Introduction: Prostate cancer (PCa) is the third most prevalent cancer among Malaysian males, often diagnosed at advanced stages, leading to suboptimal outcomes. While transrectal ultrasound-guided systematic biopsy (...Introduction: Prostate cancer (PCa) is the third most prevalent cancer among Malaysian males, often diagnosed at advanced stages, leading to suboptimal outcomes. While transrectal ultrasound-guided systematic biopsy (TRUS-SB) is the primary diagnostic method, prebiopsy multiparametric magnetic resonance imaging (mpMRI) is gaining popularity in identifying suspicious lesions. This study addresses the lack of comprehensive investigations into the efficacy of cognitive registration TRUS targeted biopsy (COG-TB) compared to conventional TRUS-SB, considering the resource limitations of the Malaysian healthcare system. Materials and Methods: A retrospective cohort study was conducted in two Malaysian healthcare facilities. 116 adult patients with a prostate-specific antigen (PSA) level of more than 4 ng/mL who underwent both COG-TB and TRUS-SB between October 2020 and March 2022 were included. Primary outcomes were cancer detection rate and histopathological outcomes, including Gleason score. Results: COG-TB showed a higher overall cancer detection rate (50%) compared to TRUS-SB (44%). Clinically significant cancer detection rates were similar between COG-TB and TRUS-SB (37.1%). Further analysis revealed that both COG-TB and TRUS-SB detected clinically significant cancer in 30.2% of patients, did not detect it in 56.0%, and had conflicting findings in 16 patients (p Conclusion: COG-TB and TRUS-SB have comparable detection rates for clinically significant prostate cancer, with COG-TB showing a higher tendency to detect insignificant prostate cancer. Further studies comparing these methods are warranted.展开更多
Water is a limited and valuable resource.Singapore has four national sources of water supply,one of which is natural precipitation.Pollutants collected in stormwater runoff are deposited into drainage systems and rese...Water is a limited and valuable resource.Singapore has four national sources of water supply,one of which is natural precipitation.Pollutants collected in stormwater runoff are deposited into drainage systems and reservoirs.Major nutrient pollutants found in local stormwater runoff include nitrate and phosphate,which may cause eutrophication.Bioretention systems are efficient in removing these pollutants in the presence of plants.This paper discusses plant traits that can enhance the phytoremediation of nutrient pollutants in stormwater runoff for application in bioretention systems.The plant species studied showed variations in chlorophyll florescence,leaf greenness,biomass production,and nitrate and phosphate removal.In general,dry biomass was moderately correlated to nitrate and phosphate removal(r=0.339–0.501).Root,leaf,and total dry biomass of the native tree species showed a moderate to strong correlation with nitrate removal(r=0.811,0.657,and 0.727,respectively).Leaf dry biomass of fastgrowing plants also showed a moderate to strong relationship with the removal of both pollutants(r=0.707 and 0.609,respectively).Root dry biomass of slow-growing plants showed a strong relationship with phosphate removal(r=0.707),but the correlation was weaker for nitrate removal(r=0.557).These results are valuable for choosing plants for application in bioretention systems.展开更多
This study investigated the effects of pH on the transport of Pb 2＋ , Mn 2＋ , Zn 2＋ and Ni 2＋ through lateritic soil columns. Model results by fitting the symmetric breakthrough curves （BTCs） of bromide （Br ） ...This study investigated the effects of pH on the transport of Pb 2＋ , Mn 2＋ , Zn 2＋ and Ni 2＋ through lateritic soil columns. Model results by fitting the symmetric breakthrough curves （BTCs） of bromide （Br ） with CXTFIT model suggested that physical non-equilibrium processes were absent in the columns. The heavy metal BTCs were, however, asymmetrical and exhibited a tailing phenomenon, indicating the presence of chemical non-equilibrium processes in the columns. The retardation factors of Pb 2＋ were the largest of the four metal ions at both pH 4.0 （33.3） and pH 5.0 （35.4）. The use of Langmuir isotherm parameters from batch studies with HYDRUS-1D did not predict the BTCs well. Rather the two-site model （TSM） described the heavy metal BTCs better than the equilibrium linear/nonlinear Langmuir model. The fraction of instantaneous sorption sites （ f ） of all four metal ions on the lateritic soil was consistently about 30%–44% of the total sorption sites.展开更多
To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODSThis retrospective observational study was conducted by analysing prospectively collected data for the firs...To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODSThis retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome. Quantitative data were summarized as percentage or median and range, and statistically assessed by the χ<sup>2</sup> test or Fisher’s exact test, as applicable. RESULTSAll 25 patients received comprehensive preoperative assessment via our dedicated multidisciplinary team approach. Long-course neoadjuvant chemoradiotherapy was provided, if indicated. The median age of the patients was 61.9-year-old. The median ASA and ECOG scores were 2 and 0, respectively. The indications for PE were locally invasive rectal adenocarcinoma (n = 13), advanced colonic adenocarcinoma (n = 5), recurrent cervical carcinoma (n = 3) and malignant sacral chordoma (n = 3). The procedures comprised 10 total PEs, 4 anterior PEs, 7 posterior PEs and 4 isolated lateral PEs. The median follow-up period was 17.6 mo. The median operative time was 11.5 h. The median volume of blood loss was 3306 mL, and the median volume of red cell transfusion was 1475 mL. The median lengths of ICU stay and of hospital stay were 1 d and 21 d, respectively. There was no case of mortality related to surgery. There were a total of 20 surgical morbidities, which occurred in 12 patients. The majority of the complications were grade 2 Clavien-Dindo. Only 2 patients experienced grade 3 Clavien-Dindo complications, and both required procedural interventions. One patient experienced grad展开更多
AIM： To evaluate the refractive outcome of Toric Lentis Mplus intraocular lens（IOL） implant.· METHODS： This is a retrospective case series.Consecutive patients with corneal astigmatism of at least1.5 D had To...AIM： To evaluate the refractive outcome of Toric Lentis Mplus intraocular lens（IOL） implant.· METHODS： This is a retrospective case series.Consecutive patients with corneal astigmatism of at least1.5 D had Toric Lentis Mplus IOL implant during cataract surgery. The exclusion criteria included irregular astigmatism on corneal topography, large scotopic pupil diameter（〉6 mm）, poor visual potential and significant ocular comorbidity. Postoperative manifest refraction,uncorrected distance visual acuity（UDVA）, best-corrected distance visual acuity（BCVA）, uncorrected intermediate visual acuity at（UIVA） 3/4 m and uncorrected near visual acuity（UNVA） were obtained.·RESULTS： There were 70 eyes from 49 patients in this study. Patients were refracted at a median of 8.9wk（range 4.0 to 15.5） from the operation date. Sixty-five percent of eyes had 6/7.5（0.10 log MAR） or better, and99% 6/12（0.30 log MAR） or better postoperative UDVA.Eighty-nine percent could read Jaeger（J） 3（0.28 log MAR）and 95% J5（0.37 log MAR） at 40 cm. The median magnitude of astigmatism decreased from 1.91 D to 0.49 D（Wilcoxon, P〈0.001） after the operation. The range of the cylindrical error was reduced from 1.5-3.95 D（keratometric） preoperatively to 0.00-1.46 D（subjective refraction transposed to corneal plane） postoperatively.· CONCLUSION： Toric Lentis Mplus IOL has good predictability in reducing preexisting corneal astigmatism.展开更多
Fungi are nature’s recyclers,allowing for ecological nutrient cycling and,in turn,the continuation of life on Earth.Some fungi inhabit the human microbiome where they can provide health benefits,while others are oppo...Fungi are nature’s recyclers,allowing for ecological nutrient cycling and,in turn,the continuation of life on Earth.Some fungi inhabit the human microbiome where they can provide health benefits,while others are opportunistic pathogens that can cause disease.Yeasts,members of the fungal kingdom,have been domesticated by humans for the production of beer,bread,and,recently,medicine and chemicals.Still,the great untapped potential exists within the diverse fungal kingdom.However,many yeasts are intractable,preventing their use in biotechnology or in the development of novel treatments for pathogenic fungi.Therefore,as a first step for the domestication of new fungi,an efficient DNA delivery method needs to be developed.Here,we report the creation of superior conjugative plasmids and demonstrate their transfer via conjugation from bacteria to 7 diverse yeast species including the emerging pathogen Candida auris.To create our superior plasmids,derivatives of the 57 kb conjugative plasmid pTA-Mob 2.0 were built using designed gene deletions and insertions,as well as some unintentional mutations.Specifically,a cluster mutation in the promoter of the conjugative gene traJ had the most significant effect on improving conjugation to yeasts.In addition,we created Golden Gate assembly-compatible plasmid derivatives that allow for the generation of custom plasmids to enable the rapid insertion of designer genetic cassettes.Finally,we demonstrated that designer conjugative plasmids harboring engineered restriction endonucleases can be used as a novel antifungal agent,with important applications for the development of next-generation antifungal therapeutics.展开更多
The increasing demands to further electrify and digitalize our society set demands for a green electrical energy storage technology that can be scaled between very small,and heavily distributed electrical energy sourc...The increasing demands to further electrify and digitalize our society set demands for a green electrical energy storage technology that can be scaled between very small,and heavily distributed electrical energy sources,to very large volumes.Such technology must be compatible with fast-throughput,large-volume and low-cost fabrication processes,such as using printing and coating techniques.Here,we demonstrate a sequential production protocol to fabricate supercapacitors including electrodes based on cellulose nanofibrils(CNF)and the conducting polymer PEDOT:PSS.Thin and lightweight paper electrodes,carbon adhesion layers and the gel electrolyte are fabricated using spray coating,screen printing,and bar coating,respectively.These all solid-state supercapacitors are flexible,mechanically robust and exhibit a low equivalent series resistance(0.22Ω),thus resulting in a high power density(∼104 W/kg)energy technology.The supercapacitors are combined and connected to a power management circuit to demonstrate a smart packaging application.This work shows that operational and embedded supercapacitors can be manufactured in a manner to allow for the integration with,for instance smart packaging solutions,thus enabling powered,active internet-of-things(IoT)devices in a highly distributed application.展开更多
Background:In Cambodia,internal migration involves migrants moving from non-malaria endemic areas to malaria endemic areas and vice versa.The majority of them work in farms or forests with various malaria transmission...Background:In Cambodia,internal migration involves migrants moving from non-malaria endemic areas to malaria endemic areas and vice versa.The majority of them work in farms or forests with various malaria transmission levels.In Cambodia,as one of the national approaches to ensure LLIN accessibility and use among mobile and migrant populations(MMPs),a lending scheme of long lasting insecticide treated nets(LLINs)was initiated among farm workers.Through this net lending program,LLINs and long-lasting insecticide treated hammock nets(LLIHNs)will be distributed annually at workplace(e.g.longstanding farms,plantations,industrial sites,as identified by operational district and health center staff)on a ratio of one LLIN per one worker.The main objective of this study is to assess MMPs’accessibility to LLINs through a lending scheme with plantation owners in remote malaria endemic areas of Cambodia.Methods:The study used a cross-sectional survey among MMPs using two-stage cluster sampling method.The sampling frame is the list of farms in the four provinces of Banteay Meanchey,Battambang,Pailin,and Pursat in western and northwestern Cambodia bordering with Thailand where the LLIN lending scheme was implemented and where an estimated 100000 MMPs worked annually.The assessment was carried out from January to February 2013 in these four provinces.It was estimated that 768 workers would be required.Results:A total of 702 MMPs were interviewed.The ratio of male:female is 1:1.The age group of 21-60 was the largest accounting for 77.6%.About 91%of the MMPs stayed on the farm for less than 6 months.93.2%of them owned either untreated or insecticide treated nets.LLINs and LLIHNs accounted for 89.5%;and 46.6%of them borrowed the nets from a lending scheme.Among those workers who have LLINs/LLIHNs,99%slept under LLINs/LLIHNs the night before.However,only 87.4%knew that sleeping under LLINs/LLIHNs protects against malaria.Conclusions:LLIN lending scheme provides an important delivery channel for a substantial percentage of net acce展开更多
Proteomics involves the separation of proteins,identification of the amino acid sequence of the interested or target proteins,study of the function of the proteins,modification,structure and ultimate assignments to fu...Proteomics involves the separation of proteins,identification of the amino acid sequence of the interested or target proteins,study of the function of the proteins,modification,structure and ultimate assignments to functional pathways in the cell.The proteomic investigations have contributed greatly to human diseases studies,new drugs discovery researches,and environmental science in recent years.This article provides a review on the development of the main proteomic technologies,including both the gel based and non-gel based technologies,and their applications in environmental science.Proteomic technologies have been utilized in the environmental stresses studies to analyze the induction or reduction of proteins at expression level and identify the target proteins to investigate their function in response to environmental stresses,such as high or low pH,oxidation stress,and toxic chemicals.Such protein responses are also helpful to understand the mechanisms of some cellular activities and the functions of some proteins.展开更多
Objective: To investigate the association between IL-1 Ra variable number of tandem repeat(rs2234663), IL-6-597 GA(rs1800797), IL-6-572 GC(rs1800796) and the risk of CrimeanCongo hemorrhagic fever(CCHF) in the Turkish...Objective: To investigate the association between IL-1 Ra variable number of tandem repeat(rs2234663), IL-6-597 GA(rs1800797), IL-6-572 GC(rs1800796) and the risk of CrimeanCongo hemorrhagic fever(CCHF) in the Turkish patients. Methods: This study included 50 patients infected with CCHF and 50 healthy controls. These variants were genotyped using polymerase chain reaction and/or restriction fragment length polymorphism method. Results: The distribution of the IL-6-572 GC genotypes and alleles varied significantly between the patients and the controls. The subjects carrying IL-6-572 GC GG genotype and G allele had increased risk of developing CCHF compared to the control group(P=0.006, P=0.014, respectively). IL-6-572 GC GC genotype was higher in the controls than the patients(P=0.006). For the triple genotype combinations, the 1/2-GC-GG genotype combination was detected more frequently in the control group than CCHF patients(P=0.016). IL-6(-572/-597) GG-GG genotype was significantly higher in the patient group(P=0.015), while the GC-GG genotype was significantly lower in the patient group(P=0.005). Additionally, the G-G haplotype was significantly higher in the patient group(P=0.042), whereas C-G was found to be significantly lower in the patients than the control group(P=0.037). Conclusions: The results of this study suggest the IL-6-572 GC variant might be genetic markers of sensitivity to CCHF in the Turkish population and may facilitate greater protection against the disease.展开更多
Single-port laparoscopic surgery (SPLS) is implemented through a tailored minimal single incision through which a number of laparoscopic instruments access. Introduction of operation-customized port system, utilizatio...Single-port laparoscopic surgery (SPLS) is implemented through a tailored minimal single incision through which a number of laparoscopic instruments access. Introduction of operation-customized port system, utilization of a camera without a separate external light, and instruments with different lengths has brought the favorable environment for SPLS. However, performing SPLS still creates several hardships compared to multiport laparoscopic surgery; a single-port system inevitably leads to clashing of surgical instruments due to crowding. To overcome such difficulties, investigators has developed novel concepts and maneuvers, including the concept of inverse triangulation and the maneuvers of pivoting, spreading out dissection, hanging suture, and transluminal traction. The final destination of SPLS is expected to be a completely seamless operation, maximizing the minimal invasiveness. Specimen extraction through the umbilicus can undermine cosmesis by inducing a larger incision. Therefore, hybrid laparoscopic technique, which combined laparoscopic surgical technique with natural orifice specimen extraction (NOSE) - i.e., transvaginal or transanal route-, has been developed. SPLS and NOSE seemed to be the best combination in pursuit of minimal invasiveness. In the near future, robotic SPLS with natural orifice transluminal endoscopic surgery’s way of specimen extraction seems to be pursued. It is expected to provide a completely or nearly complete seamless operation regardless of location of the lesion in the abdomen.展开更多
AIM: To investigate the safety and feasibility of needlescopic grasper-assisted single-incision laparoscopic common bile duct exploration(n SIL-CBDE) by comparing the surgical outcomes of this technique with those of ...AIM: To investigate the safety and feasibility of needlescopic grasper-assisted single-incision laparoscopic common bile duct exploration(n SIL-CBDE) by comparing the surgical outcomes of this technique with those of conventional laparoscopic CBDE(CL-CBDE).METHODS: We retrospectively analyzed the clinical data of patients who underwent CL-CBDE or n SILCBDE for the treatment of common bile duct(CBD) stones between January 2000 and December 2014. For performing n SIL-CBDE, a needlescopic grasper was also inserted through a direct puncture below the right subcostal line after introducing a single-port through the umbilicus. The needlescopic grasper helped obtain the critical view of safety by retracting the gallbladder laterally and by preventing crossing or conflict between laparoscopic instruments. The gallbladder was then partially dissected from the liver bed and used for retraction. CBD stones were usually extracted through a longitudinal supraduodenal choledochotomy, mostly using flushing a copious amount of normal saline througha ureteral catheter. Afterward, for the certification of CBD clearance, CBDE was performed mostly using a flexible choledochoscope. The choledochotomy site was primarily closed without using a T-tube, and simultaneous cholecystectomies were performed.RESULTS: During the study period, 40 patients underwent laparoscopic CBDE. Of these patients, 20 underwent CL-CBDE and 20 underwent n SIL-CBDE. The operative time for n SIL-CBDE was significantly longer than that for CL-CBDE(238 ± 76 min vs 192 ± 39 min, P = 0.007). The stone clearance rate was 100%(40/40) in both groups. Postoperatively, the n SIL-CBDE group required less intravenous analgesic(pethidine)(46.5 ± 63.5 mg/kg vs 92.5 ± 120.1 mg/kg, P = 0.010) and had a shorter hospital stay than the CL-CBDE group(3.8 ± 2.0 d vs 5.1 ± 1.7 d, P = 0.010). There was no significant difference in the incidence of postoperative complications between the two groups.CONCLUSION: The results of this study suggest that n SIL-CBDE could be safe and 展开更多
BACKGROUND Inflammatory bowel disease(IBD)is a chronic inflammatory condition of the gastrointestinal tract,with tumor necrosis factor(TNF)-αplaying a key role in its pathogenesis.Etanercept,a decoy receptor for TNF,...BACKGROUND Inflammatory bowel disease(IBD)is a chronic inflammatory condition of the gastrointestinal tract,with tumor necrosis factor(TNF)-αplaying a key role in its pathogenesis.Etanercept,a decoy receptor for TNF,is used to treat inflammatory conditions.The secretome derived from adipose-derived stem cells(ASCs)has anti-inflammatory effects,making it a promising therapeutic option for IBD.AIM To investigate the anti-inflammatory effects of the secretome obtained from ASCs synthesizing etanercept on colon cells and in a dextran sulfate sodium(DSS)-induced IBD mouse model.METHODS ASCs were transfected with etanercept-encoding mini-circle plasmids to create etanercept-producing cells.The secretory material from these cells was then tested for anti-inflammatory effects both in vitro and in a DSS-induced IBD mouse model.RESULTS This study revealed promising results indicating that the group treated with the secretome derived from etanercept-synthesizing ASCs[Etanercept-Secretome(Et-Sec)group]had significantly lower expression levels of inflammatory mediators,such as interleukin-6,Monocyte Chemoattractant Protein-1,and TNF-α,when compared to the control secretome(Ct-Sec).Moreover,the Et-Sec group exhibited a marked therapeutic effect in terms of preserving the architecture of intestinal tissue compared to the Ct-Sec.CONCLUSION These results suggest that the secretome derived from ASCs that synthesize etanercept has potential as a therapeutic agent for the treatment of IBD,potentially enhancing treatment efficacy by merging the anti-inflam-matory qualities of the ASC secretome with etanercept's targeted approach to better address the multifaceted pathophysiology of IBD.展开更多
AIM: To improve the diagnostic accuracy in patients with symptoms and signs of appendicitis, but without confirmative computed tomography (CT) findings.
文摘Introduction: Prostate cancer (PCa) is the third most prevalent cancer among Malaysian males, often diagnosed at advanced stages, leading to suboptimal outcomes. While transrectal ultrasound-guided systematic biopsy (TRUS-SB) is the primary diagnostic method, prebiopsy multiparametric magnetic resonance imaging (mpMRI) is gaining popularity in identifying suspicious lesions. This study addresses the lack of comprehensive investigations into the efficacy of cognitive registration TRUS targeted biopsy (COG-TB) compared to conventional TRUS-SB, considering the resource limitations of the Malaysian healthcare system. Materials and Methods: A retrospective cohort study was conducted in two Malaysian healthcare facilities. 116 adult patients with a prostate-specific antigen (PSA) level of more than 4 ng/mL who underwent both COG-TB and TRUS-SB between October 2020 and March 2022 were included. Primary outcomes were cancer detection rate and histopathological outcomes, including Gleason score. Results: COG-TB showed a higher overall cancer detection rate (50%) compared to TRUS-SB (44%). Clinically significant cancer detection rates were similar between COG-TB and TRUS-SB (37.1%). Further analysis revealed that both COG-TB and TRUS-SB detected clinically significant cancer in 30.2% of patients, did not detect it in 56.0%, and had conflicting findings in 16 patients (p Conclusion: COG-TB and TRUS-SB have comparable detection rates for clinically significant prostate cancer, with COG-TB showing a higher tendency to detect insignificant prostate cancer. Further studies comparing these methods are warranted.
基金funded by the Public Utilities Board, Singapore (R-706-000-020-490)
文摘Water is a limited and valuable resource.Singapore has four national sources of water supply,one of which is natural precipitation.Pollutants collected in stormwater runoff are deposited into drainage systems and reservoirs.Major nutrient pollutants found in local stormwater runoff include nitrate and phosphate,which may cause eutrophication.Bioretention systems are efficient in removing these pollutants in the presence of plants.This paper discusses plant traits that can enhance the phytoremediation of nutrient pollutants in stormwater runoff for application in bioretention systems.The plant species studied showed variations in chlorophyll florescence,leaf greenness,biomass production,and nitrate and phosphate removal.In general,dry biomass was moderately correlated to nitrate and phosphate removal(r=0.339–0.501).Root,leaf,and total dry biomass of the native tree species showed a moderate to strong correlation with nitrate removal(r=0.811,0.657,and 0.727,respectively).Leaf dry biomass of fastgrowing plants also showed a moderate to strong relationship with the removal of both pollutants(r=0.707 and 0.609,respectively).Root dry biomass of slow-growing plants showed a strong relationship with phosphate removal(r=0.707),but the correlation was weaker for nitrate removal(r=0.557).These results are valuable for choosing plants for application in bioretention systems.
基金the National Center of Excellence for Environmental and Hazardous Waste Management(NCE-EHWM)the Geology Department of Chulalongkorn University
文摘This study investigated the effects of pH on the transport of Pb 2＋ , Mn 2＋ , Zn 2＋ and Ni 2＋ through lateritic soil columns. Model results by fitting the symmetric breakthrough curves （BTCs） of bromide （Br ） with CXTFIT model suggested that physical non-equilibrium processes were absent in the columns. The heavy metal BTCs were, however, asymmetrical and exhibited a tailing phenomenon, indicating the presence of chemical non-equilibrium processes in the columns. The retardation factors of Pb 2＋ were the largest of the four metal ions at both pH 4.0 （33.3） and pH 5.0 （35.4）. The use of Langmuir isotherm parameters from batch studies with HYDRUS-1D did not predict the BTCs well. Rather the two-site model （TSM） described the heavy metal BTCs better than the equilibrium linear/nonlinear Langmuir model. The fraction of instantaneous sorption sites （ f ） of all four metal ions on the lateritic soil was consistently about 30%–44% of the total sorption sites.
文摘To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODSThis retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome. Quantitative data were summarized as percentage or median and range, and statistically assessed by the χ<sup>2</sup> test or Fisher’s exact test, as applicable. RESULTSAll 25 patients received comprehensive preoperative assessment via our dedicated multidisciplinary team approach. Long-course neoadjuvant chemoradiotherapy was provided, if indicated. The median age of the patients was 61.9-year-old. The median ASA and ECOG scores were 2 and 0, respectively. The indications for PE were locally invasive rectal adenocarcinoma (n = 13), advanced colonic adenocarcinoma (n = 5), recurrent cervical carcinoma (n = 3) and malignant sacral chordoma (n = 3). The procedures comprised 10 total PEs, 4 anterior PEs, 7 posterior PEs and 4 isolated lateral PEs. The median follow-up period was 17.6 mo. The median operative time was 11.5 h. The median volume of blood loss was 3306 mL, and the median volume of red cell transfusion was 1475 mL. The median lengths of ICU stay and of hospital stay were 1 d and 21 d, respectively. There was no case of mortality related to surgery. There were a total of 20 surgical morbidities, which occurred in 12 patients. The majority of the complications were grade 2 Clavien-Dindo. Only 2 patients experienced grade 3 Clavien-Dindo complications, and both required procedural interventions. One patient experienced grad
文摘AIM： To evaluate the refractive outcome of Toric Lentis Mplus intraocular lens（IOL） implant.· METHODS： This is a retrospective case series.Consecutive patients with corneal astigmatism of at least1.5 D had Toric Lentis Mplus IOL implant during cataract surgery. The exclusion criteria included irregular astigmatism on corneal topography, large scotopic pupil diameter（〉6 mm）, poor visual potential and significant ocular comorbidity. Postoperative manifest refraction,uncorrected distance visual acuity（UDVA）, best-corrected distance visual acuity（BCVA）, uncorrected intermediate visual acuity at（UIVA） 3/4 m and uncorrected near visual acuity（UNVA） were obtained.·RESULTS： There were 70 eyes from 49 patients in this study. Patients were refracted at a median of 8.9wk（range 4.0 to 15.5） from the operation date. Sixty-five percent of eyes had 6/7.5（0.10 log MAR） or better, and99% 6/12（0.30 log MAR） or better postoperative UDVA.Eighty-nine percent could read Jaeger（J） 3（0.28 log MAR）and 95% J5（0.37 log MAR） at 40 cm. The median magnitude of astigmatism decreased from 1.91 D to 0.49 D（Wilcoxon, P〈0.001） after the operation. The range of the cylindrical error was reduced from 1.5-3.95 D（keratometric） preoperatively to 0.00-1.46 D（subjective refraction transposed to corneal plane） postoperatively.· CONCLUSION： Toric Lentis Mplus IOL has good predictability in reducing preexisting corneal astigmatism.
基金Defense Advanced Research Projects Agency(DARPA),Agreement Number:D18AC00035 to B.J.KNatural Sciences and Engineering Research Council of Canada(NSERC)grant number:RGPIN-2018-06172 to B.J.K.)+5 种基金CIHR Project Grant(PJT 162195)to R.S.SNatural Sciences and Engineering Research Council of Canada(NSERC)grants to M.A.LCIFAR Azrieli Global Scholar Award(Fungal Kingdom:Threats and Opportunities)to R.S.SCIHR Project Grant(PJT 159708)to D.R.E.,G.B.G,and B.J.KIn addition,the following trainees were sponsored by NSERC Scholarships:R.R.C,S.H.,J.M.,D.P.N.,M.P.M.S,E.J.L.W.EvoFunPath Fellowship(NSERC CREATE)-M.A-T.
文摘Fungi are nature’s recyclers,allowing for ecological nutrient cycling and,in turn,the continuation of life on Earth.Some fungi inhabit the human microbiome where they can provide health benefits,while others are opportunistic pathogens that can cause disease.Yeasts,members of the fungal kingdom,have been domesticated by humans for the production of beer,bread,and,recently,medicine and chemicals.Still,the great untapped potential exists within the diverse fungal kingdom.However,many yeasts are intractable,preventing their use in biotechnology or in the development of novel treatments for pathogenic fungi.Therefore,as a first step for the domestication of new fungi,an efficient DNA delivery method needs to be developed.Here,we report the creation of superior conjugative plasmids and demonstrate their transfer via conjugation from bacteria to 7 diverse yeast species including the emerging pathogen Candida auris.To create our superior plasmids,derivatives of the 57 kb conjugative plasmid pTA-Mob 2.0 were built using designed gene deletions and insertions,as well as some unintentional mutations.Specifically,a cluster mutation in the promoter of the conjugative gene traJ had the most significant effect on improving conjugation to yeasts.In addition,we created Golden Gate assembly-compatible plasmid derivatives that allow for the generation of custom plasmids to enable the rapid insertion of designer genetic cassettes.Finally,we demonstrated that designer conjugative plasmids harboring engineered restriction endonucleases can be used as a novel antifungal agent,with important applications for the development of next-generation antifungal therapeutics.
文摘The increasing demands to further electrify and digitalize our society set demands for a green electrical energy storage technology that can be scaled between very small,and heavily distributed electrical energy sources,to very large volumes.Such technology must be compatible with fast-throughput,large-volume and low-cost fabrication processes,such as using printing and coating techniques.Here,we demonstrate a sequential production protocol to fabricate supercapacitors including electrodes based on cellulose nanofibrils(CNF)and the conducting polymer PEDOT:PSS.Thin and lightweight paper electrodes,carbon adhesion layers and the gel electrolyte are fabricated using spray coating,screen printing,and bar coating,respectively.These all solid-state supercapacitors are flexible,mechanically robust and exhibit a low equivalent series resistance(0.22Ω),thus resulting in a high power density(∼104 W/kg)energy technology.The supercapacitors are combined and connected to a power management circuit to demonstrate a smart packaging application.This work shows that operational and embedded supercapacitors can be manufactured in a manner to allow for the integration with,for instance smart packaging solutions,thus enabling powered,active internet-of-things(IoT)devices in a highly distributed application.
文摘Background:In Cambodia,internal migration involves migrants moving from non-malaria endemic areas to malaria endemic areas and vice versa.The majority of them work in farms or forests with various malaria transmission levels.In Cambodia,as one of the national approaches to ensure LLIN accessibility and use among mobile and migrant populations(MMPs),a lending scheme of long lasting insecticide treated nets(LLINs)was initiated among farm workers.Through this net lending program,LLINs and long-lasting insecticide treated hammock nets(LLIHNs)will be distributed annually at workplace(e.g.longstanding farms,plantations,industrial sites,as identified by operational district and health center staff)on a ratio of one LLIN per one worker.The main objective of this study is to assess MMPs’accessibility to LLINs through a lending scheme with plantation owners in remote malaria endemic areas of Cambodia.Methods:The study used a cross-sectional survey among MMPs using two-stage cluster sampling method.The sampling frame is the list of farms in the four provinces of Banteay Meanchey,Battambang,Pailin,and Pursat in western and northwestern Cambodia bordering with Thailand where the LLIN lending scheme was implemented and where an estimated 100000 MMPs worked annually.The assessment was carried out from January to February 2013 in these four provinces.It was estimated that 768 workers would be required.Results:A total of 702 MMPs were interviewed.The ratio of male:female is 1:1.The age group of 21-60 was the largest accounting for 77.6%.About 91%of the MMPs stayed on the farm for less than 6 months.93.2%of them owned either untreated or insecticide treated nets.LLINs and LLIHNs accounted for 89.5%;and 46.6%of them borrowed the nets from a lending scheme.Among those workers who have LLINs/LLIHNs,99%slept under LLINs/LLIHNs the night before.However,only 87.4%knew that sleeping under LLINs/LLIHNs protects against malaria.Conclusions:LLIN lending scheme provides an important delivery channel for a substantial percentage of net acce
文摘Proteomics involves the separation of proteins,identification of the amino acid sequence of the interested or target proteins,study of the function of the proteins,modification,structure and ultimate assignments to functional pathways in the cell.The proteomic investigations have contributed greatly to human diseases studies,new drugs discovery researches,and environmental science in recent years.This article provides a review on the development of the main proteomic technologies,including both the gel based and non-gel based technologies,and their applications in environmental science.Proteomic technologies have been utilized in the environmental stresses studies to analyze the induction or reduction of proteins at expression level and identify the target proteins to investigate their function in response to environmental stresses,such as high or low pH,oxidation stress,and toxic chemicals.Such protein responses are also helpful to understand the mechanisms of some cellular activities and the functions of some proteins.
文摘Objective: To investigate the association between IL-1 Ra variable number of tandem repeat(rs2234663), IL-6-597 GA(rs1800797), IL-6-572 GC(rs1800796) and the risk of CrimeanCongo hemorrhagic fever(CCHF) in the Turkish patients. Methods: This study included 50 patients infected with CCHF and 50 healthy controls. These variants were genotyped using polymerase chain reaction and/or restriction fragment length polymorphism method. Results: The distribution of the IL-6-572 GC genotypes and alleles varied significantly between the patients and the controls. The subjects carrying IL-6-572 GC GG genotype and G allele had increased risk of developing CCHF compared to the control group(P=0.006, P=0.014, respectively). IL-6-572 GC GC genotype was higher in the controls than the patients(P=0.006). For the triple genotype combinations, the 1/2-GC-GG genotype combination was detected more frequently in the control group than CCHF patients(P=0.016). IL-6(-572/-597) GG-GG genotype was significantly higher in the patient group(P=0.015), while the GC-GG genotype was significantly lower in the patient group(P=0.005). Additionally, the G-G haplotype was significantly higher in the patient group(P=0.042), whereas C-G was found to be significantly lower in the patients than the control group(P=0.037). Conclusions: The results of this study suggest the IL-6-572 GC variant might be genetic markers of sensitivity to CCHF in the Turkish population and may facilitate greater protection against the disease.
文摘Single-port laparoscopic surgery (SPLS) is implemented through a tailored minimal single incision through which a number of laparoscopic instruments access. Introduction of operation-customized port system, utilization of a camera without a separate external light, and instruments with different lengths has brought the favorable environment for SPLS. However, performing SPLS still creates several hardships compared to multiport laparoscopic surgery; a single-port system inevitably leads to clashing of surgical instruments due to crowding. To overcome such difficulties, investigators has developed novel concepts and maneuvers, including the concept of inverse triangulation and the maneuvers of pivoting, spreading out dissection, hanging suture, and transluminal traction. The final destination of SPLS is expected to be a completely seamless operation, maximizing the minimal invasiveness. Specimen extraction through the umbilicus can undermine cosmesis by inducing a larger incision. Therefore, hybrid laparoscopic technique, which combined laparoscopic surgical technique with natural orifice specimen extraction (NOSE) - i.e., transvaginal or transanal route-, has been developed. SPLS and NOSE seemed to be the best combination in pursuit of minimal invasiveness. In the near future, robotic SPLS with natural orifice transluminal endoscopic surgery’s way of specimen extraction seems to be pursued. It is expected to provide a completely or nearly complete seamless operation regardless of location of the lesion in the abdomen.
文摘AIM: To investigate the safety and feasibility of needlescopic grasper-assisted single-incision laparoscopic common bile duct exploration(n SIL-CBDE) by comparing the surgical outcomes of this technique with those of conventional laparoscopic CBDE(CL-CBDE).METHODS: We retrospectively analyzed the clinical data of patients who underwent CL-CBDE or n SILCBDE for the treatment of common bile duct(CBD) stones between January 2000 and December 2014. For performing n SIL-CBDE, a needlescopic grasper was also inserted through a direct puncture below the right subcostal line after introducing a single-port through the umbilicus. The needlescopic grasper helped obtain the critical view of safety by retracting the gallbladder laterally and by preventing crossing or conflict between laparoscopic instruments. The gallbladder was then partially dissected from the liver bed and used for retraction. CBD stones were usually extracted through a longitudinal supraduodenal choledochotomy, mostly using flushing a copious amount of normal saline througha ureteral catheter. Afterward, for the certification of CBD clearance, CBDE was performed mostly using a flexible choledochoscope. The choledochotomy site was primarily closed without using a T-tube, and simultaneous cholecystectomies were performed.RESULTS: During the study period, 40 patients underwent laparoscopic CBDE. Of these patients, 20 underwent CL-CBDE and 20 underwent n SIL-CBDE. The operative time for n SIL-CBDE was significantly longer than that for CL-CBDE(238 ± 76 min vs 192 ± 39 min, P = 0.007). The stone clearance rate was 100%(40/40) in both groups. Postoperatively, the n SIL-CBDE group required less intravenous analgesic(pethidine)(46.5 ± 63.5 mg/kg vs 92.5 ± 120.1 mg/kg, P = 0.010) and had a shorter hospital stay than the CL-CBDE group(3.8 ± 2.0 d vs 5.1 ± 1.7 d, P = 0.010). There was no significant difference in the incidence of postoperative complications between the two groups.CONCLUSION: The results of this study suggest that n SIL-CBDE could be safe and
基金Supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT),No.NRF-2021R1F1A1064566.
文摘BACKGROUND Inflammatory bowel disease(IBD)is a chronic inflammatory condition of the gastrointestinal tract,with tumor necrosis factor(TNF)-αplaying a key role in its pathogenesis.Etanercept,a decoy receptor for TNF,is used to treat inflammatory conditions.The secretome derived from adipose-derived stem cells(ASCs)has anti-inflammatory effects,making it a promising therapeutic option for IBD.AIM To investigate the anti-inflammatory effects of the secretome obtained from ASCs synthesizing etanercept on colon cells and in a dextran sulfate sodium(DSS)-induced IBD mouse model.METHODS ASCs were transfected with etanercept-encoding mini-circle plasmids to create etanercept-producing cells.The secretory material from these cells was then tested for anti-inflammatory effects both in vitro and in a DSS-induced IBD mouse model.RESULTS This study revealed promising results indicating that the group treated with the secretome derived from etanercept-synthesizing ASCs[Etanercept-Secretome(Et-Sec)group]had significantly lower expression levels of inflammatory mediators,such as interleukin-6,Monocyte Chemoattractant Protein-1,and TNF-α,when compared to the control secretome(Ct-Sec).Moreover,the Et-Sec group exhibited a marked therapeutic effect in terms of preserving the architecture of intestinal tissue compared to the Ct-Sec.CONCLUSION These results suggest that the secretome derived from ASCs that synthesize etanercept has potential as a therapeutic agent for the treatment of IBD,potentially enhancing treatment efficacy by merging the anti-inflam-matory qualities of the ASC secretome with etanercept's targeted approach to better address the multifaceted pathophysiology of IBD.
文摘AIM: To improve the diagnostic accuracy in patients with symptoms and signs of appendicitis, but without confirmative computed tomography (CT) findings.
