Notes

Continuing development of any Multiplex Bead Analysis to identify Immunoglobulin H Antibodies to be able to Babesia duncani within Individual Serum.
Recommendations on medical management and transplant candidacy will be discussed in a following consensus conference.
The transforming growth factor β (TGF-β) activates JNK, phosphorylates Smad3 to linker-phosphorylated Smad3 (pSmad3L), resulting in liver tumorigenesis. Shikonin cost However, the effect of pSmad3L on hepatocellular carcinoma (HCC) prognosis is obscure.

To detect the effect of pSmad3L on HCC prognosis and investigate the mechanism.

The expressions of pSmad3L, E-cadherin, vimentin and MicroRNA-140-5p (miR-140-5p) were detected by using immunohistochemistry, immunofluorescence and in situ hybridization. Next, the relationships of pSmad3L and HCC patients' prognoses, pSmad3L and EMT markers, pSmad3L and miR-140-5p were analyzed using Spearman's rank correlation test. JNK/pSmad3L specific inhibitor SP600125 or Smad3 mutant plasmid was used to suppress JNK/pSmad3L pathway, and QPCR assay was performed to investigate the effect of pSmad3L on miR-140-5p level. The proliferation and invasion of hepatoma cells were observed using colony formation assay and transwell assay.

We demonstrated that patient with high level of pSmad3L predicted poor prognosis. Next, we verified that pSmad3L promoted EMT of hepatoma cells in vivo and in vitro. In order to investigate the mechanism, we verified a negative correlation between pSmad3L and miR-140-5p, which was an EMT inhibitor, in the liver tissues of HCC patient and diethylnitrosamine (DEN)-induced rat HCC model. We further used SP600125 or pSmad3L mutant plasmid to decrease pSmad3L level of hepatoma cells, and inhibition of pSmad3L increased miR-140-5p level and suppressed EMT of hepatoma cells.

JNK/pSmad3L pathway induces EMT by inhibiting miR-140-5p in HCC progression.
JNK/pSmad3L pathway induces EMT by inhibiting miR-140-5p in HCC progression.
Although intravenous ferric carboxymaltose (FCM) is effective in treating iron deficiency anemia (IDA) in paediatric inflammatory bowel disease (pIBD), no data are available on its post-infusion related risks.

We assessed the efficacy of FCM and the rate of post-infusion hypophosphatemia in a large cohort of children with IBD and IDA.

All children with IBD with IDA treated with FCM over 5-year period were reviewed. Disease activity, biohumoral assessment and treatments were evaluated at baseline, 4-6 and 12 weeks after each infusion.

128 patients [median age at first infusion 13 years] were identified, 81 (63.3%) were <14 years, 10 (7.8%) <6 years. Eighty-three children (64.8%) received one infusion, whilst 45 (35.2%) repeated infusions. A significant increase in Hb (p<0.001), iron (p<0.001) and ferritin (p<0.001) was observed 4-6 and 12 weeks post-infusion. Hb gain was unrelated to disease severity. Low baseline iron was the main predicting factor for repeated infusions (p<0.05). Three patients reported infusion reactions, none <6 years. Twenty-five children had low post-infusion serum phosphate (11 were <14 years, 3 <6 years). Two children developed severe hypophosphatemia.

FCM administration is effective for IDA management in pIBD, including children <6 years. Due to the high prevalence of post-infusion hypophosphatemia, serum phosphate monitoring should be mandatory.
FCM administration is effective for IDA management in pIBD, including children less then 6 years. Due to the high prevalence of post-infusion hypophosphatemia, serum phosphate monitoring should be mandatory.
Vascular hitch (VH) gained an increasing success in treating ureteropelvic junction obstruction (UPJO) by crossing vessels (CV) in pediatrics.

We aimed (i) to compare laparoscopic VH versus laparoscopic dismembered pyeloplasty (DP) to treat UPJO by CV; (ii) to review possible amelioration given by a robot-assisted procedure.

Using defined search strategy, three investigators identified all studies on laparoscopic VH. Those studies comparing VH versus DP or versus robot-assisted VH were included in the meta-analysis. The meta-analysis was conducted using RevMan 5.3. Data are mean±SD.

Systematic review - Of 2783 titles/abstracts screened, 43 full-text articles were analyzed. Twelve studies on laparoscopic VH (298pts) reported 98.3% success rate, with 1.3% intra-operative complications. Meta-Analysis - Five studies compared laparoscopic VH versus laparoscopic DP (277pts). Operative time was reduced in VH (102.5±47.5min) compared to DP (165.7±53.7min; p<0.00001). link2 Complications were similar (VH 4/119pts promising outcomes. However, only a couple of studies compared robot-assisted VH to laparoscopic VH, with a similar incidence of complications and success rate in both procedures. The main limitations of the study were related to the slight number of papers included and to their quality, since all of them were retrospective studies or prospectively followed-up cohort of patients.

Laparoscopic VH seems to be a safe and reliable procedure to treat UPJO by CV. The procedure appeared quicker than laparoscopic DP, with shortened hospital stay. Further studies are needed to corroborate these results and to establish amelioration given by a robot-assisted procedure.
Laparoscopic VH seems to be a safe and reliable procedure to treat UPJO by CV. The procedure appeared quicker than laparoscopic DP, with shortened hospital stay. Further studies are needed to corroborate these results and to establish amelioration given by a robot-assisted procedure.
To develop and validate a tool focusing on responsive feeding (RF) practices among mothers and infants aged between 6 and 12 months in Sri Lanka.

A comprehensive review, an in-depth qualitative study, and a cross-sectional study were carried out.

Anuradhapura District, Sri Lanka.

Sample of mother-infant pairs (n = 170).

Items were developed by extracting data from a previous in-depth qualitative study on RF, informed by currently available RF items.

Content validation was performed among experts using standard techniques, followed by cognitive interviews among mothers. Structural validity was assessed using principal component analysis. Test-retest reliability was done with a sample of 50 mothers.

Cognitive validation with mothers confirmed the applicability and comprehensiveness of the tool. The tool possessed good reliability with an intraclass correlation of 0.80 and internal consistency of 0.79. The principal component analysis showed a clear 3 factor solution. The 3 factors were interpreted as responsive communication during feeding, appropriate feeding, attentive to child's signals, and proactive preparation of the feeding environment. The final version of the tool consisted of 15 items.

The 15-item Responsive Feeding Practices Assessment Tool is a valid tool to assess RF.
The 15-item Responsive Feeding Practices Assessment Tool is a valid tool to assess RF.Impostor phenomenon (IP) interferes with the desire for taking advantage of career opportunities and pursuing career advancement. There is robust literature describing the effects of IP in other health care professions, yet an absence of research exists on IP within the nutrition and dietetics profession. This perspective will explore why nutrition and dietetics professionals may experience IP, specify what might be done to mitigate the negative effects of IP, and describe future research directions. link3 Impostorism is an understudied phenomenon that could have significant implications for the profession of nutrition and dietetics on an individual and systemic level.
Previous literature has shown general trade-offs between plan complexity and resulting quality assurance (QA) outcomes. However, existing solutions for controlling this trade-off do not guarantee corresponding improvements in deliverability. Therefore, this work explored the feasibility of an optimization framework for directly maximizing predicted QA outcomes of plans without compromising the dosimetric quality of plans designed with an established knowledge-based planning (KBP) technique.

A support vector machine (SVM) was developed - using a database of 500 previous VMAT plans - to predict gamma passing rates (GPRs; 3%/3mm percent dose-difference/distance-to-agreement with local normalization) based on selected complexity features. A heuristic, QA-based optimization (QAO) framework was devised by utilizing the SVM model to iteratively modify mechanical treatment features most commonly associated with suboptimal GPRs. Specifically, leaf gaps (LGs) <50mm were widened by random amounts, which impacts all aperture-based complexity features. 13 prostate KBP-guided VMAT plans were optimized via QAO using user-specified maximum LG displacements before corresponding changes in predicted GPRs and dose were assessed.

Predicted GPRs increased by an average of 1.14±1.25% (p=0.006) with QAO using a 3mm maximum random LG displacement. There were small differences in dose, resulting in similarly small changes in tumor control probability (maximum increase=0.05%) and normal tissue complication probabilities in the bladder, rectum, and femoral heads (maximum decrease=0.2% in the rectum).

This study explored the feasibility of QAO and warrants future investigations of further incorporating QA endpoints into plan optimization.
This study explored the feasibility of QAO and warrants future investigations of further incorporating QA endpoints into plan optimization.
This study was conducted to develop national indication-based DRL values for common indications of adult computed tomography (CT) examinations for clinical application in Ghana.

The methodological approach recommended by the International Commission on Radiological Protection (ICRP), Publication 135, for the development of DRLs, was employed. Studies on CT infrastructure, common indications and quality control tests were first undertaken. A sample of 20 CT dose descriptor/quantity data sets were collected from each centre for each indication. Overall, 3960 data sets were collected for all identified common indications from 71.4% of the total CT scanners in Ghana (25/35). The data were collected from image folders reported and accepted by radiologists. The objective image quality was assessed through a signal to noise ratio (SNR) analysis prior to using the data and extracting DRL values.

Clinical indications and their respective DRL values in terms of volume weighted CT dose index (CTDI
) and dose length product (DLP) were cerebrovascular accident (CVA)/stroke (77mGy; 1313mGy.cm), head trauma/injury (76mGy; 1596mGy.cm), brain tumour/space occupying lesion (SOL) (77mGy; 2696mGy.cm), lung tumour/cancer (12mGy; 828mGy.cm) and chest lesion with chronic kidney disease (CKD) (13mGy; 467mGy.cm). Others were abdominopelvic lesion (17mGy; 1299mGy.cm), kidney stones (15mGy; 731mGy.cm), urothelial malignancy/CT-intravenous urogram (CT-IVU) (11mGy; 1449mGy.cm) and pulmonary embolism (PE) (14mGy; 942mGy.cm).

National Indication-based DRL values developed in this study are recommended to be used to manage CT radiation dose in Ghana.
National Indication-based DRL values developed in this study are recommended to be used to manage CT radiation dose in Ghana.
Postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD) can be associated with severe postoperative morbidity. This study aims to develop a preoperative POPF risk calculator that can be easily implemented in clinical routine.

Patients undergoing PD were identified from a prospectively-maintained database. A total of 11 preoperative baseline and CT-based radiological parameters were used in a binominal logistic regression model. Parameters remaining predictive for grade B/C POPF were entered into the risk calculator and diagnostic accuracy measures and ROC curves were calculated for a training and a test patient cohort. The risk calculator was transformed into a simple nomogram.

A total of 242 patients undergoing PD in the period from 2012 to 2018 were included. CT-imaging-based maximum main pancreatic duct (MPD) diameter (p=0.047), CT-imaging-based pancreatic gland diameter at the anticipated resection margin (p=0.002) and gender (p=0.058) were the parameters most predictive for grade B/C POPF.
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