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To assess the efficacy and safety of abdominal aortic (AA) balloon occlusion versus internal iliac arteries (IIA) balloon occlusion in patients with placenta accreta spectrum (PAS) disorders.

Databases of Embase, PubMed, Web of Science and Cochrane Library were systematically searched from inception to May 2020. The relevant literature was screened and the quality was assessed. RevMan software 5.3 was used to analyze the data.

Six studies involving 239 patients in AA occlusion and 281 patients in IIA occlusion were included. The results demonstrated that the intraoperative hemorrhage volume (MD-410.61ml, 95% CI -779.74 to -41.47ml, p<0.001), balloon dilatation duration (MD -5.34min, 95% CI -9.91 to -0.77min, p=0.02) and fetus radiation dose (MD-20.81mGy, 95% CI -31.84 to -9.78mGy, p<0.001) were significantly less in AA occlusion compared to IIA occlusion. There was no significant difference in the rate of lower extremity thrombosis between AA occlusion and IIA occlusion (OR 0.21, 95% CI 0.02 to 2.21, p=0.19); similarly, no significant differences were found in blood transfusion volume (MD -344.50ml, 95% CI -735.74 to 46.74ml, p=0.08), the rate of hysterectomy (OR 0.99, 95% CI 0.22 to 4.44, p=0.99) and other outcome variables.

The available data demonstrated AA occlusion was more effective in reducing intraoperative hemorrhage volume and fetus radiation dose compared with IIA occlusion in patients with PAS disorders. Larger studies or randomized controlled trials are needed to further assert this evidence.
The available data demonstrated AA occlusion was more effective in reducing intraoperative hemorrhage volume and fetus radiation dose compared with IIA occlusion in patients with PAS disorders. Larger studies or randomized controlled trials are needed to further assert this evidence.Bilingualism is a natural laboratory for studying whether the brain's structural connectome is influenced by different aspects of language experience. However, evidence on how distinct components of bilingual experience may contribute to structural brain adaptations is mixed. The lack of consistency, however, may depend, at least in part, on methodological choices in data acquisition and processing. Herein, we adopted the Network Neuroscience framework to investigate how individual differences in second language (L2) exposure, proficiency, and age of acquisition (AoA) - measured as continuous between-subject variables - relate to whole-brain structural organization. We observed that L2 exposure modulated the connectivity of two networks of regions subserving language comprehension and production. L2 proficiency was associated with enhanced connectivity within a rostro-caudal network, which supports language selection and word learning. Moreover, L2 AoA and exposure affected inter-hemispheric communication between control-related regions. These findings expand mechanistic knowledge about particular environmental factors associated with specific variation in brain structure.
Emergency laparotomy has a high reported thirty-day mortality, ranging from 11 to 15%. Current peri-operative risk assessment tools may poorly estimate the risk of perioperative mortality. We sought to determine if CT-determined sarcopenia may be a useful predictor of post-operative outcomes in patients undergoing an emergency laparotomy.

A retrospective review of a prospectively maintained database of consecutive adult patients who underwent an emergency laparotomy at our institution was performed. Post-operative mortality (90-day mortality), admission to HDU or ICU and APACHE-II scores were recorded for these patients. Sarcopenia was calculated by determining psoas area and density at the level of the third lumbar vertebra. The lowest quartile was determined to be sarcopenic. Univariate statistical analysis investigated associations between sarcopenia and these outcome measures.

Eighty patients were included in the study following application of exclusion criteria. Thirty-eight were male. The 90-day mll require higher levels of post-operative care as well as identifying those for whom surgery may not confer a survival benefit and be deemed futile.Novel mansonone F derivative MSN54 (9-bromo-2,3-diethylbenzo[de]chromene-7,8-dione) exhibited significant cytotoxicity against twelve human tumor cell lines in vitro, with particularly strong potency against HL-60/MX2 cell line resistant to Topo II poisons. MSN54 was found to have IC50 of 0.69 and 1.43 µM against HL-60 and HL-60/MX2 cells, respectively. The resistance index is 10 times lower than that of the positive control VP-16 (etoposide). find more Various biological assays confirmed that MSN54 acted as a Topo IIα specific non-intercalative catalytic inhibitor. Furthermore, MSN54 exhibited good antitumor efficacy and low toxicity at a dose of 5 mg/kg in A549 tumor xenograft models. Thus, compound MSN54 is a promising candidate for the development of novel antitumor agents.The combined effects of polycyclic aromatic hydrocarbons and seawater acidification are poorly understood. Hence, we exposed the bloom-forming diatom Skeletonema costatum to four concentrations (0, 0.1, 1 and 10 μg L-1) of benzo(a)pyrene and two pCO2 levels (400 and 1000 μatm) to investigate its physiological performance. The growth and photosynthesis of S. costatum were tolerant to low and moderate benzo(a)pyrene concentrations regardless of the pCO2 level. However, the highest benzo(a)pyrene concentration had remarkably adverse effects on most parameters, decreasing the growth rate by 69%. Seawater acidification increased the sensitivity to high light stress, as shown by the lower maximum relative electron transport rate and light saturation point at the highest benzo(a)pyrene concentration. Our results suggested that benzo(a)pyrene could be detrimental to diatoms at a habitat-relevant level, and seawater acidification might further decrease its light tolerance, which would have important ramifications for the community structure and primary production in coastal waters.Coastal eutrophication is one of the pivotal factors driving occurrence of harmful algal blooms (HABs), whose underlying mechanism remained unclear. To better understand the nutrient regime triggering HABs and their formation process, the phytoplankton composition and its response to varying nitrogen (N) and phosphorus (P), physio-chemical parameters in water and sediment in Johor Strait in March 2019 were analyzed. Surface and sub-surface HABs were observed with the main causative species of Skeletonema, Chaetoceros and Karlodinium. The ecophysiological responses of Skeletonema to the low ambient N/P ratio such as secreting alkaline phosphatase, regulating cell morphology (volume; surface area/volume ratio) might play an important role in dominating the community. Anaerobic sediment iron-bound P release and simultaneous N removal by denitrification and anammox, shaped the stoichiometry of N and P in water column. The decrease of N/P ratio might shift the phytoplankton community into the dominance of HABs causative diatoms and dinoflagellates.
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