An Undergraduate Laboratory Module Integrating Organic Chemistry and Polymer Science.

Polymer science is receiving wider acceptance in the organic chemistry community; thus, it is imperative to include it in the undergraduate organic chemistry curriculum. Despite the ever-increasing popularity of the topic of polymer chemistry in undergraduate curricula, a comprehensive laboratory experiment module describing a polypeptide synthesis by ring-opening polymerization of N-carboxyanhydride (NCA ROP) and a homopolymer synthesis by activators-regenerated by electron-transfer for atom transfer radical polymerization (ARGET ATRP) has yet to be proposed. Herein, we report a semester-long, ten week undergraduate laboratory module focusing on the synthesis and analytical characterization of polyalanine and polystyrene for an advanced organic chemistry class. Students received hands-on-experiences in synthesizing polymers followed by their characterization via proton nuclear magnetic resonance (1H NMR) spectroscopy, electrospray ionization-mass spectrometry (ESI-MS), gel permeation chromatography (GPC), thermogravimetry (TGA), differential scanning calorimetry (DSC), and transmission electron microscopy (TEM), which are not well-presented in the typical organic chemistry curricula. These engaging hands-on lessons in the newly designed laboratory module not only increase students' interests in an interdisciplinary environment of organic chemistry and polymer science but also cultivate their research interests and communication skills and promote critical thinking.

Complement mediates binding and procoagulant effects of ultralarge HIT immune complexes.

Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder mediated by ultra-large immune complexes (ULICs) containing immunoglobulin G (IgG) antibodies to a multivalent antigen composed of platelet factor 4 and heparin. The limitations of current antithrombotic therapy in HIT supports the need to identify additional pathways that may be targets for therapy. Activation of FcγRIIA by HIT ULICs initiates diverse procoagulant cellular effector functions. HIT ULICs are also known to activate complement, but the contribution of this pathway to the pathogenesis of HIT has not been studied in detail. We observed that HIT ULICs physically interact with C1q in buffer and plasma, activate complement via the classical pathway, promote codeposition of IgG and C3 complement fragments (C3c) on neutrophil and monocyte cell surfaces. Complement activation by ULICs, in turn, facilitates FcγR-independent monocyte tissue factor expression, enhances IgG binding to the cell surface FcγRs, and promotes platelet adhesion to injured endothelium. Inhibition of the proximal, but not terminal, steps in the complement pathway abrogates monocyte tissue factor expression by HIT ULICs. Together, these studies suggest a major role for complement activation in regulating Fc-dependent effector functions of HIT ULICs, identify potential non-anticoagulant targets for therapy, and provide insights into the broader roles of complement in immune complex-mediated thrombotic disorders.

Utility of Removable Rigid Dressings in Decreasing Discharge Narcotic Use and Improving Ambulation Following Below-Knee Amputation.

BACKGROUND: Lower extremity amputations are often associated with limited postoperative functionality and postoperative complications. Removable rigid dressings (RRDs) have been used following below-knee amputation (BKA) to improve limb maturation, decrease postoperative complications, reduce time to prosthesis casting, and limit conversion rates to above-knee amputation (AKA). We hypothesized that usage of RRD following BKA will correlate with decreased prescription narcotics required at discharge and improved ambulatory status at follow-up. METHODS: A retrospective chart review was conducted to identify all patients who underwent BKA performed by the vascular surgery service at a large, acute care hospital between July 2016 and July 2021. Data collected included age, sex, body mass index, conversion to AKA, narcotic prescriptions at discharge, and ambulatory status at follow-up. RESULTS: Between July 2016 and 2021, rate of conversion to AKA was significantly lower in patients who received an RRD (9.3%), as opposed to those who did not (41.5%) (P = 0.0002). Narcotic prescriptions at discharge, compared following conversion to morphine equivalents, were also significantly lower in the rigid dressing group compared to patients who did not receive the dressing (50.5 vs. 108.9 morphine eq/24 h, P = 0.0019). Furthermore, use of rigid dressing significantly improved ambulatory status at follow-up to 75.9% in RRD patients compared to 29.3% in patients with conventional dressing (P < 0.0001). This statistical significance persisted after all patients who were converted to AKA were removed from analysis (79.6% vs. 39.3% ambulatory, P = 0.000363). Multivariate analysis revealed that ambulatory status at follow-up was only associated with age more than 80 years (P = 0.042) and use of postoperative RRD (P = 0.001). CONCLUSIONS: These findings support the utility of an RRD following BKA to reduce conversion to AKA, reduce narcotic dosages required at discharge, and improve ambulatory status at follow-up.

Platinum(II)-Based Optical Probes for Imaging Quadruplex DNA Structures via Phosphorescence Lifetime Imaging Microscopy.

G-quadruplex DNA is a non-canonical structure that forms in guanine-rich regions of the genome. There is increasing evidence showing that G-quadruplexes have important biological functions, and therefore molecular tools to visualise these structures are important. Herein we report on a series of new cyclometallated platinum(II) complexes which, upon binding to G-quadruplex DNA, display an increase in their phosphorescence, acting as switch-on probes. More importantly, upon binding to G-quadruplexes they display a selective and distinct lengthening of their emission lifetime. We show that this effect can be used to selectively visualise these structures in cells using Phosphorescence Lifetime Imaging Microscopy (PLIM).

Multitargeting Prodrugs that Release Oxaliplatin, Doxorubicin and Gemcitabine are Potent Inhibitors of Tumor Growth and Effective Inducers of Immunogenic Cell Death.

A multitargeting prodrug (2) that releases gemcitabine, oxaliplatin, and doxorubicin in their active form in cancer cells is a potent cytotoxic agent with nM IC50s ; it is highly selective to cancer cells with mean selectivity indices to human (136) and murine (320) cancer cells. It effectively induces release of DAMPs (CALR, ATP & HMGB1) in CT26 cells facilitating more efficient phagocytosis by J774 macrophages than the FDA drugs or their co-administration. The viability of CT26 cells co-cultured with J774 macrophages and treated with 2 was reduced by 32 % compared to the non-treated cells, suggesting a synergistic antiproliferative effect between the chemical and immune reactions. 2 inhibited in vivo tumor growth in two murine models (LLC and CT26) better than the FDA drugs or their co-administration with significantly lower body weight loss. Mice inoculated with CT26 cells treated with 2 showed slightly better tumor free survival than doxorubicin.

Fc-modified HIT-like monoclonal antibody as a novel treatment for sepsis.

Sepsis is characterized by multiorgan system dysfunction that occurs because of infection. It is associated with high morbidity and mortality and is in need of improved therapeutic interventions. Neutrophils play a crucial role in sepsis, releasing neutrophil extracellular traps (NETs) composed of DNA complexed with histones and toxic antimicrobial proteins that ensnare pathogens, but also damage host tissues. At presentation, patients often have a significant NET burden contributing to the multiorgan damage. Therefore, interventions that inhibit NET release would likely be ineffective at preventing NET-based injury. Treatments that enhance NET degradation may liberate captured bacteria and toxic NET degradation products (NDPs) and likely be of limited therapeutic benefit as well. We propose that interventions that stabilize NETs and sequester NDPs may be protective in sepsis. We showed that platelet factor 4 (PF4), a platelet-associated chemokine, binds and compacts NETs, increasing their resistance to DNase I. We now show that PF4 increases NET-mediated bacterial capture, reduces the release of NDPs, and improves outcome in murine models of sepsis. A monoclonal antibody KKO which binds to PF4-NET complexes, further enhances DNase resistance. However, the Fc portion of this antibody activates the immune response and increases thrombotic risk, negating any protective effects in sepsis. Therefore, we developed an Fc-modified KKO that does not induce these negative outcomes. Treatment with this antibody augmented the effects of PF4, decreasing NDP release and bacterial dissemination and increasing survival in murine sepsis models, supporting a novel NET-targeting approach to improve outcomes in sepsis.

Recognition of PF4-VWF complexes by heparin-induced thrombocytopenia antibodies contributes to thrombus propagation.

Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder mediated by complexes between platelet factor 4 (PF4) and heparin or other polyanions, but the risk of thrombosis extends beyond exposure to heparin implicating other PF4 partners. We recently reported that peri-thrombus endothelium is targeted by HIT antibodies, but the binding site(s) has not been identified. We now show that PF4 binds at multiple discrete sites along the surface of extended strings of von Willebrand factor (VWF) released from the endothelium following photochemical injury in an endothelialized microfluidic system under flow. The HIT-like monoclonal antibody KKO and HIT patient antibodies recognize PF4-VWF complexes, promoting platelet adhesion and enlargement of thrombi within the microfluidic channels. Platelet adhesion to the PF4-VWF-HIT antibody complexes is inhibited by antibodies that block FcγRIIA or the glycoprotein Ib-IX complex on platelets. Disruption of PF4-VWF-HIT antibody complexes by drugs that prevent or block VWF oligomerization attenuate thrombus formation in a murine model of HIT. Together, these studies demonstrate assembly of HIT immune complexes along VWF strings released by injured endothelium that might propagate the risk of thrombosis in HIT. Disruption of PF4-VWF complex formation may provide a new therapeutic approach to HIT.

FcRn augments induction of tissue factor activity by IgG-containing immune complexes.

Thromboembolism complicates disorders caused by immunoglobulin G (IgG)-containing immune complexes (ICs), but the underlying mechanisms are incompletely understood. Prior evidence indicates that induction of tissue factor (TF) on monocytes, a pivotal step in the initiation, localization, and propagation of coagulation by ICs, is mediated through Fcγ receptor IIa (FcγRIIa); however, the involvement of other receptors has not been investigated in detail. The neonatal Fc receptor (FcRn) that mediates IgG and albumin recycling also participates in cellular responses to IgG-containing ICs. Here we asked whether FcRn is also involved in the induction of TF-dependent factor Xa (FXa) activity by IgG-containing ICs by THP-1 monocytic cells and human monocytes. Induction of FXa activity by ICs containing IgG antibodies to platelet factor 4 (PF4) involved in heparin-induced thrombocytopenia (HIT), ß-2-glycoprotein-1 implicated in antiphospholipid syndrome, or red blood cells coated with anti-(α)-Rh(D) antibodies that mediate hemolysis in vivo was inhibited by a humanized monoclonal antibody (mAb) that blocks IgG binding to human FcRn. IgG-containing ICs that bind to FcγR and FcRn induced FXa activity, whereas IgG-containing ICs with an Fc engineered to be unable to engage FcRn did not. Infusion of an α-FcRn mAb prevented fibrin deposition after microvascular injury in a murine model of HIT in which human FcγRIIa was expressed as a transgene. These data implicate FcRn in TF-dependent FXa activity induced by soluble and cell-associated IgG-containing ICs. Antibodies to FcRn, now in clinical trials in warm autoimmune hemolytic anemia to lower IgG antibodies and IgG containing ICs may also reduce the risk of venous thromboembolism.

Rapid Synthesis of Silk-Like Polymers Facilitated by Microwave Irradiation and Click Chemistry.

Silk is a natural fiber that surpasses most man-made polymers in its combination of strength and toughness. Silk fibroin, the primary protein component of silk, can be synthetically mimicked by a linear copolymer with alternating rigid and soft segments. Strategies for chemical synthesis of such silk-like polymers have persistently resulted in poor sequence control, long reaction times, and low molecular weights. Here, we present a two-stage approach for rapidly synthesizing silk-like polymers with precisely defined rigid blocks. This approach utilizes solid-phase peptide synthesis to create uniform oligoalanine "prepolymers", followed by microwave-assisted step-growth polymerization with bifunctional poly(ethylene glycol). Multiple coupling chemistries and reaction conditions were explored, with microwave-assisted click chemistry yielding polymers with Mw ∼ 14 kg/mol in less than 20 min. These polymers formed antiparallel ß-sheets and nanofibers, which is consistent with the structure of natural silk fibroin. Thus, our strategy demonstrates a promising modular approach for synthesizing silk-like polymers.

Predictive Effect of Frailty on Amputation, Mortality, and Ambulation in Patients Undergoing Revascularization for Acute Limb Ischemia.

BACKGROUND: Frailty is a common, age-associated syndrome that has been used to predict postoperative outcomes in vascular surgery. This study examines if standard measures of frailty correlate with postoperative outcomes for patients undergoing revascularization for acute limb ischemia (ALI). METHODS: A retrospective study was conducted on all adult patients undergoing revascularization for ALI at an academic medical center between January 2016 and June 2019. Frailty was calculated with the 11-factor modified frailty index (mFI-11), derived from the Canadian Study of Health and Aging Frailty Index. Outcomes examined included in-hospital mortality, major amputation, site of discharge, and ambulatory status at follow-up. RESULTS: Fifty-three ambulatory patients presented with ALI during the study time period, with 13.2% deemed not frail (mFI-11 < 3) and 86.8% deemed frail (mFI-11 ≥ 3). Frailty was significantly correlated with discharge to a skilled nursing facility (P = 0.028) and nonambulation at follow-up (P = 0.002). There was no significant correlation with other outcomes, including mortality and amputation. On multivariate analysis, frailty was the only factor contributing to nonambulation at follow-up (P = 0.012). Endovascular treatment did not mitigate the effects of frailty on discharge site and ambulatory status. CONCLUSIONS: Frailty is exceedingly common in patients with ALI. Although frailty predicts discharge site and nonambulation at follow-up, it is not associated with amputation or death. Therefore, frail patients should not be denied open or endovascular revascularization for ALI.

Multiaction Pt(IV) Carbamate Complexes Can Codeliver Pt(II) Drugs and Amine Containing Bioactive Molecules.

Multiaction Pt(IV) prodrugs can overcome resistance associated with the FDA approved Pt(II) drugs like cisplatin. Intracellular reduction of the octahedral Pt(IV) derivatives of cisplatin releases cisplatin and the two axial ligands. When the released axial ligands act synergistically with cisplatin to kill the cancer cells, we have multiaction prodrugs. Most Pt(IV) multiaction prodrugs have bioactive ligands possessing a carboxylate that is conjugated to the Pt(IV) because breaking the Pt(IV)-ligand bond releases the active moiety. As many drugs that act synergistically with cisplatin do not have carboxylates, a major challenge is to prepare multiaction Pt(IV) complexes with drugs that have amino groups or hydroxyl groups such that following reduction, the drugs are released in their active form. Our objective was to prepare multiaction Pt(IV) prodrugs that release bioactive molecules having amino groups. Because we cannot conjugate amino groups to the axial position of Pt(IV), we developed a novel and efficient approach for the synthesis of Pt(IV)-carbamato complexes and demonstrated that following reduction of the Pt(IV), the released carbamates undergo rapid decarboxylation, releasing the free amine, as in the case of the PARP-1 inhibitor 3-aminobenzamide and the amino derivative of the HDAC inhibitor SAHA. Pt(IV)-carbamato complexes are stable in cell culture medium and are reduced by ascorbate. They are reduced slower than their carboxylato and carbonato analogues. We believe that this approach paves the way for preparing novel classes of multiaction Pt(IV) prodrugs with amino containing bioactive molecules that up to now were not accessible.

Inflammatory Serine Proteases Play a Critical Role in the Early Pathogenesis of Diabetic Cardiomyopathy.

BACKGROUND/AIMS: Diabetic cardiomyopathy (DCM) is characterized by structural and functional alterations that can lead to heart failure. Several mechanisms are known to be involved in the pathogenesis of DCM, however, the molecular mechanism that links inflammation to DCM is incompletely understood. To learn about this mechanism, we investigated the role of inflammatory serine proteases (ISPs) during the development of DCM. METHODS: Eight weeks old mice with deletion of dipeptidyl peptidase I (DPPI), an enzyme involved in the maturation of major ISPs, and wild type (WT) mice controls were injected with streptozotocin (50 mg/kg for 5 days intraperitoneally) and studied after 4, 8, 16, and 20 week after induction of type 1 diabetes mellitus (T1DM). Induction of diabetes was followed by echocardiographic measurements, glycemic and hemoglobulin A1c profiling, immunoblot, qPCR, enzyme activity assays, and immunohistochemistry (IHC) analysis of DPPI, ISPs, and inflammatory markers. Fibrosis was determined from left ventricular heart by Serius Red staining and qPCR. Apoptosis was determined by TUNEL assay and immunoblot analysis. RESULTS: In the diabetic WT mice, DPPI expression increased along with ISP activation, and DPPI accumulated abundantly in the left ventricle mainly from infiltrating neutrophils. In diabetic DPPI-knockout (DPPI-KO) mice, significantly decreased activation of ISPs, myocyte apoptosis, fibrosis, and cardiac function was improved compared to diabetic WT mice. In addition, DPPI-KO mice showed a decrease in overall inflammatory status mediated by diabetes induction which was manifested by decreased production of pro-inflammatory cytokines like TNF-α, IL-1ß and IL-6. CONCLUSION: This study elucidates a novel role of ISPs in potentiating the immunological responses that lead to the pathogenesis of DCM in T1DM. To the best of our knowledge, this is the first study to report that DPPI expression and activation promotes the inflammation that enhances myocyte apoptosis and contributes to the adverse cardiac remodeling that subsequently leads to DCM.

Full Gamut Wall Tunability from Persistent Micelle Templates via Ex Situ Hydrolysis.

The predictive self-assembly of tunable nanostructures is of great utility for broad nanomaterial investigations and applications. The use of equilibrium-based approaches however prevents independent feature size control. Kinetic-controlled methods such as persistent micelle templates (PMTs) overcome this limitation and maintain constant pore size by imposing a large thermodynamic barrier to chain exchange. Thus, the wall thickness is independently adjusted via addition of material precursors to PMTs. Prior PMT demonstrations added water-reactive material precursors directly to aqueous micelle solutions. That approach depletes the thermodynamic barrier to chain exchange and thus limits the amount of material added under PMT-control. Here, an ex situ hydrolysis method is developed for TiO2 that mitigates this depletion of water and nearly decouples materials chemistry from micelle control. This enables the widest reported PMT range (M:T = 1.6-4.0), spanning the gamut from sparse walls to nearly isolated pores with ≈2 Å precision adjustment. This high-resolution nanomaterial series exhibits monotonic trends where PMT confinement within increasing wall-thickness leads to larger crystallites and an increasing extent of lithiation, reaching Li0.66 TiO2 . The increasing extent of lithiation with increasing anatase crystallite dimensions is attributed to the size-dependent strain mismatch of anatase and bronze polymorph mixtures.

Widely tunable persistent micelle templates via homopolymer swelling.

The combination of precision control with wide tunability remains a challenge for the fabrication of porous nanomaterials suitable for studies of nanostructure-behavior relationships. Polymer micelle templates broadly enable porous materials, however micelle equilibration hampers independent pore and wall size control. Persistent micelle templates (PMT) have emerged as a kinetic controlled platform that uniquely decouples the control of pore and wall dimensions. Here, chain exchange is inhibited to preserve a constant template dimension (pore size) despite the shifting equilibrium while materials are added between micelles. Early PMT demonstrations were synthesis intensive with limited 1-1.3× pore size tuning for a given polymer. Here we demonstrate PMT swelling with homopolymer enables 1-3.2× (13.3-41.9 nm) pore size variation while maintaining a monomodal distribution with up to 250 wt% homopolymer, considerably higher than the ∼90 wt% limit found for equilibrating micelles. These swollen PMTs enabled nanomaterial series with constant pore size and precision varied wall-thickness. Kinetic size control here is unexpected since the homopolymer undergoes dynamic exchange between micelles. The solvent selection influenced the time window before homopolymer phase separation, highlighting the importance of considering homopolymer-solvent interactions. This is the first PMT demonstration with wide variation of both the pore and wall dimensions using a single block polymer. Lastly this approach was extended to a 72 kg mol-1 block polymer to enable a wide 50-290 nm range of tunable macropores. Here the use of just two different block polymers and one homopolymer enabled wide ranging pore sizes spanning from 13.3-290 nm (1-22×).

Acid digestion of carbonates using break seal method for clumped isotope analysis.

RATIONALE: Acid digestion of carbonates to release CO2 is a crucial and sensitive step in sample preparation for clumped isotope analysis. In addition to data reduction and instrumental artefacts, many other uncertainties in the clumped isotope analysis of carbonates arise from the method used for the preparation of CO2 . We describe here an in-house-designed reaction vessel that circumvents degassing and contamination problems commonly associated with the McCrea-type digestion protocols. METHODS: We designed a leak-free break seal reaction vessel (made of Pyrex™) suitable for prolonged acid digestion at 25°C. Using this new vessel, several carbonate reference materials widely used in the clumped isotope community and other in-house laboratory standards were acid-digested and analysed for their δ13 C, δ18 O and Δ47 values with a dual inlet MAT 253 isotope ratio mass spectrometer following standard gas chromatography purification and data evaluation protocols. RESULTS: Long-term reproducibility in Δ47 determination was established using international references and in-house working standards as follows (mean and SE): Carrara-1 (0.395 ± 0.002‰, n = 43), Carrara-2 (0.441 ± 0.003‰, n = 22), OMC (0.587 ± 0.004‰, n = 16), NBS 19 (0.393 ± 0.005‰, n = 10), NBS 18 (0.473 ± 0.003‰, n = 5), ETH 1 (0.271 ± 0.005‰, n = 7), ETH 3 (0.698 ± 0.005‰, n = 3), MZ (0.715 ± 0.002‰, n = 3) and several others. CONCLUSIONS: A new method using a break seal tube was found to be efficient for the clumped isotope analysis of carbonates that require longer reaction time at 25°C. This method yields good precision in Δ47 analysis and was found to be suitable for acid digestions at any desired temperature.

Expanded Kinetic Control for Persistent Micelle Templates with Solvent Selection.

The precision control of nanoscale materials remains a challenge for the study of nanostructure-performance relationships. Persistent micelle templates (PMT) are a kinetic-controlled self-assembly approach that decouples pore and wall control. Here, block copolymer surfactants form persistent micelles that maintain constant template size as material precursors are added, despite the shifting equilibrium dimensions. Earlier PMT demonstrations were based upon solvent mixtures where kinetic rates were adjusted with the amount of water cosolvent. This approach is however limited because ever-higher water contents can lead to secondary porosity within the material walls. Herein, we report an improved method to regulate the PMT kinetics via the majority solvent. This enables a new avenue for the expansion of the PMT window to realize templated materials with a greater extent of tunability. In addition, we report a new small-angle X-ray scattering (SAXS)-based log-log analysis method to independently test the micelle-templated series for consistency with the expected lattice expansion with an increasing material:template ratio. The PMT window identified by the log-log analysis of the SAXS data agreed well with independent scanning electron microscopy measurements. The combination of improved micelle control with solvent selection along with SAXS validation will accelerate the development of a myriad of nanomaterial applications.

Continuous Flow Perfused Cadaver Model for Endovascular Training, Research, and Development.

BACKGROUND: Endovascular simulation employing computer, animal, and static models are common and useful adjuncts for teaching endovascular procedures and developing novel, complex endovascular techniques. Unfortunately, these models lack realistic haptic feedback and thus do not faithfully replicate many of the technical challenges associated with clinical endovascular procedures (e.g., arterial calcification, rigidity, and stenosis). We sought to develop a realistic and reproducible perfused cadaver model for endovascular training, device development, and research. METHODS: Fresh frozen, elderly (age 50-80 years) male cadavers were thawed and prepared for open dissection. The entire arterial tree (ascending aorta to femoral arteries) was dissected free and major branch vessels exposed. Sheaths were placed to allow outflow from selected vessels. A Dacron conduit was sewn to the ascending aorta to generate arterial inflow, which was provided by a centrifugal pump. Aortic aneurysms were created in the descending thoracic and abdominal aorta. Digital subtraction arteriography and various endovascular interventions were performed, including stent grafts and EndoAnchors deployment. RESULTS: Continuous antegrade flow was achieved in the thoracic, abdominal, iliac, and femoral segments. Open and percutaneous access at the femoral region was obtained with realistic back-bleeding and tactile feedback. Adequate, fluoroscopically documented flow was observed in both cannulated major and noncannulated smaller branches. We performed angiography with standard techniques via a pigtail catheter and contrast injector throughout the arterial system. Abdominal and thoracic endografts were deployed with appropriate angiographic guidance and realistic haptic feedback for both guidewire and stent grafts. Additional applications, including selective cannulation, aorto-iliac occlusive disease interventions, and anchor placement, were also successfully simulated. Finally, the model was used as a platform to test investigational devices. CONCLUSIONS: Our pressurized cadaver flow model successfully replicated multiple aspects of advanced endovascular procedures with haptic feedback. This novel human cadaver model allows for training and device development under clinically realistic conditions.

Anti-rheumatoid and anti-oxidant activity of homeopathic Guaiacum officinale in an animal model.

BACKGROUND: Homeopathy is a popular form of complementary and alternative medicine. Guaiacum extract is said to be useful for pain and inflammation, but there appears to be no scientific evidence to support this. AIMS: The aim of the present study was to evaluate the anti-rheumatic and anti-oxidant activity of homeopathic preparations of Guaiacum officinale (Gua) on experimental animal model. DESIGN: Rheumatoid arthritis (RA) was induced in male albino rats by Freund's complete adjuvant (FCA) at a dose of (0.25 mg heat killed Mycobacterium tuberculosis/ml of emulsion). Gua mother tincture (MT) (prepared from the latex part of the plant) (MT), Gua 30cc and 200cc were purchased commercially from King Company, Kolkata, India. Male albino Wistar rats (130 ± 10 g) were divided into 6 groups: Sham control; Arthritis control; Standard treatment indomethacin (0.25 mg 100 g(-1) p.o. × 5 alternative days), Gua MT (1 ml kg(-1) p.o. × 5 days) treated; Gua (30c 1 ml kg(-1) p.o. × 5 days) treated; Gua (200c; 1 ml kg(-1) p.o. × 5 days) treated. Anti-rheumatic activity was examined through physical, urinary, serum parameters. All the results were expressed in terms of mean ± SEM (statistical error of mean n = 6) at each dose level. The level of significance was determined through one-way analysis of variance (ANOVA), p < 0.05 was considered significant. RESULTS: It was observed that body weight, ankle and knee diameter, urinary parameters (hydroxyproline (OH-P), glucosamine, calcium (Ca(2)(+)), creatinine (CRE), phosphate (PO4(3)(-))), serum ACP (acid phosphatase)/ALP (alkaline phosphatase)/Ca(2+)/CRE/PO4(3-)/gamma-glutamyl transferase (GGT)/Lipid peroxidation (LPO)/Glutathione (GSH)/Superoxide dismutase (SOD)/Catalase, serum GGT, serum interleukins like IL-1ß/CINC-1/PGE2/TNF-α/IL-6, IL-12/IL-4/IL-6 levels were significantly affected. After treatment with Guaiacum in all 3 regimes was associated with normalization of these parameters compared to control group. CONCLUSION: These findings suggest that homeopathic G. officinale possesses anti-rheumatic and anti-oxidant activity in experimental animal and these activities may be more significant in higher potencies.

E-classroom as a Blended Learning Tool: A Structural Equation Modelling Analysis Using Modified Technology Acceptance Model.

BACKGROUND: E-classrooms help teachers save time, keep classes organized, and improve communication with students. This study aims to assess Google Classroom's usefulness in enhancing medical students' knowledge and acceptance of new technology for in-depth learning. MATERIAL AND METHOD: This educational interventional study was carried out on 100 students in the 3rd year of the M.B.B.S., Part 1. After a briefing about Google Classroom and educational topics, enrolled students and faculty were allowed to discuss the topic for two months. Following this, the descriptive approach was utilized to describe the respondents' technology acceptance through the administration of the technology acceptance model (TAM) survey questionnaire. RESULTS: Students were actively involved in discussion, with a 67% response rate. Nearly 85% of students agreed that Google Classroom is a satisfactory way for in-depth knowledge acquisition. On factor analysis, it was observed that the goodness of fit was 0.985, suggesting that the model is acceptable. It was also found that perceived usefulness (PU) had a significant positive effect on motivation towards self-directed learning (SDL), and perceived ease of use (PEOU) had a positive effect on both behavioural intention and actual use. CONCLUSION: Google Classroom is a valuable tool for learning that can enhance active self-learning and increase behavioural intention and actual use. It should be incorporated into day-to-day teaching activities to overcome time constraints.

A Nationwide Evaluation of Cardiothoracic Resident Research Productivity.

BACKGROUND: Evaluating the research productivity of cardiothoracic surgery residents during their training and early career is crucial for tracking their academic development. To this end, the training pathway of residents and the characteristics of their program in relation to their productivity were evaluated. METHODS: Alumni lists from integrated 6-year thoracic surgery (I-6) and traditional thoracic surgery residency programs were collected. A Python script was used to search PubMed for publications and the iCite database for citations from each trainee. Publications during a 20-year time span were stratified by the year of publication in relation to the trainee's graduation from thoracic surgery residency. Trainees were analyzed by training program type, institutional availability of a cardiothoracic surgery T32 training grant, and protected academic development time. RESULTS: A total of 741 cardiothoracic surgery graduates (I-6, 70; traditional, 671) spanning 1971 to 2021 from 57 programs published >23,000 manuscripts. I-6 trainees published significantly more manuscripts during medical school and residency compared with traditional trainees. Trainees at institutions with cardiothoracic surgery T32 training grants published significantly more manuscripts than those at non-T32 institutions (13 vs 9; P = .0048). I-6 trainees published more manuscripts at programs with dedicated academic development time compared with trainees at programs without protected time (22 vs 9; P = .004). CONCLUSIONS: I-6 trainees publish significantly more manuscripts during medical school and residency compared with their traditional colleagues. Trainees at institutions with T32 training grants and dedicated academic development time publish a higher number of manuscripts than trainees without those opportunities.