To determine whether skip metastases (SM) in high-grade appendicular osteosarcoma (HG-OS) are an indicator of more aggressive disease.
 
  Retrospective review of patients with histologically confirmed diagnosis HG-OS of the long bones from 2007 to 2020, who had whole-bone MRI to identify SM. Data collected included patient age/gender, bone involved, the presence of SM, the presence of lung metastases from chest CT, the presence of distant bone metastases from whole-body bone scintigraphy or whole-body MRI, and chemotherapy response from resection specimen histology. The presence of lung or bone metastases and chemotherapy response were compared between patients without and with SM.
 
  The study included 241 patients (146 males; 95 females mean age 18.2years; range 4-73years). Based on whole-bone MRI, 202 (83.8%) patients had no SM and 39 (16.2%) patients had a SM. Of patients without a SM, lung metastases were identified in 44 (22%) and distant bone metastases in 6 (3%) cases, while 80 (43%) had a good chemotherapy response and 105 (57%) had a poor chemotherapy response. Of patients with a SM, lung metastases were identified in 22 (58%) and distant bone metastases in 8 (21%) cases, while 11 (32%) had a good chemotherapy response and 23 (68%) had a poor chemotherapy response. The presence of SM was significantly associated with both lung metastases (p < 0.001) and skeletal metastases (p < 0.001), but not with chemotherapy response (p = 0.24). Patients with SM also had poorer survival (p < 0.001).
 
  The presence of SM in appendicular HG-OS suggests more aggressive disease.
 The presence of SM in appendicular HG-OS suggests more aggressive disease.Although lithium-ion batteries are broadly applied for various purposes, they suffer from safety problems, high cost, and short life.  https://www.selleckchem.com/products/baf312-siponimod.html  Due to widespread availability, low cost, and nontoxicity of potassium, potassium ion batteries (PIBs) can be applied instead of lithium-ion batteries. Here, dispersion-corrected B3LYP calculations were used to explore potential application of pristine carbon nanocone (CNC) as well as its B- and N-doped models in PIBs. The K cation and K atom were adsorbed onto the center of the apex ring of CNC, and the energies of adsorption were - 19.3 and - 9.0 kcal/mol. The CNC creates a cell voltage of 0.44 V as an anode material which is very small. We showed that substituting some C atoms of CNC by the electron-rich N atoms makes the nanocone more appropriate for application in the PIBs, while B-doping meaningfully decreases the cell voltage. The cell voltage created by the considered nanocones in the PIBs has the following order N-CNC (~ 1.24 V) > CNC (~ 0.45 V) > > B-CNC (~ 0.24 V). This work illustrated that the N-CNC may be a promising electrode material for PIBs.
  Recent work suggests patients with moderately depressed Glasgow Coma Scale (GCS) score in the Emergency Department (ED) who do not undergo immediate head CT (CTH) have delayed neurosurgical intervention and longer ED stay. The present study objective was to determine the impact of time to first CTH on functional neurologic outcomes in this patient population.
 
  Blunt trauma patients presenting to our Level I trauma center (11/2015-10/2019) with first ED GCS 9-12 were retrospectively identified and included. Transfers and those with extracranial AIS ≥ 3 were excluded. The study population was stratified into Immediate (≤ 1 h) and Delayed (1-6 h) CTH groups based on time from ED arrival to first CTH. Outcomes included functional outcomes at hospital discharge based on the Modified Rankin Scale (mRS).
 
  After exclusions, 564 patients were included 414 (73%) with Immediate CTH and 150 (27%) Delayed CTH. Both groups arrived with median GCS 11 and alcohol/drug intoxication did not differ (p > 0.05). AIS Head/Notential functional outcomes benefit of Immediate CTH after blunt head trauma.
 Immediate CTH shortened time to disposition decision out of the ED and ED exit. Patients requiring neurosurgical intervention after Immediate CTH had improved functional outcomes when compared to those undergoing Delayed CTH. These differences did not reach statistical significance in this single-center study and, therefore, a large, multicenter study is the next step in demonstrating the potential functional outcomes benefit of Immediate CTH after blunt head trauma.The pseudometallophyte Rumex acetosella L. occupies habitats with normal and high soil concentrations of zinc (Zn), lead (Pb), and copper (Cu). It remains unclear if the plants respond to the toxic metals by altering their morphology and increasing the resilience of their cells. We compared plants growing on soils contaminated with Zn/Pb (populations Terézia, Lintich), or Cu (populations Špania Dolina, Staré Hory), with those from non-contaminated soil (Dúbravka) in Slovakia, and analysed leaf structure, physiology, and metal contents by light and electron microscopy, element localization by energy-dispersive X-ray analysis (EDX) in scanning electron microscope, and by specific fluorescence dyes. In control population, the epidermis of the amphistomatic leaves of R. acetosella contained capitate glandular trichomes, consisting of four head (secretory), two stalk, and two basal cells. The ultrastructure of secretory cells revealed fine wall ingrowths bordered by plasma membrane protruding into the cytoplasm. The metallicolous populations had higher contents of Zn and Cu in the epidermal and glandular cells, and a higher density of both stomata and trichomes. Extensive cell wall labyrinth was present in the trichome secretory cells. Their abnormal number and elevated metal contents might indicate effects of heavy metals, especially of Cu, on mitosis and cell plate formation. Differences in leaf physiology were indicated by significantly higher cytoplasmic tolerance to Zn and Cu in metallicolous populations and by structural properties of glandular heads suggesting secretion of toxic metals. Our findings are suggestive of plant reactions to metal stress, which facilitate the populations to occupy the metal-contaminated sites.