Esophageal squamous cell carcinoma (ESCC) is one of the most common lethal cancers in the world. Dysregulation of purine-rich element binding protein alpha (PURα), which contributes to the initiation of PURΑ syndrome, is reportedly involved in the progression of multiple cancers, but its function and underlying mechanisms in ESCC progression remain unclear. Here, we first demonstrated that PURα promoted cell growth, migration and invasion in ESCC both in vitro and in vivo. An immunohistochemistry assay was then performed on 225 ESCC tissues, showing that high PURα expression was positively associated with lymph node metastasis and the AJCC stage, and the ESCC patients with positive PURα expression had worse survival. In addition, RNA sequencing implied that PURα induced epithelial-mesenchymal transition (EMT) in ESCC, which was further confirmed by qPCR, Western blotting and immunofluorescence analyses. Mechanistically, PURα enhanced the transcription of Snail2 by binding to its promoter region. Knockdown of Snail2 reversed PURα-induced EMT and inhibited the migration and invasion of ESCC cells. In conclusion, this study indicated that PURα promotes Snail2 transcriptional activity to induce EMT during ESCC progression.Due to their wide use, pharmaceuticals can be discarded, metabolized and excreted into the environment, potentially affecting aquatic organisms. Lipid-regulating drugs are among the most prescribed medications around the world, to control human cholesterol levels, in more than 20 million patients. Despite this massive use of lipid-regulating drugs, particularly simvastatin, the role of these drugs is not fully characterized and understood in terms of its potential toxicological effects at the environmental level. This work intended to characterize the toxicity of an acute (120 h post-fertilization) and chronic (60 days) exposure to the antihyperlipidemic drug simvastatin (in concentrations of 92.45, 184.9, 369.8, 739.6 and 1479.2 ng L-1), in the freshwater species zebrafish (Danio rerio). The concentrations hereby mentioned were implemented in both exposures, and were based on levels found in wastewater treatment plant influents (11.7 ± 3.2 μg L-1), effluents (2.65 ± 0.8 μg L-1) and Apies River (1.585 ± 0.3 μ exposed fish evidenced no alterations in terms of sexual characteristics, suggesting that the chronic exposure of Danio rerio to simvastatin does not alter the sex ratio and maturation stages of individuals. This assumption suggests that simvastatin did not act as an endocrine disruptor. Moreover, the metabolism, neuronal interactions and the antioxidant properties of SIM seem to have modulated the hereby-mentioned results of toxicity. Results from this assay allow inferring that simvastatin can have an ecologically relevant impact in living organisms.
  The Resource-based Relative Value Scale (RBRVS) designates quantitative values to clinical health care services to identify the relative work and cost of these services. Each clinical service translates to relative value units (RVUs). Clinical RVUs describe clinician work effort to guide employed clinician salaries in academic medical centers. The development of an academic RVU (aRVU) system also seems reasonable to establish and assess the quantity and quality of academic effort of members of our specialty that supports resident and student achievement.
 
  The 1998 Association of American Medical Colleges (AAMC) Mission-based Management (MBM) Program was assessed and adapted in creating an aRVU system. This aRVU system is hypothesized to guide oral and maxillofacial surgery faculty in advancing their missions of didactic and interactive teaching, production and dissemination of scholarly activity, performance of basic science and translational research, and participation in administrative service to academigoals.  https://www.selleckchem.com/products/sp2509.html  Annual performance evaluations of oral and maxillofacial surgery faculty can be based on aRVU accumulation.
  To characterize the impact of language discordant patient encounters on resident workflow during morning rounds.
 
  The time required for a patient encounter was measured in a cohort of patients on an acute care and trauma service. Language concordance was recorded, and for language discordant encounters, a subset utilized a call-ahead strategy in order to facilitate obtaining a phone-based or video-based interpreter.
 
  Acute care and trauma service in a Level 1 trauma center located in New York City.
 
  About 833 patient encounters were observed, with no patient identifiers recorded other than the data as noted above.
 
  Durations of English-speaking and language concordant encounters were 123.6 ± 89.6 seconds and 129.4 ± 95.8 seconds, respectively, which were not statistically different (p = 0.95). In comparison to the English-speaking group, both the unfacilitated language discordant patients (258.3 ± 189.7 seconds) and the facilitated language discordant patients (193.0 ± 91.1 seconds) were statistically different (p < 0.001). There was a statistical difference between these 2 groups of language discordant patients (p = 0.023).
 
  Language discordant encounters take twice as long as a language concordant encounter. A call-ahead strategy was able to reduce the time required for language discordant encounters. Further strategies to reduce time of encounter would benefit surgical workflow during morning rounds.
 Language discordant encounters take twice as long as a language concordant encounter. A call-ahead strategy was able to reduce the time required for language discordant encounters. Further strategies to reduce time of encounter would benefit surgical workflow during morning rounds.
  Outcomes of redo aortic valve intervention (AVI) following transcatheter aortic valve replacement (TAVR) have not been well described. We thought to investigate the incidence, predictors, and outcomes of redo AVI after TAVR.
 
  The Nationwide Readmission Database (from 2012 to 2017) was queried to identify admissions for TAVR. Redo AVI was defined as readmissions that required either TAVR or balloon aortic valvuloplasty (BAV) or surgical aortic valve replacement (SAVR). A multivariable regression model was used to identify independent predictors of redo AVI. In-hospital outcomes of redo TAVR or BAV and redo SAVR were compared in the unadjusted model.
 
  A total of weighted 148,200 (unweighted redo AVI 297, no redo AVI 73,804) index TAVRs were identified. A weighted 593 (435 TAVR or BAV and 158 SAVR) redo AVI was included with an incidence of 1.0 per 100 person-year during a median of 105 (interquartile range 41-195) days follow-up. Predictors of redo AVI were female, heart failure, obesity, atrial fibrillation, transapical approach, oral anticoagulant use, and acute kidney injury.