Notes

Look at Preclinical Task associated with Isatuximab within Sufferers together with Intense Lymphoblastic Leukemia.
4, p = 0.01).

LR-3 and LR-4 lesions are more likely to be HCC in patients with LR-5 or LR-TR lesions. The presence of coexisting definite HCC may be a useful diagnostic feature to improve risk stratification of lesions without typical imaging features of HCC. This may also affect decision-making prior to liver transplant when HCC burden must be accurately determined.
LR-3 and LR-4 lesions are more likely to be HCC in patients with LR-5 or LR-TR lesions. The presence of coexisting definite HCC may be a useful diagnostic feature to improve risk stratification of lesions without typical imaging features of HCC. This may also affect decision-making prior to liver transplant when HCC burden must be accurately determined.Macroinvertebrate community assemblages were examined in three areas of the littoral zone of an impacted, drowned river mouth lake in west Michigan, USA. Muskegon Lake has an extensive history of environmental abuse, resulting in its listing as a Great Lakes Area of Concern. A multi-organizational, shoreline restoration initiative was started in 2009 and completed in 2012. Despite pre- and post-restoration monitoring of water quality, fish assemblages, and macrophytes, no studies had examined the shifts in the littoral zone macroinvertebrate community. Using Hester-Dendy samplers, we collected macroinvertebrates monthly in submergent, emergent, and open macrophyte zones, at two restored sites and one reference site from August 2018 to October 2019. No pre-restoration samples were collected at these sites but we could examine the changes in restored vs. reference sites. In total, 22,931 individuals were observed, with Gammarus spp., Echinogammarus spp., Chironominae, and Dreissena polymorpha being among the most abundant taxa. NMDS results revealed overlap among macroinvertebrate communities between the two restored sites and separation from the reference site, with some overlapping seasonal differences and communities influenced by macrophyte habitat type. Principal components analysis revealed that the environmental factors were strongly influenced by seasonal changes and drove habitat-level differences, rather than spatial variations among sites. Our results indicate that although the macroinvertebrate community composition at the restored sites differed from that at the reference site, the macroinvertebrate assemblage at each site was dominated by tolerant generalist species. Pollution-sensitive macroinvertebrate taxa may have been reduced or eliminated in the lake due to decades of environmental abuse. Periodic monitoring is recommended to determine if these sensitive taxa return, as Muskegon Lake conditions continue to improve.To investigate whether low-level laser therapy (LLLT), at different times of application (immediate and late) in the region of the parotid glands, has a distance effect on the microarchitecture of the trabecular bone in mandible of rats irradiated by volumetric modular arc therapy (VMAT). Thirty adult Wistar rats were randomly divided into placebo control groups (CG, n = 2), only radiotherapy (RG, n = 2), only LPLT (LG, n = 2), and two other groups using LLLT in the immediate time (24 h) (ILG, n = 12) and late (120 h) (LLG, n = 12) to radiotherapy by VMAT in a single dose of 12 Gy. LLLT with AsGaAl laser (660 nm, 100 mW), a spot size of 0.0028 cm2, was applied in three points in the region of the right parotid gland, with energy of 2 J/cm2, 20 s per point, for 10 consecutive days. After euthanasia, the right hemimandibles of each animal were dissected, prepared, and analyzed by computerized microtomography (micro-CT) and histomorphometry. The different groups were analyzed by the Tukey and Bonferroni multiple comparison tests. The micro-CT analysis found statistically significant differences between the groups, especially in the LLG, which had the highest average bone volume compared to the CG (p = 0.001) and ILG (p = 0.002) and a greater number of trabeculae than the CG (p = 0.000) and ILG (p = 0.031). The ILG also had a higher number of trabeculae than the CG (p = 0.005). Trabecula separation (Tb.Sp) was lower in the LLG (p = 0.000) and ILG (p = 0.002) when compared to the CG. In the histomorphometry, there was no statistical difference between the groups in relation to all the analyzed variables. Micro-CT analysis showed that the LLLT, even applied at a distance, both in the immediate and late VMAT times, has an effect on the mandibular bone microarchitecture by increasing the volume and number of trabeculae and decreasing the spaces between them.The bone health status of a Mexican female population, including a cohort of 455 women aged over 40 years, was assessed by Radiofrequency Echographic Multi Spectrometry (REMS).
Assessment of the bone health status in an average female Mexican population with REMS. The secondary objective investigated age- and body mass index (BMI)-related effects on the diagnostic classification and the influence of risk factors for osteoporosis.

Women aged over 40years underwent a REMS scan at the lumbar spine and both femoral necks. The degree of correlation of the bone mineral density (BMD) across axial sites was assessed by the Pearson correlation coefficient (r), along with the diagnostic discordance. The association between risk factors, age, and BMI and diagnostic classification was determined by the chi-squared test.

Four hundred seventy-one women were enrolled. Osteoporosis was diagnosed in 11.0%, 8.1%, and 8.3% of cases at the lumbar spine and right and left femoral neck, respectively. The diagnostic agreement entific literature.
Acute kidney injury (AKI) appears to be particularly common in children with acute myeloid leukemia (AML), although the epidemiology data on this patient population is sparse. The objective of this study was to assess the prevalence and factors associated with AKI in childhood AML during chemotherapy treatment.

The medical records of 112 children aged under 15years diagnosed with AML who received chemotherapy in a major tertiary-care referral center in southern Thailand were reviewed. Logistic regression was used to identify factors associated with AKI.

Fifty-six (50%) children had AKI events. The median time from AML diagnosis to the first AKI was 29.5days (interquartile range 11.0-92.8) and the median follow-up time was 10.9months (interquartile range 3.6-31.1). Age at diagnosis ≥ 10years (OR 2.75, 95% CI 1.09-6.93), glomerular filtration rate < 90mL/min/1.73 m
at AML diagnosis (OR 7.58, 95% CI 1.89-30.5), and septic shock (OR 22.0, 95% CI 4.63-104.3) were independently associated with AKI.

Childhood AML has a high rate of kidney injury with 50% having AKI. Age ≥ 10years at diagnosis, impaired kidney function before treatment, and septic shock were strongly associated with AKI. A higher resolution version of the Graphical abstract is available as Supplementary information.
Childhood AML has a high rate of kidney injury with 50% having AKI. Age ≥ 10 years at diagnosis, impaired kidney function before treatment, and septic shock were strongly associated with AKI. A higher resolution version of the Graphical abstract is available as Supplementary information.Sugarcane is an economically important commercial crop which provides raw material for the production of sugar, jaggery, bioethanol, biomass and other by-products. Sugarcane breeding till today heavily relies on conventional breeding approaches which is time consuming, laborious and costly. Integration of marker-assisted selection (MAS) in sugarcane genetic improvement programs for difficult to select traits like sucrose content, resistance to pests and diseases and tolerance to abiotic stresses will accelerate varietal development. In the present study, association mapping approach was used to identify QTLs and genes associated with sucrose and other important yield-contributing traits. A mapping panel of 110 diverse sugarcane genotypes and 148 microsatellite primers were used for structured association mapping study. An optimal subpopulation number (ΔK) of 5 was identified by structure analysis. GWAS analysis using TASSEL identified a total of 110 MTAs which were localized into 27 QTLs by GLM and MLM (Q + K, PC + K) approaches. Among the 24 QTLs sequenced, 12 were able to identify potential candidate genes, viz., starch branching enzyme, starch synthase 4, sugar transporters and G3P-DH related to carbohydrate metabolism and hormone pathway-related genes ethylene insensitive 3-like 1, reversion to ethylene sensitive1-like, and auxin response factor associated to juice quality- and yield-related traits. Six markers, NKS 5_185, SCB 270_144, SCB 370_256, NKS 46_176 and UGSM 648_245, associated with juice quality traits and marker SMC31CUQ_304 associated with NMC were validated and identified as significantly associated to the traits by one-way ANOVA analysis. In conclusion, 24 potential QTLs identified in the present study could be used in sugarcane breeding programs after further validation in larger population. The candidate genes from carbohydrate and hormone response pathway presented in this study could be manipulated with genome editing approaches to further improve sugarcane crop.Gradually, the previously proposed water resource management schemes and reservoir operating policies adjusted to the historically experienced climatic conditions are losing their validity and efficacy, urging building up the models compatible with the likely climatic change conditions at the future. This paper aims at optimizing the reservoir operation under climate change conditions targeting the objectives including (1) minimizing the shortages in meeting the reservoir downstream water demands and (2) maximizing the sustainability of the reservoir storage. For evaluating the effects of the climate change, six general circulation models (GCMs) built up under the representative concentration pathway (RCP4.5) emission scenario are adopted and utilized to predict the climate variables over a 30-year planning period. To solve this problem, an improved version of our recently proposed fuzzy multi-objective particle swarm optimization (f-MOPSO) algorithm, named f-MOPSO-II, is proposed. The f-MOPSO takes a novel approach to handle multi-objective nature of the optimization problems. In this approach, the common concept of "diversity" is replaced with "extremity," to choose the better guides of the search agents in the algorithm. The f-MOPSO-II is based on the f-MOPSO. However, it is aimed at simultaneously mitigating the f-MOPSO computational complexity and enhancing the quality of the final results presented by this algorithm. The results obtained by the f-MOPSO-II were then compared with those yielded by the popular non-dominated sorting genetic algorithm-II (NSGA-II). As the results suggest, the f-MOPSO-II is capable of simultaneously meeting the water demands and holding the reservoir storage sustainable, much better than the NSGA-II.The outbreak of the novel coronavirus SARS-CoV-2 (hereafter COVID-19) has changed the daily routines of people around the world. When the first case was confirmed on 11 March 2020 in Turkey, the number of cases reached 4500 per day by 10 April in Turkey. Afterwards, the government declared more restrictive lockdown measures for 31 metropolitan cities starting 10 April, and it was implemented for the following weekends, national, and religious holidays. The change in concentrations of PM10, PM2.5, and NO2 during these measures with respect to the pre-lockdown period, the same period in the previous years and for different levels of measures for the cities in the Marmara Region of Turkey was investigated in this study. The daily mean concentrations of PM10, PM2.5, and NO2 obtained from 11 stations operated by the Ministry of Environment and Urbanization and Google mobility data are used in this study. Average PM2.5 and NO2 concentrations during the lockdown period declined with respect to the pre-lockdown period and the previous year for all stations. Average PM10 concentrations during the lockdown of 8 of 11 stations declined, while the rest of the stations increased with respect to the pre-lockdown period. In 9 of the 11 stations, the average concentration of PM10 decreased compared to the previous four years. In 7 of the 11 stations, the number of days exceeding WHO limit for PM10 was decreased during the lockdown period with respect to the pre-lockdown period. For PM2.5, the number of days exceeding WHO limit was decreased during the lockdown period compared to the pre-lockdown period for all the stations. For NO2, the number of days exceeding WHO limit was decreased during the lockdown period compared to the pre-lockdown period for 7 of the 8 stations. There is a significant relationship between mobility decrease and NO2 concentrations in large cities. The correlation coefficients are generally lower in small cities in the study region.
Even though spinal infections are associated with high mortality and morbidity, their therapy remains challenging due to a lack of established classification systems and widely accepted guidelines for surgical treatment. This study's aim therefore was to propose a comprehensive classification system for spinal instability based on the Spinal Instability Neoplastic Score (SINS) aiding spine surgeons in choosing optimal treatment for spontaneous spondylodiscitis.

Patients who were treated for spontaneous spondylodiscitis and received computed tomography (CT) imaging were included retrospectively. The Spinal Instability Spondylodiscitis Score (SISS) was developed by expert consensus. SINS and SISS were scored in CT-images by four readers. Intraclass correlation coefficients (ICCs) and Fleiss' Kappa were calculated to determine interrater reliabilities. Predictive validity was analyzed by cross-tabulation analysis.

A total of 127 patients were included, 94 (74.0%) of which were treated surgically. Mean SINS was 8.3 ± 3.2, mean SISS 8.1 ± 2.4. ICCs were 0.961 (95%-CI 0.949-0.971) for total SINS and 0.960 (95%-CI 0.946-0.970) for total SISS. SINS yielded false positive and negative rates of 12.5% and 67.6%, SISS of 15.2% and 40.0%, respectively.

We show high reliability and validity of the newly developed SISS in detecting unstable spinal lesions in spontaneous spondylodiscitis. Therefore, we recommend its use in evaluating treatment choices based on spinal biomechanics. It is, however, important to note that stability is merely one of multiple components in making surgical treatment decisions.
We show high reliability and validity of the newly developed SISS in detecting unstable spinal lesions in spontaneous spondylodiscitis. Therefore, we recommend its use in evaluating treatment choices based on spinal biomechanics. It is, however, important to note that stability is merely one of multiple components in making surgical treatment decisions.Human gut-originated lactic acid bacteria were cultivated, and high γ-aminobutyric acid (GABA)-producing Lactococcus garvieae MJF010 was identified. To date, despite the importance of GABA, no studies have investigated GABA-producing Lactococcus species, except for Lc. lactis. A recombinant glutamate decarboxylase of the strain MJF010 (rLgGad) was successfully expressed in Escherichia coli BL21(DE3) with a size of 53.9 kDa. rLgGad could produce GABA, which was verified using the silylation-derivative fragment ions of GABA. The purified rLgGad showed the highest GABA-producing activity at 35 °C and pH 5. rLgGad showed a melting temperature of 43.84 °C. At 30 °C, more than 80% of the activity was maintained even after 7 h; however, it rapidly decreased at 50 °C. The kinetic parameters, Km, Vmax, and kcat, of rLgGad were 2.94 mM, 0.023 mM/min, and 12.3 min- 1, respectively. The metal reagents of CaCl2, MgCl2, and ZnCl2 significantly had positive effects on rLgGad activity. However, most coenzymes including pyridoxal 5'-phosphate showed no significant effects on enzyme activity. In conclusion, this is the first report of Gad from Lc. garvieae species and provides important enzymatic information related to GABA biosynthesis in the Lactococcus genus.The upper Kodaganar basin, located in Dindigul district of Tamil Nadu, India, is composed of hard rock terrain. Groundwater is the major source of domestic and irrigation needs and it is being contaminated by tannery wastewater that is discharged into the nearby Sengulam Lake. The main aim of this work was to develop a contaminant transport model using the total dissolved solids (TDS) concentration of groundwater measured in the basin. The model was developed to predict the fate of contaminant in the aquifer. The TDS concentrations in the wells ranged from 249 to 20,120 mg/L, wherein extremely high values were observed in some of the severely contaminated wells. Three scenarios were proposed to predict the fate of the contaminant and to mitigate the effect of contaminant on groundwater receptors for the year 2020 scenario I developed with the existing discharge conditions; scenario II developed with discharge as per the standards; scenario III developed with zero discharge. The results of this study showed that scenario III reduced the contaminated area from 12 km2 to 6 km2. The reduction in area for different concentration contours, namely 2000 mg/L, 5000 mg/L, 10,000 mg/L, and 15,000 mg/L, was 2 km2, 0.5 km2, 0.2 km2, and 0.1 km2, respectively, and the groundwater remediation was expected to take 2050 years. Hence, there is an urgent need for the application of clean and resource efficient technologies in process industries, and the implementation of suitable wastewater treatment technologies to prevent ground water pollution in the region.Microalgae are photosynthetic organisms functioning as the green bio-factories for various pharmaceutical and biofuel products. To date, numerous attempts have been carried out to manipulate culture conditions to maximize the production of the desired metabolites. Because light is the energy source of microalgae for their growth and metabolites biosynthesis, it has been one of the most investigated variables emphasized on the deep understanding of how microalgae respond towards light changes as an external stimulus. This review discusses the effects of different light sources, light intensities, light wavelengths and length of photoperiod on various microalgae species, especially in terms of biomass and lipid productivity. Additionally, the relationship between photoregulation processes and lipid productivity of microalgae are also deliberated. The current available approaches of microalgae mass cultivation, including different types of open and closed systems are recapitulated with the intention to highlight the significant insights for the design of future photoreactors.
Access to and close links with home palliative care services are essential to ensure seamless transitions between care settings in anticancer treatment. However, the timing of referrals to home palliative care services is often delayed. We explored barriers to and facilitators of improving the integration of home palliative care and medical oncology experienced by healthcare professionals in Japan.

This qualitative study involved semi-structured focus groups and individual interviews conducted via a web conferencing system. Participants were 27 healthcare professionals, including oncologists, palliative care physicians, home palliative care physicians, nurses from both cancer hospitals and home visit nursing agencies, and social workers from cancer hospitals.

Barriers and facilitators were grouped into three themes (1) perspectives and ideas on integrating oncology and home palliative care; (2) barriers; and (3) facilitators. Barriers included seven sub-themes lack of referral criteria for home palliative care services; financial elements related to home palliative care services; patients' lack of understanding of the illness trajectory; collusion in doctor-patient communication about imminent death; frequent visits to cancer hospitals; variations in home palliative care services; and problems in providing treatment and care at home. Facilitators included two sub-themes relationships between oncologists and home palliative care physicians, and cancer hospital staff experience/knowledge of home palliative care.

This study identified barriers and facilitators to integrating home palliative care and oncology. Some barriers experienced by professionals were comparable with barriers to early integration of palliative care into oncology.
This study identified barriers and facilitators to integrating home palliative care and oncology. Some barriers experienced by professionals were comparable with barriers to early integration of palliative care into oncology.
Opioid-induced constipation is one of the heath problems with a negative impact on the quality of life. This randomized-controlled trial aimed to investigate the effects of acupressure therapy on the management of opioid-induced constipation in patients with cancer.

The trial was conducted on 140 cancer patients, who were assigned to the acupressure (n = 70) and the control groups (n = 70). In addition to routine care, patients in the acupressure group received 8-min acupressure from the Zhongwan (CV12), Guanyuan (CV4), and Tianshu (ST25) acupoints once a day for 4weeks. The outcomes included Defecation Diary (DD), Visual Analog Scale Questionnaire (VASQ), and Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL).

We found a statistically significant difference between the acupressure and control groups in terms of stool consistency (2.22 ± 0.49 vs 1.80 ± 0.55) (p = 0.001), straining (1.98 ± 0.71 vs 2.91 ± 0.37) (p = 0.001), incomplete evacuation (0.37 ± 0.29 vs 0.61 ± 0.43) (p = 0.001), stool amount (0.93 ± 0.14 vs 0.95 ± 0.20) (p = 0.001), and the number of defecations (0.70 ± 0.22 vs 0.46 ± 0.29), (p = 0.001) measured at the fifth week. Besides, with the exception of stool amount, the DD scores obtained by the acupressure group significantly increased in the fifth week. Inter-group comparison of the pre-test and post-test scores showed that acupressure group obtained statistically significantly lower scores from the PAC-QOL (p = 0.0001).

Findings of this trial suggested that a 4-week acupressure was an effective way to improve the quality of life and to reduce both the subjective and the objective constipation symptoms in patients with opioid-induced constipations.

NCT04876508.
NCT04876508.
In secondary immunodeficiency, immunoglobulin replacement therapy (IgRT) is recommended by guidelines (GL) for patients with IgG level < 4g/l and more than 3 infections or a severe infection. IgRT may be appropriate if IgG level < 4g/l and/or 1-3 less severe infections (≤ grade 2).

This was a retrospective sample analysis representative for practices and hospitals in Germany. The treatments and infection data were collected from patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM). GL adherence (GLAD) was analyzed.

Data from 1086 patients (CLL 490, MM 596) were collected from 86 centers. Of all patients, 34.8% developed IgG deficiency during therapy (CLL 35.5%; MM 34.2%). IgRT was given in 23.5% of CLL and 14.4% of MM patients. GLAD in hypogammaglobulinemia and indication to IgRT was 23.3% of 86 CLL and 22.1% of 77 MM patients. Without GLAD, the hazard ratio (HR) for any infection was 4.49 (95% CI 3.72-5.42; p < 0.001) and for severe infections (grade ≥ 3) 10.64 (95% CI 7.54-15.00; p < 0.001). Significant independent risk factors for infections were a higher Charlson Comorbidity Index, IgG deficiency, and 3
 + line treatment, as well as therapy with BTK inhibitors or chemotherapy in CLL. Multivariable analysis showed a significantly lower risk of severe infections after start of IgRT with a HR of 0.47 (95% CI 0.28-0.77; p = 0.003).

Guideline adherence correlated with fewer and less severe infections but was low in patients with indication to IgRT. Risk factors for infection can be identified. Risk of severe infections was significantly lower in patients with IgRT.
Guideline adherence correlated with fewer and less severe infections but was low in patients with indication to IgRT. Risk factors for infection can be identified. Risk of severe infections was significantly lower in patients with IgRT.The ladybird beetle Cheilomenes sexmaculata (family Coccinellidae, order Coleoptera) is a common insect predator of agricultural pests. In this study, the full genome sequence of a novel picorna-like virus, tentatively named "Cheilomenes sexmaculata picorna-like virus 1" (CSPLV1), was identified in C. sexmaculata. The full-length sequence of CSPLV1 is 11,384 nucleotides (nt) in length (excluding the polyA tail), with one predicted open reading frame (ORF) encoding a polyprotein of 3727 amino acids, a 13-nt 5' untranslated region (UTR), and a 187-nt 3' UTR. The ORF of CSPLV1 consists of four distinct domains, including an RNA virus helicase domain (nt 3029-3319), a peptidase domain (nt 5555-6121), an RNA-dependent RNA polymerase domain (nt 7154-8101), and a picorna-like coat protein domain (nt 8606-9283). Phylogenetic analysis based on the conserved RdRP sequence showed that CSPLV1, together with Wuhan house centipede virus 3, Hypera postica associated virus 1, and Diabrotica undecimpunctata virus 1, forms an unclassified group that is closely related to members of the family Solinviviridae. To the best of our knowledge, CSPLV1 is the first picorna-like virus discovered in C. sexmaculata.Non-hemolytic antimicrobial peptides (AMPs) are vital lead molecules for the designing and development of peptide-based antibiotics. Thanatin a 21-amino acid long single disulfide bonded AMP is known to be highly non-hemolytic with a limited toxicity to human cells and model animals. Thanatin demonstrates a potent antibacterial activity against multidrug-resistant Gram-negative pathogens. A single mutated variant of thanatin replaced last residue Met21 to Phe or thanatin M21F has recently been found to be more active compared to the native peptide. In order to gain mechanistic insights toward bacterial cell lysis versus non-hemolysis, here, we report atomic resolution structure and mode insertion of thanatinM21F reconstituted into zwitterionic detergent micelle by use of solution NMR spectroscopy. The 3D structure of thanatinM21F in DPC micelle is defined by an anti-parallel β-sheet between residues I9-F21 with a central cationic loop, residues N12-R14. PRE NMR studies revealed hydrophobic core residues of thanatinM21F are deeply inserted in the DPC micelle, while residues at the extended N-terminal half of the peptide are appeared to be mostly surface localized. Marked structural differences of thanatin and thanatinM21F in negatively charged LPS and DPC micelle could be correlated with non-hemolytic and antibacterial activity.Aiming at the sustainability of meat production, insects can replace traditional ingredients in the diet of poultry. Studies evaluating performance in birds have emerged to ensure this ability, but few address the health parameters of animals. This study was carried out to evaluate the effects of the inclusion of Madagascar cockroach meal in traditional diets on hematological and histopathological traits of meat-type quails. The inclusion of Madagascar cockroach meal in the diet was evaluated in four levels 0%, 6%, 12%, and 18%. Observations for hematological and histopathological traits from 6 repetitions on each group were recorded for both sexes at 35 days of age. Hematological parameters were not influenced by Madagascar cockroach inclusion on diet and quail's sex. Red and white blood cells count were within the normal range for poultry. No significant findings were observed during the histopathological evaluation of the pancreas, duodenum, jejunum, and ileum. Liver fatty degeneration was visualized in all treatments in the same intensity. Quail's diets containing up to 18% insect meal during the growth period did not affect the studied health parameters, so the Madagascar cockroach meal could be considered as an alternative to a protein ingredient for poultry production.Urbanization affects the local wind and water cycle by changing the natural surface and atmospheric conditions, which further changes the local climate and climate system. Assessment of built-up-area changes in a rapidly growing urban area within a short time is a prime factor for administrators for better environmental assessment and sustainable development of urban areas. Traditional survey approaches, on the other hand, are unable to meet the demand for rapid urban land management development, and there is a pressing need to develop new methods to address the limitations of existing ones. This study compares various urban spectral indices to other existing approaches in order to determine which index provides a better representation of the impervious area in the urban watershed. Landsat 8 OLI (Operational Land Imager) satellite images acquired on 15 March 2014 and 31 March 2020 are used in the present study. Indices, namely Modified Built-up Index (MBUI), SwiRed Index (SwiRed), and Enhanced Built-up and Bareness Index (EBBI), were utilized to extract impervious areas. Thresholding of indices is done by comparing them with 1000 reference points taken from Google Earth imagery of the respective years. The accuracy of the urban indices is assessed by comparing the results with high-resolution Google Earth Satellite Images. The impervious area is extracted from spectral indices and other remote sensing techniques such as maximum likelihood classification and support vector machine classification techniques. The overall accuracy of SVM, MLC, MBUI, EBBI, and SwiRed for the 2014 dataset was found to be 95.1%, 90.8%, 83.9%, 78.9%, and 87.3%, respectively, and the overall accuracy of SVM, MLC, MBUI, EBBI, and SwiRed was found to be 96%, 89.2%, 89.1%, 85.5%, and 92.6%, respectively. Impervious areas in the heterogeneous urban environment can be monitored in a better way and within lesser time by using spectral indices generated using Landsat 8 OLI (Operational Land Imager) satellite data.
We evaluated the accuracy, safety, and feasibility of a computed tomography (CT)-guided robotic assistance system for percutaneous needle placement in the kidney.

Fiducials surgically implanted into the kidneys of two pigs were used as targets for subsequent robotically-assisted needle insertion. Robotically-assisted needle insertions and CT acquisitions were coordinated using respiratory monitoring. An initial scan volume data set was used for needle insertion planning defining skin entry and target point. Then, needle insertion was performed according to robot positioning. The accuracy of needle placement was evaluated upon the distance between the needle tip and the predefined target on a post needle insertion scan. A delayed contrast-enhanced CT scan was acquired to assess safety.

Eight needle trajectories were performed with a median procedural time measured from turning on the robotic system to post needle insertion CT scan of 21 min (interquartile range 15.5-26.5 min). Blind review of needle placement accuracy was 2.3 ± 1.2 mm (mean ± standard deviation) in lateral deviation, 0.7 ± 1.7 mm in depth deviation, and 2.8 ± 1.3 mm in three-dimensional Euclidian deviation. All needles were inserted on the first attempt, which determined 100% feasibility, without needle readjustment. The angulation and length of the trajectory did not impact on the needle placement accuracy. Two minor procedure-related complications were encountered 2 subcapsular haematomas (13 × 6 mm and 35 × 6 mm) in the same animal.

Robotically-assisted needle insertion was shown feasible, safe and accurate in a swine kidney model. Further larger studies are needed.
Robotically-assisted needle insertion was shown feasible, safe and accurate in a swine kidney model. Further larger studies are needed.
An intragastric balloon is used to cause weight loss in super-obese patients (BMI > 60kg/m
) prior to bariatric surgery. Whether weight loss from intragastric balloon influences that from bariatric surgery is poorly studied.

In this retrospective, single-center study, the effects of intragastric balloon in 26 patients (BMI 69.26 ± 6.81) on weight loss after bariatric surgery (primary endpoint), postoperative complications within 30days, hospital readmission, operation time, and MTL30 (secondary endpoints) were evaluated. Fifty-two matched-pair patients without intragastric balloon prior to bariatric surgery were used as controls.

Intragastric balloon resulted in a weight loss of 17.3 ± 14.1kg (BMI 5.75 ± 4.66kg/m
) with a nadir after 5months. Surgical and postoperative outcomes including complications were comparable between both groups. Total weight loss was similar in both groups (29.0% vs. 32.2%, p = 0.362). Direct postoperative weight loss was more pronounced in the control group compared to the therapeutic regime and managing patients' expectations.
A totally implantable vascular access port (TIVAP) is commonly required in cancer patients. Possible adverse events after TIVAP implantation include surgical site infection (SSI) and port-related bacteremia. This study examined whether adhesive surgical drapes can reduce the risk of SSI.

A total of 100 mostly cancer patients were randomized into two groups before undergoing TIVAP implantation by surgical cut-down. In one group, an adhesive, non-impregnated drape was applied to the skin prior to incision, while the control group underwent surgery without a drape. Swabs were taken from the surgical site and sent for microbiologic testing. SSI rates were compared between groups.

No SSI occurred within 30days after surgery. In each group, two patients died. There were 5 complications (port thrombosis, port dislocation, two cases of pneumothorax, skin allergy), all in the intervention group (p = 0.056). Using the incision drape prolonged procedure time by + 5min (95% CI - 1 to + 10, p = 0.125). Microbiologic swab testing failed to detect any effect of the incision drape.

Plastic adhesive skin drapes may be unnecessary in cancer patients who undergo surgical implantation of a TIVAP.
Plastic adhesive skin drapes may be unnecessary in cancer patients who undergo surgical implantation of a TIVAP.
A five-parameter fecal continence evaluation questionnaire (FCEQ) and incidence of complications were used for long-term assessment of laparoscopy-assisted anorectoplasty (LAARP) and posterior sagittal anorectoplasty (PSARP) for treating male imperforate anus (MIA) with rectobulbar (RB) or rectoprostatic (RP) fistulas.

Subjects were 64 consecutive Japanese MIA patients with RB or RP fistulas treated at a single institution between 1995 and 2021. FCEQ data collected retrospectively were used to calculate a fecal continence evaluation (FCE) score (best = 10) and coefficient of variation for FCE (FCECV). The statistical significance threshold was defined atp < 0.05.

Fistulas were RB (n = 40; LAARP = 25/40, PSARP = 15/40) or RP (n = 24; LAARP = 17/24, PSARP = 7/24). Mean ages at surgery and status of the sacrum were similar (p = 0.06, 0.05 and 0.51). FCE scores in RP-LAARP were consistently higher with less FCECV but differences were only statistically significant from 7years postoperatively (p < 0.05). While FCE scores for RB-LAARP and RB-PSARP were similar (p = 0.99), FCECV were lower for RB-LAARP compared with RB-PSARP. LAARP was associated with less-wound infections, but greater incidence of anal mucosal prolapse unrelated to preoperative status of the sacrum.

Long-term postoperative FCEQ assessment favored LAARP for treating MIA with either RB or RP fistulas.
Long-term postoperative FCEQ assessment favored LAARP for treating MIA with either RB or RP fistulas.Tick-borne diseases have been an increasing threat to human and animal health all over the world. Anaplasmosis is one of the emerging tick-borne diseases and has zoonotic potential. A new novel species, which was detected in China in 2010-2012 and provisionally named Anaplasma capra in 2015, causes zoonotic infections and infects many different animal species. In this study, we investigated the presence of A. capra in domestic ruminants from Turkey. A total of 468 blood samples (cattle, sheep, and goat) were examined by the gltA gene-specific nested polymerase chain reaction, revealing the presence of A. capra in six samples (1.28%) one of them from cattle (0.41%) and the other five from sheep (3.22%). According to DNA sequences results of the gltA gene, A. capra isolates identified in the present study were shown high nucleotide similarity with A. capra isolates detected from different hosts. However, the nucleotide differences were detected in the same nucleotide positions between A. capra isolates. For this reason, we thought that at least two different A. capra genotypes could be circulating in the world. As a result, it is seen that A. capra, which was determined to be a new species with zoonotic potential, was revealed in European and Asian countries and in different hosts. In order to raise awareness about human anaplasmosis infections, it is important to reveal the prevalence of the species in the world. The emergence of A. capra in Turkey reveals the need for a re-evaluation of the human and animal health risk analysis in terms of anaplasmosis.While arithmetic training reduces fronto-temporo-parietal activation related to domain-general processes in typically developing (TD) children, we know very little about the training-related neurocognitive changes in children with mathematical disabilities (MD), who seek evidenced-based educational interventions. In a within-participant design, a group of 20 children (age range = 10-15 years old) with MD underwent 2 weeks of arithmetic training. Brain activation was measured using functional near-infrared spectroscopy (fNIRS) before and after training to assess training-related changes. Two weeks of training led to both behavioral and brain changes. Training-specific change for trained versus untrained (control) simple multiplication solving was observed as activation increase in the bilateral temporo-parietal region including angular gyrus and middle temporal gyrus. Training-specific change for trained versus untrained (control) complex multiplication solving was observed as activation increase in the bilateral parietal region including intraparietal sulcus, superior parietal lobule, and supramarginal gyrus. Unlike the findings of a similar study in TD children, 2 weeks of multiplication training led to brain activation increase in the fronto-parietal network in children with MD. Interestingly, these brain activation differences between the current findings and a recent similar study in TD children underlie a rather similar behavioral improvement as regards response time and accuracy after 2 weeks of training. This finding provides valuable insights into underlying mechanisms of mathematics learning in special samples and suggests that the findings in TD children may not be readily generalized to children with MD.
Primary CNS lymphoma (PCNSL) is a highly aggressive non-Hodgkin lymphoma (NHL) that occurs in the CNS (e.g. brain, meninges, spinal cord, cerebrospinal fluid, or intraocular involvement) in the absence of systemic NHL. Tumor resection does not improve survival, and neurosurgical intervention is generally limited to stereotactic biopsy to provide a histopathological diagnosis.

The objective of this single-center study was to evaluate the management and outcome of PCNSL patients diagnosed by biopsy, using overall survival and progression-free survival as endpoints.

At our department of neurosurgery, 140 patients were diagnosed with PCNSL by biopsy between January 1, 2009, and December 31, 2018. Of these, 37 patients were included in the study and were divided into three groups according to their postoperative therapy.

Median OS was 35.7months for the intensive treatment group, 29.5months for the moderate treatment group, and 8.6months for the palliative treatment group. The intensive and moderate treatment groups had similar progression-free survival, while the palliative treatment group had poor overall and progression-free survival. Six patients were long-term survivors (> 80months). Age under 65years was the main significant parameter affecting overall survival.

In this cohort, patients with PCNSL had an overall fair prognosis if they (1) were under 65years old, (2) had a performance score < 2 at the time of diagnosis, and (3) received either intensive or moderate chemotherapeutic treatment. Biopsy is still the primary diagnostic tool; other methods have been investigated but are not yet recommended.
In this cohort, patients with PCNSL had an overall fair prognosis if they (1) were under 65 years old, (2) had a performance score  less then  2 at the time of diagnosis, and (3) received either intensive or moderate chemotherapeutic treatment. Biopsy is still the primary diagnostic tool; other methods have been investigated but are not yet recommended.Graphene oxide (GO) is an excellent chemical tunable optical platform for imaging and sensing. The photoluminescence (PL) quantum yield of GO is relatively low, which limited the application of the intrinsic and tunable fluorescence from GO. Here, we report the first case of metal-enhanced fluorescence (MEF) of GO. A significant enhancement (~10-fold) in fluorescence intensity is observed from GO on the Ag substrate as compared to that on the glass. FL, Raman, and SEM images are used to investigate the MEF behavior and are coincident with each other. The influence of the metal particle size of Ag substrate is investigated. The fluorescence is also found to be responsive when adding different metal ions into GO solution. GO contacting directly with metal substrate exhibits strong MEF without quenching, which makes it possible to use GO sheets for three-dimension optical imaging and sensing.Iron-cobalt oxide nanosheets (FeCo-ONSs) were proved to have intrinsic peroxidase-like activity. Additionally, the peroxidase-like activity of FeCo-ONSs toward the oxidation of 3,3,5,5-tetramethylbenzidine (TMB) was dramatically enhanced after heparin addition due to the stronger affinity toward TMB. Protamine combines with heparin, so the promotion of peroxidase-like activity of FeCo-ONSs with heparin was suppressed. With the addition of trypsin, protamine was hydrolyzed and the enhancement effect of catalytic activity of FeCo-ONSs was recovered. Based on above process, a sensitive colorimetric platform for trypsin activity determination was constructed through measuring the absorbance of produced oxTMB at 652 nm, providing a linear detection range of 5 to 500 ng/mL and a low detection limit of 2.8 ng/mL. The method was applied to trypsin determination in real samples (human urine sample and multienzyme tablet sample) with satisfactory results, illustrating the potential application of this biosensor.
Many surgical disciplines have demonstrated superior outcomes when procedures are performed at "high-volume". Esophagomyotomy is commonly performed for achalasia, however it's unclear what constitutes "high-volume" for this procedure, and if individual procedure volume and outcome are related. We identified physicians performing esophagomyotomy, stratified them by individual case volume, and examined their outcomes with the hypothesis that high-volume surgeons will be associated with improved outcomes as compared to low-volume surgeons.

The 2015-2019 Florida Agency for Health Care Administration (AHCA) inpatient dataset was queried for esophagomyotomy. Surgeons who performed ≥ 10 procedures during the study period were placed into the high-volume cohort, and those performing < 10 into the low-volume cohort. Groups were compared by length of stay, discharge disposition, and postoperative complications. Patient demographics were evaluated using student's t test and chi square test, p < 0.05 consideredher inquiry into defining what constitutes a high-volume center in foregut surgery and their role in improving patient outcomes.
Surgeons who perform higher volumes of esophagomyotomies are associated with decreased length of stay, higher likelihood of patient discharge to home, and decreased rates of some postoperative complications. This research should prompt further inquiry into defining what constitutes a high-volume center in foregut surgery and their role in improving patient outcomes.
Carbazochrome sodium sulfonate (CSS) is conventionally administered to prevent post-endoscopic submucosal dissection (ESD) bleeding in many institutions, but research on its preventive efficacy is lacking. Therefore, we investigated the risk of post-ESD bleeding and the preventive efficacy of CSS administration.

We retrospectively reviewed 304 lesions in 259 patients with gastric neoplasms who underwent ESD at Asahikawa Medical University Hospital from 2014 to 2021. In the CSS group, CSS 100mg/day was intravenously infused with maintenance fluid replacement on postoperative days 0-2. The risk factors of post-ESD bleeding, including CSS administration, were investigated.

The overall rate of post-ESD bleeding was 4.6% (14/304). The univariate analysis showed that atrial fibrillation (Af), warfarin intake, heparin replacement, and tumor location in the lower third were significant risk factors for increasing the likelihood of postoperative bleeding. In the multivariate analysis, Af (odds ratio [OR] 3.83, 9 This suggests that the administration of CSS for post-ESD bleeding prevention may need to be reconsidered.
In Asia, laparoscopic splenectomy and azygoportal disconnection (LSD) has been widely regarded as a preferential treatment modality for cirrhotic portal hypertension (PH). However, LSD involves high surgical risk, technical challenges, and many potential postoperative complications. Technology optimization and innovation in LSD aiming to solve to these difficulties has scarcely been reported. In this retrospective study, we aimed to evaluate the clinical therapeutic effect of our cluster technology optimization and innovation on LSD for PH.

From February 2012 to January 2020, 500 patients with cirrhosis who had esophagogastric variceal bleeding and hypersplenism underwent LSD in our department. According to different operation periods, patients were divided into the early-, intermediate-, and late-period groups. We collected information regarding clinical characteristics of all patients as well as their preoperative and postoperative follow-up data.

Compared with the early-period group, operation time afewer complications but also enhanced surgical safety for patients. It is worth promoting this approach among patients with EVB and hypersplenism secondary to cirrhotic PH.
Incisional hernia repair (IHR) carries a high risk of wound complications. Thirty-day outcomes are frequently used in comparative-effectiveness research, but may miss a substantial number of surgical site occurrences (SSO) including surgical site infection (SSI). The objective of this study was to determine an optimal length of follow-up to detect SSI after IHR.

All adult patients undergoing open IHR at a single academic center over a 3year period were reviewed. SSIs, non-infectious SSOs, and wound-related readmissions were recorded up to 180days. The primary outcome was the proportion of SSIs detected at end-points of 30, 60, and 90days of follow-up. Time-to-event analysis was performed for all outcomes at 30, 60, 90, and 180days. Logistic regression was used estimate the relative risk of SSI for relevant risk factors.

A total of 234 patients underwent open IHR. Median follow-up time of 102days. Overall incidence of SSI was 15.8% with median time to occurrence of 23days. Incidence of non-infectious SSOyond 30 days, but 90-day follow-up detected 92% of SSIs. Follow-up to 90 days captured only 83% of SSO-related readmissions. These results have implications for the design of trials evaluating wound complication after open IHR, as early endpoints may miss clinically relevant outcomes and underestimate the number needed to treat. Where possible, we recommend a minimum follow-up of 90 days to estimate wound complications following open IHR.
Proposed mechanisms that potentially contribute to polypropylene mesh degradation after in vivo exposure include oxidizing species and mechanical strains induced by normal healing, tissue integration, muscle contraction, and the immediate and chronic inflammatory responses.

This study explores these potential degradation mechanisms using 63 mesh implants retrieved from patients after a median implantation time of 24months following hernia repair surgery (mesh explants) and analysis of multivariate associations between the material changes and clinical characteristics. Specifically, polypropylene mesh degradation was characterized in terms of material changes in surface oxidation, crystallinity and mechanical properties, and clinical characteristics included mesh placement location, medical history and mesh selection.

Compared to pristine control samples, subsets of mesh explants had evidence of surface oxidation, altered crystallinity, or changed mechanical properties. Using multivariate statistical approach to control for clinical characteristics, infection was a significant factor affecting changes in mesh stiffness and mesh class was a significant factor affecting polypropylene crystallinity changes.

Highly variable in vivo conditions expose mesh to mechanisms that alter clinical outcomes and potentially contribute to mesh degradation. These PP mesh explants after 0.5 to 13years in vivo had measurable changes in surface chemistry, crystallinity and mechanical properties, with significant trends associated with factors of mesh placement, mesh class, and infection.
Highly variable in vivo conditions expose mesh to mechanisms that alter clinical outcomes and potentially contribute to mesh degradation. These PP mesh explants after 0.5 to 13 years in vivo had measurable changes in surface chemistry, crystallinity and mechanical properties, with significant trends associated with factors of mesh placement, mesh class, and infection.Azacitidine (AZA) improves overall survival (OS) in patients with high-risk myelodysplastic syndromes (MDS). However, predictive factors for response to AZA remain largely unknown. To elucidate whether dynamic change in peripheral blood (PB) Wilms' Tumor 1 (WT1) mRNA levels could predict response to AZA, we retrospectively identified 75 treatment-naïve patients with high-risk MDS who received at least 3 cycles of AZA. We classified patients into 4 groups, low-increase (LI), low-stable (LS), high-decrease (HD), and high-stable (HS) based on the dynamic change in PB WT1 mRNA levels within 3 cycles of AZA. Cumulative incidence of overall response after 10 cycles of AZA was significantly higher in LS/HD than in HS/LI (75.5% vs 4.5%, P  less then  0.001). The median OS for LS/HD was 18.2 months (95% CI, 12.8-28.1 months), whereas it was 11.6 months for HS/LI (95% CI, 6.6-14.1 months; P  less then  0.001). Multivariate analysis demonstrated that poor-/very poor-IPSS-R cytogenetic risk and HS/LI were independently associated with poor OS (poor-/very poor-IPSS-R cytogenetic risk HR, 2.
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