Preoperative Narcotic Use, Impaired Ambulation Status, and Increased Intraoperative Blood Loss Are Independent Risk Factors for Complications Following Posterior Cervical Laminectomy and Fusion Surgery.

ObjectiveThis retrospective cohort study seeks to identify risk factors associated with complications following posterior cervical laminectomy and fusion (PCLF) surgery.MethodsAdults undergoing PCLF from 2012 through 2018 at a single center were identified. Demographic and radiographic data, surgical characteristics, and complication rates were compared. Multivariate logistic regression models identified independent predictors of complications following surgery.ResultsA total of 196 patients met the inclusion criteria and were included in the study. The medical, surgical, and overall complication rates were 10.2%, 23.0%, and 29.1% respectively. Risk factors associated with medical complications in multivariate analysis included impaired ambulation status (odds ratio [OR], 2.27; p=0.02) and estimated blood loss over 500 mL (OR, 3.67; p=0.02). Multivariate analysis revealed preoperative narcotic use (OR, 2.43; p=0.02) and operative time (OR, 1.005; p=0.03) as risk factors for surgical complication, whereas antidepressant use was a protective factor (OR, 0.21; p=0.01). Overall complication was associated with preoperative narcotic use (OR, 1.97; p=0.04) and higher intraoperative blood loss (OR, 1.0007; p=0.03).ConclusionPreoperative narcotic use and estimated blood loss predicted the incidence of complications following PCLF for CSM. Ambulation status was a significant predictor of the development of a medical complication specifically. These results may help surgeons in counseling patients who may be at increased risk of complication following surgery

How Local Interactions Give Rise to Large-Scale Conformational Changes in Proteins: A Molecular Dynamics Study

Proteins are dynamic entities that undergo conformational changes essential for their biological functions. These structural changes often correspond with chemical events such as lipid interactions or environmental changes like protonation or acidification. Understanding the complex relationship between these chemical perturbations and the resultant mechanical responses is crucial for elucidating protein mechanisms. This dissertation investigates the chemo-mechanical coupling in the conformational dynamics of the bacterial ABC transporter Sav1866 and the impact of protonation on the Influenza virus hemagglutinin HA0. Using molecular dynamics simulations, we explore the conformational landscapes of Sav1866 and HA0. Our study examines how varying lipid compositions affect the dynamics of Sav1866, revealing distinct conformational behaviors. Notably, Sav1866 demonstrates unique channel-like behavior in DMPC lipid environments, with both cytoplasmic and periplasmic gates open throughout the simulation, unlike the transition observed in POPE lipids. Specific lipid-protein interactions, including crucial hydrogen bonds, are shown to influence these conformational states, underscoring the lipid-dependent specificity in the function of ABC transporters. Furthermore, our research delves into the effects of protonation on HA0’s conformational dynamics, particularly focusing on the residue H106 in the HA2 region. Protonation at this site leads to significant conformational changes necessary for the fusion process, including the destabilization and opening of the S4 helix and the observation of FP release in the protonated systems. These findings illuminate the complex and detailed dynamics of Sav1866 and HA0. The insights gained could inform structure-based drug discovery, offering potential applications in drug design, biotechnology, and precision medicine where understanding protein dynamics is critical for developing effective and selective treatments

How Local Interactions Give Rise to Large-Scale Conformational Changes in Proteins: A Molecular Dynamics Study

Proteins are dynamic entities that undergo conformational changes essential for their biological functions. These structural changes often correspond with chemical events such as lipid interactions or environmental changes like protonation or acidification. Understanding the complex relationship between these chemical perturbations and the resultant mechanical responses is crucial for elucidating protein mechanisms. This dissertation investigates the chemo-mechanical coupling in the conformational dynamics of the bacterial ABC transporter Sav1866 and the impact of protonation on the Influenza virus hemagglutinin HA0. Using molecular dynamics simulations, we explore the conformational landscapes of Sav1866 and HA0. Our study examines how varying lipid compositions affect the dynamics of Sav1866, revealing distinct conformational behaviors. Notably, Sav1866 demonstrates unique channel-like behavior in DMPC lipid environments, with both cytoplasmic and periplasmic gates open throughout the simulation, unlike the transition observed in POPE lipids. Specific lipid-protein interactions, including crucial hydrogen bonds, are shown to influence these conformational states, underscoring the lipid-dependent specificity in the function of ABC transporters. Furthermore, our research delves into the effects of protonation on HA0’s conformational dynamics, particularly focusing on the residue H106 in the HA2 region. Protonation at this site leads to significant conformational changes necessary for the fusion process, including the destabilization and opening of the S4 helix and the observation of FP release in the protonated systems. These findings illuminate the complex and detailed dynamics of Sav1866 and HA0. The insights gained could inform structure-based drug discovery, offering potential applications in drug design, biotechnology, and precision medicine where understanding protein dynamics is critical for developing effective and selective treatments

The epidemiology of Candida species isolated from urinary tract infections

Candida spp. are members of a genus, including closely related fungal species that cause a variety of infections. Objectives: The aim of this study was the isolation of various Candida species from vulvovaginitis and urethra of patients in Neyshabur, Northeast Iran from 2013 to 2015. Methods: This descriptive-analytical and cross-sectional study was performed to identify Candida spp. causing vulvovaginitis and Urinary Tract Infection (UTI) at a referral laboratory in Neyshabur district, Khorasan Razavi Province. A total of 451 vaginal and midstream urine samples were collected. Ten micro-liters of each specimen was cultured on CHROM agar plates and then incubated at 37°C for 24 to 48 hours, aerobically. Candida species were identified based on colony morphology, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. Results: The mean age of the patients was 34.7_16.3. Candida albicans was the predominant species isolated. Moreover, age groups of 21 to 30 and 0 to 1 years were the most and the least infected individuals. Moreover, Candida spp. were significantly morecommon in females compared to males (P value 103. Conclusions: In this study, C. albicans was the most common species isolated from patients with vulvovaginitis and UTI, and significantly more common amongst females compared to males. The prevalence of candida spp. had significantly declined from 2013 to 2015. Moreover, the candida spp. counts were mostly higher than 103cfu/mL

Cholesterol in Class C GPCRs: Role, Relevance, and Localization

G-protein coupled receptors (GPCRs), one of the largest superfamilies of cell-surface receptors, are heptahelical integral membrane proteins that play critical roles in virtually every organ system. G-protein-coupled receptors operate in membranes rich in cholesterol, with an imbalance in cholesterol level within the vicinity of GPCR transmembrane domains affecting the structure and/or function of many GPCRs, a phenomenon that has been linked to several diseases. These effects of cholesterol could result in indirect changes by altering the mechanical properties of the lipid environment or direct changes by binding to specific sites on the protein. There are a number of studies and reviews on how cholesterol modulates class A GPCRs; however, this area of study is yet to be explored for class C GPCRs, which are characterized by a large extracellular region and often form constitutive dimers. This review highlights specific sites of interaction, functions, and structural dynamics involved in the cholesterol recognition of the class C GPCRs. We summarize recent data from some typical family members to explain the effects of membrane cholesterol on the structural features and functions of class C GPCRs and speculate on their corresponding therapeutic potential

The Alternating Access Mechanism in Mammalian Multidrug Resistance Transporters and Their Bacterial Homologs

Multidrug resistance (MDR) proteins belonging to the ATP-Binding Cassette (ABC) transporter group play a crucial role in the export of cytotoxic drugs across cell membranes. These proteins are particularly fascinating due to their ability to confer drug resistance, which subsequently leads to the failure of therapeutic interventions and hinders successful treatments. One key mechanism by which multidrug resistance (MDR) proteins carry out their transport function is through alternating access. This mechanism involves intricate conformational changes that enable the binding and transport of substrates across cellular membranes. In this extensive review, we provide an overview of ABC transporters, including their classifications and structural similarities. We focus specifically on well-known mammalian multidrug resistance proteins such as MRP1 and Pgp (MDR1), as well as bacterial counterparts such as Sav1866 and lipid flippase MsbA. By exploring the structural and functional features of these MDR proteins, we shed light on the roles of their nucleotide-binding domains (NBDs) and transmembrane domains (TMDs) in the transport process. Notably, while the structures of NBDs in prokaryotic ABC proteins, such as Sav1866, MsbA, and mammalian Pgp, are identical, MRP1 exhibits distinct characteristics in its NBDs. Our review also emphasizes the importance of two ATP molecules for the formation of an interface between the two binding sites of NBD domains across all these transporters. ATP hydrolysis occurs following substrate transport and is vital for recycling the transporters in subsequent cycles of substrate transportation. Specifically, among the studied transporters, only NBD2 in MRP1 possesses the ability to hydrolyze ATP, while both NBDs of Pgp, Sav1866, and MsbA are capable of carrying out this reaction. Furthermore, we highlight recent advancements in the study of MDR proteins and the alternating access mechanism. We discuss the experimental and computational approaches utilized to investigate the structure and dynamics of MDR proteins, providing valuable insights into their conformational changes and substrate transport. This review not only contributes to an enhanced understanding of multidrug resistance proteins but also holds immense potential for guiding future research and facilitating the development of effective strategies to overcome multidrug resistance, thus improving therapeutic interventions

The Role of Liposomal CpG ODN on the Course of L. major Infection in BALB/C Mice

"nBackground: Historically, leishmanization is the most effective protective measure against Cutaneous Leishmaniasis (CL), CL lesion induced by leishmanization sometimes takes a long time to heal. Ma­nipulation of leishmanization inoculums needed to induce a mild and acceptable CL lesion. The aim of this study was to explore if liposomal form of CpG ODN (Cytosin phosphate Guanin Oligodeoxynu­cleotides) mixed with Leishmania major   would induce a milder lesion size in Balb/c mice."nMethods: This study was performed in Biotechnology Research Center, Mashhad, and Center for Re­search and Training in Skin Diseases and Leprosy, Tehran, Iran during 2008-2009.  mice were subcutaneously (SC) inoculated with L. major mixed with liposomal form of CpG ODN, or L. major plus free CpG ODN, or L. major mixed with empty liposomes or L. major in PBS. The lesion onset and the size of lesion were recorded; the death rate was also monitored. "nResult: Footpad thickness was significantly (P<0.01) smaller, death rate was also significantly (P<0.05) lower in the mice received L. major mixed with liposomal CpG ODN or free CpG ODN than control groups received L. major in PBS or L. major plus liposomes, also mice which received L. ma­jor mixed with CpG ODN in soluble form showed a significantly (P < 0.001) smaller lesion size than control groups."nConclusion: CpG ODN seems to be an appropriate immunopotentiator mixed with Leishmania stabi­late in leishmanization

Using Combined Descriptive and Predictive Methods of Data Mining for Coronary Artery Disease Prediction: a Case Study Approach

Heart disease is one of the major causes of morbidity in the world. Currently, large proportions of healthcare data are not processed properly, thus, failing to be effectively used for decision making purposes. The risk of heart disease may be predicted via investigation of heart disease risk factors coupled with data mining knowledge. This paper presents a model developed using combined descriptive and predictive techniques of data mining that aims to aid specialists in the healthcare system to effectively predict patients with Coronary Artery Disease (CAD). To achieve this objective, some clustering and classification techniques are used. First, the number of clusters are determined using clustering indexes. Next, some types of decision tree methods and Artificial Neural Network (ANN) are applied to each cluster in order to predict CAD patients. Finally, results obtained show that the C&RT decision tree method performs best on all data used in this study with 0.074 error. All data used in this study are real and are collected from a heart clinic database

OPTIma:simplifying calorimetry for proton computed tomography in high proton flux environments

Objective. Proton computed tomography (pCT) offers a potential route to reducing range uncertainties for proton therapy treatment planning, however the current trend towards high current spot scanning treatment systems leads to high proton fluxes which are challenging for existing systems. Here we demonstrate a novel approach to energy reconstruction, referred to as ‘de-averaging’, which allows individual proton energies to be recovered using only a measurement of their integrated energy without the need for spatial information from the calorimeter. Approach. The method is evaluated in the context of the Optimising Proton Therapy through Imaging (OPTIma) system which uses a simple, relatively inexpensive, scintillator-based calorimeter that reports only the integrated energy deposited by all protons within a cyclotron period, alongside a silicon strip based tracking system capable of reconstructing individual protons in a high flux environment. GEANT4 simulations have been performed to examine the performance of such a system at a modern commercial cyclotron facility using a σ ≈ 10 mm beam for currents in the range 10–50 pA at the nozzle. Main results. Apart from low-density lung tissue, a discrepancy of less than 1% on the Relative Stopping Power is found for all other considered tissues when embedded within a 150 mm spherical Perspex phantom in the 10–30 pA current range, and for some tissues even up to 50 pA. Significance. By removing the need for the calorimeter system to provide spatial information, it is hoped that the de-averaging approach can facilitate clinically relevant, cost effective and less complex calorimeter systems for performing high current pCTs