We investigated whether responses about possible scientific misconduct from journals to journalists would differ in speed, usefulness, and tone from responses to academics. Twelve journals that published 23 clinical trials about which concerns had been previously raised were randomly assigned to enquiries by a journalist or academics. Emails were sent every 3 weeks to the journal editor. We recorded the time for the journal to respond, and two investigators independently assessed the usefulness and tone of the journal responses.10/12 journals responded: 3 after one email, 5 after two emails, and 2 after three emails . Of the 10 responses, 8 indicated the journal was investigating, 5 had a positive tone, 4 a neutral tone, and 1 a negative tone. Five of the enquiries by the academics produced information of limited use and 1 no useful information, whereas none of the 6 journalist enquiries produced useful information (P = 0.015). None of the 10 responses was considered very useful. In conclusion, journal responses to a journalist were less useful than those to academics in understanding the status or outcomes of journal investigations.The online version of this article (10.1186/s13104-018-3613-1) contains supplementary material, which is available to authorized users. When scientific misconduct occurs, the relevant literature ought to be promptly corrected. However, there are often lengthy delays between concerns being raised and formal actions such as expression of concern notices or article retraction  who has recently investigated and written about scientific misconduct and the world of academic publishing for the ewspaper –11 to taWe contacted the editors of the 12 journals that published the 23 unretracted trial publications using email contact details on the journal website, or where these were not available or not responded to, using email details obtained from an internet search. Each journal was randomised to receive a standard letter from the journalist or from our group of academics , who provide guidance for dealing with scientific misconduct, or had previous experience with retractions, as determined by Pubmed and Google searches. For each journal, we recorded the time taken to respond and any details provided about investigations being undertaken. Two authors blinded to randomisation  independently classified the usefulness of information provided in the responses, and the tone of the journal response. We pre-specified that a very useful response would clearly state what the journal had done to date and the current status of its investigation; whereas a response of no use would not indicate what the journal had done nor the current status of the investigation, and a response of limited use would lie between these two categories. Tone of the response, defined by the Oxford English dictionary as “The general character or attitude of a piece of writing”, was classified as positive, negative or neutral by each investigator according to their own judgement. Agreement of these classifications between authors was 75%-kappa statistic for usefulness 0.64, and for tone 0.53. In cases of disagreement, the independent assessment of a third author (MB) acted as a tiebreaker, with final categorisation agreed by consensus.https://www.graphpad.com). P < 0.05 was considered statistically significant.We compared the median time to a response using the log-rank test and the differences in usefulness and tone with Fisher’s Exact test .Table Overall, we considered that 5 of the 6 enquires made by academics produced information of limited use and 1 no useful information, whereas none of the 6 enquiries by the journalist produced useful information (P = 0.015). None of the 10 responses were considered to be very useful. Table One of the 23 publications was retracted because of scientific misconduct in the 5 months after our initial emails , than they provided to the journalist, but there were no differences in the tone or speed of the journal response to the academics or journalist. These findings were contrary to some of our expectations. Prior to the study, we had a range of views as to whether there would be differences in journal responses to being contacted by a journalist or by a group of academics, in general expecting either no differences or that the journalist would receive faster responses.Only 25% of journals (3/12) responded to the initial email contact, and 17% (2/12) did not respond despite being sent 3 separate emails. When journals did reply, the response was quick: 8/10 responses came within 1 day of the most recent email, and the other two within 8 days of the most recent email. However, the information provided by the journals was of limited or no use in understanding what was happening. While 8/10 responses indicated that an investigation was taking place, only 4 indicated whether or not the author had been contacted and only 1 whether or not the institution had been contacted. Three responses stated that we could expect further contact from the journal, but none gave an indication of the expected time frame and no journal has contacted us as yet. Despite our enquiries, the investigations of the possible misconduct did not appear to have proceeded: in the 11 months after the journals were all first notified by another journal editor about the possible scientific misconduct (including the 5 months after our first email) only one journal made any public statement about the integrity of an RCT—it was retracted.Unbeknown to us, a journalist from the Retraction Watch website also contacted the journals with the unretracted papers between our 2nd and 3rd email contacts . RetractOur study has highlighted an important problem. When there is clear-cut evidence of research misconduct identified in previous investigations, there seems little reason for long delays or a reluctance to provide useful information about the processes being undertaken to correct the scientific record, nor to promptly publish an expression of concern. But even after recommendation for retraction following an official investigation by a German State Medical Association, 10% of articles remained unretracted after 2 years . FailureThe major limitations to our findings arise from the necessarily small and selected group of journals contacted. By necessity, the study focused only on a group of 23 RCTs published in 12 journals. These RCTs were part of a broader group of 33 RCTs about which concerns regarding possible scientific misconduct had been published . All theAdditional file 1. Template for letters from academics to journalist to journal editors. Table S1. References of 23 randomised controlled trials.Additional file 2. Study data. Contains all study data.


Arterial stiffness is an age-related disorder. In the medial layer of arteries, mechanical fracture due to fatigue failure for the pulsatile wall strain causes medial degeneration vascular remodeling. The alteration of extracellular matrix composition and arterial geometry result in structural arterial stiffness. Calcium deposition and other factors such as advanced glycation end product-mediated collagen cross-linking aggravate the structural arterial stiffness. On the other hand, endothelial dysfunction is a cause of arterial stiffness. The biological molecular mechanisms relating to aging are known to involve the progression of arterial stiffness. Arterial stiffness further applies stress on large arteries and also microcirculation. Therefore, it is closely related to adverse outcomes in cardiovascular and cerebrovascular system. Cardio-ankle vascular index (CAVI) is a promising diagnostic tool for evaluating arterial stiffness. The principle is based on stiffness parameter β, which is an index intended to assess the distensibility of carotid artery. Stiffness parameter β is a two-dimensional technique obtained from changes of arterial diameter by pulse in one section. CAVI applied the stiffness parameter β to all of the arterial segments between heart and ankle using pulse wave velocity. CAVI has been commercially available for a decade and the clinical data of its effectiveness has accumulated. The characteristics of CAVI differ from other physiological tests of arterial stiffness due to the independency from blood pressure at the time of examination. This review describes the pathophysiology of arterial stiffness and CAVI. Molecular mechanisms will also be covered. Arterial stiffness increases with age . HoweverFor this purpose, appropriate evaluation for arterial stiffness is necessary. Cardio-ankle vascular index (CAVI) as an index of arterial stiffness was first proposed in 2006 ; therefoArterial stiffness is characterized by impaired distensibility of large arteries. The structure of the arterial wall consists of three layers: intima, media, and adventitia. The possible mechanisms of arterial stiffness in each layer of arterial wall are shown in 2+ concentration leading to vascular relaxation. Therefore, deficiency of NO production caused by endothelial dysfunction increase peripheral arterial resistance, which promotes pulse wave reflection in the central arteries and causes additional stress on the vessel wall leading to intima–media thickening [Endothelial dysfunction is considered to be a functional cause of arterial stiffness in addition to the medial degeneration. Vascular tone is determined by the balance of endothelium-derived vasoactive substances that include vasodilators such as nitric oxide (NO), prostaglandins, endothelium-derived hyperpolarization factor, epoxyeicosatrienoic acids, and vasoconstrictors such as angiotensin II, endothelin-1, prostanoids, and isoprostanes . In themickening .l-Arginine serves as the sole source of nitrogen for NO. Endothelial NO synthase (eNOS) converts l-arginine to l-citrulline with producing molecules of NO. The restoration of l-arginine from l-citrulline is catalyzed by the enzymes argininosuccinate synthase and argininosuccinate lyase in urea cycle [l-asymmetric dimethylarginine (l-ADMA), a l-arginine derivative, increases with cardiovascular risks. The methylation of l-arginine is catalyzed by S-adenosylmethionine in methionine cycle. l-ADMA acts as a competitive NO synthase inhibitor and the relative increase of l-ADMA to l-arginine is associated with arterial stiffness [l-arginine bioavailability defined as the ratio of serum l-arginine to the sum of l-citrulline and l-ornithine [l-arginine, especially eNOS, and arginase. Arginase is a rate-limiting enzyme in the urea cycle converting l-arginine to l-ornithine and urea. The enhanced activity of arginase induces chronic l-arginine deficiency and endothelial dysfunction. Arginase expression or activity is upregulated in hypertension, diabetes, and oxidative stress, as well as inflammation in human and animal models of various vascular diseases [l-ornithine is the precursor of polyamines that induce proliferation of vascular smooth muscle cells. Proline and hydroxyproline, which are the main precursors of collagens, are also synthesized from l-ornithine. Vascular endothelium-specific arginiase-1 knockout decreases arterial stiffening and fibrosis, elevated BP induced by high fat-high sucrose diet in mice [l-arginine flux into the arginase pathway is involved in aortic stiffness via metabolic mechanisms.ea cycle . l-asymmtiffness . Furtherrnithine . The ratdiseases . Moreove in mice . Thus, a−, one of the reactive oxygen species, is produced instead of NO [Although the receptor of shear forces is not identified , increasad of NO . The defad of NO ,28.Sirtuin-1 (SIRT-1) is a nuclear nicotinamide adenine dinucleotide-dependent nuclear deacetylase  that actThere are other underlying mechanisms of arterial stiffening which may occur independently but relates to each other. Arterial stiffness has been considered to be related with lipids, calcification, fibrosis, chronic inflammation, advanced glycation end product-mediated collagen cross-linking, oxidative stress, and sympathetic nervous activity ,39. The There have been many non-invasive methods for validating arterial stiffness. The approaches of the methods can be mainly classified into the three groups; two-dimensional (2D) imaging technique, pulse wave analysis technique (PWA), and PWV. The approach of the 2D imaging technique is to measure the change of diameter, or sectional area under distensional pressures . A reprePWV is the velocity at which the pulse wave propagates through the circulatory system . The parIn addition, endothelial function tests are also important for patients suspected vascular disease because endothelial dysfunction causes functional arterial stiffening as described above. The endothelial function tests fundamentally assess the reactivity to hyperaemia after releasing the cuff at an upper arm or a forearm. This type of measurements includes venous occlusion digital plethysmography, flow-mediated dilation (FMD) of the brachial artery, and reactive hyperemia index (RHI) using fingertip peripheral arterial tonometry. However, the difference in the results of FMD and RHI was reported. This is supposed to be due to the difference of the targeted arteries ,58. CAVI is based on the principle of stiffness parameter β, an index of the 2D imaging technique, but requires PWV for the calculation. Therefore, reevaluation from clinical data is needed to know whether CAVI is superior to PWV for prediction of further cardiovascular events. The detail of the principle of CAVI is described in the following section.CAVI was developed as a clinical test of arterial stiffness in Japan after the development of PWV. Previously, Hayashi et al. developed stiffness parameter β to stand for arterial stiffness in the 1980s . The stuCAVI is calculated using BP and heart-ankle PWV (haPWV), monitoring of heart sounds and electrocardiogram. haPWV is calculated by dividing the distance from the aortic valve to the ankle artery by the sum of the time intervals between aortic valve closure sound and notch of the brachial pulse wave and between the rise of the brachial pulse wave and the ankle pulse wave. CAVI is derived from the stiffness parameter β and Bramwell-Hill formula  and deteThe pressure-diameter curve of an artery is linearized by log-transformation of BP and a linear function is established between ln(Ps/Pd) and ΔD/D. The inclination of the straight line is defined as stiffness parameter β (ln(Ps/Pd)/(ΔD/D)).2 is small and negligible):On the other hand, the Bramwell-Hill formula was proven and derived in experiments. It is determined by the following formula: follows :CAVI = as method ,63,64.This equation reflects the global stiffness of the aorta, femoral arteries, and tibial artery; CAVI represents the stiffness parameter β of a whole arterial segment . CAVI coThe most important characteristic of CAVI is the reproducibility due to the independence from BP at testing ,70. The The difference of drug-response between CAVI and baPWV was shown in a previous paper . MetoproCBP is a non-invasive test estimating ascending aortic BP and reflects direct stress on the heart. Therefore, CBP is thought to be a better indicator than brachial BP. CBP can also distinguish the different effects of anti-hypertensive drugs . A previThe limitations of CAVI are mainly attributed to the placement of cuffs on ankles, which are equivalent to baPWV. For the CAVI evaluation, patients with severe aortic insufficiency, bilateral ankle-brachial index <0.9, or persistent, atrial fibrillation should be excluded because it is difficult to obtain accurate measurements in such patients . Thus, pClinically, increased arterial stiffness contributes to elevating left ventricular afterload and developing LV diastolic dysfunction. The Windkessel effect is when intermittent blood flow injected from the heart becomes a smoother and steadier stream after passing through the elastic aorta . This is2 consumption for maintaining adequate flow is increased [However, cardiac function can be deteriorated when the Windkessel effect has declined. The return of the reflection pulse wave occurs during late systole when PWV is fast due to arterial stiffness. The change in loading sequence amplifies systolic BP and increases pulse pressure ,80,81 anncreased . This moMoreover, progression of large artery stiffness induces excessive penetration of pulsatility . Aortic Approximately half of the patients with heart failure have preserved LV ejection fraction, called HFpEF ,92,93. T2), E’ , E/E’ (>14) and tricuspid regurgitation velocity (>2.8 m/s) [The diagnosis of diastolic dysfunction is achieved by abnormal left ventricular relaxation and increased left ventricular chamber stiffness. Cardiac catheterization is the gold standard for assessment of diastolic dysfunction . Cathete2.8 m/s) .The close relationships between CAVI, diastolic dysfunction classified by E/A, and DT in Doppler echocardiography were described previously . The reln = 100, mean age: 70 ± 8 years old) and a subgroup of patients with HFpEF  [Several studies demonstrated that CAVI positively correlates with the index of LV filling pressure measured by tissue Doppler echocardiography (E/E’) ,108. Thears old) . CAVI alars old) .Additionally, there are previous studies evaluating diastolic dysfunction with ultrasonic strain imaging, although it is not currently included in the criteria of diastolic dysfunction ,113,114.In previous cross-sectional studies, CAVI is associated with various cardiovascular risk factors. CAVI correlates with high-sensitivity cardiac troponin T , renal fCAVI is significantly lower in physically active women doing aerobic exercise in comparison with controls with similar ages . HoweverTo date, there are increasing numbers of studies suggesting the prognostic value of CAVI for cardiovascular events. But most of them are single-centered and the sample size are small. The studies targeted mainly thromboembolic events for the endpoints such as traditional major adverse cardiac events (MACE) including cardiac death myocardial infarction and stroke ,138,139.Hemodialysis (HD) patients are characterized as severe arterial stiffness by various causes including hypertension, fluid overload, and arterial calcification due to secondary hyperparathyroidism. In patients with end-stage chronic kidney disease who underwent surgical construction of arteriovenous shunt for HD, CAVI reflects the histological arterial fibrosis in the arterial fragments . HoweverThere are more obvious causal relationships between arterial stiffness and heart failure because decrease of arterial wall compliance increases cardiac afterload and exacerbate the condition of heart failure. There are the evidences that arterial stiffness assessed by baPWV ,145 or cCAVI is independently associated with brain natriuretic peptide levels in patients with hypertension . HoweverThe prospective multicenter cohort study to evaluate the usefulness of the CAVI to predict cardiovascular events in Japan (CAVI-J) is ongoing. The primary endpoints are cardiovascular death, nonfatal myocardial infarction, and stroke, and the secondary endpoints are composite cardiovascular events including all cause death, heart failure requiring hospitalization, angina pectoris with revascularization, new incidence of peripheral artery disease, abdominal aortic aneurysm, aortic dissection, and deterioration in renal function  The largFurthermore, we recently published a paper of a study investigating the association of CAVI with endothelial insulin resistance. Freshly isolated arterial endothelial cells (FIECs) were harvested from radial catheter sheath, a disposable device for coronary angiography. Endothelial insulin resistance was defined as a decrease of insulin-stimulated phosphorylation of eNOS at serine 1177 (p-eNOS Ser1177). CAVI negatively correlated with percent increase of insulin-mediated p-eNOS Ser1177 in the FIECs. The result suggests that high CAVI is associated with deteriorated signal transduction of IRS1-PI3K-Akt-eNOS pathway indicating endothelial dysfunction . Thus, wArterial stiffness is a factor of arteriosclerosis and heart failure, especially in HFpEF. Endothelial dysfunction involves the progression of arterial stiffness for which various clinical and molecular biological research has been conducted. CAVI is a convenient yet effective marker of this disorder. The efficacy will be clarified to a greater and necessary extent in future clinical research.


To conduct a systematic review of literature about the use of contralateral patellar tendon autograft in anterior cruciate ligament reconstructions and present the results. The LILACS, MEDLINE, Cochrane, PubMed, Scielo and Google Scholar databases were searched without date restrictions for the keywords “anterior cruciate ligament reconstruction” combined with “contralateral” in the article title. After the studies were identified, two independent evaluators collected the qualitative characteristics of the studies and classified them according to clinical outcomes of these grafts as positive, neutral, or negative. A total of 755 articles were found initially, and after detailed evaluation of all references, followed by a screening process and assessment of quality, a total of 11 studies were determined to be eligible for inclusion in this systematic review. Of these, 72.72% were level II studies, the most common level of evidence among the results. Positive results for this type of graft were found in 63.63% of the studies. Based on the literature review, most of the included articles (63.63%) presented positive results for the use of contralateral patellar tendon grafts. Level of Evidence III; Systematic review. Because of the high incidence of ACL injuries in the population, this ligament has been the subject of many contemporary studies. Considering the instability ACL injuries cause, and potential comorbidities resulting from ACL rupture , the recommended treatment is surgical and involves ligament reconstruction.An improved surgical technique for reconstructing this ligament has made it less invasive, and when combined with early rehabilitation leads to joint stability and decreases the time patients need to return to their normal activities , which has greatly increased the number of surgical reconstructions in recent years.,Despite the frequency of ACL reconstruction surgery, extensive experience among orthopedic surgeons, and increasing advancement in surgical techniques, the choice of graft to be used in ligament reconstruction remains a main topic of debate in the literature.Currently, several graft sources have been shown effective in ACL reconstruction; the choice of the ideal graft is tailored to the patient profile and the injury, and also is affected by the surgeon’s personal experience. Grafts derived from the quadriceps tendon and the flexors have emerged as an option for patellar grafting, following studies on anterior knee pain and morbidity of the donor site.-With increasing numbers of revision procedures after ACL reconstruction surgery, there was a need for grafts from other sites such as the contralateral patellar tendon. Clinical observations by surgeons choosing this new site produced results equaling or even exceeding those of the primary surgery, raising the possibility that this site could be a good donor candidate for primary reconstructions.Because of the importance and scarcity of scientific studies on the use of the contralateral patellar tendon as a graft in reconstructing the ACL, the authors conducted this review, which is principally intended to present the results of studies that used this graft in primary reconstructions of the ACL of the knee.A systematic review of the literature in the LILACS, MEDLINE, Cochrane, Scielo, PubMed and Google Scholar databases was conducted. The search was not limited to any date range because of the need for a historical delineation. The text keywords we used were: “anterior cruciate ligament reconstruction” combined with “contralateral”, and we always searched for these terms in the article title.The selection criteria for studies included in this review were:articles written in English or Portuguese;  theoretical studies matching the objectives of this analysis;  cross-sectional studies comparing graft types including contralateral patellar tendon grafts; correlation studies involving the use of the contralateral patellar tendon as a graft; controlled clinical trials verifying outcomes from the use of the contralateral patellar tendon as a graft.Exclusion criteria were:articles in languages other than English or Portuguese; articles with deficiencies in their methodology section, principally with regard to selection and sample power, as well as materials used; studies which did not involve the use of the contralateral patellar tendon as a graft; case reports or case series involving fewer than five patients; letters to the editor or expert opinions.Data were collected from May 2017 to August 2017. The main author of this study evaluated all the articles and applied the inclusion and exclusion criteria. Each relevant study was obtained and reviewed in its entirety. The studies were identified electronically, based on the abstracts and full texts in the databases. After the studies were identified, two evaluators independently collected the qualitative characteristics and results of the studies, grouping them as positive, negative, or neutral. Any doubts related to selecting the articles or their results were resolved by consensus between the two researchers. When questions remained, a third reviewer was consulted to achieve a majority opinion.This level of evidence has been determined in accordance with the Oxford Levels of Evidence Classification System produced by the Oxford Center for Evidence-Based Medicine.Searching for the terms “anterior cruciate ligament reconstruction” combined with “contralateral” in the article titles, we initially identified 755 articles from the electronic databases consulted. After detailed evaluation of all references followed by a screening process and quality assessment, a total of 11 studies were determined eligible for inclusion in this systematic review, as shown in Over the last 40 years, the therapeutic approach to ACL injury has undergone significant alterations, returning to the 1939 technique which used the patellar tendon to replace the ruptured ACL. This return to the old technique was only possible through advances in anatomy and biomechanics, along with arthroscopy using new tools and fixation techniques which provide earlier rehabilitation and better results.,Besides good fixation, the current goal is anatomical reconstruction of the ACL in order to reestablish the structural and biomechanical properties of the knee, mainly with regard to rotational instability. The items that contribute to satisfactory progress after this procedure are adequate choice of surgical technique for each patient, the condition of the secondary restrictors (meniscus and ligaments), post-operative analgesia, and early and safe rehabilitation. Improvements and innovations in ACL reconstruction techniques have produced satisfactory results for instability control and early return to sports.,Since it is a surgical procedure, ACL reconstruction presents complications inherent to any intervention, such as healing problems, deep venous thrombosis, infection, and hemorrhage. However, there are specific complications arising from the use of different graft types.,During the study period, several types of grafts were used: autologous, allografts, and synthetic. Currently, the tendency is to use a strong biological graft; autologous grafts from the patellar and ischiotibial tendons (semitendinosus and gracilis tendons) are the most frequently discussed. One of the complications which have been most widely studied with regard to the use of patellar tendon graft is patellar fracture. When the ischiotibial tendons are used, a possible complication is that patients may present some deficit of knee flexion in the donor knee.Among the most frequent complications of ACL reconstruction, pain in the anterior face of the knee and loss in residual muscle strength seem to be linked to the choice of donor source. The studies are controversial in defining whether these comorbidities  are related to the graft harvest, a rehabilitation program, or the reduction in movement. However, complications such as fracture of the patella or the proximal portion of the tibia and patellar tendon rupture are clearly attributed to the process of collecting the patellar graft.,As the number of primary ACL reconstructions grows, the need for revision surgery has increased significantly, and while the ideal graft choice continues to be unresolved, the contralateral patellar tendon has emerged as an option. Studies on ACL injury revision procedures and the use of this graft type found no adverse effects over the long term, and also showed a potentially more rapid post-operative recovery, with better functional scores and an even lower rate of complications.However, because collection of the patellar tendon graft leads to some degree of morbidity to the donor site, such as decreased sensitivity, difficulty kneeling, and quadriceps muscle weakness, orthopedic surgeons tend to choose other graft sources as their first option.,In 1994, a study by Rubinstein reported the results of using contralateral patellar tendon grafts in ACL reconstruction revision procedures and proposed the use of this tendon in primary reconstruction based on the results obtained in patients related to recovery of knee range of motion, muscular strength of the quadriceps in both knees, in both the reconstructed and the donor knees. In another study in 1998, Bruck found good results for the use of this graft in ACL reconstructions, with low donor site morbidity.,Other subsequent articles showed that the contralateral patellar tendon could be used in primary ACL reconstructions, restoring range of motion and muscle strength as early as an ipsilateral patellar tendon graft, and consequently could offer a faster full-capacity return to sports without compromising maximum stability, since after proper post-surgical rehabilitation there was no loss of strength or subjective symptoms that were not resolved.,On the other hand, one study showed that the losses in isokinetic muscle strength after ACL revision seem similar to those observed after primary reconstruction of this ligament using the same surgical technique and grafts of the ipsilateral patellar tendon, ipsilateral ischiotibial tendons, and contralateral patellar tendon. Additionally, contralateral patellar tendon graft appeared to offer no advantages over the ipsilateral graft, because all the symptoms related to morbidity in the donor site are transferred to the healthy knee, and return to sports or professional activities is not faster.This present study shows that the contralateral patellar tendon graft has been used for at least twenty years, and studies are still recent. Of the 11 articles included in this review, no study used evidence level I, and studies with levels IV and V were discarded according to the exclusion criteria. Eight articles were at level II and 3 at level III. Therefore, this review demonstrates a lack of articles with a high evidence levels and A-level recommendation which compared the contralateral patellar tendon to other graft types. Despite the lack of these studies with higher levels of evidence, it is important to emphasize that there are cohort studies with a large number of patients, most notably by Shelbourne, who authored or co-authored 5 of the articles in this review (45.45%), all of which presented positive results for the use of contralateral patellar tendon grafts. This author also has some bibliographic reviews and texts classified as expert opinions, indicating that he is a major scholar and proponent of this type of graft. Besides these 5 articles, another 2 articles reported positive results for the use of this graft, 3 articles presented neutral results, and only 1 study indicated negative results. However, this latter case was a cohort study with evidence level II.This literature review encountered some obstacles, such as a small number of articles addressing the use of the contralateral patellar tendon as a graft; broader descriptors were required to find more studies and then develop inclusion and exclusion criteria as well as exclusion methods involving only reading the title and abstract. A review of studies describing the use of the contralateral patellar tendon as a graft in ACL reconstruction surgeries provides information and parameters required for decision-making. According to the literature studied, most of the articles (63.63%) presented positive results for the use of contralateral patellar tendon grafts.


To report the management of an intraoperative complication during large (9.5 mm) ultra-thin Descemet Stripping Automated Endothelial Keratoplasty (UT-DSAEK) surgery in a patient with a large area of dysfunctional endothelium.2 at a focal depth of 496 μm with some polymegathism.A single case study of an 89 y/o male with a history of Fuchs corneal endothelial dystrophy is presented. The patient was listed for a large UT-DSAEK, but due to an intraoperative complication during graft preparation, an 8.00 mm Descemet membrane endothelial keratoplasty (DMEK) was prepared from the same graft using a standardized SCUBA technique and delivered. Early postoperative examination of the graft showed decentred, residual corneal oedema in the absence of DM detachment and a well-formed anterior chamber. The endothelial graft was found attached after 3 months and the corneal oedema was cleared. After 5 months, the patient's BSCVA was recorded at 6/6(20/20) in the left eye, but complained of mild discomfort. A circular ring of corneal oedema was observed around the graft and decentralization of the transplanted graft was observed. Endothelial cell density (ECD) of the central cornea at 5th month was 1506 cells/mmand importance: It is possible to prepare DMEK starting from a failed DSAEK graft. Thickness map on corneal tomography could be a useful tool after DMEK for checking graft centration, function, and corneal recovery indirectly. It is recommended to only maintain a small distance between the descemetorhexis area and the size of the endothelial graft. We have also noted that matching the size of descemetorhexis with the graft size is important in order to avoid peripheral stromal edema and reduce the detachment rate. Thus, the aim of this single case report is to show that a DMEK graft can be prepared even after a failed DSAEK preparation further reducing possible wastage of tissue.2,in vivo confocal microscopy  5 months after surgery was 1506 cells/mm2 at a focal depth of 496 μm with some polymegathism.An 89-year-old man with a history of Fuchs corneal endothelial dystrophy presented in the left eye with reduced visual acuity and discomfort due to the development of pseudophakic corneal edema following previous uneventful cataract surgery in 2005. The best spectacle corrected distance visual acuity (BSCVA) was 6/18 (20/63) in the right eye and 6/24(20/80) in the left eye. Intraocular pressure was 12 mmHg in both the eyes with central corneal thickness in the left eye of 658 microns, measured using ultrasound pachymeter. The guttae and resulting endothelial dysfunction involved most of the endothelial surface, therefore, a large (9.5 mm) ultra-thin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) was planned. The graft was prepared following our previously published protocol.https://doi.org/10.1016/j.ajoc.2018.09.003.Supplementary video related to this article can be found at Descemet Membrane Endothelial Keratoplasty (DMEK) graft preparation from a failed Descemet Stripping Automated Endothelial Keratoplasty graft. The video illustrates the method of stripping a DMEK graft from an irregularly cut Ultra Thin-DSAEK graft due to loss of vacuum while cutting UT-DSAEK in the surgical theatre.1Video 1The following is the supplementary data related to this article:31 of 9.5 mm, the circumferential arc length is 9.5mm × α1, where α1 can be calculated from the function, α1 = 2Arcsin(Y1/2R1). Therefore, for an 8.00 mm sized graft, α1 = 2Asin(4.00/2 × 9.5) or 1.05 radians or 60°, giving a circumferential arc length C of 8.25 mm. If the graft assumes a radius of curvature on the posterior corneal surface R2 in the eye of 5.70 mm, then α2 = (C/R2) or 1.75 radians or 100°. The expected chord length (Y2) of the graft in the eye is therefore Y2 = 2 (5.7) sin 50° or 7.75 mm. Therefore, for a 8 mm donor DMEK preparation we will have a smaller graft size of 7.75 mm in the eye using Barron, 7.9 mm using Moria, 7.88 mm using Janach. There is always an under sizing of the graft compared to the trephine used. This under sizing increases with larger diameter graft. Migration of endothelial cells to cover the gap between the edge of the graft and host Descemet's membrane and endothelium may not be a consistent event and in this case by 5 months, appeared insufficient to have bridged the circumferential gap of 1.75mm (9.5mm - 7.75mm).This case report highlights some interesting points. It is possible to prepare a DMEK lenticule starting from a posterior lamellar graft (DSAEK). In cases of irregular donor surfaces it is still a valid and achievable option. A multimodal approach AS-OCT and the thickness map on corneal tomography are useful tools after DMEK for indirectly checking graft centration, function, attachment, and corneal recovery. Melles et al. have previously reported the utility of corneal tomography in the follow-up to highlight early signs of rejection after DMEK.The corneas were harvested by Fondazione Banca degli Occhi del Veneto Onlus for transplantation purpose after obtaining a written consent from the donor's next-of-kin.A written consent from the patient was obtained before transplantation.None of the authors have any financial interest.None of the authors have any conflict of interest.All authors attest that they meet the current ICMJE criteria for authorship.MP, AR, SK, VR - Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND.MP, AK, BS, VR - Drafting the work or revising it critically for important intellectual content; AND.MP, AR, AK, BS, SK, VR - Final approval of the version to be published; AND.MP, AR, AK, BS, SK, VR - Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


NERICA1, NERICA7, WITA4, and IR841) on resistant, damaged starch fractions and glycemic response in rats was investigated. Resistant and damaged starch fractions were influenced by variety and steaming time but this was not the case for glycemic index. Nonparboiled NERICA7 and NERICA7 steamed for 25 min recorded the highest (10.07%) and lowest (2.49%) resistant starch fraction, respectively. Resistant starch correlated negatively with protein and sodium and positively with lipids. Damaged starch was high for WITA4 steamed for 45 min (26.80%) and low for nonparboiled NERICA1 (6.59%). Damaged starch correlated positively with lipid content and negatively with ash and total starch content. NERICA7 steamed for 35 min recorded the lowest postprandial glucose level 30 min after feeding (0.16 g/L), while WITA4 steamed for 15, 25, and 35 min and nonparboiled NERICA7 recorded higher levels . NERICA7 steamed for 35 min recorded both low glycemic and weak digestive properties because the glycemic index was lowest 120 min and increased steadily up to 180 min after feeding. We conclude that the digestive properties of rice depend both on the intrinsic properties of the variety and the parboiling steaming time.Consumers with diabetes mellitus have shown interest in products with low postprandial glucose. To produce rice for this group of consumers, the effect of parboiling steaming time  and variety ( Food products whose starch are slowly digested or resistant to enzyme digestion are preferred by some groups of consumers due to their health‐promoting benefits  for 12 min and then predried at 100°C for 3 min before final drying at room temperature.) parboiled rice reduced glycemic index by 30% relative to the nonparboiled sample. Previously, we showed that rice variety and parboiling steaming time at atmospheric pressure affected the physicochemical and nutritional properties of rice with the possibility of selecting specific varieties and steaming time to achieve desired outcomes. The apparent amylose, total starch, protein and lipid content of the rice varieties: NERICA1, NERICA7, WITA4, and IR841 after parboiling for 5, 15, 25, 35, and 45 min have been reported , gelatinization (cooking), and lose of granule integrity (extrusion cooking) increases starch digestion because these processes make it easier for enzymes to attack the starch granules  and two sativa (irrigated) varieties (IR841 and WITA4) were obtained from the Genetic Resource Unit at AfricaRice and used for this study. The rice was planted in demonstration plots at AfricaRice station in Cotonou, Benin, in May and harvested in August 2014 using recommended agronomic practices  parboiler and procedures . Sun drying was halted when the moisture content was 16%–18% and drying continued in the shade to final moisture content of 14% to avoid rapid drying at this small moisture range that could lead to fissures in the rice grain and increase breakages during milling  and polished using a large‐scale SB10D rubber roll mill .Rice samples were dehusked using a large‐scale AGRINDO2.5For each sample, 5 g of grains was ground to fine powder in a grinder  fitted with a fine sieve of 0.5‐mm mesh size. The prepared rice flour was used for starch fraction analysis.2.62.6.1™ sheet for resistant starch .Resistant starch was enzymatically determined using the Megazyme Resistant Starch Assay  protocol (AOAC method 2002.02 and AACC method 32‐40.01). Briefly, 100 mg rice flour sample was hydrolyzed and solubilized in 4.0 ml of 10 mg/ml of pancreatic alpha‐amylase containing 3 U/ml of amyloglucosidase by incubating overnight (16 hr) at 37°C in a shaking water bath  set at 100 revolutions/min. Ethanol  was added with vigorous stirring on a vortex mixer followed by a series of centrifugations at 2,000 g for 10 min to recover the resistant starch as pellets. The recovered resistant starch pellets were dissolved in KOH  by stirring on an ice water bath for 20 min using a magnetic stirrer. Sodium acetate buffer  was added with continuous magnetic stirring and immediately followed by the addition of amyloglucosidase . This mixture was homogenized and incubated in a water bath at 50°C for 30 min with intermittent vortexing. Thereafter, the entire solution was transferred into a 100‐ml volumetric flask and volume adjusted to 100 ml with distilled water. An aliquot (3 ml) of this diluted solution was centrifuged at 2,000 g for 10 min. Duplicate 0.1 ml aliquots of the supernatant was transferred into clean tube, GOPOD reagent (3.0 ml) added, and the mixture incubated at 50°C for 10 min. The absorbance was read at 510 nm against the reagent blank constituted of sodium acetate buffer  and GOPOD reagent (3 ml). Resistant starch (g/100 g “as is”) was then computed using the Megazyme Mega‐Calc2.6.2™ calculation sheet for starch damage .The measurement of damaged starch was done with the Megazyme starch damage assay kit  protocol  approved method 76‐32.01 and ICC Method No. 164). Briefly, rice flour sample (100 mg) was weighed into glass test tube, pre‐equilibrated by adding fungal alpha‐amylase solution (50 U/ml), and incubated for 5 min in a water bath  set at 40°C. Following equilibration, 1 ml of the fungal alpha‐amylase solution was added to the rice flour and vortexed for 5 s and then incubated at 40°C for 10 min. Eight milliliter sulfuric acid (2% v/v) was added at the 10th min and vortexed vigorously for 5 s to completely inhibit α‐amylase activity. The content of the tube was then centrifuged at 2,000 g for 10 min and 0.1 ml aliquots of the supernatant pipetted in duplicates into a clean test tube. Amyloglucosidase  was added into the tube, vortexed and incubated at 40°C for 10 min to complete the digestion of the disaccharides and trioses to monosaccharides. GOPOD reagent solution (4 ml) was then added into the tubes and into the glucose standard tube and further incubated for 20 min for color development. The absorbance was then read against a blank at 510 nm and the damaged starch of the sample computed using the Megazyme Mega‐Calc2.7Ratus norvegicus albino) were used for the study. The animals were 2 months old with an average weight of 239 ± 13.5 g. The study lasted for 7 weeks (1 week of adaption and 6 weeks of experimentation). The feed formulation was made by mixing 1 g of rice flour (per variety and per steaming time) with 4 ml of deionized water. The six different rice treatments for each variety were given to the six (repetition) animals using a completely randomized design with each animal receiving all the treatments at the end of the experimental period. After the animals were fed, retro‐orbital blood was collected after 0, 30, 90, and 180 min and blood glucose determined spectrophotometrically. Glycemic index was determined as previously described . All analyses were done at 5% significance level.Line plots of resistant, total, and damage starch fractions against steaming time for NERICA1, NERICA7, WITA4, and IR841 were prepared, while bar charts of glycemic index against time after feeding were produced for NERICA7 and WITA4. Multivariate regression analysis was used to study the effect of rice variety and steaming time on resistant starch fraction, damage starch fractions, plasma glucose 30 and 90 min after feeding. Two‐way interactions between variety and steaming time for the different dependent variable above were compared using Fisher's least significant difference multiple comparison test followed by ranking. The relationship between resistant starch, damage starch, apparent amylose, protein, lipids, and mineral contents was determined using Pearson correlations. The statistical program used for the analysis was XLSTAT33.13.1.1F = 13.10, p < .0001) (Sup. 1). Nonparboiled NERICA7 and NERICA7 steamed for 25 min recorded the highest (10. 07%) and lowest (2.49%) resistant starch fraction, respectively. The amount of resistant starch present in NERICA7 steamed for 25 min was identical to that in NERICA7 steamed for 15 min and nonparboiled WITA4. Resistant starch increased with steaming time in three of the four varieties   and amylose content decreased with steaming time as previously reported  Figure . However) Figure . It has ) Figure . Resista3.1.2F = 31.94; p < .0001)  and ash content  and negatively with sodium and total starch content  (Table Steaming time and variety influenced damaged starch fraction 1) Table . WITA4 s Table . 1) Table . Damaged3.1.3p > .05) (Table p < .05). Nonparboiled NERICA7 recorded the lowest postprandial glucose level 90 min after feeding (0.15 g/L), while NERICA7 steamed for 5 min and WITA4 steamed for 35 min recorded the highest (0.54 g/L)  Table . However5) Table . This ob5) Table . Zohoun 5) Table  indicate5) Table  who indiL) Table . Larsen L) Table  showed tL) Table . FurtherNERICA7 steamed for 35 min recorded both low glycemic and slow digesting properties because the glycemic index was lowest after 120 min and increased steadily up to 180 min after feeding  was suggested as being important for resistant starch formation in NERICA7, while starch retrogradation was important for resistant starch formation in NERICA1, WITA4, and IR841. Reduced amylose played an important role in the formation of resistant starch in NERICA7, while proteins play a protective role in reducing starch damage in rice. The starch in NERICA7 was digested much slower in rats than that from WITA4 mainly because the starch in NERICA7 was not completely gelatinized even after steaming for 45 min. NERICA7 steamed for 35 min recorded the lowest postprandial glucose level 30 min after feeding (0.16 g/L) probably because this sample recorded low apparent amylose, total starch and high protein content facilitating the formation of starch granules that were resistant to digestion. In addition, NERICA7 steamed for 35 min recorded both low glycemic and weak digesting properties. Although this work reinforces the concept of selecting specific varieties and parboiling regimes to achieve desired processing outcomes, more work is needed to conform these results in humans and elucidate the structural characteristics of starch granules of the different parboiling treatments. Click here for additional data file.


The use of organs from expanded criteria donors for Liver Transplantation (LT) represents a major challenge. In the current era of Normothermic Machine Perfusion (NMP), donor age boundaries are often overcome and may contribute to reduce the gap between supply and demand of organs suitable for transplantation.We report on a unique case of nonagenarian liver successfully transplanted after NMP.®, UK, Oxford) perfusion at University of Rome Tor Vergata on April 2018. The histology assessment showed 15% macro and 35% micro vescicular steatosis. Liver fulfilled viability criteria after NMP and was thus transplanted. The recipient was a 53 years old male with hepatocellular carcinoma who underwent two previous trans-arterial chemo-embolization. The post-LT AST peak was 1556 U/L; post operative course was characterized by hepatic artery thrombosis that required re-laparotomy and successful thrombectomy. Recipient experienced biliary stricture three months after discharge successfully treated by endoscopic retrograde cholangiopancreatography. At 7 months of follow-up patient has good clinical status and graft function.A fatty previously declined liver graft from nonagenarian male brain death donor underwent NMP (OrganOx MetraNMP represents a safe approach in order to increase the usage of very old fatty livers, that otherwise would be declined because of the high risk of primary non function and death.Nonagenarian liver recruitment after NMP seems to be feasible but a major attention is advisable on the manipulation and cannulation of hepatic artery in order to avoid intimal damage that can lead hepatic artery thrombosis. Nowaday2−7 g/kg BW/min. The donor risk Index was 2: considering the donor age as well as both surgical appearance and histological findings, liver was considered not eligible for transplantation by itself and was connected to the NMP  at the donor hospital.In April 2018, a 88 years old male brain death donor was declined by all local transplant centres due to high-risk of graft loss. At the time of procurement the reasons for discarding liver were elderly age and macroscopic appearance of moderate firmness, round liver edges and suboptimal liver graft perfusion. The liver histology findings detected 15% macro and 35% micro-vesicular steatosis. Major donor comorbidities included hypertension, hypertensive heart disease and chronic obstructive pulmonary syndrome. The donor liver function tests were in normal range, and the inotropic support was 1 × 10Haemodynamic [hepatic artery flow (>0.150 ml/min) and portal vein flow (>0.500 ml/min)] and metabolic parameters   were evaAt the beginning of the perfusion, the hepatic artery and portal vein flow rate were 0.200 ml/min and 1000 ml/min respectively and remained stable throughout the perfusion time A. The pHAfter a perfusion of 282 min, the graft fulfilled all viability criteria  thus wasThe recipient was a 53 years old caucasian male with Hepatocellular Carcinoma fulfilling Milan criteria after two trans arterial chemo embolization (TACE) with underlined HCV- cirrhosis  who consented for NMP; alpha-fetoprotein (AFP) level at listing was 5.72 UI/ml, balance of risk (BAR) [® Solution; total perfusion time in NMP was 478 min. The mean arterial pressure, vasopressors support [After the hepatectomy, the liver was disconnected from the NMP and flushed with 2 l of cold CelsiorThe macroscopic appearance after reperfusion was excellent and intraoperative ultrasound showed good artery and portal flow. AST and ALT time-course as well as bilirubin and INR trends during the post-operative days are displayed in Three months after LT the patient suffered a non-anastomotic biliary stricture that required endoscopic retrograde cholangiopancreatography with stent positioning. At last follow up (7 months) patient showed good clinical status and graft function.3®, Oxford, UK) increased the utilization rate of 50% vs SCS liver, decreasing also early allograft dysfunction and AST peak [Between December 2017 and September 2018, in Italy out of 1360 donors suitable for donation 1201 livers were eligible for transplantation  where ouAST peak . In 2016AST peak  recentlyAST peak  and perhThe viability assessment has been mostly adopted in a range adult age between 16 and 84 years old    in order to decrease the post-operative risk; however, we can maybe argue that a well-reconditioned extended nonagenarian liver that fulfil viability-criteria could be even allocated to a higher risk recipient. This could be an option in order to minimize the waiting list time in an organ-shortage era. The main learning point of this single case is that a great caution must be taken on the artery cannulation and perfusion of these very old donors and no recipient further risk, as previous TACE, should be taken in order to avoid unwanted arterial complications. Randomized controlled trial powered only for HAT in elderly donors assessed with NMP are needed in order to well define the HAT risk after LT.International Journal Surgery Case Report.The authors of this manuscript have no conflicts of interest to disclose, as described by This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.The current case as well as all extended criteria donors (ECD) considered for NMP in our centre met the viability assessment and the criteria approved by our local ethical committee .Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review by the Editor-in-Chief of this journal on requestTommaso Maria Manzia wrote the manuscript. Luca Toti, Claudia Quaranta and Francesca Blasi collected and analyzed data. Giuseppe Tisone has approved the final versionNA.Prof Giuseppe Tisone.Not commissioned, externally peer-reviewed.


Xenocypris davidi Bleeker, YT) and topmouth culter  are both famous and important economic freshwater fish in China. YT, a kind of omnivorous fish, has strong resistance. TC, a kind of carnivorous fish, has high-quality meat but poor resistance. Distant hybridization can integrate the advantages of both parents. There has been no previous report regarding hybrid fish derived from female YT × male TC. It is expected that hybridization of these two kinds of fish will result in F1 hybrids with improved characteristics, such as faster growth rate, stronger resistance, and high-quality meat, which are of great significance in fish genetic breeding.Bleeker’s yellow tail  and lost specific 5S rDNA derived from the maternal parent (designated class II: 221 bp), which might be related to hybridization. In terms of reproductive traits, all the tested female hybrids exhibited normal gonadal development, and the two-year-old FObtaining a fertile female hybrid fish made the creation of a new type of fish possible, which was significant in fish genetic breeding. Hybr L., CC) –3. Autotla, BSB) . Allodipsky, TC) . Allodipmale BSB .In the process of speciation, hybridization and genetic introgression between species are a relatively frequent occurrence, particularly in rapidly radiating biological populations, promoting species formation , 7–10. NIn eukaryotes, the genes encoding 5S ribosomal RNA (rRNA) are composed of tandem repeat units, and every repeat unit is formed by a highly variable non-transcribed spacer (NTS) region and a highly conserved coding region of the 5S rRNA gene (approximately 120 bp) –13. ManySox genes have a conserved motif encoding a high-mobility group (HMG) DNA-binding domain of 79 amino acids, regulating the binding of specific DNA sequences [Sox genes were found in many organisms, including nematodes, fishes, amphibians, reptiles, birds, mammals and hexapods [Sox gene was specific in various species and was a new and highly conserved molecular marker sequence.In animals, equences –24. Morehexapods . Throughhexapods  verifiedXenocypris davidi Bleeker, YT) and male TC, possessing the same number of chromosomes (2n = 48). YT and TC are both famous and important economic freshwater fish in China. In zootaxy, YT is an omnivore with strong resistance belonging to the Xenocyprininae subfamily [1 hybrids with improved characteristics, such as faster growth rate, stronger resistance, and high-quality meat, might have great significance for fish genetic breeding. This study provided guidance for further study of the general laws of distant hybridization.Based on our previous study, we performed inter-subfamily hybridization by crossing female Bleeker’s yellow tail  from those of the control groups (YT (♀) × YT (♂) and TC (♀) × TC (♂)). However, only 2% of the offspring of YT (♀) × TC (♂) survived to adulthood, and only approximately 100 living hybrids were obtained each year.The average fertilization rate and hatching rate of all groups were listed in Table The phenotypes of YT Fig. a, TC Fib and 2nYP < 0.01) between YT and 2nYC for all measurable traits, indicating that the appearance of 2nYC was strikingly different from that of YT. Likewise, there were significantly differences (P < 0.01) in the BL/WL, HL/BL, HH/HL, HH/BH, and CPH/CPL ratios between TC and 2nYC, suggesting that 2nYC was different from TC in terms of most phenotypic traits. The ratios of HH/HL and HH/BH for 2nYC were numerically intermediate between those for YT and TC, indicating that 2nYC exhibited a variable hybrid-type shape for these morphological traits. Peculiarly, the HL/BL ratio was significantly higher in 2nYC than in either YT or TC, and the CPH/CPL ratio in 2nYC was lower than that in either YT or TC.The average BL/WL, HL/BL, BH/BL, HH/HL, HH/BH, and CPH/CPL ratios were shown in Table P > 0.05) to the sum of half YT and half TC, suggesting that 2nYC, which might receive half of their chromosomes from YT and half the TC, were diploid, similar to the parent fish.We used the DNA content of the parents (YT and TC) as the control. The comparison of the DNA content of YT, TC, and 2nYC was presented in Table The chromosome number distribution of YT, TC, and 2nYC was shown in Table The primers (5SP1 and 5SP2R) were used to amplify DNA fragments from YT, TC, and 2nYC, and the results of agarose gel electrophoresis showed that YT had three bands , TC had three bands , and 2nYC had three bands  Fig. . A totalBLASTn was used for sequence analysis, and all fragments of YT, TC, and 2nYC were shown to be 5S rDNA repeat units that consisted of a highly conserved coding region (120 bp) and highly variable NTS regions of different lengths. In YT, the two monomeric 5S rDNA classes (designated class I: 188 bp and class II: 221 bp) were characterized by diverse NTS types (designated NTS-I: 68 bp and NTS-II: 101 bp). In TC, the two monomeric 5S rDNA classes (designated class I: 188 bp and class III: 286 bp) were characterized by disparate NTS types (designated NTS-I: 68 bp and NTS-III: 166 bp). 2nYC inherited class I (188 bp) and class III 287 bp) from its parents but derived a new 5S rDNA class (designated class IV: 212 bp) with a novel NTS type (designated NTS-IV: 92 bp). However, no maternal-specific 5S rDNA sequence (class II) was found in 2nYC. All 5S rDNA sequences were submitted to GenBank, and their accession numbers were listed in Table  bp from Sox patterns, and there were three different DNA fragments in YT , three in TC , and four in 2nYC .Primers (HMG (+) and HMG (−)) were used to amplify DNA fragments from YT, TC, and 2nYC, and the results of agarose gel electrophoresis showed that there were two bands (approximately 200 and 700 bp) in YT, TC, and 2nYC Fig. . Twenty Sox1 gene and the other belonging to the Sox11 gene. A 710 bp DNA fragment existed in YT and 2nYC and belonged to the Sox9 gene, whereas a 726 bp DNA fragment in TC and 2nYC also belonged to the Sox9 gene. We compared all fragments belonging to Sox genes in YT, TC, and 2nYC. In the Sox1 sequences, which consisted of a 215 bp DNA fragment, two base substitutions were found between YT and TC; the sequence in 2nYC was exactly the same as that in the paternal TC and had two base substitutions compared with that in the maternal YT  (♀) × Megalobrama terminalis (♂) [1 generation of some distant crosses [1 hybrids of RCC (♀) × BSB (♂) [1 hybrids of female RCC and male TC, their fertility was not good enough [1 hybrid offspring by mating of female YT with male TC, which belonged to different subfamilies but with the same chromosome number. The ploidy level of 2nYC was verified by measuring the DNA content, counting the chromosomal number   and CC   showed t crosses , 33–37.  BSB (♂) , RCC (♀) BSB (♂) , etc. Mod enough , 19. In ber Fig.  and prod studies , 38, 39.1 hybrid offspring tended to integrate favourable parental traits and exhibit heterosis [In the process of distant hybridization, the Feterosis , 41. In Sox9 (710 bp) from YT and Sox9 (726 bp) from TC, which suggested the heredity in 2nYC. Thus, the Sox gene fragments could also serve as feasible molecular genetic markers to distinguish hybrids and their parents.Compared with the 5S rDNA results of He et al.  and Wu eLeporinus, different 5S rDNA arrays characterized two possible 5S rRNA gene subfamilies that evolved independently in the genome [FISH is a valid method for determining the chromosomal location of 5S rDNA . This tee genome . In thisSox, and fertility. The production of fertile female hybrid fish not only provided the possibility of creating a new type of fish but also expanded the range of genetic material available for breeding. In the future, we will generate a hybrid lineage by back-crossing the female diploid hybrids with their parents. In addition, these results further revealed the influence of hybridization on the organization and genetic variation in 5S rDNA multigene families.This research offered solid genetic evidence to support the successful formation of diploid hybrids, and 2nYC exhibited heredity and variability, as determined by analysis of morphological traits, ploidy, 5S rDNA, Sexually mature YT and TC were obtained from the Engineering Research Center of Polyploid Fish Breeding and Reproduction of the State Education Ministry at Hunan Normal University. All experiments performed were approved by the Animal Care Committee of Hunan Normal University. Approval was acquired for the Administration of Affairs Concerning Animal Experimentation guidelines from the Science and Technology Bureau of China. To minimize suffering, 100 mg/L MS-222  was used to anaesthetize fish before dissection.1) was obtained in this cross-group. Meanwhile, self-mating of both YT and TC was conducted as a control. Concrete implementation was performed based on the patented “A method of distant crossing between Xenocypris davidi and Erythroculter ilishaeformis” (patent no. ZL 2012 1 0449551.7) [During the reproductive seasons since 2010, crosses between female YT and male TC were performed. The mature eggs were fertilized with the mature sperm, and the embryos were incubated in freshwater at 22–26 °C. 2nYC (F49551.7) . Two thoAt 2 years of age, 20 YT, 20 TC, and 20 2nYC individuals were taken at random for morphological examination. The examination standards followed a kind of schematic diagram of the studied seven measurable traits . Six couχ2 test using SPSS Statistics 19.0 software  with Yate’s correction was used to examine the deviation in the ratios of the mean DNA content of 2nYC to the sum of that from YT and TC from expected ratio values.Peripheral blood was collected from the caudal veins of 5 YT, 5 TC and 10 2nYC individuals with the age of more than six months from each group using a syringe containing sodium heparin and then treated according to the method described by Liu et al. . Blood s2 for 72 h, adding colchicine  for 3.5 h before the end of cultivation. Cells were harvested by centrifugation, and the erythrocytes were ruptured by hypotonic treatment with 0.075 M KCl at 37 °C for 30–40 min and then fixed in 3:1 methanol-acetic acid with three changes. Cells were dropped onto a cold and wet slide, air-dried and stained with 4% Giemsa solution for 30 min. All the images were obtained using an oil lens at a magnification of 330×. High-quality metaphase spreads were photographed for karyotype analysis. The lengths of the entire chromosomes, as well as the long and short arms, were measured. Chromosomes were classified according to Levan et al. [Chromosome preparation was performed with cultured peripheral blood cells of the hybrids and their parents as described by Huang et al.  with minn et al. .Sox genes was performed based on the method described by Chen et al. [Escherichia coli DH5α, and positive clones were sequenced by Sangon. For the purpose of analysing sequence homology and variation among the amplified products from YT, TC, and 2nYC, Bioedit [Total genomic DNA of YT, TC, and 2nYC was isolated from the whole blood collected from the fish caudal vein based on the method described by Sambrook et al. . A pair n et al. . The PCR Bioedit  and Clus Bioedit  were useFluorescence in situ hybridization (FISH) probes for the 5S rRNA gene were constructed for YT. The PCR and temperature adjustments were executed as previously described by Qin et al.  with minAt 2 years of age, 5 2nYC individuals were selected at random for histological observation of the gonadal structure via paraffin sectioning. The ovaries were fixed in Bouin’s solution, dehydrated in an increasing ethanol gradient, cleared in xylene, embedded in paraffin, sectioned using a Leica RM2016 microtome (Germany) and stained with haematoxylin and eosin. Ovary sections were examined and photographed using an Olympus microscope CX41 (Japan), and ovarian development in each sample was classified based on the previous standards for cyprinid fish .


This study updates Haaland’s 1999 dental hygiene mapping study. By identifying core journals and estimating database coverage, it characterizes changes in dental hygiene research and aids librarians in collection development and user education.Cited references from a three-year (2015–2017) sample of core dental hygiene journals were collected, categorized into five formats, and analyzed by format and publication year according to Bradford’s Law of Scattering. CINAHL Complete, MEDLINE, and EMBASE were surveyed to determine the indexing coverage of cited journals.The number of cited journal titles increased from 389 in 1999 to 1,675 in 2018. Core Zone 1 titles increased from 5 to 11. Journal article citations increased from 69.5% of all citations in 1999 to 78.4% in the present study, whereas book citations decreased from 18.1% to 5.1%. A newly added category, “Internet sources,” accounted for 8.4% of citations. Overall, 68.6% of citations were 10 years or younger versus 71.4% in 1999. Most Zone 1 and Zone 2 journals were specific to dentistry or dental hygiene.Notable changes since 1999 were an increased volume of literature and a shift from print to online sources, reflecting improved accessibility of the literature and greater Internet use. From 1999 to 2018, citations to journal articles increased, books decreased, websites appeared, and government publications increased slightly. These findings indicate that dental hygiene research is growing and that indexing coverage for this field has improved dramatically in the past two decades. As part of the Medical Library Association (MLA) Nursing and Allied Health Resources Section (NAHRS) project to map the literature of allied health , HaalandAs noted in Haaland’s article , dental In 2013, dental hygiene celebrated 100 years as a profession. Research articles in dental hygiene began appearing in the 1940s, and in the 1960s, dental hygienists began to engage in dental research projects, usually as associates or administrators rather than principal investigators. The first conference on dental hygiene research was held in 1982 . The NatA current mapping study would support such research endeavors and shed light on changes that have shaped applicable literature during the last two decades. Thus, the purpose of this study is, like the original study , to idenThis study used the mapping protocol outlined by NAHRS, as updated in December 2017 [Journal of Dental Hygiene and Probe , were reused. The third source journal used in Haaland’s study, Journal of Practical Hygiene, is no longer published. After consulting with and interviewing the director and faculty of a dental hygiene program, Dimensions of Dental Hygiene was selected as a replacement, as it is a widely read journal covering practical issues. All three journals are North American–based titles.Two source journals from the 1999 mapping study , the JouReferences from each journal article that were published from 2015–2017 in the three source journals were collected. Letters to the editor, editorials, supplementary issues, and brief news items were omitted. Each reference was given a unique identifier and categorized as one of five formats: journal (print or online), book (print or online), government publication , Internet source , or miscellaneous . The year of publication of each reference was noted. For journal citations, the cited journal name was recorded as the current or most recent title. The National Library of Medicine (NLM) catalog was used to track title changes.n equals the number of Zone 2 journals, and the number of Zone 3 journals is predicted to be n2 × the total number of journals in Zone 1 [Spreadsheets of references from each journal were sorted by format and publication year. References from journal titles were listed in order from the most frequently cited to the least frequently cited. The list of journal titles was separated into three zones, each containing about a third of the total cited journal references. According to the NAHRS mapping protocol, these zones correspond roughly to the highly productive, moderately productive, and minimally productive journals in the field . Data wen Zone 1 .The indexing coverage of the cited journals in CINAHL Complete, MEDLINE, and EMBASE was recorded. Coverage was determined from 2018 online title lists that database producers published and recorded as “yes,” “no,” or “selective.”Dimensions of Dental Hygiene. Over half (64.8%) of the cited journal articles and most of the cited Internet sources (90.1%) and government publications (85.6%) were published in 2007–2017  and non-dental journals (39%) such as JAMA, the New England Journal of Medicine, the American Journal of Public Health, MMWR, Academic Medicine, and the Journal of Allied Health. Compared with the 1999 mapping study [Zone 1 contained 11 journals that accounted for 33.5% of the cited references . All Zonn for this study was 9.8 , meaning that the number of Zone 3 journals should be 1,056 (9.82 × 11). However, there were 1,556 journals in Zone 3, which was larger than predicted and might be attributed to the growing utilization of online-only journals.According to Bradford’s Law of Scattering, the CINAHL Complete, MEDLINE, and EMBASE indexed most of the resources in all three zones, but no single database indexed all of the resources . EMBASE The most striking finding was the sheer volume of work that has been produced since the 1999 dental hygiene mapping study was performed. Previously, a small core of only 5 titles constituted Zone 1, which has now grown to 11 titles. In 1999, Zone 2 comprised 42 journals, which number has grown to 108. The total number of journals referenced has grown more than 4-fold from 389 to 1,675.Dimensions of Dental Hygiene, a journal that is highly practice oriented. The increased number of journal titles cited may be due to the use of web search engines, such as Google Scholar, for scholarly research. However, the 2 time periods are not strictly comparable due to the greater number of source articles (426 versus 149) and the larger number of citations  in the present study.Citation patterns may have been skewed by the fact that over half the citations came from Documentation [Bradford’s Law of Scattering, a unifying feature of NAHRS mapping studies, is described as “most valuable to librarians who are faced with the cost-benefit considerations of additional journal coverage” . Based oentation , this laJournal of Dental Hygiene, Journal of the American Dental Association, Journal of Periodontology, Journal of Dental Education, and Journal of Clinical Periodontology. All Zone 1 journals were refereed, and all but Dimensions of Dental Hygiene are subscription-based and might be less accessible to dental hygienists outside an academic setting.Traditional refereed journals have retained their preeminent place in dental hygiene research. In fact, the percentage of journal article citations increased from 69.5% of total cited references in the 1999 study  to 78.4%Dimensions of Dental Hygiene, a refereed, practice-oriented title freely available on the web, and the International Journal of Dental Hygiene, a more research-oriented journal. Another interesting addition to Zone 1 is the Cochrane Database of Systematic Reviews, which began in the 1990s and was cited ninety-one times. In all, Zone 1 contained seven dental titles, three dental hygiene titles, and the Cochrane Database of Systematic Reviews. The Zone 1 journal list provides a good answer to the frequently asked question, “What are the ‘top’ journals in my field to which I should submit my manuscript?”Two journal titles that began in 2003 now appear in Zone 1: A key development in dental hygiene research from 1999 to 2018 was the growth of the World Wide Web. In 1995, CompuServe and America Online began marketing dial-up access to end users , but mosOne might expect the cited references in the present study to be more current than in the 1999 study , as onliBook citations, including both print and electronic books, shrank from 18.1% of total citations in 1999  to 5.1% Improved database coverage and web search engines appear to have occurred in parallel with an increase in dental hygiene research between 1999 and the present. In 1999 , only MEDimensions of Dental Hygiene is freely available online and is distributed free of charge to students. Additionally, the Journal of Dental Hygiene and Access are widely available to members of the American Dental Hygiene Association.Marked changes in database access between 1999 and the present also deserve mention. In the 1990s, researchers commonly searched individual databases on locally mounted discs, through librarian-mediated searches, or via print indexes. Today, most searches are done on the web using open access or subscription databases, or web browsers such as Google and Google Scholar. Also, multiple databases are often searched together via library federated search engines or vendor-supplied packages. In addition to database searching, dental hygienists commonly access several key titles directly. For example, Compared with the 1999 mapping study , the lis


Regarding the paper, ‘Willingness to use HIV pre‐exposure prophylaxis among gay men, other men who have sex with men and transgender women in Myanmar’ by Bridget L. Draper, Freya J. I. Fowkes, Zaw Min Oo, Zaw Win Thein, Poe Poe Aung, Vanessa Veronese, Claire Ryan, Myo Thant, Chad Hughes, Mark Stoové.Journal of the International AIDS Society, Citation: Draper BL et al. Journal of the International AIDS Society 2017, 20:21885. http://www.jiasociety.org/index.php/jias/article/view/21885 |http://dx.doi.org/10.7448/IAS.20.1.21885Published in The co‐author Freya J. I. Fowkes was missing from the original author list. The correct author list and information is as follows:1§, Freya J. I. Fowkes5, Zaw Min Oo2, Zaw Win Thein2, Poe Poe Aung2, Vanessa Veronese1,3, Claire Ryan2, Myo Thant4, Chad Hughes1,3, Mark Stoové1Bridget L. DraperAffiliations:1 Department of Disease Elimination Burnet Institute, Melbourne, Australia2 Department of International Development, Burnet Institute, Yangon, Myanmar3 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia4 Yangon Regional Public Health Department, Yangon, Myanmar5 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.No competing interests. FJIF contributed to the data cleaning and analysis process.Updated Authors’ contribution:ZWO, ZWT, PPA, CR, MT, CH and MS all contributed to the development of the data collection tools, training of peer educators to recruit participants, oversight of recruitment, data collection and interpretation of results. BLD, FJIF, VV and MS led the data cleaning and analysis process. BLD led the writing of the manuscript. All authors have read and approved the final manuscript.


The authors report on studies in rat hearts using a Langendorff model. Besidesa control group, two other groups were investigated: Custodiol HTK solution and Del Nidosolution. Pinacidil was added to both solutions, while lidocaine was only added toCustodiol, since Lidocaine is already an essential compound of Del Nido solution. After180-min-ischemia at 4ºC all hearts were aerobically reperfused for 90 mins and thefollowing parameters were analyzed (unfortunately only as percentage of recovery):contractility, coronary resistance and alpha-fodrin degeneration.In the issue 33(3) of the Brazilian Journal of Cardiovascular Surgery, Carmo etal.The authors reported on superior outcome by Del Nido solution after90-min-reperfusion.Although the study shows some interesting approaches to intraoperative myocardialprotection, some aspects are objectionable regarding their comparative analyticalmethodology.First, only one compound - pinacidil - was added to Del Nido solution, while two,pinacidil and lidocaine, were added to custodiol, since lidocaine is already anessential component of Del Nido solution. This is not consistent with a clean,scientifically acceptable comparative analysis, as Del Nido already meets one of theparameters subject to the investigation.Second, to measure myocardial contractility, mostly dP/dt max. is used in appropriateexperimental or clinical investigations. However, from scientific point of view this isnot completely accurate, since the time until the maximal pressure is reached, may playan important role. Therefore, it would be correct to additionally divide dP/dt by t(time).. Lactate/pH relationships differ depending on thecardioplegic solutions applied and concerning a buffered solution, the lactate/pHrelationship depends on the nature of the buffer applied, on buffer concentration and,on additional compounds in a cardioplegic solution. Any drug that stabilizes myocardialmembranes, will impair the permeation of H+-ions from the intra- to theextracellular space. Such impaired permeation leads to an intracellular 'overload' ofH+-ions and, conversely, to less acidification of the myocardialextracellular space. Consequently, the lactate/pH curve will shift towards alkalosis!This effect should occur if procaine or lidocaine are parts of the solution, since bothdrugs are membrane stabilizing drugs. In experiments on ischemic hearts of mongrel dogsat 15ºC we compared histidine buffered solutions with and without procaine  being protected either by original custodiolor by Del Nido solution. It became obvious that after two-hour-arrest mitochondrialscoring was superior in the custodiol groupGiven the aforementioned objections, we would question the conclusions drawn by theauthors. They would have been correct, had they concluded that a decisively modified (!)Custodiol solution - mainly by lidocaine - causes inferior efficacy in myocardialprotection due to the relatively reduced buffering power. But their study does notaddress the intraoperative protective efficacy of the original version of custodiol andtherefore, the results are not applicable to clinical usage. In conclusion, this paperdoes not represent a valid comparative study between custodiol and Del Nidosolutions.


Hm), crystallinity (Xc), and crystallization temperature (Tc) of the blends decrease and the cold crystallization temperature (Tcc) increase when inorganic salts is added. Moreover, inorganic salts with smaller anionic radius have much better effects on the starch/PBS blends plasticized with ((BMIM)Cl).1-butyl-3-methylimidazole chloride ((BMIM) Cl) modified starch/poly (butylene succinate) (PBS) blends with different anions of inorganic salts were prepared by HAAKE mixer. The compatibility and thermal behaviors including crystallinity, crystallization and melting temperature, thermal stability and mechanical properties were systematically investigated by Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and X-ray diffraction (XRD). The results show that inorganic salts can produce a strong interaction with starch/PBS blends, which can improve the mechanical properties of starch/PBS blends, enhance the mechanical strength and elongation at break of starch/PBS blends, meanwhile, the thermal stability of starch/PBS blends decreased. The SEM images reveal that the compatibility of starch/PBS become better with the increase of inorganic salts. The melting and crystallization absorption peaks in the DSC curves show that the melting enthalpy (Δ As the continuous consumption of petroleum resources of raw materials for the preparation of polymer materials, and the increasing emphasis on environmental pollution caused by the difficult degradation of waste polymer materials, the development of eco-friendly polymer materials based on natural and non-petroleum resources has been greatly concerned by the governments and scientific research institutions all over the world ,2,3. StaStarch is a highly abundant, non-toxic, and renewable biopolymer, which is produced from assimilating plants. It is extensively utilized in various fields, such as food, paper, wood, and pharmaceutical industry ,17,18,194) and magnesium chloride (MgCl2) inorganic salts cooperatively with the ((BMIM)Cl) to modify the starch/PBS blends, in addition, the different effects of MgSO4 and MgCl2 on the structure and properties of starch/PBS were studied. There are abundant oxygen atoms in starch and PBS, the ions of inorganic salt can interact with oxygen atoms and the interaction can change the aggregation structure of starch/PBS blends, the bonding strength of “macromolecule-modifying agent-macromolecule” in starch and starch/PBS blends are regulated which can inhibit the strength reduction from the plastication of ((BMIM)Cl) and improve the compatibility of starch/PBS blends. This method provides a new idea for the modification of starch/PBS blends.In our work, we use extra magnesium sulphate (MgSO2) and Magnesium sulphate (MgSO4) were purchased from Kelong Chemical Co. , which was in analytical purity.Poly(butylene succinate) was kindly provided from Anqing Hexing Chemical Co., Ltd. , which was injected in the molding grade. Corn starch was purchased from Xiadian corn development Industrial Co., Ltd. , which was in an edible level. Ionic liquid ((BMIM)Cl) (purity 97%) was purchased from Aladdin Biochemical Technology Co., Ltd. , which was used without any further purification. Magnesium chloride (MgClp < 0.3 MPa). Starch and plasticizer  were pre-mixed at room temperature for 2 h, and placed in a vacuum oven at 105 °C for 72 h before blending. The mixture was further plasticized in HAAKE Rheomix OS Torque Rheometer  at 125 °C with a rotor speed of 70 rpm for 15 min.The samples were prepared by the melt blending method. The starch and PBS were dried at 105 °C for 5 h under vacuum oven , at spectral resolution of 4 cmThe morphology of the samples was examined with a scanning electron microscope JSM-5900LV . The surfaces were coated with platinum prior to examination. The accelerating voltage was 10 kV.−1.TGA was performed by the TA2950 TGA thermal analysis instrument . The samples for testing were heated from room temperature to 600 °C at a heating rate of 20 °C min−1, kept at 140 °C for 3 min to eliminate thermal history, cooled to 30 °C at a cooling rate of 10 °C min−1, kept at 30 °C for 2 min, and then reheated at a rate of 10 °C min−1 to 140 °C.The DSC measurements were performed by a differential scanning calorimeter . Samples (3–5 mg) were placed in sealed aluminum crucibles under a flow of nitrogen. Each sample was first heated from 30 to 140 °C at a rate of 50 °C minThe XRD test was carried out by using an X’Pert Pro MPD diffractometer , with nickel filter CuKa as the radiation source. The acceleration voltage was 50 kV and the current was 35 mA. The samples were continuously scanned over the 2θ range from 5° to 50°.−1. The initial gauge length of the specimen was 20 mm. The width of each tensile sample was 4 mm. All samples were balanced in 30% relative humidity (RH) at 25 °C for 48 h before the test. Five specimens were used for each group, and the average values plus the standard deviation were determined. t-Test was carried out to determine the statistically significant difference (p < 0.05) among the mechanical properties using STATA (STATA 11.2 for windows).The mechanical properties (tensile strength (TS), elongation at break (%Eb) and Young’s modulus) of the samples were determined using a tensile testing equipment . The crosshead speed was 20 mm min−1 which corresponds to the stretching vibration absorption peak of starch and PBS molecular chains [−1 corresponds to the stretching vibration peak of C–O in the C–O–H group of the starch molecules, and a peak at 1028 cm−1 corresponds to the stretching vibration peak of C–O in C–O–C of the starch molecular chain, and a peak at 1723 cm−1 corresponds to the stretching vibration absorption peak of C–O in the ester group of the PBS molecules [The interaction between anion and cation of inorganic salts and the hydroxy(-OH) of starch and PBS is the main interaction between inorganic salts and TSP composite. The movement of the stretching vibration peak of –OH can reflect the intensity of the electron interaction. Therefore, FT-IR was used to characterize the TSP before and after the modification by inorganic salts. The TSP sample without any addition of inorganic salt shows a peak at 3411 cmr chains , a peak olecules .4 and MgCl2, and no extra absorption peaks of new chemical groups, which indicates that both MgSO4 and MgCl2 did not react with the matrix. As shown in 4 and MgCl2 shift to the high wavenumber, which indicates that the inorganic salt has strong interaction with starch and PBS molecular chains. Additionally, − or SO42− formed an electronic interaction with oxygen atoms in the hydroxyl group of starch molecules and in the ester group of PBS molecules, while the electron-deficient Mg2+ can interact with the hydrogen atoms in the hydroxyl group of both starch and PBS molecules with the separation role of ionic liquid. Therefore, inorganic salts can weaken the hydrogen bonds and lead to the change of aggregation structure and properties of the TSP. Furthermore, the comparison of TSPMS and TSPM shows that the effect of MgCl2 on the blue shift of hydroxyl peak in starch and PBS was more obvious than that of MgSO4, as the addition of both inorganic salts were the same. Meanwhile, the comparison between TSPMS and TSPM shows that the MgCl2 had a greater effect on the blue shift of –OH than MgSO4, which indicates that Cl−1 has a more pronounced effect on the –OH peak of TSP than SO42−. This is probably because the ion radius of SO42− is larger than that of Cl−, thus the interaction between SO42− and hydroxyl groups on TSP is weaker than that of Cl−, which eventually leads to the movement of stretching vibration absorption peak of –OH. The smaller the ionic radius of the ion is, the stronger the interaction between ions and –OH, the more obvious the infrared blue shift of hydroxyl. In summary, inorganic salts can further affect the absorption peaks of hydroxyl and ester groups in TSP. The ionic radius is the main factor which can impact the hydroxyl peaks in TSP. The smaller the ionic radius of inorganic ions, the stronger the ability of ions to enter the molecular chains between starch and PBS, and the more obvious the influence on the movement of hydroxyl and ester groups peaks.As the mechanical properties are strongly dependent on the microscopic morphologies, the performance and properties of blending materials not only depend on the properties of the individual components but also their interfacial compatibility, so increasing the compatibility between the components is an important way to improve the performance of the materials.In order to investigate the effect of inorganic salts on the compatibility of TSP blends, − with small ionic radius is stronger than that of SO42−, hence the electronic interaction with hydroxyl groups of starch molecular chains and ester groups of PBS molecular chains is strong.In general, the compatibility of starch/PBS blends plasticized with IL is further improved by the addition of inorganic salts. As the inorganic salts interfere in the formation of hydrogen bonds within the starch and PBS matrix and disturb the crystallization of the starch and PBS. Meanwhile, the electron-rich Cl4 and MgCl2 modified starch/PBS composite samples, respectively. The corresponding initial thermal decomposition temperatures (Ti) are listed in Ti of each sample shows a decreasing tendency along with the increase of inorganic salt, moreover, the MgCl2 modified starch/PBS composite sample shows a much lower Ti than the MgSO4 modified sample. On the other hand, the Ti of the composite sample decreases to 215 °C as the content of MgSO4 is 4 wt%, while the Ti of the MgCl2 modified sample is 203 °C. This is due to the MgSO4 and MgCl2 weak the hydrogen bonds between the starch and PBS molecules and damage the perfect degree of crystallization of starch/PBS system, thus weak the thermal stability. In addition, the electronic interaction between MgSO4 and starch/PBS system is weaker than the MgCl2 modified sample, hence MgSO4 shows less impact on the thermal stability of the blend system.The effect of inorganic salts on the thermal stability of starch/PBS composite system was studied by thermogravimetric analysis, as Ti of each sample shows a decreasing tendency. Moreover, the electron-rich Cl− with small ionic radius is stronger than that of SO42−, hence the electronic interaction with hydroxyl groups of starch molecular chains and ester groups of PBS molecular chains become stronger and the MgCl2 modified starch/PBS composite sample shows a much lower thermal stability.In general, as the inorganic salts interfere the formation of hydrogen bonds within the starch and PBS matrix and disturb the crystallization of the starch and PBS. The 4 or MgCl2 and starch /PBS, the inorganic salt modified starch /PBS blend samples were tested by DSC. 4 and MgCl2, respectively. The melting enthalpy corresponding Δ(mH), crystallinity (cX), the crystallization temperature (Tc), and the cold crystallization temperature (Tcc) are listed in cX is calculated as Equation (1):mΔH represents the melting enthalpy of the corresponding sample, 0mΔH is the melting enthalpy of one hundred percent crystallization, and wt is the content of PBS.In order to further study the interaction between MgSOmΔH, cX and Tc of starch/PBS composites decrease while the Tcc increase as the content of MgSO4 and MgCl2 increased. This is due to the strong interaction between MgSO4 and the molecular chain of starch and PBS, as the Mg2+ tend to form the electronic interaction with the oxygen atoms of hydroxy in starch chains and oxygen atoms of ester in PBS chains, which make the force of molecular inter-atomic strong and restrict the movement of chains, hence raise the energy of the rearrangement and the temperature of cold crystallization. The addition of MgSO4 enhances the interaction between PBS and starch molecules, so relatively hindered the orderly arrangement in PBS chains and disturb the perfect degree of crystallization. Hence, the ΔHm and corresponding Xc decrease, meanwhile, the chain segment is difficult to pile up and requires great driving force, and the crystallization temperature decreases.2 on thermal properties of starch/PBS composite is similar to the MgSO4, as shown in 4 and MgCl2 have the similar rules. The thermal performance parameters of the MgSO4 blending system changes more slightly than that of MgCl2 as the adding amount was 4 wt%, by contrasting Xc and Tc of MgSO4 blending system decrease to 39.5% and 63.2 °C, respectively, and the Tcc raises to 89.8 °C, while the Xc, Tc, and Tcc of the corresponding MgCl2 system change to 37.8%, 59.2 and 91.7 °C, respectively (this conclusion is only suggested by our test results.) This is mainly because the participation efficiency of ions in MgSO4 is low, as only cation participates in the formation of strong electron interaction, while the electron interaction between SO42− and starch /PBS is very weak for the volume of SO42− is huge which restricts the electron interaction. Additionally, MgCl2 shows strong electron interaction as both cation and anion can easily participate in the formation of electron interaction. The effect of MgClThe previous studies have proved that inorganic salts could play the role of plasticizer by disturbing the crystallization of starch/PBS blends . Both th4 or MgCl2. There is no new crystal diffraction peaks that appear, indicating that the addition of inorganic salts does not alter the crystalline form of PBS.4 or MgCl2 had a damaging effect on the crystals of TSP blends and form strong interaction with TSP blends molecules, the interaction could interrupt the hydrogen bonding in the crystalline structure of TSP blends. In addition, the intensity of the TSPM crystal peak was weaker than that of the TSPMS crystal peak. This is because the ionic radius of Cl−1 is smaller than that of SO42−, and Cl−1 can more easily enter into the molecular chains of the starch and PBS and break the crystallization. This is also consistent with the results of DSC. It could also be noticed that the diffraction peaks of MgSO4 and MgCl2 did not appear in 4 and MgCl2 were completely dissolved in TSP blends and no MgSO4 and MgCl2 crystals or congregates existed.Moreover, the crystallization peak intensity of the TSP blends obviously reduced with the increase of inorganic salts. This phenomenon indicated that MgSO4 and MgCl2. − with smaller ionic radius has higher anionic utilization efficiency than that of SO42−, which may have stronger interaction with starch/PBS molecular chains. These result in the tensile strength and the elongation at break of the TSPM blends increasing more than that of TSPMS blends, this is consistent with the previous results in this article. Without adding inorganic salts, the tensile strength of TSP was 10.8 MPa, the elongation at break was 14.1%, which showed obvious brittleness. After adding 4 wt% MgCl2, the tensile strength increased to 15.8 MPa and the elongation at break increased to 19.5%, which increased 46% and 38%, respectively than that without adding MgCl2. Meanwhile, the tensile strength increased to12.5 MPa and the elongation at break increased to 15.4% with the addition of 4 wt% MgSO4 (this conclusion is only suggested by our test results.) The elongation at break of all the TSPMS and TSPM blends maintained at a high level, which is rarely observed in previous researches. This is because the addition of inorganic salts weakens the original hydrogen bonds in starch and PBS molecules. Electron-rich anions can interact strongly with oxygen atoms in starch/PBS blends to enhance the compatibility of starch and PBS phases, thus improving the mechanical strength and flexibility of the composites. It was worth noting that the tensile strength and elongation at break of the TSP blends modified by MgCl2 were both higher than that of MgSO4. This is because the Cl− in MgCl2 has more smaller ion radius and form stronger electronic interaction, the performance is improved more obviously. From all the above, we can conclude that inorganic salts can compensate the loss of mechanical strength caused by the plasticizers and provide a new method to control the properties of starch/PBS blends composites, especially, when using inorganic salts with the same cations to modify the blends, the anionic parts of inorganic salts with small volume can be preferentially selected.The influence of inorganic salts on the mechanical properties of TSP blends was evaluated by tensile testing. As the starch contains a large number of intermolecular and intramolecular hydrogen bonds, it is easy to form microcrystals, which makes the starch and starch-based materials show strong brittleness. 4 and MgCl2, in which the electron-rich anions SO42− and Cl− form electronic interaction with the oxygen atoms in the hydroxyl groups of starch and the ester group of PBS and destroy the original hydrogen bonds in the molecules. Compared to starch/PBS blends modified only with ((BMIM)Cl), the samples with the addition of inorganic salts can further break the ordered arrangement of the molecular chains in the crystal regions of both starch and PBS, resulting in a decrease in crystallinity and making the compatibility of starch and PBS significantly improve. With the increase of the inorganic salts, the melting enthalpy (ΔHm), crystallization temperature (Tc), and the crystallinity (Xc) decrease, while the cold crystallization temperature (Tcc), the tensile strength, and elongation at break of starch/PBS blends increase. This is due to the electron interaction between inorganic salts and starch/PBS blends. This method of adding inorganic salts can compensate the loss of mechanical strength caused by ((BMIM)Cl) modification, and MgCl2 has a more significant effect on starch/PBS for the small anionic radius.In summary, the ((BMIM)Cl) modified starch/PBS blends were further modified by MgSO