Background: Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disease. Because of variable clinical manifestations, NIID was often misdiagnosed. According to published case reports, the common clinical manifestations of NIID include dementia, muscle weakness, autonomic impairment, sensory disturbance, rigidity, ataxia convulsions, etc. However, no cases of oromandibular dystonia were mentioned.Case Presentation: We describe a case of a 58-year-old woman presenting with mouth involuntary chewing initially. She started to show hand tremors, ataxia, and walking instability until 2 years later. Diffusion-weighted imaging showed high intensity signal along the corticomedullary junction. Fluid-attenuated inversion recovery imaging showed white matter hyperintensity. Electromyography (EMG) indicated peripheral nerve degeneration. Neuropsychological testing showed memory loss. Finally, skin biopsy and GGC repeat expansions in the NOTCH2NLC  gene confirmed the diagnosis of NIID.Conclusion: This case demonstrated that oromandibular dystonia could be the first symptom of NIID. This case report provides new characteristics of NIID and broadens its clinical spectrum. Neuronal intranuclear inclusion disease (NIID) is a slowly progressive neurodegenerative disease characterized by eosinophilic hyaline intranuclear inclusions in the central, peripheral, and autonomic nervous systems . Head MR+/5 in the lower limbs on the Medical Research Council (MRC) scale. Hypoesthesia to pinprick in the left arm was detected. Deep tendon reflexes could not be elicited. Resting and postural tremors in the hands were noted, and gait was slightly unsteady. The finger-to-nose test was positvie on the left side and the Romberg's sign was also positive.A 58-year-old woman was admitted to our hospital with a 2-year history of mouth involuntary chewing and a 1-month history of hand tremor. She presented with mouth involuntary chewing initially 2 years ago. It was easy to bite the tongue when speaking. Symptoms gradually worsen as the course of the disease progressed. She began to have vague speech and a sense of fatigue. She had excessive saliva and complaining of chronic constipation. Two years later, she had shaky hands, difficulty in swallowing, and walking. During the course of the disease, the patient had no other discomforts, such as headache, dizziness, limb convulsions, etc. She denied a history of chronic diseases, such as high blood pressure, diabetes, and heart disease. There was no family history of neurological problems. A neurologic examination found vague speech, involuntary and repetitive jaw deviation, and chewing. Muscle strength was evaluated as 4/5 in the hands and as 42O, nucleated cell count of 1 × 106 cells/L, total protein level of 484.20 mg/L, glucose level of 3.70 mmol/L, and chloride level of 129.00 mmol/L. Autoimmune encephalitis antibody tests of the cerebrospinal fluid were negative. Electromyography (EMG) showed that the motor and sensory conduction velocity was generally slower than normal, with an average conduction velocity of 40 or 35 m/s, respectively. The shortest latency of the bilateral ulnar nerve and the tibial nerve F wave was prolonged. Head MRI showed high intensity signal along the corticomedullary junction on diffusion-weighted image and white matter hyperintensity on fluid-attenuated inversion recovery images  gene. Genetic testing for FMR1 CGG repeat expansion was negative. At the same time, her son also had performed the genetic examination, and it was normal. With the evidence of characteristic imaging support, optimal genetic testing, and definite pathological diagnosis, it was diagnosed as NIID.After admission, relevant examinations were carried out. No abnormality was revealed by blood routine, routine urine and stool testing, biochemical indicators, coagulation function, thyroid function, glycosylated hemoglobin, and tumor markers. The titer of anti-ANA was 1:100, and anti-Ro-52 was positive (+). Anti-double-stranded DNA, anti-CCP, anti-SSA, ANCA, and other autoantibody tests were negative. A cerebrospinal fluid examination showed an intracranial pressure of 85 mm Hy images . The neuy images . Dense fy images . Geneticy images . The patNeuronal intranuclear inclusion disease is a group of degenerative diseases characterized by regional neuron loss and the presence of eosinophilic intranuclear inclusion in the glial cells and neurons . At the In 2016, Sone et al. . HoweverIn patients with NIID, MRI , 2 showeNeuronal intranuclear inclusion disease is similar to other neurodegenerative diseases, and there is no special recommended treatment. Symptomatic treatment may improve the quality of the patient's life and delay the progress of some symptoms, such as Parkinson's syndrome, epilepsy, and dementia. Identifying and intervening of patients with suspected NIID as soon as possible may be the key to diagnosis and treatment.In summary, NIID is involved in a wide range of parts, and the heterogeneity of symptoms is obvious. The clinical heterogeneity of NIID increases the difficulty of our diagnosis. Dementia, ataxia, and limb weakness are more common clinical manifestations in NIID patients. High intensity signal along the corticomedullary junction is of high value for diagnosis. This case provides that oromandibular dystonia may be the initial symptom of NIID. In the future, more international studies may find more clinical symptoms of NIID and clarify the pathogenesis of NIID, so as to develop a more effective treatment for this disease.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.The studies involving human participants were reviewed and approved by Rui Jin Hospital Ethics Committee, Shanghai Jiao Tong University School of Medicine. The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.W-PD and ZY: data collection and drafting the manuscript. X-JH and J-WJ: data evaluation and manuscript revision. X-HL: pathological test and manuscript revision. LC: funding, data collection and evaluation, supervision, manuscript revision, and final approval. All authors contributed to the article and approved the submitted version.LC is in charge of the National Natural Science Foundation of China (81870889 and 82071258). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


For successful anterior cruciate ligament (ACL) reconstruction, several factors, such as preoperative planning, operation technique, and postoperative rehabilitation, have to be considered , 2. GrafKnee Surgery & Related Research is the preparation method of HT autograft and the evaluation of the graft maturation in ACL reconstruction. Graft preparation for the HT during ACL reconstruction can be performed by several methods, mostly quadruple semitendinosus & gracilis (ST&G), triple ST&G, and quadruple ST [The theme of this issue of ruple ST , 4. Adeqruple ST , 6.Dr. Goyal’s report about HT graft preparation is a very interesting article. They compared weave graft and parallel graft preparations to make graft length over 8 cm and graft diameter 7~10 mm. Weave preparation of three-strand ST could be made thicker in diameter, which reduced the gracilis harvesting compared with the parallel graft. Weave graft preparation did not compromise functional outcome and seems to have better graft re-rupture rate 2 years after the operation. So the authors expected preserving the strength in deep flexion and internal rotation of tibia through preserving the gracilis tendon.Another report about ACL reconstruction, by Dr. Kim, is a systematic review related to evaluation methods of graft maturation on second-look arthroscopy in which 28 studies were analyzed. Graft integrity, tension, and synovial coverage were most frequently evaluated for graft maturation on second-look arthroscopy. Although a few studies reported that the graft tension was significantly correlated with objective stability, second-look findings seem to be less correlated to the clinical outcomes –9. GraftThe recent increased use of allograft for ACL reconstruction is due to no donor site morbidity, decreased surgical time, diminished postoperative pain, and good availability of source . HoweverIf adequate length and diameter of autograft can be obtained for ACL reconstruction, autograft with adequate graft fixation and postoperative rehabilitation should be chosen instead of allograft to expect better results. Every effort to enhancing graft maturation and to make a strong graft should be made for a better outcome after ACL reconstruction.


Ongoing aortic wall degeneration and subsequent aneurysm exclusion failure are major concerns after an endovascular aneurysm repair with a stent-graft. An ideal solution would be a drug therapy that targets the aortic wall and inhibits wall degeneration. Here, we described a novel drug delivery system, which allowed repetitively charging a graft with therapeutic drugs and releasing them to the aortic wall in vivo. The system was composed of a targeted graft, which was labeled with a small target molecule, and the target-recognizing nanocarrier, which contained suitable drugs. We developed the targeted graft by decorating a biotinylated polyester graft with neutravidin. We created the target-recognizing nanocarrier by conjugating drug-containing liposomes with biotinylated bio-nanocapsules. We successfully demonstrated that the target-recognizing nanocarriers could bind to the targeted graft, both in vitro and in blood vessels of live mice. Moreover, the drug released from our drug delivery system reduced the expression of matrix metalloproteinase-9 in mouse aortas. Thus, this hybrid system represents a first step toward an adjuvant therapy that might improve the long-term outcome of endovascular aneurysm repair. Abdominal aortic aneurysm (AAA) is a noteworthy disease that causes segmental expansion and aortic rupture ,2. AAA iThere are two ways to apply drugs in the treatment of AAA: primary therapy and adjuvant therapy. We have long awaited a primary pharmacologic treatment for small AAAs to prevent progression; currently, there is no effective therapy for patients with small AAA. However, large AAAs can be treated with endovascular aneurysm repair (EVAR), and this approach might benefit from adjuvant pharmacologic therapy . EVAR has become widely accepted as a minimally invasive treatment for aortic aneurysms . HoweverTo address this problem, we created a new hybrid device that combined a drug delivery system and an endovascular stent graft, for treating aortic aneurysms. We called it a rechargeable drug delivery system (RDDS), because it can be charged with a drug, release the drug, and then be recharged, which provided great flexibility in drug administration. Briefly, the RDDS is composed of a target-recognizing nanocarrier that transports the drug to a targeted device A. Any arIn the present study, we aimed to demonstrate the feasibility of the RDDS in vitro and in vivo.2 biotin, and the grafts biotinylated with a pHEMA coating contained 245 nmol/cm2 biotin. Thus, the pHEMA-coating technique greatly increased the amount of biotin on the graft , into the mouse inferior vena cava. Then, we injected fluorescence-labeled neutravidin intravenously. At 15 min after injection, neutravidin had successfully accumulated on the biotinylated graft. This result indicated that the interaction between biotin and neutravidin was preserved within blood vessels in vivo .The bio-nanocapsule-liposome (BNC-LP) complex was previously reported to be useful for delivering drugs to specific tissues in vivo ,18,19. TNext, we checked the binding of the biotinylated BNC-LP complex to the targeted graft, in vitro. The targeted graft was prepared by allowing DyLight488-labeled neutravidin to bind to the biotin attached to the graft D. Then, We checked that the biotinylated BNC-LP complex could bind to the targeted graft in vivo by placing the targeted graft into the mouse inferior vena cava, then injecting the biotinylated BNC-LP complex intravenously. A non-biotinylated BNC-LP complex was used as the control A. At 180Next, we examined how efficiently the target-recognizing BNC-LP complex could be loaded onto the targeted graft. Here, we placed either the targeted graft or an untreated graft into the mouse inferior vena cava. The next day, we injected the biotinylated BNC-LP complex labeled with Cy3 intravenously. At 60 min after injection, the grafts were excised, and we examined the Cy3 fluorescence intensities A. p < 0.01 compared to untreated graft). This result indicated that charging the targeted graft was over ten times more efficient than charging an untreated graft (We found that the targeted grafts showed significantly higher fluorescence intensities (relative intensity) than the untreated grafts . Importantly, no mouse died, during this study, due to use of the RDDS, which included biotin, neutravidin, BNC-LP, and pitavastatin.Regardless of promising results in preclinical studies, to date, no AAA drug has shown beneficial effects in the clinical setting. One potential explanation for this failure might be that inappropriate doses were used in previous clinical trials ,23. SincThe surface of an artificial blood vessel  was treated with 1 N sodium hydroxide, which partially hydrolyzed it and exposed free carboxyl groups. The carboxyl groups were activated with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC), a cross-linker, combined with N-hydroxysuccinimide (NHS). Then, the EZ-Link Biotin-PEO3-LC Amine kit  was used to attach biotin to the graft surface. To produce the p (HEMA-Biotin) conjugate, we performed a condensation reaction between poly (2-hydroxyethyl methacrylate) (pHEMA) and (+)-biotin. We combined pHEMA and biotin at a molar ratio of 1:5, with EDC in N,N-dimethylformamide (DMF), and incubated the reaction at room temperature for 24 h. Then, a graft was immersed in the p (HEMA-Biotin) solution for 6 h to produce a surface-biotinylated graft. The amount of biotin coupled to the graft surface was measured with the 4’-hydroxyazobenzene-2-carboxylic acid biotin quantification kit. For binding assays, the biotinylated graft was combined with DyLight488-labeled neutravidin (Pierce), which served as the target molecule that could bind a biotinylated drug carrier.Male C57BL/6 mice, obtained from Chiyoda Kaihatsu (Japan), were used for experiments at 10- to 15-weeks old. An operating microscope with 25× magnification was used for the procedure.A mid-line abdominal incision was made. The inferior vena cava, together with the infrarenal aorta, were dissected as a unit and mobilized at levels between the renal arteries and the aortic bifurcation. The proximal and distal portions of the inferior vena cava, together with the infrarenal aorta, were clamped as a unit with an Acland microvascular clamp (B-1V). A longitudinal incision was made in the inferior vena cava between the clamps, and a tiny piece of the biotinylated graft (4 × 1 mm) was placed within the lumen of the inferior vena cava. The incision in the inferior vena cava was closed with the interrupted suture technique, performed with 10-0 nylon sutures . The clamps were then released, and blood flow was reestablished.Shortly thereafter, DyLight549-labeled neutravidin (Pierce) was injected through the iliac vein. The fluorescent signal was visualized with a fluorescence stereomicroscope  in real time. During the fluorescence-labeled neutravidin injection, successful reestablishment of the blood flow was confirmed when the fluorescent signal passed through the inferior vena cava. The interaction between biotin and neutravidin was considered successful when the fluorescent signal accumulated in the biotinylated graft.All experiments in this study were performed in accordance with the Guidelines for the Care and Use of Laboratory Animals, published by the United States National Institutes of Health. All protocols were approved by the Institutional Animal Care and Use Committee of Yamaguchi University Graduate School of Medicine .We used two commonly known therapeutic drugs for aortic aneurysms ,11,12,32Saccharomyces cerevisiae AH22R− cells that carried the ZZ-BNC expression plasmid, pGLD-ZZ50. Next, as described previously [As described previously ,33,34, Beviously ,35, BNCseviously . Finallyeviously .The targeted graft was prepared by incubating the biotinylated graft with DyLight488-labeled neutravidin (0.1 mg/mL)/phosphate buffered saline (PBS) for 30 min. Next, pieces of the targeted graft (5 × 5 mm) were immersed in Tris-buffered saline with Tween20 (TBS-T), and then incubated with 5% bovine serum albumin/TBS-T for 30 min, to block non-specific binding. After washing in TBS-T, the targeted grafts were incubated with the biotinylated BNC-LP complex labeled with Cy3 (0.2 mg/mL)/PBS for 20 min. The targeted grafts were washed three times with TBS-T, then fluorescence was measured with a fluorescence stereomicroscope. Negative controls included non-biotinylated grafts, biotinylated grafts without neutravidin, and non-biotinylated BNC-LP complexes.The targeted graft was prepared by incubating the biotinylated graft with neutravidin (0.1 mg/mL)/PBS for 30 min. After non-specific blocking and washing, as described in The targeted graft was prepared by incubating the biotinylated graft with neutravidin (0.1 mg/mL)/PBS for 90 min. After non-specific blocking and washing , a pieceThe targeted graft was prepared by incubating the biotinylated graft with neutravidin (0.1 mg/mL)/PBS for 90 min. After non-specific blocking and washing , a pieceThe targeted graft was prepared by incubating the biotinylated graft with neutravidin (0.1 mg/mL)/PBS for 90 min. The pitavastatin-containing biotinylated BNC-LP complex was prepared by conjugating biotinylated BNC with pitavastatin-containing liposomes  at a weight ratio of 1:35, as described previously . Subsequ2 for 15 min, to induce inflammation in the aorta, as described previously [2. The control graft was used in the control group. The mice were sacrificed at 24 h after the CaCl2 treatment. The abdominal aorta was immediately excised and subjected to protein analysis.Eight-week-old male C57BL/6 mice were used for this experiment. A mid-line abdominal incision was made. The infrarenal aorta was dissected and mobilized at levels between the renal arteries and the aortic bifurcation. Next, the mobilized aorta was stimulated by applying periaortic 0.5 M CaCleviously ,37,38,39Protein extraction and western blotting were performed, as described previously ,40,41. Bt-test (n = 3) or the Mann–Whitney test (n > 3). Data were analyzed with Prism 6.0 . p-values < 0.05 were considered statistically significant.Data are expressed as the mean ± standard deviation. Statistical analyses were performed with the Student’s In conclusion, we provided a proof-of-concept for the novel RDDS. We showed that the RDDS was capable of transporting and releasing desired drugs to a specific site, repeatedly and safely. The practical development of this system might be a major step toward improving the long-term outcome after EVAR.


We are pleased to announce that International Brazilian Journal of Urology became the official communication organ of the American Confederation of Urology. The editorial board and the Brazilian Urology Society are very happy because the beginning of this partnership what will contribute to reinforce the impact of the International Brazilian Journal of Urology on the American continent.We are experiencing very difficult times because of the Covid-19 pandemic and at the time of writing this editorial a second wave of the disease is starting in Europe. However, research cannot stop. The March-April 2021 number of Int Braz J Urol, the ninth under my supervision, presents original contributions with a lot of interesting papers in different fields: Prostate Cancer, Urethral Stricture, Male Incontinence, Vesicoureteral Reflux, Renal Cell Carcinoma, Bladder Cancer, BPH, SARS-CoV-2 and Urology, Radiation Induced Cystitis, Vaginoplasty, Varicocele, Basic Research applied to Female Urinary Incontinence, Flexible Ureteroscopy, Penile Fracture and Straghorn Renal Calculi. The papers came from many different countries such as Brazil, USA, Turkey, China, Iran, Portugal, Serbia, Montenegro and Spain, and as usual the editor's comment highlights some of them.In the present issue we present four important papers in reconstructive urology and 2 very important papers about SARS-CoV-2 pandemic in Urology. Dr. Benson and colleagues from USA performed in page 237  a nice sDr. Angulo and colleagues from Spain and Portugal  present The 2 papers about COVID-19 in urology came from Brazil. Dr. Mazzuchi and collegues from Brazil presented in page 251  an imporDr. Jeremias and collegues from Brazil  on page Dr. Castellanti de Mattos and collegues from Brazil  performeDr Menezes and collegues  from BraDr. Wang and collegues  from ChiDr. Loftus and collegues  from USADr. Maluf and collegues  from BraDrs. Djordjevic and Vokovic  from SerWe hope that readers will enjoy the present number of the International Brazilian Journal of Urology in this very difficult times of COVID-19.


Coronary artery bypass grafting (CABG) is performed either with the aid of cardiopulmonary bypass (on-pump) or without cardiopulmonary bypass (off-pump). There is a scarcity of angiographic data to support the non-inferiority of off-pump technique to on-pump technique. The objective of this study is to ascertain the non-inferiority of off-pump CABG when compared to on-pump CABG in terms of angiographically assessed graft patency at 3 months.n = 162) or off-pump CABG (n = 158) between March 2016 through March 2017. Graft patency was evaluated by using either multidetector computerized tomographic angiography or conventional coronary angiography at 3 months. The major adverse cardiac and cardiovascular events (MACCE) were also analyzed at 3 months.A total of 320 patients with multivessel coronary artery disease were enrolled in a multicenter prospective randomized trial either to on-pump CABG (p = 0.01). There was no significant difference in mortality at 3 months between the off-pump (0.63%) and on-pump groups (1.85%) with p value of 0.62. The cumulative combined MACCE showed significant difference between off-pump group (0.63%) and on-pump group (5.55%), p = 0.01. Follow-up angiograms were done in 239 (75%) patients with 120 off-pump and 119 in the on-pump group. The analysis was also done regarding graft patency in a graded manner—when analysis of A (excellent) grafts vs B (stenosed) grafts and O (occluded) grafts were made, there was no statistically significant difference in overall graft patency at 3 months between on-pump [376 /429 grafts (87.6%)] and off-pump [366 /420 grafts (87.1%)] groups (p = 0.82). The patency rates were similar among bypass conduits  in off-pump (91.4%) vs on-pump (92.9%) p = 0.66, right ITA in off-pump (82.1%) vs on-pump (81.8%) p = 0.97, radial artery in off-pump (84.4%) vs on-pump (82.6%) p = 0.81; saphenous vein in off-pump (85.8%) vs on-pump (86.3%), p = 0.86 and among 3 coronary territories.The median number of grafts per patient in off-pump was 3.00 (Q1:3.00 and Q3:4.00) vs on-pump 4.00 (Q1:3.00 to Q3:4.00), and the mean number of grafts per patient was lower in the off-pump CABG at 3.45 ± 0.75 vs 3.64 ± 0.70 in the on-pump CABG  contains supplementary material, which is available to authorized users. CABG is the preferred method of treatment for patients with multivessel coronary artery disease (CAD) and is performed either with the aid of cardiopulmonary bypass (on-pump) or without cardiopulmonary bypass (off-pump) . Since tOff-pump CABG is adopted in over 50% of the patients in India , whereasn = 162) or off-pump (n = 158) CABG at 6 centers by 7 surgeons in India.This Prospective Randomized comparison of Off-pump and On-pump Multivessel coronary artery bypass surgery To Evaluate outcomes and graft patency (PROMOTE patency) trial was conducted between March 2016 through March 2017. The patients who met the inclusion and exclusion criteria were randomized in the ratio of 1:1 using block randomization, with a block size as 4, using software SAS version 9.2. A total of 321 patients were randomized and 320 patients (recruitment ranged from 26 to 56 patients per surgeon) were enrolled to either on-pump . This trial complies with the principles of The Declaration of Helsinki and was approved by the institutional ethics committees by the participating institutions and all patients gave an informed written consent to participate in the study.The inclusion criteria were male or female aged ≥ 21 years and ≤ 70 years, and multivessel CAD, with triple vessel disease or left main coronary artery (LMCA) stenosis, requiring isolated CABG and with left ventricular ejection fraction (LVEF) of ≥ 40%. Exclusion criteria were CABG with concomitant procedures, contra-indications to either off-pump or on-pump CABG, chronic atrial fibrillation, and serum creatinine > 1.3% mg/dL. Graft patency was assessed at 3 months by either 128 slice multidetector computed tomographic angiography (MDCT) or conventional catheter coronary angiography (CAG). Graft patency was evaluated on the basis of type of conduit and coronary artery territory, as well as the number of anastomoses patent per patient. The graft evaluation was made similar to Fitzgibbon grading of grafts  at 3 months. The sample size in this study was calculated based on the graft patency of the above trials. The current study is a non-inferiority trial, and hence, the null hypothesis is formulated as H0: The graft patency rate for off-pump is inferior to on-pump graft patency rate by a clinically relevant patency rate of 10%. HA: The graft patency rate for off-pump is non-inferior to the graft patency rate of on-pump or, alternatively is formulated as H0: The difference in the graft patency rate between off-pump and on-pump is (− 10%) HA: The difference in the graft patency rate between off-pump and on-pump is (> − 10%). The required sample size (n) for each group has been arrived assuming an α = 5% or a confidence level (1-a) of 95%, ß = 10% or a power (1-ß) of 90%, the non-inferiority clinical margin (d) of 10%, and Zx is the standard normal variate for a one sided x.ROOBY trial  reportedn et al.  reportedt test. The statistical significance for all the tests was accepted at a probability level < 0.05.Statistical analysis was performed by the trial coordinating center using software SAS version 9.2. Continuous variables have been expressed as median, mean ± standard deviation. The categorical variables have been expressed as raw numbers and percentages. The differences were analyzed with chi-square, Fisher exact test (if cell frequency was less than 5), and two sample Withdrawal of antiplatelet drugs was done 4 days prior to surgery and low molecular weight heparin was started.Premedication, anesthetic protocols, surgical access to the heart via a standard median sternotomy, conduit harvesting techniques, and distal and proximal anastomotic techniques were similar between the groups. Heparin dose was adjusted to achieve target activated clotting time of > 480 s and > 350 s for on-pump and off-pump groups respectively. Heparin was reversed using protamine at a dose of 1.3 mg/100 IU heparin in both the groups. The surgical techniques of revascularization were followed as described earlier .Myocardial protection was achieved by cold (4 °C) antegrade blood and potassium cardioplegia. The distal coronary anastomoses were performed with either 7–0 or 8–0 polypropylene continuous suturing techniques and the proximal anastomoses were performed using 6–0 polypropylene sutures as described earlier .The method of exposure and stabilization of heart to perform distal coronary anastomoses consisted of the technique previously described . Target The primary endpoint was graft patency at 3 months, assessed by either 128 slice MDCT or CAG. Graft assessment was done similar to Fitzgibbon grading of ABO grade grafts  and 49 patients (165 grafts)  underwent catheter CAG. The modality of graft evaluation was not uniform due to non-availability of MDCT facility at some centers where the graft evaluation was done by catheter CAG. The baseline characteristics were comparable between patients who underwent graft evaluation and who declined graft evaluation. However, the patients who underwent graft evaluation are younger than the patients who declined graft evaluation . There was no significant deference in overall patency rates between the two techniques  . The analysis was made by comparing A grade (excellent patency) grafts vs B and O grade (stenosed and occluded) grafts. In off-pump group (120 patients) out of 420 grafts, 366 (87.1%) grafts were grade A (excellent patency) grafts and in on-pump group (119 patients) out of 420 grafts, 376 (87.6%) grafts were grade A (excellent patency) grafts (p = 0.66); RITA: off-pump 23/28 (82.1%) vs on-pump 18/22 (81.8%), (p = 0.97); radial artery (RA) graft: off-pump 38/45 (84.4%) vs on-pump 38/46 (82.6%), (p = 0.81); saphenous vein graft (SVG): off-pump 187/218 (85.8%) vs on-pump 202/234 ] between the groups. Among the 3 coronary artery territories, patency rates of grafts were also similar  (Table The comparison between A grade grafts vs B and O grade grafts showed that there was no significant difference in the patency rates of various bypass conduits  between the groups. Among the 3 coronary artery territories, patency rates of grafts were also similar  between the groups .When comparison was made between A and B grade grafts vs O grade grafts, there was no significant difference in the patency rates of various bypass conduits. [LITA: off-pump 122/129 (94.5%) vs on-pump 122/127 (96.06%), , thus rejecting the null hypothesis (off-pump CABG is inferior to on-pump CABG).Of 119 patients in on-pump CABG group who underwent graft evaluation, 111 (93%) patients had grade A grafts and of 120 patients in off-pump CABG group, and 113 (94%) patients had grade A grafts. Of 429 grafts in on-pump CABG group, 376 (87%) grafts were grade A grafts and of 420 grafts in off-pump CABG group 366 (87%) grafts were grade A grafts ESM 2(PDF 192 kb)


Potato starch is one of the most important renewable sources for industrial manufacturing of organic compounds. Currently, it is produced from mixed potato varieties that often are harvested from different fields. Meanwhile, tuber starches of various potato breeds differ in their crystallinity, granule morphology, and other physical and chemical parameters. We studied the reactions of raw potato starches of different origins to chemical and biochemical reactions typically used for industrial starch modification. The results clearly demonstrate that there is a significant difference in the reactivity of the starches of different potato genotypes. While the main products of the transformations are the same, their preparative yields differ significantly. Thus, tuber starch of certain potato varieties may be more suitable for specific industrial purposes. Starch reactivity may potentially be a phenotypical trait for potato breeding to obtain potato starches for various industrial applications. Starch is one of the most economical and widely used industrial renewable feedstocks . TechnolHowever, a long time ago researchers noticed that significant differences in physical parameters  for starch granules could be observed between different potato varieties. Thus, Theoretically, chemical and biochemical reaction capacity of raw potato starch has to depend on the crystallinity, morphology, and other chemical and physical properties of starch granules. A few practical studies confirming that statement are known. Indeed, fractionation of the raw potato starch according to granule size followed by chemical acylation demonstrated an increased degree of substitution with decreasing granule size. Additionally, the acetyl group distributions were different for amylopectin molecules from different granule size fractions ,6. The lThe goal of current study was to discover if starches of various potato genotypes have different reactivity in chemical and biochemical transformations. That difference could be used as a phenotyping trait in potato breeding processes to create special potato varieties for the manufacturing of starch with characteristics specially tuned for certain industrial processing technologies .1 (HMF) from starch  to increase the industrial potential for this kind of natural feedstock, we tested experimental procedures for synthesis of 5-hydroxymethyl furfuraldehyde m starch .One of the most promising protocols was described in . We repe2  by 1H-NMR revealed noticeable differences between the products obtained from different potato genotypes  relates to starch fragments that are protected from digestion by the conformation or structure of the starch granules. Because of their crystalline nature, they are poorly susceptible to hydrolysis . To deteTaking into account the importance of starch as a renewable natural feedstock and its high volume usage in industrial processing, every percent change in preparative yield of the starch-based product may turn into significant earnings or losses for a manufacturer. For now, quality control on incoming potato starch does not include sophisticated chemical and biological parameters. Often, manufacturers produce starch from potato crops with an expired shelf life or that must be utilized for some reasons. Meanwhile, one can propose that physical and chemical characteristics of starch granules should influence their reactivity. Indeed, the polymeric carbohydrates, amylose and amylopectin, composing starch granules may vary in chemical composition  and structure  . Starch There are two major factors responsible for the above-mentioned difference in the physical and chemical parameters of starch: environment and genetics. It has been shown that environmental conditions, particularly temperature, have a significant impact on starch granules’ crystallinity, and subsequently on digestion, starch granule dimensions, and amylopectin structure, via deactivation of some enzymes . InterspSurprisingly, our accidental test for synthesis of HMF from starches isolated from different potato varieties, showed that HMF may be obtained with significantly different yields when certain varieties are used (17.4% vs. 8–11%). We chose the potato varieties Kuznechanka and Kolobok for further systematic study as they only differ in starch granule mean diameter, while their other traits are similar (circularity and related aspect ratio as well as phosphorous content) .The synthesis of HMF or levulinic acid from starch both include fast hydrolysis of carbohydrate polymers into glucose as a first stage. Thus, these two reactions should not depend significantly on the morphology of starch granules and their surface area. It would also be interesting to test the reactivity of the starches, which does not include granules destruction. For example, surface modification by an acylation agent may depend on the granules’ surface area and size distribution and does not include cleavage of polysaccharide chains. However, starch from the variety Kuznechanka with higher granules diameter and lower surface area gave higher yields in acylation. In contrast, starch from the variety Kolobok showed higher digestion by amylase, resulting in a lower residue of resistant starch. Therefore, it is not clear which of the multiple parameters satisfactorily explains the reactivity of starch from the two potato varieties. We know that the average diameter of the starch granules differs noticeably. However, other not-yet-determined characteristics, like molecular weight, crystallinity, or degree of branching, may also play a dominating role in limiting the rate of the reactions.Solanum tuberosum L.) varieties was obtained from the ICG “GenAgro” collection . The process for the collection of planting samples is described in [A set of potato . Note tThe first experiment (synthesis of HMF) was performed with potato starches of different potato varieties . The choice of the varieties was based on the known availability of the starches.For other chemical and biochemical transformations, potato tuber starches of Kuznechanka and Kolobok varieties were chosen as the model starches. Their parameters are close, and the only significant difference is in their starch granules’ mean diameters . Their m2, 1-methyl-3-octylimidazolium chloride, and enanthic acid were purchased from Sigma-Aldrich  and used as received. A sample of 5-hydroxymethyl furfural (HMF) for comparison was prepared from fructose according to [http://www.sibbio.ru). Resistant starch was determined with a Resistant Starch Assay Kit K-RSTAR (https://secure.megazyme.com/Resistant-Starch-Assay-Kit) with the same effectiveness. Lipase  was purchased from Sigma-Aldrich. Glucose concentration was determined with a Glucose Kit 032 from Glucose-Olvex .CrClrding to . α-Amyla1H-NMR spectra were recorded from a DMSO-d6 solution at room temperature on a Bruker Avance III 500 FT-spectrometer with a working frequency of 500.03 MHz. Chemical shifts were reported in ppm of the δ scale and referred to signals of the solvents . For glucose determination, the plate UV-spectrophotometer Epoch2 was used.The 2, and 1 mL of EtOAc were added. The vessel was sealed and heated at 120 °C for 60 min while stirring. After cooling to the ambient temperature, the pH of the water layer was adjusted to pH~7 and the NaOH solution and EtOAc layer were collected. The water layer was extracted 3 times with 3 mL of EtOAc. The combined organic solutions were dried with MgSO4, filtered, and evaporated. Column chromatography , evaporation, and drying to a constant mass gave HMF 1 as a yellowish oil. 1H-NMR spectrum of HMF 1 matched the HMF spectrum from the AIST database.Potato starch was converted to HMF according to the procedure described in . Starche2 was evaporated in a vacuum rotary evaporator at 80 °C and dissolved in 0.5 mL of DMSO-d6 with 2 µL HMDS added for NMR. The solution was used for the evaluation of levulinic acid 2 yield from 1H-NMR spectra according to Formula by means of comparison of the integrals for signals of HMDS and the signals of the CH2 group of levulinic acid 2 (1H-NMR spectra of 2 (ppm): 2.092 , 2.374 , 2.645   .%LA = N3. The 1H-NMR spectra of 3 (ppm): starch signals-3.58–3.65 , 4.548 , 5.102 , 5.376 , 5.469 ; ester group signals: 0.853 , 1.143 , 1.242 , 1.477 , 2.180  .Potato starch was acylated with enanthic acid by an enzymatic reaction, similar to that described in . Starche1H, CHb) . Degree .548 ppm  accordinResistant starch was determined in triplicate for potato varieties Kuznechanka and Kolobok according to the procedure described in . First, Starch from a few potato varieties showed different reactivity in thermal hydrolysis, lipase-catalyzed acylation, and digestion by amylase. Despite the reasons for the different reactive abilities of starches from various potato genotypes not yet being clear, their effect on reaction products’ yields is significant. It may be reasonable to test potato varieties for starch manufacturing for the starch reactivity, and to produce specified starch from selected potato breeds for certain chemical products. Moreover, chemical product yields may potentially be taken as a phenotyping trait for potato breeding and an intravital potato starch modification while growing. However, the role of the environment for starch properties, discussed elsewhere, should be carefully analyzed and taken into account.


The author mistakenly used the word "screws" instead of "holes" throughout the article, including the title. These incorrect instances of "screws" have been replaced with the correct word ("holes"). In addition, the following sentence was removed as it was also mistakenly included by the author: "Furthermore, retentive holes were made and screws were placed into the dentin to retain the fragment in position."The Cureus editorial team deeply regrets that these errors were not caught prior to publication.


Once considered a contraindication to liver transplantation, portal vein thrombosis still represents a significant challenge to the liver transplant surgeon. Yerdel grade 3 thrombosis is usually managed by interposing a donor iliac vein jump graft between graft portal vein and distal superior mesenteric vein. Venous patch is normally placed in a retrogastric position to avoid its kinking.We report a new technical variant of standard mesoportal jump graft, in which a U-shaped graft was obtained using iliac bifurcation. This technique was used to manage a case of grade 3 portal vein thrombosis in which portal vein was unsuitable due to severe pylephlebitis and pylorus dissection had to be abandoned due to inflammatory changes issue of chronic pancreatitis. The venous patch was of sufficient length and shape to bypass pancreatic head and first duodenum, avoiding the need for its retrogastric placement and pylorus dissection.This case is a further demonstration that technical approach to portal vein thrombosis must be tailored according to its extent and surgical scenario. In selected cases, use of a curved U-shaped jump graft may represent a valuable option.This technical option should be included among options for the management of portal vein thrombosis and be part of the armamentarium of liver transplant surgeon. Portal In Yerdel grade 3 PVT, i.e. complete thrombosis of the portal vein andproximal superior mesenteric vein (SMV), one technical option is distal dissection of the SMV and mesoportal anastomosis using an interposition jump graft. To avoid kinking, the graft normally placed through the transverse mesocolon and posterior to the first duodenum (D1) and the pylorus . In patiWe present here a novel technique of mesoportal jump graft to manage Yerdel 3 PVT during LT. In the case reported herein, a “U-shaped” donor iliac vein jump graft including iliac bifurcation and the proximal segment of iliac veins was used to get over the pancreatic head and D1, avoiding the need for D1 dissection or Kocher maneuver. The case is reported in line with the SCARE criteria .2Patient was a 49-year-old male with end-stage alcohol-related liver disease and a history of several hospital admissions due to decompensated ascites and hepatic encephalopathy. He was referred for LT in May 2019 with creatinine 0.93 mg/dl, total bilirubin 11.2 mg/dl and INR 2.28 and a model of end-stage liver disease (MELD) score of 25. Pre-LT computed tomography (CT) highlighted the presence of a large thrombus in the portal vein and proximal SMV, sparing the splenic vein and the distal SMV A. CT alsTransjugular intrahepatic portosystemic shunt was deemed unfeasible due to the low extension of PVT. Based on PVT extension, LT was deemed feasible by using a mesoportal jump graft interposed between SMV and graft portal vein, the back-up options being renoportal anastomosis or cavoportal hemitransposition. At waitlisting, his MELD score was 29 .During organ retrieval, iliac arteries and veins, including aortic and IVC bifurcations, were procured. At liver transplant, long-standing PVT and presence of large portosystemic collaterals were confirmed. As shown by pre-LT imaging, a large mesocaval shunt originated at the level of the gastrocolic trunk of Henle and drained into infrarenal IVC. There was a picture of severe chronic pancreatitis, with peripancreatic inflammatory changes. After dissection of the hepatoduodenal ligament, portal vein appeared to be involved by severe pylephlebitis, with thickened and inflammatory walls and minimal residual lumen. A low dissection of splenomesenteric confluence and an eversion thrombectomy were carried out, which were partially successful in re-establishing a satisfactory flow into the previously obstructed vessel. However, due to the extremely narrowed residual lumen and the thickening of the vessel wall, portal vein was judged unsuitable for anastomosis and abandoned. As originally planned, we decided to perform portal vein anastomosis using an interposition graft between the SMV and graft portal vein. To avoid prolonging cold ischemia time, artery anastomosis was performed first. After graft reperfusion, SMV was dissected distally to the gastrocolic trunk of Henle for approximately 4 cm, preserving the large mesocaval shunt. Preparation of the retrogastric tunnel was abandoned due to the severe inflammatory reaction issue of chronic pancreatitis. A U-shaped donor iliac interposition patch was then prepared by suturing IVC about 2 cm above the iliac bifurcation using a vascular stapler  and by stitching small collaterals originating from common iliac veins. SMV was tangentially clamped and an end-to-side anastomosis between the venous patch and the SMV was performed using a 5/0 polypropylene suture, followed by an end-to-end anastomosis between the venous patch and graft portal vein using the same material . After cPostoperative course was characterized by immediate graft function and no surgical complications. Due to low platelet count, anticoagulant treatment with enoxaparin 6000 IU was started on the 7th postoperative day and replaced by acetylsalicylic acid 200 mg o.d. one month after LT. Repeated Doppler ultrasound examinations and a CT scan performed in the postoperative period demonstrated patency of the reconstructed venous axis and otherwise regular graft perfusion B. Patien3a priori based on PVT extent are not taken into account. Since the very early experiences with PVT management, it appeared that surgical technique has to be tailored to the anatomy of PVT, including its extension below the splenomesenteric confluence, availability of large portal vein collaterals and presence of spontaneous or surgical portosystemic shunts [Once considered a contraindication to LT, complex PVT still represents a technical challenge during LT and its incidence is likely underestimated in LT series, in which patients who are refused c shunts . Whereasc shunts ,9, gradeAt our Institution, which is approaching 3500 LT performed at a single center, all candidates to LT are screened for PVT by a contrast-enhanced computed tomography with 3D reconstructions. In last 10 years, PVT was diagnosed in 126 candidates to LT, classified as grade 1, 2 or 3 in 58 (46%), 46 (36.5%) and 22 (17.5%), respectively. In case grade 1–2 PVT is detected, low molecular weight heparin is started and, in patients who are suitable for, early TIPS is considered to preserve or reestablish portal vein patency .In grade 3 PVT anticoagulants are more frequently ineffective and TIPS may be unfeasible due to the impossibility to identify a safe “landing point” in the portal venous system. Form a surgical standpoint, several options are available, of which mesoportal anastomosis using an interposition jump graft has been most frequently described.In standard technique, the mesoportal interposition jump graft is placed in a transmesocolic, prepancreatic and retrogastric position . The retIn our case, we were forced to recur to a mesoportal interposition graft by the impossibility of using native portal vein due to its severe thickening and inflammatory changes. The jump graft was manufactured by using the iliac bifurcation and the proximal tract of common iliac veins, obtaining a graft of appropriate length and shape to get along the pancreatic head and D1, while avoiding any D1 or pylorus dissection or the need for a double elongation patch. In our practice, iliac vessels, if suitable, are always procured to allow possible vascular reconstructions in the recipient. In case pancreas is retrieved for transplantation, iliac vessels are shared with the pancreas team, according to each team necessities.As feasibility of this technique depends upon the availability of IVC bifurcation, it could not be feasible when this has to be shared with other transplant teams, or in living donor LT. Furthermore, appropriate management of complex PVT is driven by careful evaluation of vascular anatomy and of the degree of portal hypertension. Thus, no “one-fits-all” approach can be recommended and our technique may not be appropriate in all grade 3 PVT cases.4In conclusion, we describe the “U-shaped” mesoportal jump graft, a technical variant of mesoportal jump graft to be employed in case of grade 3 PVT, when use of native portal vein is not possible. By this easy and reproducible technique, a graft of good length and appropriate shape can be obtained, possibly avoiding the need for its placement in a retrogastric position. Although long-term follow-up of our case is reassuring, further experience is necessary to confirm the value of the proposed technique in similar cases.Authors declare they received no funding for this paper.The study is exempt from ethical approval at our Institution.The patient has given informed consent to the processing of personal data, including consent to the use of health data and images for scientific purposes.No registration was required for this study.Dott. Damiano Patrono.Not commissioned, externally peer-reviewed.Damiano Patrono: Conceptualization, Data curation, Writing - review & editing. Sara Salomone: Writing - original draft. Carla Guarnaccia: Data curation, Visualization. Francesco Tandoi: Writing - review & editing. Francesco Lupo: Writing - review & editing. Paolo Fonio: Writing - review & editing, Supervision. Renato Romagnoli: Writing - review & editing, Supervision.Authors declare they have no conflict of interest.


Cordia gum is not widely studied as a starch modifier and this fact could make this study more interesting and unique. This study investigated the effects of the non-conventional hydrocolloid gum (Cordia gum) on corn starch properties. Corn starch and gum Cordia (GC) blends were prepared at different replacement levels . The effect of GC levels on pasting, thermal, rheological, and textural properties were evaluated using rapid viscoanalyzer, differential scanning colorimeter, rheometer, and texture analyzer. The presence of GC significantly increased starch gelatinization temperatures, enthalpies, peak viscosities, final viscosities, and setback viscosities. GC improved freeze thaw stability in starch. The shear rate (1/s) versus shear stress (σ) data of all samples fitted well to the simple power law model (R2 = 0.97–0.99). The control had the lowest flow behavior index , which increased to (0.36–0.56) with increasing GC levels. The consistency index (K) of the starch-gum blends increased with increasing GC levels. The dominance of elastic properties over viscous properties was demonstrated by G′ > G″. The magnitudes of G′ and G″ increased with increasing GC concentration. The outcomes could help to use this modification method as an alternative to chemical and enzymatic modification with respect to cost, safety, less time consumption and less requirement of process modifications.Incorporation of hydrocolloid gums in native starches help to improve their pasting, thermal, rheological and textural properties along with improvement in the stability of starch gels. The use of  Starch is abundantly stored as an energy reserve in different plant parts including tubers, roots, stems, and seeds. Starch is widely used in food industry as a gelling, stabilizing, and thickening agent depending on the specific properties ,2. The fCordia myxa L. (Assyrian plum or lasura), locally known as “Bumber” [Cordia has high nutritive value, rich in antioxidants and flavonoids and is used as anti-inflammatory, antimalarial, cough suppressant, appetite suppressant and diuretic [Cordia gum is anionic polysaccharide having strong adhesive properties and is used as an emulsifier and tablet binder [Cordia gum is reported to have 1.8 million Da molecular weight [Cordia has not been studied in detail for its starch modifying properties; therefore, the current study was carried out to evaluate the effect of gum Cordia on the pasting, thermal, and rheological properties of corn starch. The outcomes of this research provides insights on the use of this gum as an alternative to existing gum sources that are used in starch and baking industries.Hydrocolloid gums are hydrophilic molecules of high molecular weight and high viscosity when dissolved in water. The hydrocolloids are comprised of sugars like xylose, glucose, galactose, mannose, arabinose, and uronic acid. They are used in different food formulations as gelling, thickening, stabilizing, and foaming agents or to improve their water holding capacity, texture, palatability, and dietary fiber content ,9. They “Bumber” , can be diuretic ,20. The t binder ,22. It it binder  and coatt binder . Cordia r weight  and the r weight . The useC. myxa fruits were picked from the local farm and stored at refrigeration temperature till further use. Corn starch (20.4% amylose content) was obtained from a local company.The mature g for 30 min. The pH of freshly extracted supernatant was recorded as 6.7. The collected supernatant was neutralized , freeze dried, ground into fine powder (60 mesh), and stored in airtight jars in refrigeration till further use.Collected fruits were thoroughly washed, steamed for 3 min to inhibit the enzymatic activity, and seed were removed to obtain the pulp. The pulp was blended with distilled water at 1:3 ratio for 1 min, filtered through muslin cloth and centrifuged at 10,000× Cordia (GC) freeze dried powder was blended  with corn starch at 3, 6, 9 and 12%. The blends were prepared on the dry weight bases by keeping in view the 9% initial moisture content of corn starch and 11.2% of gum Cordia. The wet blending method was used to achieve uniform distribution of gum in starch. The starch-gum blends were mixed with water (1:2), stirred well, and freeze dried. The freeze dried blends were milled to fine powder and stored in air tight jars till further use. The moisture content of the blends was recorded between 9–11% which was standardized in all experiments based on their respective procedure.The gum DSC  was used to study the thermal behaviors of starch-gum blends. Samples (6–8 mg) and 10 µL distilled water were added into aluminum pans. Pans were hermetically sealed and allowed to equilibrate at room temperature for 3 h. Empty pan was used as a reference cell. Thermal scanning of sealed samples was done from 30–120 °C @ 10 °C/min increment. Thermal transitions like enthalpy ΔH (J/g), onset temperature (OT), and peak temperature (PT) were determined using the Universal Analysis Software.Starch-gum blends and native corn starch (3 g at 14% moisture basis) were transferred into aluminum canisters and distilled water was added to achieve a total weight of 28 g. The slurry was incubated at 50 °C for 30 s, heated to 95 °C in 4.40 min (at 10.23 °C/min), incubated at 95 °C for 4 min and finally cooled to 50 °C in 4.40 min (at 10.23 °C/min) and incubated at 50 °C for 2 min. The data for different parameters was processed using Thermocline window software provided with the instrument.g for 15 min, and the water separated from the gels was measured. The gels were then stored in freezer for 4 days until another freeze thaw cycle. Separation of water from gels after 4 and 8 days storage was reported as % syneresis.Starch gels were cooked  using the rapid visco analyzer (RVA) program as mentioned in Starch gels obtained from RVA experiment (3 g starch at 14% moisture) as described in τ = shear stress (Pa), γ˙ = shear rate (s−1), and The flow curves as a dependence of shear stress on shear rate were determined at 25 °C with shear rate of 0 to 300 (1/s) using TA Discovery Hybrid Rheometer  equipped with cone-plate measuring system . Starch/gum blends were cooked in RVA using same weight and experimental conditions as mentioned in Dynamic rheology measurements were carried out on cooked starch samples obtained from RVA experiments .All data were collected in triplicates  gradually increased with gum presence up to 13.63 ± 0.10 J/g at 9% gum level, and reduced to 11.86 ± 0.06 J/g at 12% gum level. Concentration dependent response of gum was observed on the gelatinization enthalpy of starch. The ΔH of plain corn starch was 12.08 ± 0.19 J/g. The increase in ΔH due to the presence of gum could be attributed to hydrophilic nature of gums which binds the available water molecules and reduction in starch hydration, reduction in chain mobility and ultimately resulting in higher energy requirement for melting. Similar results were reported by Torres, et al. [Mesona bloom gum in rice starch [n) of the power law at 12% gum concentration. The reduction in gelatinization enthalpies with higher levels of different hydrocolloids is well supported by the many other studies. The peak and onset temperatures of the gum blends were also significantly increased with the increase of gum Cordia percentage. The highest OT (71.34 ± 0.12 °C) and PT (77.66 ± 0.20 °C) were recorded in 12% blend while lowest OT (66.36 ± 0.15 °C) and PT (70.96 ± 0.52 °C) were noticed in plain corn starch (control). The presence of GC in the blends resulted in almost 7 °C increase in OT as compared to plain corn starch. The amount of energy required for reversible swelling o starch granules is called as onset temperature [Thermal properties of starch blends determined using DSC is presented in , et al.  where the starch ,27 has se starch . Anotherperature . The incperature ,29. Seveperature ,26. The perature .p ≤ 0.05) increased the peak (PV), final (FV), and setback (SB) viscosities while a slight decrease in peak time and peak temperature of blends was observed. The blend with 12% GC had the highest PV (3269 ± 33.23 cP), FV (3032 ± 15.56 cP), and SB (1695 ± 7.78 cP), while the lowest PV (2002 ± 24.04 cP), FV (1915 ± 39.60 cP), and SB (994 ± 2.83 cP) were recorded in control (plain starch). Peak viscosity is considered to be the point where maximum swelling of starch takes place. The increase in peak viscosity due to higher gum levels could be due to this reason as explained below. Primarily, it is considered that starch-gum-water system is a biphasic with the presence of gum in continuous phase (liquid). Soluble molecules are found in the liquid portion at a certain concentration before heating which increases with heating because of the reduction in liquids due to absorption by starch granules. It is considered that concentration of continuous phase shrunk during gelatinization due to amylose leaching from the starch granules and volume of accessible continuous phase for gum was reduced and lead to increase in the concentration of the water soluble molecules. Therefore, the viscosity increases due to the reduction of water molecules caused by starch granules swelling and the increase in the concentration of the water soluble molecules. In other words, we can say that interactions of gum, solubilized starch (leached amylose and shorn chain amylopectin’s) and swollen starch granules resulted in overall higher viscosity of the paste.Pasting properties of starch-gum blends are presented in Cordia, because the gum Cordia hydrocolloid is dominated by galactomannan fraction [The findings of our study are well supported by several previous studies that increase in overall viscosity of the starch hydrocolloid system occurs due to additive effect of the increased viscosity of the hydrocolloid that is more concentrated as the volume, and interaction between the hydrocolloid, solubilized amylose and short chain (low molecular weight) amylopectin’s ,32,33,34fraction . Short-tfraction ,38. The fraction . The higfraction ,41,42. Tfraction  and xantfraction . This defraction .Cordia can be used as a freeze- thaw stabilizing agent in different types of sauces and frozen products as an alternative to guar, xanthan, agar and locust bean gum with different starches [Frozen food products containing starch are prone to repeated freeze-thaw cycles during storage and transport. The thermal fluctuations during storage and transportation of such foods lead to melting and re-freezing of water that ultimately deteriorates their quality. Starch undergo retrogradation during cooling which can lead to water separation during thawing. Gels obtained from RVA experiment during the present study were subjected to two freeze-thaw cycles at 4 and 8 days after the initial freezing. The separation from gels (irrespective of gum concentration) was higher in 2nd cycle than 1st thaw cycle. It is evident from the data presented in starches ,49,50. Tstarches ,13 and Hstarches  where liGels obtained from RVA experiments were stored overnight at room temperature and TPA studies were conducted. The data pertaining to the TPA properties of gels are presented in 2 = 0.97–0.99) as shown in n) value of less than 1 which indicates the non-Newtonian (pseudoplastic or shear thinning) behavior. Shear thinning is a phenomenon when the viscosity of the gel is decreased with increasing shear rate. The deviation of value on n away from 1 describes that material is more pseudoplastic. The value of n was the lowest (0.17) for control starch and it increased to (0.36–0.56) at different levels of gums in starch. The data indicates that presence of gum had resulted in reduction in pseudoplasticity when compared to control. The lower degree of psuedoplasticity in the presence of GC could be attributed to the formation of intra-molecular hydrogen bonding in gum molecules, which resulted in the shortage of hydroxyl groups to form inter-molecular hydrogen bonding with amylose. Several researchers have reported the decrease in pseudoplastic behavior of different starches in the presence of locust bean gum and Tara gum [The gels obtained from plain corn starch or its blends with GC at various levels were evaluated at 25 °C using a variable shear rate between 0–350 (1/s) to determine the flow behavior. The shear rate (1/s) versus shear stress (σ) data of all samples fitted well to the simple power law model  is directly related with the viscosity of starch gels, which increased with the increase in concentration of GC. The value of K was higher in all blends (0.69–0.76 Pa sn) as compared to control (0.65 Pa sn) which represents synergism between gum and starch. The K value is directly related to thickness of the samples and the results of viscosity observed in RVA experiments , loss/viscous modulus (G″) and tan delta  as a function of angular frequency (rad/s) is presented in Cordia (GC) is a natural polysaccharide and can be easily extracted from the mature Cordia fruit. The gum was used to modify the corn starch properties so that it can be used as an alternative to the other commonly used hydrocolloids, e.g., xanthan, gum Arabic, guar gum, etc. Significant increases in the starch gelatinization temperatures, enthalpies, peak viscosities, final viscosities, and setback viscosities were observed in the presence of gum Cordia. The flow behavior index (n) value of all samples was less than one, indicating the non-Newtonian (pseudoplastic or shear thinning) behavior. The consistency index (K) of the starch-gum blends increased with higher levels of gum Cordia. The magnitudes of G′ and G″ were also dependent on gum concentration and increased as a function of gum concentration. The presence of gum m resulted in the reduction in syneresis that could be due to gum interaction with amylose. Hardness, cohesiveness, adhesiveness, and chewiness of gels were significantly affected in the presence of Cordia gum. These results can be used in formulation of corn starch-GC based products with improved textural, rheological and stability properties.Gum


The end of the decade marks the end of my tenure as Editor-in-Chief of Open Biology. How far have we come since the launch of the journal in September 2011? This has certainly been a difficult time to start a new journal in molecular and cell biology, where the competition is fierce. We have made impact, however, with our dreaded Impact Factor oscillating between 3.5 and 5.8 during this time. I anticipate the metrics will soon rise higher because, most importantly, we are now recognized within the community as a journal that truly represents the interests of scientists. There has been a lot of debate about scientific publishing in the past decade and we have seen many new models emerge. We have watched this happen and taken up many suggestions from our readers and editorial board. While considering many different options, however, we have continued to follow a fairly traditional pattern of peer review. I believe this works well for us exactly because the journal is run by scientists for scientists and we know of the problems facing scientific publishing, particularly in molecular and cell biology, and wish to avoid them. It is vital that the academic academies and societies provide their members with publishing opportunities and indeed, the Royal Society serves us all well in this respect. Whereas competition from the publishing houses keeps us on our toes, our motivation is simply one of scientific communication to aid scientific progress.In trying to broaden our ability to communicate, I have had a particular focus over the past 3 or 4 years. This is to promote the publication of more review articles in the journal. I see this as an important role for the journal and I am delighted that I will be maintaining my connection with the journal as Reviews Editor from 2020. I am very pleased to welcome Jon Pines as my successor as Editor-in-Chief. I am certain that Jon will bring new ideas for steering the journal to greater success.During my own tenure as Editor-in-Chief, I have had tremendous help and assistance from many of the staff in Royal Society publishing. Of these, I would like to single out Buchi Okereafor, in particular, for her unfailing help and cheerful optimism. I am also grateful for the help of my wonderfully organized secretary Kseniya Tyshkevych that has enabled us to write emails to literally thousands of scientists all over the world and so make direct contact with the community.A new decade brings new challenges and opportunities for all of us. I am now spending much more of my time in Pasadena than Cambridge and have a delightful new set of colleagues. The journal is in new hands and yet has the continued support of many of its original editorial team. I am therefore confident that it will continue to make new inroads representing the academic society that was first to establish a scientific journal over 350 years ago. We continue to build for the next 350 years and beyond.


The characteristics of the obtained materials (Fourier transform infrared (FTIR), differential scanning calorimetry (DSC), thermal analysis (TGA), X-Ray Diffraction (XRD) and laser scanning microscopy (LSM)) confirmed their diversity in terms of composition and structure. The effect of N,N’-Methylenebisacrylamide (MBA) and polyacrylamide (PAM) content in the starch graft copolymers, treatment time and concentration of metal ions on adsorption efficiency were investigated. The adsorption efficiency for StMBA was 14.0 mg Cu2+/g and 2.9 mg Fe3+/g, regardless of the initial concentration of ions, whereas for starch graft copolymer St60 it was 23.0 mg Cu2+/g and 21.2 mg Fe3+/g. Absorption of Fe(III) was persisted even after 2 days. Pseudo-second order model was used to investigate the adsorption mechanisms. It was found that in addition to the chemical adsorption of ions on the surface, there is sorption inside the polymer network and chelating mechanism may dominate. Satisfactory results were attributed to the adequate grafting of PAM onto starch, the ability to form complexes with metal cations and changes in material structure.Cross-linked potato starch (StMBA) and starch-g-polyacrylamide materials with a high content of natural polymer from 60 to 90 wt.% (St60–St90) were synthesized by double chemical-chemical modification (grafting and cross-linking). Eco-friendly starch absorbents were tested for removal of Cu It is known that naturally occurring starch is a renewable, cheap, biodegradable, and easily available polysaccharide obtained from plants ,2. NaturSuperabsorbent polymers (SAP), as three-dimensional crosslinked hydrophilic polymers are capable of absorbing and retaining significant amounts of water, dyes, or heavy metals from wastewater. These pollutants, apart from the color of the wastewater, cause many dangerous damages to organisms  . The SAPStarch can complex various metal particles ,18,19, bThe results of the absorption of heavy metals by modified starch sorbents were collected by M. Haroon et al. . HoweverIn this work, grafting and crosslinking modified potato starch and starch-g-polyacrylamide were synthesized. The starch SAPs were synthesized by free radical initiated polymerization with ammonium persulfate as initiator. Eco-friendly SAPs with high starch content ware characterized using Fourier transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), thermal analysis (TGA), X-Ray Diffraction (XRD) and laser scanning microscopy (LSM). Sorption studies of starch SAPs were carried out depending on treatment time, initial concentration of metal ions, content of cross-linker agent as well as content of polyacrylamide in the material. This manuscript partially fills “the research gap” concerning cation absorption in starch-g-polyacrylamide cross-linked materials. These results are of value for the development of “green SAP” for wide applications.7 g/mol, 29.7 wt.% amylose content was purchased from Potato Industrial Enterprise “Nowamyl” S.A., Nowogard, Poland. Acrylamide  and N,N’-Methylenebisacrylamide  from Merck, Germany, were used as monomer and crosslinker, respectively. Ammonium persulfate (ASP)—polymerization initiator (~99%) and acetone  were purchased from Chempur, Piekary Slaskie, Poland. Aqueous metal salt solution Fe(III) and Cu(II) were prepared from hydrated sulfates . All materials were used without further purification.Potato starch  with moisture content about 16.5 wt.%, average molecular weight 4.37 ∙ 103 of distilled water was always used in the synthesis. The detailed procedure of obtaining starch superabsorbents is presented in the form of a schematic diagram  with acrylamide (AM content from 10 to 40 wt.% on the starch weight). Polymerization initiator ASP was used in 1.0 wt. % on the weight of AM and MBA in 0.5 wt.% or 1.0 wt.% on the substrates weight. A total amount of 75 cm diagram . The sta−1 in the range of 500–4000 cm−1 for all the samples.The FTIR spectra of dried powdered samples of starch copolymers from 60 to 90 wt.% of natural polymer, potato starch and crosslinked potato starch were obtained using Nexus FTIR spectrometer  with Golden Gate (ATR) attachment and OMNIC computer program. The spectra were baseline corrected and were collected at a resolution of 0.5 cmQ100 DSC  was used for the starch-g-polyacrylamide absorbents and crosslinked starch characterization . Samples were weighed (~5 mg) on the aluminum pans and hermetically sealed before analyses.A TGA Q5000 TA Instruments thermal analyzer was used to determine the decomposition temperature and weight loss of starch-polyacrylamide SAPs. The absorbent samples were heated from 20 °C to 900 °C with the heating rate of 10 °C/min.The surface morphology of selected freeze-dried  St90, St60 and starch samples was observed by laser scanning microscopy (LSM), model VK 9700  equipped with a violet laser source (wavelength 408 nm) and a pin hole optical system. During LSM analysis the field of the microscope was scanned using a laser beam and an X–Y scan optical system. Application of the optical system assured high measurement accuracy. The area of the measured samples was scanned several times by moving the objective lens along the Z-axis, and the intensity of the reflective light was obtained on the basis of the Z position. The magnification of 3000 was used for the measurements. Surface images of the samples were prepared using the VK Analyzer software . The samples were freeze-dried to remove moisture and homogenize the material before microscope imaging.Potato starch and starch absorbents were characterized by the XRD method. X-ray powder diffraction (XRD) patterns of the samples were performed on Empyrean  X-ray diffractometer employing CuKα radiation (λ = 1.544 Å). The microstructures of SAPs were characterized with a generator voltage of 40 kV and a tube current of 7.5 mA. The scanning range of the diffraction angle 2θ were from 7° to 90° with a step of 0.02° and a step interval of 0.01°/s. Starch moisture was 16.5 wt.%.All sorption tests (adsorption of copper(II) and iron(III) cations from aqueous solutions together with swelling) were carried out on mechanically powdered materials separated by a set of vibrating sieves. The powder fraction with particle diameter of less than 0.3 mm was used in sorption studies.3 and 10, 30 and 50 mg of Fe(III) in 1000 cm3. Measurements of the changes in absorbance of colored solutions of Fe3+ and Cu2+ ions in time were determined spectrophotometrically  using wavelengths: 480 nm for Fe3+ solutions and 608 nm for Cu2+ ions. Cooper(II) and iron(III) cations were adsorbed from aqueous solutions with the initial concentrations of 50 and 100 mg of Cu(II) in 100 cm3 of the appropriate cation solution and the resulting dispersion was maintained at room temperature (25 °C ± 1 °C) for 2 days. At that time, samples were taken for analysis, initially every minute, then every 10 min, and finally the tests were carried out after 24 and 48 h.The ion adsorption was carried out by using 50 mg ± 2.0 mg of starch sorbents added to 50 cm0 is the initial ion concentration (mg/L), Ct is the ion concentration after time t (mg/L) calculated from calibration—The removal of cations from solution (R) was calculated from the following Equation (1):The adsorption efficiency—the amount of metal ion bond by starch absorbent (mg/g)—(AE) was calculated with Equation (2):t and AEt are the values of amount adsorbed per unit mass at equilibrium and at any time t and k is the second order rate coefficient. Separation of the variables followed by integration and application of the boundary conditions (AEt = 0 at t = 0 and AEt = AEt at t = t) yields a linear expression of the form—Equation (4):To investigate the adsorption mechanisms, pseudo-second order mathematical model was used . The int0 is the mass of dried absorbent.The swelling measurements were performed at room temperature for samples with different starting metal ion concentration in the solution after 48 h. After the allotted time, the excess of solution was removed from the swelling samples by filtration. The swelling properties of acrylamide starch copolymers were carried out on samples weighing 50.0 mg ± 2.0 mg. The mass swelling was determined using Equation (5):The swelling tests were carried out on three samples of the same material and the results are averaged.The double grafting and cross-linking starch modification was carried out by free radical initiated polymerization of potato starch (St) with AM . The diagram for the formation of the three-dimensional cross-linked starch-g-PAM network is shown in The cross-linked starch—SAP presented in −1 ascribes to the –OH groups stretching vibrations and at 2900 cm−1 to the C–H and symmetrical CH2 groups stretching vibrations. A typical for starch FTIR spectra, the absorption bands at 1160, 1080 and 1015 cm−1 are attributed to C–O–C stretching vibrations. Additionally, the absorption bands at 1460 and 1380 cm−1 belong to O–H in-plane bending vibrations. The peak at 1640 cm−1 can be ascribed to the water absorption on the starch amorphous region in the native starch [The confirmation of double chemical modification of starch was made by the infrared spectroscopy. e starch .−1 and 1610 cm−1 proved the cross-linking reaction between St and MBA [−1 and 1610 cm−1 corresponded to the stretching vibration of –C=O (amide I) and –N–H bending vibrations (amide II) [−1 became sharp thanks of the active groups and the elongation molecular chain with the cross-linking action [The new adsorption peaks of StMBA1 and StMBA1 at 1680 cm and MBA . The absmide II)  in crossg action —marked a−1 (stretching vibration of –OH groups and –N–H groups resulting from PAM) flatten with the shift to the lower wavenumber, which was ascribed to the cross-linking reaction of weakened hydrogen bonding interaction [2: –C=O at 1680 cm−1, and –N–H at 1610 cm−1 and –C–N at 1405 cm−1 [In eraction  and the 405 cm−1 . From thThe surface morphology of potato starch St and the starch SAP with marginal contents of St (St90 AND St60) is presented in p was 97.06 °C, which is a relatively high temperature compared to the study by Hu et al. [For St, the peak gelatinization temperature—Tu et al. , which mu et al. .m—was determined for starch SAPs with PAM [m for St90 was 116.45 °C, for St80 was 100.29 °C, for St70—94.15 °C and for St60 was 90.48 °C. In this case, the incorporation of the hydrophilic amide groups with PAM reduce the characteristic temperature of starch SAPs.On the other hand, the melting temperature—Twith PAM , as the The results of the thermogravimetric studies are shown in Potato starch showed significant and fastest weight loss at 301.18 °C . AccordiThe XRD patterns of native potato starch, StMBA1 and all starch-g-polyacrylamide SAPs were determined and shown in 3) was studied in the adsorption experiments. The effect of treatment time, initial metal ion concentration and composition of starch graft copolymers on the adsorption of Cu(II) were considered  mg/100 cmnsidered , Table 13, while for the concentration of 100 mg Cu(II) mg/100 cm3, even after 2 days the adsorption efficiency remained at the level of 7.1–7.2 mg Cu(II)/g (Cu(II)/g . PurificAdsorption efficiency of Cu(II) for starch SAPs after 1 and 2 days of treatment decreased slightly e.g., to 19.5 mg/g—St60 for the initial concentration of 50 mg Cu(II) after 24 h or to 20 mg/g—St60 for the initial concentration of 100 mg Cu(II) after 48 h . The eloThe adsorption of Fe(III) from the aqueous solutions /L) was also investigated. The results are included in The removal of Fe(III) ions from solutions b–d, both2) in polymer materials that attracted Fe(III) ions by complexing ability [The Fe(III) adsorption efficiency is strongly correlated with the composition of starch-g-polyacrylamide SAP. This phenomenon can be explained by the presence of amide groups  solutions and 12–14.6 times in Fe(III) solutions) compared to St. Changes in the initial concentration of the starting metal cation solutions had a smaller influence on the swelling properties of starch materials than the structure of copolymers. Even a small amount of grafted PAM in the material made visible increase in St90 swelling. These excellent swelling properties may be due to the hydrophilicity of polyacrylamide, adequate grafting of PAM onto starch, and a well-chosen amount of cross-linker. The change in the structure of the tested materials is also important for the swelling properties see .Cross-linked potato starches and starch grafted polyacrylamide copolymers were prepared by chemical crosslinking polymerization using MBA. The starch SAPs were synthesized by free radical initiated polymerization with ammonium persulfate as initiator in double chemical-chemical modification (grafting and cross-linking). The characteristics of the obtained materials confirmed their diversity in terms of composition and structure. Their adsorption behavior toward copper(II) and iron(III) ions from aqueous solutions was investigated under various conditions such as treatment time, relatively high concentration of metal ions, content of MBA on cross-linked starch as well as content of grafted PAM on starch chains. It was found that cross-linked starches can adsorb metal ions; however, increasing the amount of cross-linking agent does not improve sorption properties. The optimal dose of MBA turned out to be the concentration of 0.5 wt.%. It has been proved that starch-g-PAM SAPs have much better Cu(II) and Fe(III) adsorption properties than StMBAs and the ability of SAPs to adsorb metals increases with increasing grafting of polyacrylamide onto starch chains. The adsorption efficiency for SAPs is ordered: St90 < St80 < St70 < St60 and removal of cations depends on initial solution concentration. The best results of solutions purification from Cu(II) was 23 mg/g and from Fe(III)—21.2 mg/g for St60. However, the Cu(II) adsorption efficiency after 1 and 2 days of treatment slightly decreased. For all tested materials, absorbed amount of iron cations was persisted even after 48 h. The obtained results are mostly better than the results for similar materials presented so far in the literature. The adsorption properties of the tested materials are significantly correlated with the presented mathematical model and with the swelling capacity. Satisfactory adsorption properties ware explained by the proposed cations sorption mechanism, the ability to form complexes with metal cations, adequate grafting of PAM onto starch, a well-chosen amount of cross-linker as well as changes in the material structure.