BACKGROUND Early diagnosis of pancreatic ductal adenocarcinoma(PDAC)has been a longstanding challenge.The prognosis of patients with PDAC depends on the stage at diagnosis.It is necessary to identify biomarkers for th...BACKGROUND Early diagnosis of pancreatic ductal adenocarcinoma(PDAC)has been a longstanding challenge.The prognosis of patients with PDAC depends on the stage at diagnosis.It is necessary to identify biomarkers for the detection and differentiation of pancreatic tumors and optimize PDAC sample preparation procedures for DNA and RNA analysis.Most molecular studies are done using paraffin-embedded blocks;however,the integrity of DNA and RNA is often compromised in this format.Moreover,RNA isolated from human pancreatic tissue samples is generally of low quality,in part,because of the high concentration of endogenous pancreatic RNAse activity present.AIM To assess the potential of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)to obtain specimens from pancreatic neoplasms for subsequent RNA molecular profiling,including next-generation sequencing(NGS).METHODS Thirty-four EUS-FNA samples were included in this study:PDAC(n=15),chronic pancreatitis(n=5),pancreatic cysts(n=14),mucinous cysts(mucinous cystic neoplasia/intraductal papillary mucinous neoplasia)n=7,serous cystic neoplasms n=5,and pseudocysts n=2.Cyst material consisted of cyst fluid and cyst wall samples obtained by through-the-needle biopsy(TTNB).Samples were stored at -80℃ until analysis.RNA purity(A260/230,A260/280 ratios),concentration,and integrity(RIN)were assessed.Real-time polymerase chain reaction was conducted on all samples,and small RNA libraries were prepared from solid mass samples.RESULTS RNA was successfully extracted from 29/34(85%)EUS-FNA samples:100% pancreatic adenocarcinoma samples,100% chronic pancreatitis samples,70% pancreatic fluid cyst samples,and 50%TTNB samples.The relative expression of GAPDH and HPRT were obtained for all successfully extracted RNA samples(n=29)including lowquality RNA specimens.Low concentration and nonoptimal RIN values(no less than 3)of RNA extracted from EUS-FNA samples did not prevent NGS library preparation.The suitability of cyst fluid samples for RNA profiling varied.The quality of RNA extracted from mucinous cyst fluid had a median RIN of 7.7(5.0-8.2),which was compatible with that from solid neoplasms[6.2(0-7.8)],whereas the quality of the RNA extracted from all fluids of serous cystic neoplasms and TTNB samples had a RIN of 0.CONCLUSION The results demonstrate the high potential of EUS-FNA material for RNA profiling of various pancreatic lesions,including low-quality RNA specimens.展开更多
BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is an aggressive lethal malignancy with limited options for treatment and a 5-year survival rate of 11%in the United States.As for other types of tumors,such as colorec...BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is an aggressive lethal malignancy with limited options for treatment and a 5-year survival rate of 11%in the United States.As for other types of tumors,such as colorectal cancer,aberrant de novo lipid synthesis and reprogrammed lipid metabolism have been suggested to be associated with PDAC development and progression.AIM To identify the possible involvement of lipid metabolism in PDAC by analyzing in tumoral and non-tumoral tissues the expression level of the most relevant genes involved in the long-chain fatty acid(FA)import into cell.METHODS A gene expression analysis of FASN,CD36,SLC27A1,SLC27A2,SLC27A3,SLC27A4,SLC27A5,ACSL1,and ACSL3 was performed by qRT-PCR in 24 tumoral PDAC tissues and 11 samples from non-tumoral pancreatic tissues obtained via fine needle aspiration or via surgical resection.The genes were considered significantly dysregulated between the groups when the p value was<0.05 and the fold change(FC)was≤0.5 and≥2.RESULTS We found that three FA transporters and two long-chain acyl-CoA synthetases genes were significantly upregulated in the PDAC tissue compared to the non-tumoral tissue:SLC27A2(FC=5.66;P=0.033),SLC27A3(FC=2.68;P=0.040),SLC27A4(FC=3.13;P=0.033),ACSL1(FC=4.10;P<0.001),and ACSL3(FC=2.67;P=0.012).We further investigated any possible association between the levels of the analyzed mRNAs and the specific characteristics of the tumors,including the anatomic location,the lymph node involvement,and the presence of metastasis.A significant difference in the expression of SLC27A3(FC=3.28;P=0.040)was found comparing patients with and without lymph nodes involvement with an overexpression of this transcript in 17 patients presenting tumoral cells in the lymph nodes.CONCLUSION Despite the low number of patients analyzed,these preliminary results seem to be promising.Addressing lipid metabolism through a broad strategy could be a beneficial way to treat this malignancy.Future in vitro and in vivo studies on these genes may offer important insights into the mechanisms linking PDAC with the long-chain FA import pathway.展开更多
BACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic complications.AIM To evaluate the effects of ...BACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic complications.AIM To evaluate the effects of intensive and supportive glycemic management strategies over a 12-month period in individuals with T2DM with glycated hemoglobin(HbA1c)≥10%and varying backgrounds of glycemic control.METHODS This prospective observational study investigated glycemic control in patients with poorly controlled T2DM over 12 months.Participants were categorized into four groups based on prior glycemic history:Newly diagnosed,previously well controlled with recent worsening,previously off-target but now worsening,and HbA1c consistently above 10%.HbA1c levels were monitored quarterly,and patients received medical,educational,and dietary support as needed.The analysis focused on the success rates of good glycemic control and the associated factors within each group.RESULTS The study showed significant improvements in HbA1c levels in all participants.The most significant improvement was observed in individuals newly diagnosed with diabetes:65%achieved an HbA1c target of≤7%.The results varied between participants with different glycemic control histories,followed by decreasing success rates:39%in participants with previously good glycemic control,21%in participants whose glycemic control had deteriorated compared to before,and only 10%in participants with persistently poor control,with mean HbA1c levels of 6.3%,7.7%,8.2%,and 9.7%,respectively.After one year,65.2%of the“newly diagnosed patients”,39.3%in the“previously controlled group”,21.9%in the“previously off-target but now worsened'”group and 10%in the“poorly controlled from the start”group had achieved HbA1c levels of 7 and below.CONCLUSION In poorly controlled diabetes,the rate at which treatment goals are achieved is associated with the glycemic background characteristics,emphasizing the need for tailored strategies.Therefore,different and comprehensive treatment approaches are needed for patients with persistent uncontrolled diabetes.展开更多
Non-typhoid Salmonella is a common foodborne infection.[1]In the setting of immunosuppression,the classical symptom of diarrhea,that is an immune defense mechanism,may be absent,[2,3]allowing the bacteria to hematogen...Non-typhoid Salmonella is a common foodborne infection.[1]In the setting of immunosuppression,the classical symptom of diarrhea,that is an immune defense mechanism,may be absent,[2,3]allowing the bacteria to hematogenous spread and settle in other organs.[4,5]As a result,in the setting of acute pericarditis in immunosuppressed patients,a bacterial etiology must always be considered,which requires pericardiocentesis to complete drainage and pathogen identification.展开更多
The aim of the study is to explore the essential characteristic of tourism,transport,and terrorism and to highlight the connection between them.Tourism as a phenomenon is related to the question“why do people travel?...The aim of the study is to explore the essential characteristic of tourism,transport,and terrorism and to highlight the connection between them.Tourism as a phenomenon is related to the question“why do people travel?”.The answer to this question requires clarifying a number of sociological and psychological features such as leisure and budget time travel,motivation for travel,psychological benefits,fashion,terrorism,and more.Tourism is a socio-economic and cultural phenomenon that has multiple manifestations.It is one of the factors and driving forces of globalization.Its operation and development leads to the emergence of different economic,socio-cultural,environmental,political,and health effects,making it an indispensable part of modern life.展开更多
Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional seve...Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional severe manifestations like meningoencephalitis and myocarditis.展开更多
We report a unique case of bilateral femoral stem fractures in a patient with Dorr A femoral morphology,underscoring the need for a critical reassessment of implant selection strategies.The initial failure involved a ...We report a unique case of bilateral femoral stem fractures in a patient with Dorr A femoral morphology,underscoring the need for a critical reassessment of implant selection strategies.The initial failure involved a cemented revision stem placed using the cement-within-cement technique combined with an extended trochanteric osteotomy(ETO).A second revision was subsequently performed using a cortical window osteotomy and a distally fixed uncemented stem,which resulted in successful recovery.A similar approach was used to treat a subsequent contralateral stem fracture,also with favorable outcomes.This case emphasizes three key considerations:First,that standard-length cemented stems may lead to oversizing and increased stress concentration in Dorr A femurs with narrow canals;second,that ETO may compromise femoral integrity and contribute to implant failure;and third,that cortical window osteotomy enables safer implant removal and reimplantation.Based on these findings,we advocate for an individualized approach to implant selection that may include cemented short stems,uncemented short stems,or modular solutions depending on femoral anatomy and patient-specific factors,and we encourage further investigation into optimal fixation strategies for patients with Dorr A femoral morphology.展开更多
This paper reconstructs in detail the course leading to the inception of the Chinese material medica(CMM)research at the Peking Union Medical College(PUMC)in 1920.By analyzing the primary materials from several archiv...This paper reconstructs in detail the course leading to the inception of the Chinese material medica(CMM)research at the Peking Union Medical College(PUMC)in 1920.By analyzing the primary materials from several archives,it provides,for the first time,a historiographical account of the major events and key figures in the process.These include the China Medical Board(CMB)Commission to East Asia in 1915 that shaped the attitudes of Drs.William H.Welch and Simon Flexner,the PUMC’s chief scientific architects,toward CMM and its scientific investigation;the influence of medical missionaries and Japanese scientists on these attitudes;the medical leaders’decisive roles in recruiting Ralph G.Mills and Bernard E.Read,two of medical missionaries with strong interests in and actual studies on CMM,to the PUMC,which serendipitously made them central figures associated with the CMM research at the College;and finally the critical role of Mills and other medical missionaries in introducing CMM research,both concept and material,to the CMB executives and in their reconciliating the research subject with the institutional aims.The findings of the study contextualize the inception of CMM research at PUMC from the perspective of broader narrative of transnational circulation and recognition of medical knowledge and highlight the intermediatory roles played by medical missionaries that were critical in the intersection between traditional Chinese medicine(TCM)and scientific medicine.The study also reveals multiple serendipitous occurrences associated with the eventual inception of the program,thus offers a fresh interpretation of the beginning of the most impactful research program of scientizing TCM in the first half of the 20th century.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an invasive endoscopic procedure used mainly to treat hepato-pancreato-biliary(HPB)diseases.The need for ERCP has increased with the rising number of H...BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an invasive endoscopic procedure used mainly to treat hepato-pancreato-biliary(HPB)diseases.The need for ERCP has increased with the rising number of HPB diseases over the past decade.Thus,due to increased demand,ERCP is performed at more centers.Currently,it is performed by general surgeons,gastroenterology and invasive radiology specialists in the United States and Europe as recommended by the British Society of Gastroenterology(BSG).AIM To present the results of ERCP procedures from fourteen surgical centers in Türkiye.METHODS Fourteen surgical centers performing ERCP were included in the present study.The age,gender,ERCP indication,success status,post-ERCP complications,ERCP reports and the files of 66993 patients who underwent ERCP were collected from the participating centers.The results are discussed according to the targets declared by the BSG,which are volume load per annum,proportion of successful cannulation(>85%),bile duct clearance rate(>75%),stenting rate for strictures(>80%)and complications(<6%).RESULTS A total of 66993 ERCP procedures were performed in the centers included in the study up to August 2024.29250(43.6%)of the procedures were performed urgently,especially for suppurative cholangitis,biliary tract injuries,etc.The remaining 37743(56.4%)cases were performed electively.50.2%of the patients were female and 49.8%were male.The average ages were 56.5 years for women and 55.9 years for men.General anesthesia was used in 84.1%of the patients while sedation was used in 15.9%.The indications were bile duct stone(78.7%),pancreatic tumor(3.9%),papillary tumor(3.3%),cholangiocarcinoma(2.6%),Oddi sphincter dysfunction(2.4%),bile leakage after cholecystectomy(2%),bile leakage after hydatid cyst surgery(1.9%),biliary stricture(1.7%),and other diseases(3.1%).Hyperamylasemia and post-ERCP pancreatitis were the most common complications as observed in 8.1%of the patients.They were usually self-limited and responded to supportive measures.The frequency of the other complications was also consistent with the literature.CONCLUSION There is a huge shortage of ERCP endoscopists worldwide due to insufficient ERCP training and centers especially in developing and underdeveloped countries.As patients requiring ERCP usually present to surgical practitioners,the incorporation of surgeons into this training program is an effective and reliable solution.The BSG recommends the incorporation of surgeons and radiologists in addition to gastroenterology specialists.This study is the first to present the results of ERCP procedures from fourteen surgical centers throughout Türkiye.The results suggest that the surgical centers included were able to achieve the targets set by the BSG.This study demonstrated that the surgical ERCP units in the present work have reached satisfactory results and provided a reliable and successful ERCP service.There are currently no issues regarding the validity and appropriateness of the surgeons performing ERCP.Therefore,ERCP training should be encouraged in surgeons and more surgical ERCP centers should be provided.展开更多
The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discov...The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discovery.[2]Due to its rarity,knowledge mainly comes from case reports and small case series,though some decision algorithms have been proposed in systematic reviews.展开更多
Despite numerous research investigations to understand the influences of various structural parameters,to the authors'knowledge,no research has been the effect of different angles of incidence on stab response and...Despite numerous research investigations to understand the influences of various structural parameters,to the authors'knowledge,no research has been the effect of different angles of incidence on stab response and performance of different types of protective textiles.Three distinct structures of 3D woven textiles and 2D plain weave fabric made with similar high-performance fiber and areal density were designed and manufactured to be tested.Two samples,one composed of a single and the other of 4-panel layers,from each fabric type structure,were prepared,and tested against stabbing at[0○],[22.5○],and[45○]angle of incidence.A new stabbing experimental setup that entertained testing of the specimens at various angles of incidence was engineered and utilized.The stabbing bench is also equipped with magnetic sensors and a UK Home Office Scientific Development Branch(HOSDB)/P1/B sharpness engineered knives to measure the impact velocity and exerted impact energy respectively.A silicon compound was utilized to imprint the Back Face Signature(BFS)on the backing material after every specimen test.Each silicon print was then scanned,digitized,and precisely measured to evaluate the stab response and performance of the specimen based on different performance variables,including Depth of Trauma(DOT),Depth of Penetration(DOP),and Length of Penetration(LOP).Besides,the post-impact surface failure modes of the fabrics were also measured using Image software and analyzed at the microscale level.The results show stab angle of incidence greatly influences the stab response and performance of protective textiles.The outcome of the study could provide not only valuable insights into understanding the stab response and capabilities of protective textiles under different angle of incidence,but also provide valuable information for protective textile manufacturer,armor developer and stab testing and standardizing organizations to consider the angle of incidence while developing,testing,optimizing,and using protective textiles in various applications.展开更多
Conventional bioplastic production from seaweed often relies on extraction processes that are costly,time-consuming,and yield limited product.This study presents a direct fabrication method using Gracilaria sp.,a red ...Conventional bioplastic production from seaweed often relies on extraction processes that are costly,time-consuming,and yield limited product.This study presents a direct fabrication method using Gracilaria sp.,a red seaweed rich in polysaccharides,to produce bioplastic films without the need for extraction.Sorbitol was incorporated as a plasticizer at concentrations of 0%–10%(w/w)to modify film characteristics.Thermal analysis revealed improved stability at moderate sorbitol levels(5%–7%),while excessive plasticizer slightly reduced thermal resistance.Mechanical testing showed that sorbitol increased film flexibility and elongation at break,though tensile strength and stiffness declined.Tear strength followed a non-linear trend,with improvement observed at higher sorbitol concentrations.Seal strength also increased,peaking at 7%,indicating stronger interfacial bonding between film layers.Biodegradation tests demonstrated accelerated decomposition with increased sorbitol content,achieving complete degradation within 30 days at 10% concentration.Color analysis showed increased brightness and reduced yellowing,enhancing the visual quality of the films.These results confirm that direct conversion of bioplastic is both feasible and effective.Sorbitol plays a key role in tuning film properties,offering a low-cost,scalable pathway to biodegradable materials suitable for environmentally friendly packaging applications.展开更多
Background:Intermediate-risk prostate cancer(IR-PC)represents a heterogeneous group requiring nuanced treatment approaches,and recent advancements in radiotherapy(RT),androgen deprivation therapy(ADT),and prostatespec...Background:Intermediate-risk prostate cancer(IR-PC)represents a heterogeneous group requiring nuanced treatment approaches,and recent advancements in radiotherapy(RT),androgen deprivation therapy(ADT),and prostatespecific membrane antigen positron emission tomography(PSMA-PET/CT)imaging have prompted growing interest in personalized,risk-adapted management strategies.This study by the Turkish Society for Radiation Oncology aims to examine radiation oncologists’practices in managing IR-PC,focusing on RT and imaging modalities to identify trends for personalized treatments.Methods:A cross-sectional survey was conducted among Turkish radiation oncologists treating at least 50 prostate cancer(PC)cases annually.The 22-item questionnaire covered IR-PC management aspects such as risk stratification,imaging preferences,androgen deprivation therapy(ADT)use and duration,RT techniques,and treatment combinations.Anonymous responses were analyzed using descriptive statistics.Results:Thirty radiation oncologists participated,57%with over 20 years of experience.The median annual number of PC cases treated was 130.For risk stratification,43% followed the National Comprehensive Cancer Network(NCCN)guidelines,while 30%used the D’Amico classification.Imaging preferences revealed 47% favored PSMA-PET/CT.External beam RT was universally preferred,with 60% adopting ultra-hypofractionation.ADT was used by 97%,with 73% recommending it for unfavorable IR-PC cases.Short-term ADT(4–6 months)was the standard,administered concurrently with RT by 57%.Cardiovascular status influenced decisions for 97% of respondents,while 37% also considered patient age,preferences,and sexual health.Conclusions:This national survey demonstrates a shift toward personalized care in intermediate-risk prostate cancer in Turkey,marked by selective PSMA-PET/CT use,tailored ADT,and evolving radiotherapy practices.The findings underscore the importance of multidisciplinary collaboration—particularly between urologists and radiation oncologists—to optimize imaging integration and treatment outcomes.展开更多
Fish constitutes the main protein source for the Amazonian population.However,the impact of different anthropogenic activities on trace element and metal accumulation in fish and their risks for human health at a regi...Fish constitutes the main protein source for the Amazonian population.However,the impact of different anthropogenic activities on trace element and metal accumulation in fish and their risks for human health at a regional scale remain largely unexplored.Here we assessed exposure levels of 10 trace elements andmetals(Cr,Mn,Fe,Ni,Cu,Zn,As,Cd,Pb,and Hg)in 56 samples belonging to 11 different species of fish from the Brazilian Amazon.We studied the relationship between exposure levels,fish origin,and fish feeding habits,and assessed toxicological and carcinogenic risks for the Amazonian population.No significant correlation was found between sampling site and exposure levels to the studied elements,but a significant difference was found between the accumulation of some metals and the position of the fish species in the food chain.The concentrations of Cr and Hg in fish flesh were found to exceed the Brazilian limits for human consumption.This study shows that current fish consumption patterns can lead to estimated daily intakes of Hg,As and Cr that exceed the oral reference dose,thus posing a toxicological concern.Furthermore,carcinogenic risks may be expected due to the continued exposure to Cr and As.The results of this study show that the consumption of wild caught fish in the Amazon region should be controlled.Moreover,continued monitoring of trace element and metal contamination in fish and on the health of the Amazonian population is recommended,particularly for riverine and indigenous communities.展开更多
Rapid and precise diagnostic tools for Monkeypox(Mpox)lesions are crucial for effective treatment because their symptoms are similar to those of other pox-related illnesses,like smallpox and chickenpox.The morphologic...Rapid and precise diagnostic tools for Monkeypox(Mpox)lesions are crucial for effective treatment because their symptoms are similar to those of other pox-related illnesses,like smallpox and chickenpox.The morphological similarities between smallpox,chickenpox,and monkeypox,particularly in how they appear as rashes and skin lesions,which can sometimes make diagnosis challenging.Chickenpox lesions appear in many simultaneous phases and are more diffuse,often beginning on the trunk.In contrast,monkeypox lesions emerge progressively and are typically centralized on the face,palms,and soles.To provide accessible diagnostics,this study introduces a novel method for automated monkeypox lesion classification using the HMTNet(Hybrid Mobile Transformer Network).The convolutional layers and Vision Transformers(ViT)are combined to enhance the spatial features.In addition,we replace the classical MHSA(Multi-head self-attention)with the WMHSA(Window-based Multi-Head Self-Attention)to effectively capture long-range dependencies within image patches and depth-wise separable convolutions for local feature extraction.We trained and validated HMTNet on the two datasets for binary and multiclass classification.The model achieved 98.38% accuracy for multiclass classification using cross-validation and 99.25% accuracy for binary classification.These findings show that the model has the potential to be a useful diagnostic tool for monkeypox,especially in environments with limited resources.展开更多
The by-catch fauna of the shrimp fishery includes a number of marine invertebrates that are discarded because they do not have commercial value.In order to try to add some value to these materials,we analyzed the chem...The by-catch fauna of the shrimp fishery includes a number of marine invertebrates that are discarded because they do not have commercial value.In order to try to add some value to these materials,we analyzed the chemical composition of the starfish Luidia senegalensis collected in the Brazilian coast as a consequence of the trawling fishery method.In order to access their chemical composition,we used a combination of solid phase extraction(SPE)followed by ultra-high performance liquid chromatography coupled to electrospray ionization ion trap tandem mass spectrometry(UPLC-ESI-IT-MSn).Luidia sene-galensis contains asterosaponins,which are sulphated glycosilated steroids,containing five and six sugar moieties,in addition to polyhydroxysteroids.This study helped us to support the presence of important and potentially bioactive compounds in invertebrates associated to the by-catch fauna of the shrimp fishery,using a fast and efficient method.展开更多
BACKGROUND Alcoholic liver disease(ALD)is a major cause of chronic liver disease worldwide.AIM To describe the epidemiological profile and mortality rates of patients with ALD admitted to public hospitals in different...BACKGROUND Alcoholic liver disease(ALD)is a major cause of chronic liver disease worldwide.AIM To describe the epidemiological profile and mortality rates of patients with ALD admitted to public hospitals in different regions of Brazil from 2006 to 2015.METHODS This is a descriptive study that evaluated aggregate data from the five Brazilian geographic regions.RESULTS A total of 160093 public hospitalizations for ALD were registered.There was a 34.07%increase in the total number of admissions over 10 years,from 12879 in 2006 to 17267 in 2015.The region with the highest proportion(49.01%)of ALD hospitalizations was Southeast(n=78463).The North region had the lowest absolute number of patients throughout the study period,corresponding to 3.9%of the total(n=6242).There was a 24.72%increase in the total number of ALD deaths between 2006 and 2015.We found that the age group between 50 and 59 years had the highest proportion of both hospitalizations and deaths:28.94%(n=46329)of total hospital admissions and 29.43%(n=28864)of all deaths.Men were more frequently hospitalized than women and had the highest proportions of deaths in all regions.Mortality coefficient rates increased over the years,and simple linear regression analysis indicated a statistically significant upward trend in this mortality(R^2=0.744).CONCLUSION Our study provides a landscape of the epidemiological profile of public hospital admissions due to ALD in Brazil.We detected an increase in the total number of admissions and deaths due to ALD over 10 years.展开更多
The global financial crisis has brought stateowned enterprises (SOEs) into the spotlight. Even Western countries like the U.S. have been forced to take some measures of nationalization, a departure
基金Supported by the Ministry of Science and Higher Education of the Russian Federation,No.075-15-2022-301.
文摘BACKGROUND Early diagnosis of pancreatic ductal adenocarcinoma(PDAC)has been a longstanding challenge.The prognosis of patients with PDAC depends on the stage at diagnosis.It is necessary to identify biomarkers for the detection and differentiation of pancreatic tumors and optimize PDAC sample preparation procedures for DNA and RNA analysis.Most molecular studies are done using paraffin-embedded blocks;however,the integrity of DNA and RNA is often compromised in this format.Moreover,RNA isolated from human pancreatic tissue samples is generally of low quality,in part,because of the high concentration of endogenous pancreatic RNAse activity present.AIM To assess the potential of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)to obtain specimens from pancreatic neoplasms for subsequent RNA molecular profiling,including next-generation sequencing(NGS).METHODS Thirty-four EUS-FNA samples were included in this study:PDAC(n=15),chronic pancreatitis(n=5),pancreatic cysts(n=14),mucinous cysts(mucinous cystic neoplasia/intraductal papillary mucinous neoplasia)n=7,serous cystic neoplasms n=5,and pseudocysts n=2.Cyst material consisted of cyst fluid and cyst wall samples obtained by through-the-needle biopsy(TTNB).Samples were stored at -80℃ until analysis.RNA purity(A260/230,A260/280 ratios),concentration,and integrity(RIN)were assessed.Real-time polymerase chain reaction was conducted on all samples,and small RNA libraries were prepared from solid mass samples.RESULTS RNA was successfully extracted from 29/34(85%)EUS-FNA samples:100% pancreatic adenocarcinoma samples,100% chronic pancreatitis samples,70% pancreatic fluid cyst samples,and 50%TTNB samples.The relative expression of GAPDH and HPRT were obtained for all successfully extracted RNA samples(n=29)including lowquality RNA specimens.Low concentration and nonoptimal RIN values(no less than 3)of RNA extracted from EUS-FNA samples did not prevent NGS library preparation.The suitability of cyst fluid samples for RNA profiling varied.The quality of RNA extracted from mucinous cyst fluid had a median RIN of 7.7(5.0-8.2),which was compatible with that from solid neoplasms[6.2(0-7.8)],whereas the quality of the RNA extracted from all fluids of serous cystic neoplasms and TTNB samples had a RIN of 0.CONCLUSION The results demonstrate the high potential of EUS-FNA material for RNA profiling of various pancreatic lesions,including low-quality RNA specimens.
基金Supported by Romanian Ministry of Research,Innovation and Digitization,No.PN23.16.02.04 and No.31PFE/30.12.2021.
文摘BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is an aggressive lethal malignancy with limited options for treatment and a 5-year survival rate of 11%in the United States.As for other types of tumors,such as colorectal cancer,aberrant de novo lipid synthesis and reprogrammed lipid metabolism have been suggested to be associated with PDAC development and progression.AIM To identify the possible involvement of lipid metabolism in PDAC by analyzing in tumoral and non-tumoral tissues the expression level of the most relevant genes involved in the long-chain fatty acid(FA)import into cell.METHODS A gene expression analysis of FASN,CD36,SLC27A1,SLC27A2,SLC27A3,SLC27A4,SLC27A5,ACSL1,and ACSL3 was performed by qRT-PCR in 24 tumoral PDAC tissues and 11 samples from non-tumoral pancreatic tissues obtained via fine needle aspiration or via surgical resection.The genes were considered significantly dysregulated between the groups when the p value was<0.05 and the fold change(FC)was≤0.5 and≥2.RESULTS We found that three FA transporters and two long-chain acyl-CoA synthetases genes were significantly upregulated in the PDAC tissue compared to the non-tumoral tissue:SLC27A2(FC=5.66;P=0.033),SLC27A3(FC=2.68;P=0.040),SLC27A4(FC=3.13;P=0.033),ACSL1(FC=4.10;P<0.001),and ACSL3(FC=2.67;P=0.012).We further investigated any possible association between the levels of the analyzed mRNAs and the specific characteristics of the tumors,including the anatomic location,the lymph node involvement,and the presence of metastasis.A significant difference in the expression of SLC27A3(FC=3.28;P=0.040)was found comparing patients with and without lymph nodes involvement with an overexpression of this transcript in 17 patients presenting tumoral cells in the lymph nodes.CONCLUSION Despite the low number of patients analyzed,these preliminary results seem to be promising.Addressing lipid metabolism through a broad strategy could be a beneficial way to treat this malignancy.Future in vitro and in vivo studies on these genes may offer important insights into the mechanisms linking PDAC with the long-chain FA import pathway.
文摘BACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic complications.AIM To evaluate the effects of intensive and supportive glycemic management strategies over a 12-month period in individuals with T2DM with glycated hemoglobin(HbA1c)≥10%and varying backgrounds of glycemic control.METHODS This prospective observational study investigated glycemic control in patients with poorly controlled T2DM over 12 months.Participants were categorized into four groups based on prior glycemic history:Newly diagnosed,previously well controlled with recent worsening,previously off-target but now worsening,and HbA1c consistently above 10%.HbA1c levels were monitored quarterly,and patients received medical,educational,and dietary support as needed.The analysis focused on the success rates of good glycemic control and the associated factors within each group.RESULTS The study showed significant improvements in HbA1c levels in all participants.The most significant improvement was observed in individuals newly diagnosed with diabetes:65%achieved an HbA1c target of≤7%.The results varied between participants with different glycemic control histories,followed by decreasing success rates:39%in participants with previously good glycemic control,21%in participants whose glycemic control had deteriorated compared to before,and only 10%in participants with persistently poor control,with mean HbA1c levels of 6.3%,7.7%,8.2%,and 9.7%,respectively.After one year,65.2%of the“newly diagnosed patients”,39.3%in the“previously controlled group”,21.9%in the“previously off-target but now worsened'”group and 10%in the“poorly controlled from the start”group had achieved HbA1c levels of 7 and below.CONCLUSION In poorly controlled diabetes,the rate at which treatment goals are achieved is associated with the glycemic background characteristics,emphasizing the need for tailored strategies.Therefore,different and comprehensive treatment approaches are needed for patients with persistent uncontrolled diabetes.
文摘Non-typhoid Salmonella is a common foodborne infection.[1]In the setting of immunosuppression,the classical symptom of diarrhea,that is an immune defense mechanism,may be absent,[2,3]allowing the bacteria to hematogenous spread and settle in other organs.[4,5]As a result,in the setting of acute pericarditis in immunosuppressed patients,a bacterial etiology must always be considered,which requires pericardiocentesis to complete drainage and pathogen identification.
文摘The aim of the study is to explore the essential characteristic of tourism,transport,and terrorism and to highlight the connection between them.Tourism as a phenomenon is related to the question“why do people travel?”.The answer to this question requires clarifying a number of sociological and psychological features such as leisure and budget time travel,motivation for travel,psychological benefits,fashion,terrorism,and more.Tourism is a socio-economic and cultural phenomenon that has multiple manifestations.It is one of the factors and driving forces of globalization.Its operation and development leads to the emergence of different economic,socio-cultural,environmental,political,and health effects,making it an indispensable part of modern life.
文摘Human herpesvirus 6(HHV-6)is a common childhood infection but rarely causes severe complications.In immunocompetent children,conditions such as febrile convulsions and roseola infantum are typical,with occasional severe manifestations like meningoencephalitis and myocarditis.
文摘We report a unique case of bilateral femoral stem fractures in a patient with Dorr A femoral morphology,underscoring the need for a critical reassessment of implant selection strategies.The initial failure involved a cemented revision stem placed using the cement-within-cement technique combined with an extended trochanteric osteotomy(ETO).A second revision was subsequently performed using a cortical window osteotomy and a distally fixed uncemented stem,which resulted in successful recovery.A similar approach was used to treat a subsequent contralateral stem fracture,also with favorable outcomes.This case emphasizes three key considerations:First,that standard-length cemented stems may lead to oversizing and increased stress concentration in Dorr A femurs with narrow canals;second,that ETO may compromise femoral integrity and contribute to implant failure;and third,that cortical window osteotomy enables safer implant removal and reimplantation.Based on these findings,we advocate for an individualized approach to implant selection that may include cemented short stems,uncemented short stems,or modular solutions depending on femoral anatomy and patient-specific factors,and we encourage further investigation into optimal fixation strategies for patients with Dorr A femoral morphology.
文摘This paper reconstructs in detail the course leading to the inception of the Chinese material medica(CMM)research at the Peking Union Medical College(PUMC)in 1920.By analyzing the primary materials from several archives,it provides,for the first time,a historiographical account of the major events and key figures in the process.These include the China Medical Board(CMB)Commission to East Asia in 1915 that shaped the attitudes of Drs.William H.Welch and Simon Flexner,the PUMC’s chief scientific architects,toward CMM and its scientific investigation;the influence of medical missionaries and Japanese scientists on these attitudes;the medical leaders’decisive roles in recruiting Ralph G.Mills and Bernard E.Read,two of medical missionaries with strong interests in and actual studies on CMM,to the PUMC,which serendipitously made them central figures associated with the CMM research at the College;and finally the critical role of Mills and other medical missionaries in introducing CMM research,both concept and material,to the CMB executives and in their reconciliating the research subject with the institutional aims.The findings of the study contextualize the inception of CMM research at PUMC from the perspective of broader narrative of transnational circulation and recognition of medical knowledge and highlight the intermediatory roles played by medical missionaries that were critical in the intersection between traditional Chinese medicine(TCM)and scientific medicine.The study also reveals multiple serendipitous occurrences associated with the eventual inception of the program,thus offers a fresh interpretation of the beginning of the most impactful research program of scientizing TCM in the first half of the 20th century.
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an invasive endoscopic procedure used mainly to treat hepato-pancreato-biliary(HPB)diseases.The need for ERCP has increased with the rising number of HPB diseases over the past decade.Thus,due to increased demand,ERCP is performed at more centers.Currently,it is performed by general surgeons,gastroenterology and invasive radiology specialists in the United States and Europe as recommended by the British Society of Gastroenterology(BSG).AIM To present the results of ERCP procedures from fourteen surgical centers in Türkiye.METHODS Fourteen surgical centers performing ERCP were included in the present study.The age,gender,ERCP indication,success status,post-ERCP complications,ERCP reports and the files of 66993 patients who underwent ERCP were collected from the participating centers.The results are discussed according to the targets declared by the BSG,which are volume load per annum,proportion of successful cannulation(>85%),bile duct clearance rate(>75%),stenting rate for strictures(>80%)and complications(<6%).RESULTS A total of 66993 ERCP procedures were performed in the centers included in the study up to August 2024.29250(43.6%)of the procedures were performed urgently,especially for suppurative cholangitis,biliary tract injuries,etc.The remaining 37743(56.4%)cases were performed electively.50.2%of the patients were female and 49.8%were male.The average ages were 56.5 years for women and 55.9 years for men.General anesthesia was used in 84.1%of the patients while sedation was used in 15.9%.The indications were bile duct stone(78.7%),pancreatic tumor(3.9%),papillary tumor(3.3%),cholangiocarcinoma(2.6%),Oddi sphincter dysfunction(2.4%),bile leakage after cholecystectomy(2%),bile leakage after hydatid cyst surgery(1.9%),biliary stricture(1.7%),and other diseases(3.1%).Hyperamylasemia and post-ERCP pancreatitis were the most common complications as observed in 8.1%of the patients.They were usually self-limited and responded to supportive measures.The frequency of the other complications was also consistent with the literature.CONCLUSION There is a huge shortage of ERCP endoscopists worldwide due to insufficient ERCP training and centers especially in developing and underdeveloped countries.As patients requiring ERCP usually present to surgical practitioners,the incorporation of surgeons into this training program is an effective and reliable solution.The BSG recommends the incorporation of surgeons and radiologists in addition to gastroenterology specialists.This study is the first to present the results of ERCP procedures from fourteen surgical centers throughout Türkiye.The results suggest that the surgical centers included were able to achieve the targets set by the BSG.This study demonstrated that the surgical ERCP units in the present work have reached satisfactory results and provided a reliable and successful ERCP service.There are currently no issues regarding the validity and appropriateness of the surgeons performing ERCP.Therefore,ERCP training should be encouraged in surgeons and more surgical ERCP centers should be provided.
文摘The incidence of saphenous vein graft aneurysms(SVGAs)after coronary artery bypass grafting(CABG)is approximately 0.07%;[1]however,the true incidence is likely underreported because of their frequent incidental discovery.[2]Due to its rarity,knowledge mainly comes from case reports and small case series,though some decision algorithms have been proposed in systematic reviews.
文摘Despite numerous research investigations to understand the influences of various structural parameters,to the authors'knowledge,no research has been the effect of different angles of incidence on stab response and performance of different types of protective textiles.Three distinct structures of 3D woven textiles and 2D plain weave fabric made with similar high-performance fiber and areal density were designed and manufactured to be tested.Two samples,one composed of a single and the other of 4-panel layers,from each fabric type structure,were prepared,and tested against stabbing at[0○],[22.5○],and[45○]angle of incidence.A new stabbing experimental setup that entertained testing of the specimens at various angles of incidence was engineered and utilized.The stabbing bench is also equipped with magnetic sensors and a UK Home Office Scientific Development Branch(HOSDB)/P1/B sharpness engineered knives to measure the impact velocity and exerted impact energy respectively.A silicon compound was utilized to imprint the Back Face Signature(BFS)on the backing material after every specimen test.Each silicon print was then scanned,digitized,and precisely measured to evaluate the stab response and performance of the specimen based on different performance variables,including Depth of Trauma(DOT),Depth of Penetration(DOP),and Length of Penetration(LOP).Besides,the post-impact surface failure modes of the fabrics were also measured using Image software and analyzed at the microscale level.The results show stab angle of incidence greatly influences the stab response and performance of protective textiles.The outcome of the study could provide not only valuable insights into understanding the stab response and capabilities of protective textiles under different angle of incidence,but also provide valuable information for protective textile manufacturer,armor developer and stab testing and standardizing organizations to consider the angle of incidence while developing,testing,optimizing,and using protective textiles in various applications.
基金funded by IAEA Coordinated Research Project F22081.
文摘Conventional bioplastic production from seaweed often relies on extraction processes that are costly,time-consuming,and yield limited product.This study presents a direct fabrication method using Gracilaria sp.,a red seaweed rich in polysaccharides,to produce bioplastic films without the need for extraction.Sorbitol was incorporated as a plasticizer at concentrations of 0%–10%(w/w)to modify film characteristics.Thermal analysis revealed improved stability at moderate sorbitol levels(5%–7%),while excessive plasticizer slightly reduced thermal resistance.Mechanical testing showed that sorbitol increased film flexibility and elongation at break,though tensile strength and stiffness declined.Tear strength followed a non-linear trend,with improvement observed at higher sorbitol concentrations.Seal strength also increased,peaking at 7%,indicating stronger interfacial bonding between film layers.Biodegradation tests demonstrated accelerated decomposition with increased sorbitol content,achieving complete degradation within 30 days at 10% concentration.Color analysis showed increased brightness and reduced yellowing,enhancing the visual quality of the films.These results confirm that direct conversion of bioplastic is both feasible and effective.Sorbitol plays a key role in tuning film properties,offering a low-cost,scalable pathway to biodegradable materials suitable for environmentally friendly packaging applications.
文摘Background:Intermediate-risk prostate cancer(IR-PC)represents a heterogeneous group requiring nuanced treatment approaches,and recent advancements in radiotherapy(RT),androgen deprivation therapy(ADT),and prostatespecific membrane antigen positron emission tomography(PSMA-PET/CT)imaging have prompted growing interest in personalized,risk-adapted management strategies.This study by the Turkish Society for Radiation Oncology aims to examine radiation oncologists’practices in managing IR-PC,focusing on RT and imaging modalities to identify trends for personalized treatments.Methods:A cross-sectional survey was conducted among Turkish radiation oncologists treating at least 50 prostate cancer(PC)cases annually.The 22-item questionnaire covered IR-PC management aspects such as risk stratification,imaging preferences,androgen deprivation therapy(ADT)use and duration,RT techniques,and treatment combinations.Anonymous responses were analyzed using descriptive statistics.Results:Thirty radiation oncologists participated,57%with over 20 years of experience.The median annual number of PC cases treated was 130.For risk stratification,43% followed the National Comprehensive Cancer Network(NCCN)guidelines,while 30%used the D’Amico classification.Imaging preferences revealed 47% favored PSMA-PET/CT.External beam RT was universally preferred,with 60% adopting ultra-hypofractionation.ADT was used by 97%,with 73% recommending it for unfavorable IR-PC cases.Short-term ADT(4–6 months)was the standard,administered concurrently with RT by 57%.Cardiovascular status influenced decisions for 97% of respondents,while 37% also considered patient age,preferences,and sexual health.Conclusions:This national survey demonstrates a shift toward personalized care in intermediate-risk prostate cancer in Turkey,marked by selective PSMA-PET/CT use,tailored ADT,and evolving radiotherapy practices.The findings underscore the importance of multidisciplinary collaboration—particularly between urologists and radiation oncologists—to optimize imaging integration and treatment outcomes.
基金supported by the National Geographic Society through an early career grant to A.Rico (EC-59809C-19)Support Programme-PlanGenT (CIDEGENT/2020/043)of the Generalitat ValencianaR.Oliveira acknowledges"Fundacao de Amparo a Pesquisa do Estado de Sao Paulo"-FAPESP (Project 2018/03108-0).
文摘Fish constitutes the main protein source for the Amazonian population.However,the impact of different anthropogenic activities on trace element and metal accumulation in fish and their risks for human health at a regional scale remain largely unexplored.Here we assessed exposure levels of 10 trace elements andmetals(Cr,Mn,Fe,Ni,Cu,Zn,As,Cd,Pb,and Hg)in 56 samples belonging to 11 different species of fish from the Brazilian Amazon.We studied the relationship between exposure levels,fish origin,and fish feeding habits,and assessed toxicological and carcinogenic risks for the Amazonian population.No significant correlation was found between sampling site and exposure levels to the studied elements,but a significant difference was found between the accumulation of some metals and the position of the fish species in the food chain.The concentrations of Cr and Hg in fish flesh were found to exceed the Brazilian limits for human consumption.This study shows that current fish consumption patterns can lead to estimated daily intakes of Hg,As and Cr that exceed the oral reference dose,thus posing a toxicological concern.Furthermore,carcinogenic risks may be expected due to the continued exposure to Cr and As.The results of this study show that the consumption of wild caught fish in the Amazon region should be controlled.Moreover,continued monitoring of trace element and metal contamination in fish and on the health of the Amazonian population is recommended,particularly for riverine and indigenous communities.
基金supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2025R432),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia。
文摘Rapid and precise diagnostic tools for Monkeypox(Mpox)lesions are crucial for effective treatment because their symptoms are similar to those of other pox-related illnesses,like smallpox and chickenpox.The morphological similarities between smallpox,chickenpox,and monkeypox,particularly in how they appear as rashes and skin lesions,which can sometimes make diagnosis challenging.Chickenpox lesions appear in many simultaneous phases and are more diffuse,often beginning on the trunk.In contrast,monkeypox lesions emerge progressively and are typically centralized on the face,palms,and soles.To provide accessible diagnostics,this study introduces a novel method for automated monkeypox lesion classification using the HMTNet(Hybrid Mobile Transformer Network).The convolutional layers and Vision Transformers(ViT)are combined to enhance the spatial features.In addition,we replace the classical MHSA(Multi-head self-attention)with the WMHSA(Window-based Multi-Head Self-Attention)to effectively capture long-range dependencies within image patches and depth-wise separable convolutions for local feature extraction.We trained and validated HMTNet on the two datasets for binary and multiclass classification.The model achieved 98.38% accuracy for multiclass classification using cross-validation and 99.25% accuracy for binary classification.These findings show that the model has the potential to be a useful diagnostic tool for monkeypox,especially in environments with limited resources.
基金supported by Funda-cao de Amparo a Pesquisa do Estado de Sao Paulo(FAPESP Grant 2012/19419-9 to W.V.and Grant 2011/23159-0 to M.M.P.T.)。
文摘The by-catch fauna of the shrimp fishery includes a number of marine invertebrates that are discarded because they do not have commercial value.In order to try to add some value to these materials,we analyzed the chemical composition of the starfish Luidia senegalensis collected in the Brazilian coast as a consequence of the trawling fishery method.In order to access their chemical composition,we used a combination of solid phase extraction(SPE)followed by ultra-high performance liquid chromatography coupled to electrospray ionization ion trap tandem mass spectrometry(UPLC-ESI-IT-MSn).Luidia sene-galensis contains asterosaponins,which are sulphated glycosilated steroids,containing five and six sugar moieties,in addition to polyhydroxysteroids.This study helped us to support the presence of important and potentially bioactive compounds in invertebrates associated to the by-catch fauna of the shrimp fishery,using a fast and efficient method.
文摘BACKGROUND Alcoholic liver disease(ALD)is a major cause of chronic liver disease worldwide.AIM To describe the epidemiological profile and mortality rates of patients with ALD admitted to public hospitals in different regions of Brazil from 2006 to 2015.METHODS This is a descriptive study that evaluated aggregate data from the five Brazilian geographic regions.RESULTS A total of 160093 public hospitalizations for ALD were registered.There was a 34.07%increase in the total number of admissions over 10 years,from 12879 in 2006 to 17267 in 2015.The region with the highest proportion(49.01%)of ALD hospitalizations was Southeast(n=78463).The North region had the lowest absolute number of patients throughout the study period,corresponding to 3.9%of the total(n=6242).There was a 24.72%increase in the total number of ALD deaths between 2006 and 2015.We found that the age group between 50 and 59 years had the highest proportion of both hospitalizations and deaths:28.94%(n=46329)of total hospital admissions and 29.43%(n=28864)of all deaths.Men were more frequently hospitalized than women and had the highest proportions of deaths in all regions.Mortality coefficient rates increased over the years,and simple linear regression analysis indicated a statistically significant upward trend in this mortality(R^2=0.744).CONCLUSION Our study provides a landscape of the epidemiological profile of public hospital admissions due to ALD in Brazil.We detected an increase in the total number of admissions and deaths due to ALD over 10 years.
文摘The global financial crisis has brought stateowned enterprises (SOEs) into the spotlight. Even Western countries like the U.S. have been forced to take some measures of nationalization, a departure
