Systematic review on antibacterial photodynamic therapeutic effects of transition metals ruthenium and iridium complexes.

The prevalence of antibiotic-resistant pathogenic bacteria poses a significant threat to public health and ranks among the principal causes of morbidity and mortality worldwide. Antimicrobial photodynamic therapy is an emerging therapeutic technique that has excellent potential to embark upon antibiotic resistance problems. The efficacy of this therapy hinges on the careful selection of suitable photosensitizers (PSs). Transition metal complexes, such as Ruthenium (Ru) and Iridium (Ir), are highly suitable for use as PSs because of their surface plasmonic resonance, crystal structure, optical characteristics, and photonics. These metals belong to the platinum family and exhibit similar chemical behavior due to their partially filled d-shells. Ruthenium and Iridium-based complexes generate reactive oxygen species (ROS), which interact with proteins and DNA to induce cell death. As photodynamic therapeutic agents, these complexes have been widely studied for their efficacy against cancer cells, but their potential for antibacterial activity remains largely unexplored. Our study focuses on exploring the antibacterial photodynamic effect of Ruthenium and Iridium-based complexes against both Gram-positive and Gram-negative bacteria. We aim to provide a comprehensive overview of various types of research in this area, including the structures, synthesis methods, and antibacterial photodynamic applications of these complexes. Our findings will provide valuable insights into the design, development, and modification of PSs to enhance their photodynamic therapeutic effect on bacteria, along with a clear understanding of their mechanism of action.

Ralstonia solanacearum differentially modulates soil physicochemical properties and rhizospheric bacteriome of resistant and susceptible tobacco cultivars.

Ralstonia solanacearum is a devastating soilborne pathogen which poses significant yield and economic losses to tobacco production globally. The impact of R. solanacearum on rhizosphere bacteriome and soil physicochemical characteristics in resistant and susceptible tobacco cultivars is poorly understood. This study aims to determine the effect of R. solanacearum on soil physicochemical parameters and rhizosphere bacteriome of resistant (K326) and susceptible (Hongda) tobacco cultivars at various growth stages. Results demonstrated that the contents of available potassium and phosphorus, as well as soil pH were significantly increased in K326 soils (CK and T2) compared with Hongda (T1) after 21, 42, and 63 days post-inoculation (dpi) of R. solanacearum except for available nitrogen which showed an opposite trend. The qPCR results showed a significant decrease in R. solanacearum population in rhizosphere of K326 (T2) compared to the Hongda (T1) at 21 and 63 dpi than that after 42 dpi. The rhizosphere bacteriome analysis through 16S rRNA amplicon sequencing revealed that rhizosphere bacterial community composition was significantly different between two tobacco cultivars (Hongda and K326) and this effect was more prominent after 63 dpi (93 days after post-transplantation), suggesting that each cultivar recruits a unique set of bacterial communities. There was no obvious difference observed in the rhizosphere bacteriome of CK (K326) and T2 (K326), which might be attributed to the same genetic makeup and inherent resistance of K326 to bacterial wilt infection. Analysis of co-occurrence networks revealed that the microbial network in T1 (Hongda) was more complex than those in T2 (K326) and CK (K326), while the networks in CK and T2 were almost identical. The present research highlights the time-course relationship between environmental factors and rhizosphere bacteriome of tobacco cultivars showing different levels of resistance against R. solanacearum. Conclusively, studying the plant-soil-microbe interaction system in susceptible and resistant tobacco cultivars may enable us to develop effective integrated disease control plans for the healthy production of tobacco crops.

Institutional quality, oil price, and environmental degradation in MENA countries moderated by economic complexity and shadow economy.

This paper aims to analyze the link between environmental degradation and institutional quality and the price of oil moderated by economic complexity and the underground economy. We use quantile regressions with annual panel data for 15 countries in the Middle East and North Africa during 1995-2021. The findings indicate that institutional quality, economic complexity, and output positively and heterogeneously impact environmental degradation. However, the square of production has a negative impact, confirming an inverted U relationship between production and environmental degradation. Likewise, we find that the price of oil and the underground economy have a negative and heterogeneous impact on environmental degradation. Based on our results, a potential recommendation for policymakers is that the institutional framework of Middle Eastern and North African countries should be accompanied by a more significant concern for the environment instead of prioritizing extractive growth that is detrimental to the environment's environmental sustainability. Likewise, economic diversification will mitigate environmental degradation and improve formal employment. Our findings are relevant to policymakers and researchers interested in promoting ecological sustainability.

Human fitting of pediatric and infant continuous-flow total artificial heart: visual and virtual assessment.

Background: This study aimed to determine the fit of two small-sized (pediatric and infant) continuous-flow total artificial heart pumps (CFTAHs) in congenital heart surgery patients. Methods: This study was approved by Cleveland Clinic Institutional Review Board. Pediatric cardiac surgery patients (n = 40) were evaluated for anatomical and virtual device fitting (3D-printed models of pediatric [P-CFTAH] and infant [I-CFTAH] models). The virtual sub-study consisted of analysis of preoperative thoracic radiographs and computed tomography (n = 3; 4.2, 5.3, and 10.2 kg) imaging data. Results: P-CFTAH pump fit in 21 out of 40 patients (fit group, 52.5%) but did not fit in 19 patients (non-fit group, 47.5%). I-CFTAH pump fit all of the 33 patients evaluated. There were critical differences due to dimensional variation (p < 0.0001) for the P-CFTAH, such as body weight (BW), height (Ht), and body surface area (BSA). The cutoff values were: BW: 5.71 kg, Ht: 59.0 cm, BSA: 0.31 m2. These cutoff values were additionally confirmed to be optimal by CT imaging. Conclusions: This study demonstrated the range of proper fit for the P-CFTAH and I-CFTAH in congenital heart disease patients. These data suggest the feasibility of both devices for fit in the small-patient population.

Surgical strategies to address re-operative complex left ventricular outflow tract and thoracic aortic pathology: Cleveland Clinic children's experience.

BACKGROUND: Complex patients requiring operations on the left ventricular outflow tract, aortic valve, or thoracic aorta after previous repair of aortopathy constitute a challenging group, with limited information guiding decision-making. We aimed to use our institutional experience to highlight management challenges and describe surgical pearls to address them. METHODS: Forty-one complex patients with surgery on the left ventricular outflow tract, aortic valve, or aorta at Cleveland Clinic Children's between 2016 and 2021 following previous repair of aortic pathology were retrospectively reviewed. Patients with known connective tissue disease or single ventricle circulation were excluded. RESULTS: Median age at index procedure was 23 years (range 0.25-48) with median of 2 prior sternotomies. Previous aortic operations included subvalvular (n = 9), valvular (n = 6), supravalvular (n = 13), and multi-level surgeries (n = 13). Four deaths occurred in median follow-up of 2.5 years. Mean left ventricular outflow tract gradients improved significantly for patients with obstruction (34.9 ± 17.5 mmHg versus 12.6 ± 6.0 mmHg; p < 0.001). Technical pearls include the following: 1) liberal use of anterior aortoventriculoplasty with valve replacement; 2) primarily anterior aortoventriculoplasty following the subpulmonary conus in contrast to more vertical incision for post-arterial switch operation patients; 3) pre-operative imaging of mediastinum and peripheral vasculature for cannulation and sternal re-entry; and 4) proactive use of multi-site peripheral cannulation. CONCLUSIONS: Operation to address the left ventricular outflow tract, aortic valve, or aorta following prior congenital aortic repair can be accomplished with excellent outcomes despite high complexity. These procedures commonly include multiple components, including concomitant valve interventions. Cannulation strategies and anterior aortoventriculoplasty in specific patients require modifications.

A Direct Formaldehyde Fuel Cell for CO2 -Emission Free Co-generation of Electrical Energy and Valuable Chemical/Hydrogen.

Converting carbon-based molecular fuels into electricity efficiently and cleanly without emitting CO2 remains a challenge. Conventional fuel cells using noble metals as anode catalysts often suffer performance degradation due to CO poisoning and a host of problems associated with CO2 production. This study provides a CO2 -emission-free direct formaldehyde fuel cell. It enables a flow of electricity while producing H2 and valuable formate. Unlike conventional carbon-based molecules electrooxidation, formaldehyde 1-electron oxidation is performed on the Cu anode with high selectivity, thus generating formate and H2 without undergoing CO2 pathway. In addition, the fuel cell produces 0.62 Nm3 H2 and 53 mol formate per 1 kWh of electricity generated, with an open circuit voltage of up to 1 V and a peak power density of 350 mW cm-2 . This study puts forward a zero-carbon solution for the efficient utilization of carbon-based molecule fuels that generates electricity, hydrogen and valuable chemicals in synchronization.

Carbohydrate mouth rinse is no more effective than placebo on running endurance of dehydrated and heat acclimated athletes.

PURPOSE: To determine whether carbohydrate mouth rinsing would improve endurance running performance of tropical natives in a warm-humid (30 °C and 70% relative humidity) environment. METHOD: Twelve endurance male runners [age 25 ± 3 years; peak aerobic capacity ([Formula: see text]O2peak) 57.6 ± 3.6 mL.kg-1.min-1] completed three time-to-exhaustion (TTE) trials at ~ 70% [Formula: see text]O2peak while swilling 25 ml of a 6% carbohydrate (CHO) or taste-matched placebo (PLA) as well as no mouth rinse performed in the control (CON) trial. RESULTS: TTE performance was significantly longer in both CHO and PLA trials when compared with the CON trial (54.7 ± 5.4 and 53.6 ± 5.1 vs. 48.4 ± 3.6 min, respectively; p < 0.001 and p = 0.012, respectively), but was not significantly different between CHO and PLA trials (p = 1.000). The rating of perceived exertion was not different between the CHO and PLA trials, however, was significantly affected when compared to the CON trial (p < 0.001). A similar effect was observed for perceived arousal level between the CHO and PLA trials to the CON trial. Core temperature, mean skin temperature and skin blood flow were not significantly different between the three trials (all p > 0.05). Similarly, plasma lactate and glucose as well as exercise heart rate were not influenced by the trials. CONCLUSIONS: The present study demonstrates that mouth rinsing, whether carbohydrate or placebo, provides an ergogenic benefit to running endurance when compared to CON in a heat stress environment. Nevertheless, the results do not support the notion that rinsing a carbohydrate solution provides a greater advantage as previously described among non-heat acclimated individuals within a temperate condition.

Multifunctional Iron Oxide Nanocarriers Synthesis for Drug Delivery, Diagnostic Imaging, and Biodistribution Study.

The aim of the current study is to design the radiolabeled and drug-loaded nanocarrier with high loading capacity and pH-dependent drug release characteristics that could effectively transport loaded compounds to various organs for efficient diagnostic imaging and chemotherapeutic drug delivery. The aqueous extract of green tea leaves was used to synthesize the small-sized iron oxide nanoparticles (IONPs). The nanoparticles were characterized with UV-visible spectroscopy, Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and energy-dispersive X-ray analysis (EDX). Iron oxide nanoparticles with sizes smaller than 50 nm were successfully synthesized, making them suitable for in vivo studies. In drug loading trials, 94% of the drug was loaded onto the active surface of iron oxide nanoparticles from the solution. The in vitro drug release study revealed that an acidic environment (pH 4.5) effectively triggers the release of doxorubicin (DOX) from the nanoparticles as compared to a neutral environment (pH 7.4). The gamma-emitting radionuclide 99mTc was successfully labeled with IONPs for biodistribution and imaging studies. The efficiency of radiolabeling was observed to be ≥ 99%. Furthermore, the in vivo biodistribution study of radiolabeled IONPs in rabbit model showed rapid accumulation in various organs such as heart, liver, and kidneys. This work suggested that green synthesized iron oxide nanoparticles are potential nanocarriers for diagnostic imaging and efficiently distributing DOX to specific organs. The aqueous extract of green tea leaves was used for the facile green synthesis of iron oxide nanoparticles (IONPs). Furthermore, the chemotherapeutic drug doxorubicin (DOX) and gamma-emitting radionuclide 99mTc were loaded on these iron oxide nanoparticles to evaluate the in vivo biodistribution and drug delivery studies in the rabbit models.

Surgical Pearls of the Transconal Unroofing Procedure-Modifications and Midterm Outcomes.

We have previously described our novel surgical technique in addressing the anomalous aortic origin of the left coronary artery with a transseptal course behind the right ventricular outflow tract. By means of the Najm procedure, we performed complete unroofing of the transseptal anomalous aortic origin of the left coronary artery and elongated the right ventricular outflow tract posteriorly using an autologous pericardial patch. This report documents modifications to address challenging anatomic variants and highlights the importance of managing septal arteries and myocardial bridges. We also describe the excellent midterm outcomes of 14 patients who have undergone the Najm procedure.

Kidney Cancer Prediction Empowered with Blockchain Security Using Transfer Learning.

Kidney cancer is a very dangerous and lethal cancerous disease caused by kidney tumors or by genetic renal disease, and very few patients survive because there is no method for early prediction of kidney cancer. Early prediction of kidney cancer helps doctors start proper therapy and treatment for the patients, preventing kidney tumors and renal transplantation. With the adaptation of artificial intelligence, automated tools empowered with different deep learning and machine learning algorithms can predict cancers. In this study, the proposed model used the Internet of Medical Things (IoMT)-based transfer learning technique with different deep learning algorithms to predict kidney cancer in its early stages, and for the patient's data security, the proposed model incorporates blockchain technology-based private clouds and transfer-learning trained models. To predict kidney cancer, the proposed model used biopsies of cancerous kidneys consisting of three classes. The proposed model achieved the highest training accuracy and prediction accuracy of 99.8% and 99.20%, respectively, empowered with data augmentation and without augmentation, and the proposed model achieved 93.75% prediction accuracy during validation. Transfer learning provides a promising framework with the combination of IoMT technologies and blockchain technology layers to enhance the diagnosing capabilities of kidney cancer.

Do E2 and P4 contribute to the explained variance in core temperature response for trained women during exertional heat stress when metabolic rates are very high?

PURPOSE: Women remain underrepresented in the exercise thermoregulation literature despite their participation in leisure-time and occupational physical activity in heat-stressful environments continuing to increase. Here, we determined the relative contribution of the primary ovarian hormones (estrogen [E2] and progesterone [P4]) alongside other morphological (e.g., body mass), physiological (e.g., sweat rates), functional (e.g., aerobic fitness) and environmental (e.g., vapor pressure) factors in explaining the individual variation in core temperature responses for trained women working at very high metabolic rates, specifically peak core temperature (Tpeak) and work output (mean power output). METHODS: Thirty-six trained women (32 ± 9 year, 53 ± 9 ml·kg-1·min-1), distinguished by intra-participant (early follicular and mid-luteal phases) or inter-participant (ovulatory vs. anovulatory vs. oral contraceptive pill user) differences in their endogenous E2 and P4 concentrations, completed a self-paced 30-min cycling work trial in warm-dry (2.2 ± 0.2 kPa, 34.1 ± 0.2 °C, 41.4 ± 3.4% RH) and/or warm-humid (3.4 ± 0.1 kPa, 30.2 ± 1.2 °C, 79.8 ± 3.7% RH) conditions that yielded 115 separate trials. Stepwise linear regression was used to explain the variance of the dependent variables. RESULTS: Models were able to account for 60% of the variance in Tpeak ([Formula: see text]2: 41% core temperature at the start of work trial, [Formula: see text]2: 15% power output, [Formula: see text]2: 4% [E2]) and 44% of the variance in mean power output ([Formula: see text]2: 35% peak aerobic power, [Formula: see text]2: 9% perceived exertion). CONCLUSION: E2 contributes a small amount toward the core temperature response in trained women, whereby starting core temperature and peak aerobic power explain the greatest variance in Tpeak and work output, respectively.

Sources, toxicity potential, and human health risk assessment of heavy metals-laden soil and dust of urban and suburban areas as affected by industrial and mining activities.

Sources and levels of heavy metals (HMs) in soil and dust of urban and suburban areas in Riyadh (industrial city) and Mahad AD'Dahab (mining area) cities in Saudi Arabia were reported in this study. Additionally, the concentrations of HMs in different soil particle size fractions (> 250, 63-250 and < 63 µm) were reported. Pollution extent, and ecological and human health risks associated with collected soil and dust samples were explored. Contamination levels of HMs were higher in dust as compared to soil samples at all sites. The average integrated potential ecological risk in dust samples of urban area of Mahad AD'Dahab was 139, and thus characterized as a very-high-risk criterion. Enrichment factor (EF), correlation analyses, and principal component analysis showed that aluminum (Al), cobalt (Co), chromium (Cr), iron (Fe), manganese (Mn), nickel (Ni), titanium (Ti), and zinc (Zn) had mainly the lithogenic occurrence (EF < 2). However, Zn, copper (Cu), and lead (Pb) in Riyadh, and cadmium (Cd), Cu, Zn, and Pb in the Mahad AD'Dahab were affected by industrial and mining activities, respectively, that were of anthropogenic origins (EF > 2). The hazard index values of dust and soil (< 63 µm) samples in both urban and suburban areas in Mahad AD'Dahab were > 1, suggesting non-carcinogenic risk. Therefore, the dust and soil samples from the mined area of Mahad AD'Dahab had a higher pollution levels, as well as ecological and human health risks than those from Riyadh. Hence, the pollution of such residential environments with HMs (especially Cd, Cu, Zn, and Pb) needs to be monitored.

Detection of Benign and Malignant Tumors in Skin Empowered with Transfer Learning.

Skin cancer is a major type of cancer with rapidly increasing victims all over the world. It is very much important to detect skin cancer in the early stages. Computer-developed diagnosis systems helped the physicians to diagnose disease, which allows appropriate treatment and increases the survival ratio of patients. In the proposed system, the classification problem of skin disease is tackled. An automated and reliable system for the classification of malignant and benign tumors is developed. In this system, a customized pretrained Deep Convolutional Neural Network (DCNN) is implemented. The pretrained AlexNet model is customized by replacing the last layers according to the proposed system problem. The softmax layer is modified according to binary classification detection. The proposed system model is well trained on malignant and benign tumors skin cancer dataset of 1920 images, where each class contains 960 images. After good training, the proposed system model is validated on 480 images, where the size of images of each class is 240. The proposed system model is analyzed using the following parameters: accuracy, sensitivity, specificity, Positive Predicted Values (PPV), Negative Predicted Value (NPV), False Positive Ratio (FPR), False Negative Ratio (FNR), Likelihood Ratio Positive (LRP), and Likelihood Ratio Negative (LRN). The accuracy achieved through the proposed system model is 87.1%, which is higher than traditional methods of classification.

Hybrid Transcarotid Exclusion of Postoperative Ascending Aortic Dissection in an Infant.

Aortic dissection is very rare in pediatric patients, and associated risk factors include congenital heart disease, previous cardiac surgery, and vasculopathies. Acute postoperative aortic dissection in pediatric patients can be life-threatening. We performed a novel hybrid transcarotid covered stent exclusion of a postoperative ascending aortic dissection in an infant. (Level of Difficulty: Advanced.).

Hypohydration but not menstrual phase influences pain perception in healthy women.

Chronic pain is a pervasive health problem and is associated with tremendous socioeconomic costs. However, current pain treatments are often ineffective due, in part, to the multifactorial nature of pain. Mild hypohydration was shown to increase experimental pain sensitivity in men, but whether this also occurs in women has not been examined. Fluctuations in ovarian hormones (i.e., 17ß-estradiol and progesterone) throughout the menstrual cycle may influence a woman's pain sensitivity, as well as hydration levels, suggesting possible interactions between hypohydration and menstrual phase on pain. We investigated the effects of mild hypohydration (HYPO, 24 h of fluid restriction) on ischemic pain sensitivity in 14 eumenorrheic women during the early follicular (EF) and mid-luteal (ML) phases of their menstrual cycle. We also examined whether acute water ingestion could reverse the negative effects of hypohydration. Elevated serum osmolality, plasma copeptin, and urine specific gravity indicated mild hypohydration. Compared with euhydration, HYPO reduced pain tolerance (by 34 ± 46 s; P = 0.02, [Formula: see text] = 0.37) and increased ratings of pain intensity (by 0.7 ± 0.7 cm; P = 0.004; [Formula: see text] = 0.55) and unpleasantness (by 0.7 ± 0.9 cm; P = 0.02; [Formula: see text] = 0.40); these results were not influenced by menstrual phase. Water ingestion reduced thirst perception (visual analog scale, by 2.3 ± 0.9 cm; P < 0.001, [Formula: see text] = 0.88) but did not reduce pain sensitivity. Therefore, hypohydration increases pain sensitivity in women with no influence of menstrual phase.NEW & NOTEWORTHY Whether hypohydration can increase pain in women remains untested. Menstrual phase may influence pain, but findings are equivocal and may be confounded by the lack of hydration measures. We found that pain sensitivity in women increased after 24 h of fluid restriction versus ad libitum fluid intake, but did not differ between menstrual phases. Water ingestion did not acutely attenuate the negative effects of hypohydration on pain, highlighting the importance of staying well-hydrated throughout the day.

Unexpected Septal and Truncal Valve Endocarditis After Transcatheter Pulmonary Valve Replacement.

Despite early clinical success of transcatheter pulmonic valve replacement, there is concern for an increased risk of endocarditis requiring complex surgery to repair. We present a case of endocarditis of a Melody (Medtronic, Minneapolis, MN) valve in a 33-year-old male patient with prior neonatal repair of persistent truncus arteriosus and 2 subsequent right ventricular outflow tract to pulmonary artery conduit replacements. The infection had extended from the Melody valve through the prior ventricular septal defect patch to the truncal valve and highlights the risk of endocarditis, particularly with the Melody transcatheter valve.

Infant Ross-Konno, Endocardial Fibroelastosis Resection and Mitral Valve Repair.

Optimal management of critical aortic stenosis (AS) in infants depends on the left ventricle's (LV's) ability to maintain adequate output. Determining feasibility of biventricular repair may be difficult, particularly in those with mitral disease, endocardial fibroelastosis (EFE), multi-level obstruction, and uncertain physiologic capacity. We report a case of a three-month-old with critical AS, severely reduced LV function, EFE, and moderate mitral regurgitation (MR), who underwent a Ross-Konno procedure with concomitant EFE resection and mitral valve repair. Although the technical sequence is challenging, definitive surgery completely relieved multi-level obstruction and MR with markedly improved LV function.

Menstrual phase and ambient temperature do not influence iron regulation in the acute exercise period.

The current study investigated whether ambient heat augments the inflammatory and postexercise hepcidin response in women and if menstrual phase and/or self-pacing modulate these physiological effects. Eight trained females (age: 37 ± 7 yr; V̇o2max: 46 ± 7 mL·kg-1·min-1; peak power output: 4.5 ± 0.8 W·kg-1) underwent 20 min of fixed-intensity cycling (100 W and 125 W) followed by a 30-min work trial (∼75% V̇o2max) in a moderate (MOD: 20 ± 1°C, 53 ± 8% relative humidity) and warm-humid (WARM: 32 ± 0°C, 75 ± 3% relative humidity) environment in both their early follicular (days 5 ± 2) and midluteal (days 21 ± 3) phases. Mean power output was 5 ± 4 W higher in MOD than in WARM (P = 0.02) such that the difference in core temperature rise was limited between environments (-0.29 ± 0.18°C in MOD, P < 0.01). IL-6 and hepcidin both increased postexercise (198% and 38%, respectively); however, neither was affected by ambient temperature or menstrual phase (all P > 0.15). Multiple regression analysis demonstrated that the IL-6 response to exercise was explained by leukocyte and platelet count (r2 = 0.72, P < 0.01), and the hepcidin response to exercise was explained by serum iron and ferritin (r2 = 0.62, P < 0.01). During exercise, participants almost matched their fluid loss (0.48 ± 0.18 kg·h-1) with water intake (0.35 ± 0.15 L·h-1) such that changes in body mass (-0.3 ± 0.3%) and serum osmolality (0.5 ± 2.0 osmol·kgH2O-1) were minimal or negligible, indicating a behavioral fluid-regulatory response. These results indicate that trained, iron-sufficient women suffer no detriment to their iron regulation in response to exercise with acute ambient heat stress or between menstrual phases on account of a performance-physiological trade-off.

Multifunctional self-assembled peptide nanoparticles for multimodal imaging-guided enhanced theranostic applications against glioblastoma multiforme.

The synthesis of self-assembled peptide nanoparticles using a facile one-pot synthesis approach is gaining increasing attention, allowing therapy in combination with diagnosis. Their drawback is limited diagnostic potential, which can be improved after necessary modifications and efficacious functionalization. Herein, a cyclic heptapeptide having the Arg-Gly-Asp-Lys-Leu-Ala-Lys sequence was modified by conjugation of the ε-amino group of the terminal lysine residue with diethylenetriamine pentaacetic acid (DTPA) as a bifunctional chelating agent (BFC) for radiolabeling with a γ-emitting radionuclide (99mTc, half-life 6.01 h; energy 140 keV). Further, the free amino group of the middle lysine residue was successfully conjugated with near-infrared fluorescence (NIRF) dye Cyanine5.5 N-succinimidyl ester (Ex/Em = 670/701 nm) by a co-assembly method to form newly designed novel NIRF dye conjugated self-assembled peptide-DTPA (Cy5.5@SAPD) nanoparticles. The fluorescent nanoparticle formation was confirmed by using a fluorescence spectrophotometer (Ex/Em = 650/701 nm), and the transmission electron microscope (TEM) images showed a size of ∼ 40 nm with a lattice fringe distance of 0.294 nm. Cytotoxicity and confocal laser scanning microscopy (CLSM) studies showed that these nanoparticles possess a high affinity for the αvß3-integrin receptor overexpressed on brain tumor glioblastoma with an EC50 = 20 µM. Moreover, these nanoparticles were observed to have potential to internalize into U87MG cells more prominently than HEK-293 cancer cells and induce apoptosis. The apoptosis assay showed 79.5% apoptotic cells after 24 h treatment of Cy5.5@SAPD nanoparticles. Additionally, these nanoparticles were also radiolabeled with 99mTc for the single photon emission computed tomography (SPECT) imaging study in tumor-bearing female Balb/c mice. The excellent imaging feature of Cy5.5@SAPD-99mTc nanoparticles as a multimodal (SPECT/NIRF) diagnostic probe, as well as noteworthy therapeutic potential was observed. The results suggested that our newly designed novel dual-targeting dual-imaging nanoparticles may serve as an admirable theranostic probe to treat brain tumor glioblastoma multiforme.

Early Outcomes for In Situ Pericardial Roll Repair for Distant Anomalous Pulmonary Venous Return.

BACKGROUND: Repair of anomalous pulmonary venous return (APVR) when veins are remote from the left atrium (LA) is challenging and may eventuate in a higher prevalence of pulmonary vein stenosis, superior vena cava stenosis, or intracardiac baffle obstruction. We describe our experience in 6 patients with a technique, using both anterior and posterior in situ pericardial roll repairs, which reduces these complications. METHODS: Six patients underwent in situ pericardial roll repair of APVR at Cleveland Clinic between 2018 and 2019. Median age was 40 years (range, 0.25-65 years). Three patients had partial APVR of right upper and middle veins into superior vena cava high above the right pulmonary artery without atrial septal defect; 2 had scimitar syndrome, and the infant had heterotaxy with unbalanced atrioventricular canal and mixed obstructed total APVR. The anomalous pulmonary vein drained into the respective cava far from the LA, which was not ideal for traditional repair techniques. In situ pericardial roll directed anomalous pulmonary vein to the LA. Most patients had concomitant complex cardiac procedures. RESULTS: There was no mortality. Median hospital stay was 23 days (range, 4-60 days) and median follow-up was 20 months (range, 1-36 months). The infant required percutaneous dilatation and stenting of LA anastomosis but since underwent ventricular switch. At last follow-up, pulmonary veins were unobstructed and adult patients were asymptomatic with excellent functional status. CONCLUSIONS: In situ autologous pericardial roll is a useful technique that abrogates the need for mobilization of distant anomalous pulmonary vein with direct anastomosis or complex intracardiac baffles. It is suitable for multiple anatomic configurations and can be used in infants and adults.