formation.

We have previously demonstrated that the transcription co-factor yes-associated protein 1 (YAP1) promotes vascular smooth muscle cell (VSMC) de-differentiation. Yet, the role and underlying mechanisms of YAP1 in neointima formation in vivo remain unclear. The goal of this study was to investigate the role of VSMC-expressed YAP1 in vascular injury-induced VSMC proliferation and delineate the mechanisms underlying its action. Experiments employing gain- or loss-of-function of YAP1 demonstrated that YAP1 promotes human VSMC proliferation. Mechanistically, we identified platelet-derived growth factor receptor beta (PDGFRB) as a novel YAP1 target gene that confers the YAP1-dependent hyper-proliferative effects in VSMCs. Furthermore, we identified TEA domain transcription factor 1 (TEAD1) as a key transcription factor that mediates YAP1-dependent PDGFRß expression. ChIP assays demonstrated that TEAD1 is enriched at a PDGFRB gene enhancer. Luciferase reporter assays further demonstrated that YAP1 and TEAD1 co-operatively activate the PDGFRB enhancer. Consistent with these observations, we found that YAP1 expression is upregulated after arterial injury and correlates with PDGFRß expression and VSMC proliferation in vivo. Using a novel inducible SM-specific Yap1 knockout mouse model, we found that the specific deletion of Yap1 in adult VSMCs is sufficient to attenuate arterial injury-induced neointima formation, largely due to inhibited PDGFRß expression and VSMC proliferation. Our study unravels a novel mechanism by which YAP1/TEAD1 promote VSMC proliferation via transcriptional induction of PDGFRß, thereby enhancing PDGF-BB downstream signaling and promoting neointima formation.

Long noncoding RNA NEAT1 (nuclear paraspeckle assembly transcript 1) is critical for phenotypic switching of vascular smooth muscle cells.

In response to vascular injury, vascular smooth muscle cells (VSMCs) may switch from a contractile to a proliferative phenotype thereby contributing to neointima formation. Previous studies showed that the long noncoding RNA (lncRNA) NEAT1 is critical for paraspeckle formation and tumorigenesis by promoting cell proliferation and migration. However, the role of NEAT1 in VSMC phenotypic modulation is unknown. Herein we showed that NEAT1 expression was induced in VSMCs during phenotypic switching in vivo and in vitro. Silencing NEAT1 in VSMCs resulted in enhanced expression of SM-specific genes while attenuating VSMC proliferation and migration. Conversely, overexpression of NEAT1 in VSMCs had opposite effects. These in vitro findings were further supported by in vivo studies in which NEAT1 knockout mice exhibited significantly decreased neointima formation following vascular injury, due to attenuated VSMC proliferation. Mechanistic studies demonstrated that NEAT1 sequesters the key chromatin modifier WDR5 (WD Repeat Domain 5) from SM-specific gene loci, thereby initiating an epigenetic "off" state, resulting in down-regulation of SM-specific gene expression. Taken together, we demonstrated an unexpected role of the lncRNA NEAT1 in regulating phenotypic switching by repressing SM-contractile gene expression through an epigenetic regulatory mechanism. Our data suggest that NEAT1 is a therapeutic target for treating occlusive vascular diseases.

Subvolt electro-optical modulator on thin-film lithium niobate and silicon nitride hybrid platform.

A low voltage operation electro-optic modulator is critical for applications ranging from optical communications to an analog photonic link. This paper reports a hybrid silicon nitride and lithium niobate electro-optic Mach-Zehnder modulator that employs 3 dB multimode interference couplers for splitting and combining light. The presented amplitude modulator with an interaction region length of 2.4 cm demonstrates a DC half-wave voltage of only 0.875 V, which corresponds to a modulation efficiency per unit length of 2.11 V cm. The power extinction ratio of the fabricated device is approximately 30 dB, and the on-chip optical loss is about 5.4 dB.

Molecular epidemiology of toxigenic Clostridioides difficile isolates from hospitalized patients and the hospital environment in Dhaka, Bangladesh.

Epidemiology of Clostridioides difficile (syn. Clostridium difficile) infection (CDI) in Bangladesh is poorly understood. This study assessed the epidemiology of CDI in hospitalized patients and hospital environmental contamination of toxigenic C. difficile at two large urban Bangladesh hospitals. This 12-month prospective observational cohort study collected stool samples from adults with diarrhea and recent antimicrobial exposure during 2017. Environmental samples were collected by swabbing surfaces of hospital common areas. Samples underwent toxigenic culture. C. difficile isolates were tested for toxins A and B and PCR-ribotyped. Of 208 stool samples, 18 (8.7%) were positive for toxigenic C. difficile. Of 400 environmental samples, 45 (11%) were positive for toxigenic C. difficile. Ribotypes present in ≥10% of stool isolates were 017 (38%), 053-163 (13%), and a novel ribotype (FP435 [13%]). Common ribotypes in environmental isolates were 017 (22%), 053-163 (11%), 106 (24%). This is the first report describing current epidemiology of CDI in at risk hospitalized adult patients in Bangladesh.

High-performance racetrack resonator in silicon nitride - thin film lithium niobate hybrid platform.

In this paper, we propose an electro-optic modulator design in a hybrid Si3N4-X-cut LiNbO3. The modulator is based on a modified racetrack resonator and performs at both DC and heightened frequencies. Here the driving electrodes are defined along the straight section of the racetrack. This is done to maximize modulation and minimize modulation-cancelation that occurs in a conventional X-cut LiNbO3-based resonator due to the directional change of the electric field in the micro-ring. The single bus racetrack resonator is formed in a hybrid Si3N4-LiNbO3 platform, to guide the optical mode. The fabricated device is characterized and has a measured tunability and intrinsic quality factor (Q) of 2.9 pm/V and 1.3 × 105, respectively. In addition, the proposed racetrack device exhibits enhanced electro-optic conversion efficiency at modulation frequencies that match with the racetrack's optical free spectral range (FSR). For example, at the modulation frequency of 25 GHz, which corresponds to the fabricated device's optical FSR frequency, a ∼10 dB increase in electro-optic conversion efficiency is demonstrated. With the enhancement, our measured device demonstrates a conversion efficiency comparable to non-resonant thin-film LiNbO3 devices that possess RF electrodes that are 10 times longer in length.

Tunable hybrid silicon nitride and thin-film lithium niobate electro-optic microresonator.

This Letter presents, to the best of our knowledge, the first hybrid Si3N4-LiNbO3-based tunable microring resonator where the waveguide is formed by loading a Si3N4 strip on an electro-optic (EO) material of X-cut thin-film LiNbO3. The developed hybrid Si3N4-LiNbO3 microring exhibits a high intrinsic quality factor of 1.85×105, with a ring propagation loss of 0.32 dB/cm, resulting in a spectral linewidth of 13 pm, and a resonance extinction ratio of ∼27 dB within the optical C-band for the transverse electric mode. Using the EO effect of LiNbO3, a 1.78 pm/V resonance tunability near 1550 nm wavelength is demonstrated.

Self-Assembled Nanostructured CuCo2 O4 for Electrochemical Energy Storage and the Oxygen Evolution Reaction via Morphology Engineering.

CuCo2 O4 films with different morphologies of either mesoporous nanosheets, cubic, compact-granular, or agglomerated embossing structures are fabricated via a hydrothermal growth technique using various solvents, and their bifunctional activities, electrochemical energy storage and oxygen evolution reaction (OER) for water splitting catalysis in strong alkaline KOH media, are investigated. It is observed that the solvents play an important role in setting the surface morphology and size of the crystallites by controlling nucleation and growth rate. An optimized mesoporous CuCo2 O4 nanosheet electrode shows a high specific capacitance of 1658 F g-1 at 1 A g-1 with excellent restoring capability of ≈99% at 2 A g-1 and superior energy density of 132.64 Wh kg-1 at a power density of 0.72 kW kg-1 . The CuCo2 O4 electrode also exhibits excellent endurance performance with capacity retention of 90% and coulombic efficiency of ≈99% after 5000 charge/discharge cycles. The best OER activity is obtained from the CuCo2 O4 nanosheet sample with the lowest overpotential of ≈290 mV at 20 mA cm-2 and a Tafel slope of 117 mV dec-1 . The superior bifunctional electrochemical activity of the mesoporous CuCo2 O4 nanosheet is a result of electrochemically favorable 2D morphology, which leads to the formation of a very large electrochemically active surface area.

Two-Dimensional Layered Hydroxide Nanoporous Nanohybrids Pillared with Zero-Dimensional Polyoxovanadate Nanoclusters for Enhanced Water Oxidation Catalysis.

The oxygen-evolution reaction (OER) is critical in electrochemical water splitting and requires an efficient, sustainable, and cheap catalyst for successful practical applications. A common development strategy for OER catalysts is to search for facile routes for the synthesis of new catalytic materials with optimized chemical compositions and structures. Here, nickel hydroxide Ni(OH)2 2D nanosheets pillared with 0D polyoxovanadate (POV) nanoclusters as an OER catalyst that can operate in alkaline media are reported. The intercalation of POV nanoclusters into Ni(OH)2 induces the formation of a nanoporous layer-by-layer stacking architecture of 2D Ni(OH)2 nanosheets and 0D POV with a tunable chemical composition. The nanohybrid catalysts remarkably enhance the OER activity of pristine Ni(OH)2 . The present findings demonstrate that the intercalation of 0D POV nanoclusters into Ni(OH)2 is effective for improving water oxidation catalysis and represents a potential method to synthesize novel, porous hydroxide-based nanohybrid materials with superior electrochemical activities.

Vertical mode transition in hybrid lithium niobate and silicon nitride-based photonic integrated circuit structures.

This Letter presents an optical mode transition structure for use in Si3N4/LiNbO3-based hybrid photonics. A gradual modal transition from a Si3N4 waveguide to a hybrid Si3N4/LiNbO3 waveguide is achieved by etching a terrace structure into the sub-micrometer thick LiNbO3 film. The etched film is then bonded to predefined low pressure chemical vapor deposition Si3N4 waveguides. Herein we analyze hybrid optical devices both with and without the aforementioned mode transition terrace structure. Experimental and simulated results indicate that inclusion of the terrace significantly improves mode transition compared to an abrupt transition, i.e., a 1.78 dB lower mode transition loss compared to the abrupt transition. The proposed transition structure is also applied to the design of hybrid Si3N4-LiNbO3 micro-ring resonators. A high-quality factor (Q) resonator is demonstrated with the terrace transition which mitigates undesired resonances.

Detection of dinitrosyl iron complexes by ozone-based chemiluminescence.

Dinitrosyl iron complexes (DNICs) are important intermediates in the metabolism of nitric oxide (NO). They have been considered to be NO storage adducts able to release NO, scavengers of excess NO during inflammatory hypotensive shock, and mediators of apoptosis in cancer cells, among many other functions. Currently, all studies of DNICs in biological matrices use electron paramagnetic resonance (EPR) for both detection and quantification. EPR is limited, however, by its ability to detect only paramagnetic mononuclear DNICs even though EPR-silent binuclear are likely to be prevalent. Furthermore, physiological concentrations of mononuclear DNICs are usually lower than the EPR detection limit (1 µM). We have thus developed a chemiluminescence-based method for the selective detection of both DNIC forms at physiological, pathophysiological, and pharmacologic conditions. We have also demonstrated the use of the new method in detecting DNIC formation in the presence of nitrite and nitrosothiols within biological fluids and tissue. This new method, which can be used alone or in tandem with EPR, has the potential to offer insight about the involvement of DNICs in many NO-dependent pathways.

MicroRNA-15b/16 Attenuates Vascular Neointima Formation by Promoting the Contractile Phenotype of Vascular Smooth Muscle Through Targeting YAP.

OBJECTIVE: To investigate the functional role of the microRNA (miR)-15b/16 in vascular smooth muscle (SM) phenotypic modulation. APPROACH AND RESULTS: We found that miR-15b/16 is one of the most abundant mRs expressed in contractile vascular smooth muscle cells (VSMCs). However, when contractile VSMCs get converted to a synthetic phenotype, miR-15b/16 expression is significantly reduced. Knocking down endogenous miR-15b/16 in VSMCs attenuates SM-specific gene expression but promotes VSMC proliferation and migration. Conversely, overexpression of miR-15b/16 promotes SM contractile gene expression while attenuating VSMC migration and proliferation. Consistent with this, overexpression of miR-15b/16 in a rat carotid balloon injury model markedly attenuates injury-induced SM dedifferentiation and neointima formation. Mechanistically, we identified the potent oncoprotein yes-associated protein (YAP) as a downstream target of miR-15b/16 in VSMCs. Reporter assays validated that miR-15b/16 targets YAP's 3' untranslated region. Moreover, overexpression of miR-15b/16 significantly represses YAP expression, whereas conversely, depletion of endogenous miR-15b/16 results in upregulation of YAP expression. CONCLUSIONS: These results indicate that miR-15b/16 plays a critical role in SM phenotypic modulation at least partly through targeting YAP. Restoring expression of miR-15b/16 would be a potential therapeutic approach for treatment of proliferative vascular diseases.

Prognostic factors affecting survival after pancreaticoduodenectomy for pancreatic adenocarcinoma (single center experience).

BACKGROUND: Pancreatic cancer is considered to have the worst prognosis of the periampullary carcinomas. This retrospective study was to determine prognostic factors for survival after pancreaticoduodenectomy in patients had pancreatic carcinoma. METHODS: We retrospectively studied all patients who underwent PD for pancreatic adenocarcinoma originating from the head, neck or uncinate process from January 1996 to January 2011 in our center. Preoperative variables, intraoperative variables and postoperative variables were collected. RESULTS: The study included 480 patients (282 males and 198 females with a median age of 53 years. At the time of analysis, 180 (37.5%) patients were still alive. The median survival was 19 months. This corresponded to a 1-, 3-, and 5-year actuarial survival of 44 %, 20%, and 15% respectively. Mass size less than 2 cm (P=0.0001), lymph node ratio (P=0.0001), safety margin (P=0.0001), perineural, perivascular infiltration, age above 60 years (P=0.03), gender, preoperative bilirubin, SGPT, liver status, pre and postoperative CEA, CA19- 9 (P=0.0001) were significant predictors of survival. CONCLUSION: Mass size less than 2 cm, lymph node ratio, safety margin, perineural, perivascular infiltration, age above 60 years, gender, liver status, pre and postoperative CEA, CA19-9 are important predictors of survival in patients undergoing PD for pancreatic cancer.

Hypoxia-induced pulmonary hypertension in adults and newborns: implications for drug development.

Chronic hypoxia-induced pulmonary hypertension (CHPH) presents a complex challenge, characterized by escalating pulmonary vascular resistance and remodeling, threatening both newborns and adults with right heart failure. Despite advances in understanding the pathobiology of CHPH, its molecular intricacies remain elusive, particularly because of the multifaceted nature of arterial remodeling involving the adventitia, media, and intima. Cellular imbalance arises from hypoxia-induced mitochondrial disturbances and oxidative stress, reflecting the diversity in pulmonary hypertension (PH) pathology. In this review, we highlight prominent mechanisms causing CHPH in adults and newborns, and emerging therapeutic targets of potential pharmaceuticals.