Notes

Performance associated with multislice-CT employing multiplanar renovation in the preoperative evaluation with the ossicular skin lesions in the center ear conditions.
Under a certain ZPP concentration, the size and viscosity of emulsion increased with an increase in the oil volume fraction, indicating that the Pickering emulsions stabilized by ZPPs showed better stability against coalescence. Metabolism inhibitor Confocal laser scanning microscopy (CLSM) revealed that the ZPPs constructed a dense filling layer on the surface of oil droplets, thus further emphasizing that ZPPs can potentially be used in fabricating Pickering emulsion gels.

Zein/pullulan complex particles are an excellent Pickering emulsion gel stabilizer that can be used in the delivery system of bioactive substances in food formulations. © 2020 Society of Chemical Industry.
Zein/pullulan complex particles are an excellent Pickering emulsion gel stabilizer that can be used in the delivery system of bioactive substances in food formulations. © 2020 Society of Chemical Industry.
To evaluate the effect of structured training on the cardiotocograph (CTG) interpretation skills of healthcare workers (HCWs) involved in obstetric care in a recourse constrained setting.

In all, 218 HCWs completed pre- and post-intervention questionnaires. The intervention involved structured teaching on technical aspects of CTG monitoring, fetal physiology, and adaptation to stress, and a holistic approach to interpretation. Descriptive statistics were used to summarize demographic characteristics, frequencies, and percentages for categorical data.

Only 26.2% of participants felt that their pre-graduate training was adequate; this was reflected by the poor baseline knowledge in CTG interpretation (56% misinterpreted) and lack of knowledge regarding technical aspects of CTG monitoring in 48.8% of participants. The training session led to a 65% improvement in technical aspects and interpretation. Those HCWs not receiving continuous training showed a more significant improvement (P <0.001) and there was a 100% improvement in knowledge regarding the required documentation before commencing monitoring. Most (99.5%) HCWs acknowledged an improvement in knowledge, and 96.2% would participate in similar mandatory education sessions.

These findings highlight the fact that training in CTG monitoring is warranted and desired by HCWs. link2 It also supports the implementation of structured CTG education in resource-constrained settings.
These findings highlight the fact that training in CTG monitoring is warranted and desired by HCWs. It also supports the implementation of structured CTG education in resource-constrained settings.
To examine the effects of selenium supplementation on pregnancy outcomes and disease progression among HIV-infected pregnant women in Lagos.

A randomized, placebo-controlled trial conducted among HIV-positive pregnant women between September 2018 and August 2019. At enrollment, 90 women were randomly assigned into each treatment arm to receive either a daily tablet of 200μg elemental selenium or a placebo. Relevant participants' sociodemographic and clinical data were collected at enrollment and delivery.

Women in the selenium arm had a significantly lower risk of preterm delivery (relative risk [RR] 0.32, 95% confidence interval [CI] 0.11-0.96) and a non-significant reduction in the risk of delivering term neonates with a low delivery weight (RR 0.24, 95% CI 0.05-1.19). Supplemental selenium does not increase the risk of perinatal death and adverse drug events.

The study reported a beneficial effect of prenatal selenium supplements on the risk of preterm delivery with no further reduction in risk among HIV-infected women who used the supplements for more than 14weeks.

Pan African Clinical Trial Registry (PACTR201809756724274).
Pan African Clinical Trial Registry (PACTR201809756724274).ABCB1, also called MDR1 or P-glycoprotein, exports various hydrophobic compounds and plays an essential role as a protective physiological barrier in several organs, including the brain, testis, and placenta. However, little is known about the structural mechanisms that allow ABCB1 to recognize hydrophobic compounds of diverse structures or the coupling of ATP hydrolysis to uphill substrate export. High-resolution X-ray crystal structures of the pre- and post-transport states and FRET analyses in living cells have revealed that an aromatic hydrophobic network at the top of the inner cavity is key for the conformational change in ABCB1 that is triggered by a hydrophobic substrate. ATP binding, but not hydrolysis, induces a progressive network that results in a twisting motion of the whole protein, squeezing out the substrate directly to the extracellular space. This twist-and-squeeze mechanism by which ABCB1 exports hydrophobic substrates is distinct from those of other transporters.
To evaluate trappin-2 levels in cervicovaginal secretions for prediction of spontaneous preterm birth (sPTB) and compare it with transvaginal sonography (TVS) cervical length in asymptomatic women at risk of PTB.

Trappin-2 levels assessed in cervicovaginal secretions collected from 80 asymptomatic pregnant women at high risk for preterm delivery and cervical length measured by TVS, first at 14-20weeks of pregnancy and repeated 8weeks later. On the basis of delivery outcomes, participants were divided into cases (delivery <37weeks) and controls (delivery at 37-41weeks).

The mean value of cervicovaginal trappin-2 was significantly higher in women who delivered preterm (n=40), compared with the term group (n=40 P<0.001) both at 14-20weeks and at 22-28weeks. The critical cut-off value for cervicovaginal trappin-2 at 14-20weeks was 4620pg/mL, above which participants delivered prematurely with sensitivity, specificity, and positive and negative predictive values of 82.5%, 71.0%, 78.5%, and 81.5% respectively, whereas TVS cervical length in this window period was not significantly associated with preterm birth. At 22-28weeks a trappin-2 value of 6900pg/mL had similar predictive accuracy.

Raised cervicovaginal trappin-2 levels can be used as an early tool for prediction of PTB as early as 14-20weeks (earlier than TVS) in asymptomatic high-risk women.
Raised cervicovaginal trappin-2 levels can be used as an early tool for prediction of PTB as early as 14-20 weeks (earlier than TVS) in asymptomatic high-risk women.
To ascertain the threshold value for anti-Müllerian hormone (AMH) in the diagnosis of polycystic ovarian syndrome (PCOS) in an Indian population.

A retrospective observational study was carried out on infertile women at the Department of Reproductive Medicine and Surgery at a tertiary hospital from January 2017 to November 2019. Serum AMH was analyzed with Access AMH chemiluminescent immunoassay. Receiver operating characteristic curves were used to calculate the diagnostic threshold value of serum AMH in two age groups 20-29 and 30-39years.

Of 688 women, 200 (29.1%) were diagnosed with PCOS by the Rotterdam criteria 98/282 (34.8%) aged 20-29years and 102/406 (25.4%) aged 30-39years. Mean serum AMH was 5.07±3.97 and 4.330±7.15ng/ml in women aged 20-29 and 30-39years, respectively. A threshold value of serum AMH above 3.75ng/ml was predictive of PCOS by Youden's J statistics in the entire cohort, whereas it was 5.46 and 3.46ng/ml in women aged 20-29 and 30-39years, respectively.

Serum AMH of 5.46 and 3.46ng/ml in women aged 20-29 and 30-39years, respectively, can be used to diagnose PCOS when there is a diagnostic dilemma in the Rotterdam criteria.
Serum AMH of 5.46 and 3.46 ng/ml in women aged 20-29 and 30-39 years, respectively, can be used to diagnose PCOS when there is a diagnostic dilemma in the Rotterdam criteria.We read with great interest the study published by Luis calzadilla-bertot et al.1 The study has proposed the ABIDE score which aims to predict decompensation in a selected cohort of NAFLD patients with cirrhosis which is a simple bedside tool. However, there are issues which need further clarification.The Swiss Group for Clinical Cancer Research (SAKK) conducted the SAKK 35/03 randomized trial (NCT00227695) to investigate different rituximab monotherapy schedules in patients with follicular lymphoma (FL). Here, we report their long-term treatment outcome. Two-hundred and seventy FL patients were treated with 4 weekly doses of rituximab monotherapy (375 mg/m2); 165 of them, achieving at least a partial response, were randomly assigned to maintenance rituximab (375 mg/m2 every 2 months) on a short-term (4 administrations; n = 82) or a long-term (up to a maximum of 5 years; n = 83) schedule. The primary end point was event-free survival (EFS). At a median follow-up period of 10 years, median EFS was 3.4 years (95% confidence interval [CI], 2.1-5.5) in the short-term arm and 5.3 years (95% CI, 3.5-7.5) in the long-term arm. Using the prespecified log-rank test, this difference is not statistically significant (P = .39). link3 There also was not a statistically significant difference in progression-free survival or overall survival (OS). Median OS was 11.0 years (95% CI, 11.0-NA) in the short-term arm and was not reached in the long-term arm (P = .80). The incidence of second cancers was similar in the 2 arms (9 patients after short-term maintenance and 10 patients after long-term maintenance). No major late toxicities emerged. No significant benefit of prolonged maintenance became evident with longer follow-up. Notably, in symptomatic patients in need of immediate treatment, the 10-year OS rate was 83% (95% CI, 73-89%). These findings indicate that single-agent rituximab may be a valid first-line option for symptomatic patients with advanced FL.The prevalence and distribution of congenital thrombophilia is still unclear in patients with pulmonary embolism (PE). We aimed to determine the prevalence and clinical characteristics of congenital thrombophilia in PE patients and their subsequent outcomes. A prospective observational study was conducted from May 2013 to June 2018. A total of 436 consecutive patients with PE were enrolled. All patients were tested for protein C, protein S, antithrombin III (ATIII), factor V Leiden, and prothrombin G20210A mutations. The median follow-up duration was ∼800 days (range, 11-1872 days). Congenital thrombophilia was diagnosed in 31 of 436 (7.1%) patients; 12 patients had protein C deficiency (2.8%), 13 had protein S deficiency (3.0%), 5 had ATIII deficiency (1.1%), and 1 had (0.2%) factor V Leiden. Age ≤50 years at the first episode (odds ratio [OR], 5.43; 95% confidence interval [CI], 2.35-13.52; P less then .001) and male sex (OR, 2.67; 95% CI, 1.15-6.78; P = .03) were 2 independent predictors of congenital thrombophilia in PE patients. There was no statistically significant difference in the prevalence of congenital thrombophilia between PE patients with and without risk factors (P = .58). We also found no significant difference in the risk of having a composite outcome of death or recurrent venous thromboembolism between patients with and without congenital thrombophilia (hazard ratio, 0.18; 95% CI, 0.02-5.69; P = .08). These results suggest that age and male sex are independently associated with the occurrence of congenital thrombophilia in PE patients but that congenital thrombophilia is not associated with the risk of recurrence or death with anticoagulation therapy.
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