DEV Community: Sargent Dunn

Ultrasound Blinking Water Plane Peening: Affect of Force as well as Pattern Strategy.

Sargent Dunn — Mon, 27 Jan 2025 08:56:12 +0000

Evidence regarding protein structure and function manifest the imperative role that dynamics play in proteins, underlining reconsideration of the unanimated sequence-to-structure-to-function paradigm. Structural dynamics portray a heterogeneous energy landscape described by conformational ensembles where each structural representation can be responsible for unique functions or enable macromolecular assemblies. read more Using the human p27/Cdk2/Cyclin A ternary complex as an example, we highlight the vital role of intramolecular and intermolecular dynamics for target recognition, binding, and inhibition as a critical modulator of cell division. Rapidly sampling configurations is critical for the population of different conformational ensembles encoding functional roles. To garner this knowledge, we present how the integration of (sub)ensemble and single-molecule fluorescence spectroscopy with molecular dynamic simulations can characterize structural dynamics linking the heterogeneous ensembles to function. The incorporation of dynamics into the sequence-to-structure-to-function paradigm promises to assist in tackling various challenges, including understanding the formation and regulation of mesoscale assemblies inside cells.AAA+ ATPases are a diverse protein superfamily which power a vast number of cellular processes, from protein degradation to genome replication and ribosome biogenesis. The latest advances in cryo-EM have resulted in a spectacular increase in the number and quality of AAA+ ATPase structures. This abundance of new information enables closer examination of different types of structural insertions into the conserved core, revealing discrepancies in the current classification of AAA+ modules into clades. Additionally, combined with biochemical data, it has allowed rapid progress in our understanding of structure-functional relationships and provided arguments both in favour and against the existence of a unifying molecular mechanism for the ATPase activity and action on substrates, stimulating further intensive research.
Bipolar symptoms and borderline personality features occur in both unipolar and bipolar major depressive episodes (MDEs). We investigated their prevalence, severity, co-occurrence and overlap.

We interviewed 124 psychiatric outpatients with MDE using the Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders, the Borderline Personality Disorder Severity Index (BPDSI-IV), and about past (hypo)manic episodes, and stratified them according to the principal diagnosis into subcohorts of major depressive disorder (MDD, n=50), bipolar disorder (BD, n=43), and borderline personality disorder (BPD, n=31). We quantified (hypo)manic symptoms using a novel semi-structured interview (MIXed symptoms during MDE, MIX-MDE) with good psychometric qualities.

The subcohorts did not differ in MDE severity. They differed significantly in some (hypo)manic symptoms being present on most days in 24% of MDD, 30% of BD, and 42% of BPD subcohort, but only 5% of the BD subcohort fulfilled the DSM-5 mixed features. The mean MIX-MDE scores were 5.7 (SD 4.0), 12.0 (8.2) and 10.5 (7.5), and BPDSI-IV scores 15.6 (7.0), 17.2 (6.2) and 26.9 (8.7), respectively (both p < 0.001). (Hypo)manic days and unspecific symptoms of distractibility and irritability inflated the correlation of observed (hypo)manic symptoms and borderline features.

Moderate sample size, limited age variation (18-50 years); no previous validation of MIX-MDE.

Presence of some mixed and borderline features is common in MDEs, with overlap and diagnosis-specific differences. Unspecific symptoms of irritability and distractibility and the aggravating impact of hypomania on perceived BPD features blur the differential diagnosis.
Presence of some mixed and borderline features is common in MDEs, with overlap and diagnosis-specific differences. Unspecific symptoms of irritability and distractibility and the aggravating impact of hypomania on perceived BPD features blur the differential diagnosis.
The majority of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are admitted to the Intensive Care Unit (ICU) for mechanical ventilation. The role of multi-organ failure during ICU admission as driver for outcome remains to be investigated yet.

Prospective cohort of mechanically ventilated critically ill with SARS-CoV-2 infection.

94 participants of the MaastrICCht cohort (21% women) had a median length of stay of 16days (maximum of 77). After division into survivors (n=59) and non-survivors (n=35), we analysed 1555 serial SOFA scores using linear mixed-effects models.

Survivors improved one SOFA score point more per 5days (95% CI 4-8) than non-survivors. Adjustment for age, sex, and chronic lung, renal and liver disease, body-mass index, diabetes mellitus, cardiovascular risk factors, and Acute Physiology and Chronic Health Evaluation II score did not change this result. This association was stronger for women than men (P-interaction=0.043).

The decrease in SOFA score associated with survival suggests multi-organ failure involvement during mechanical ventilation in patients with SARS-CoV-2. Surviving women appeared to improve faster than surviving men. Serial SOFA scores may unravel an unfavourable trajectory and guide decisions in mechanically ventilated patients with SARS-CoV-2.
The decrease in SOFA score associated with survival suggests multi-organ failure involvement during mechanical ventilation in patients with SARS-CoV-2. Surviving women appeared to improve faster than surviving men. Serial SOFA scores may unravel an unfavourable trajectory and guide decisions in mechanically ventilated patients with SARS-CoV-2.Analyzing the abnormality of morphological characteristics of male human sperm has been studied for a long time mainly because it has many implications on the male infertility problem, which accounts for approximately half of the infertility problems in the world. Yet, detecting such abnormalities by embryologists has several downsides. To clarify, analyzing sperms through visual inspection of an expert embryologist is a highly subjective and biased process. Furthermore, it takes much time for a specialist to make a diagnosis. Hence, in this paper, we proposed two deep learning algorithms that are able to automate this process. The first algorithm uses a network-based deep transfer learning approach, while the second technique, named Deep Multi-task Transfer Learning (DMTL), employs a novel combination of network-based deep transfer learning and multi-task learning to classify sperm's head, vacuole, and acrosome as either normal or abnormal. This DMTL technique is capable of classifying all the aforementioned parts of the sperm in a single prediction.read more

Increased dimensional Bianchi type-I string cosmological style inside f ree p(3rd r) concept of gravity.

Sargent Dunn — Sun, 26 Jan 2025 09:07:31 +0000

Finally, circRNA targeted miRNAs were predicted and a circRNA-miRNA-mRNA network was constructed for hsa_circRNA_404686.Our results showed that several circRNAs, such as hsa_circRNA_404686, may serve as promising diagnostic marker for PTMC (L) in female.
This study aims to appraise the clinical efficacy of traditional Chinese medicine (TCM) for the management of patients with primary dysmenorrhea (PD) in the UK.

We will comprehensively search electronic databases (Cochrane Library, PUBMED/MEDLINE, EMBASE, PsycINFO, AMED, Web of Science, and CNKI) and additional resources for original articles on randomized controlled trials published in English, Chinese, German, Spanish, Korean and Japanese. Outcomes will be the pain intensity, pain duration, menstrual cramps, amount of bleeding, and severity of dysmenorrhea symptoms, quality of life, and adverse events. Two authors will independently check all citations, extract data, and assess study quality. All potential conflicts will be solved through discussion by consulting another experienced author. A narrative synthesis will summarize the characteristics and findings of eligible trials. If it is possible, we will also pool the data and carry out meta-analysis.

The available evidence of the clinical efficacy of TCM for the treatment of PD in UK will be assessed through outcome measurements.

The findings of this study will determine whether or not TCM is effective and safe for the treatment of PD in UK. OSF REGISTRATION NUMBER osf.io/jyc95.
The findings of this study will determine whether or not TCM is effective and safe for the treatment of PD in UK. OSF REGISTRATION NUMBER osf.io/jyc95.
Primary open-angle glaucoma (POAG) is a very common disorder, and it is the second leading cause that results in blindness worldwide after cataracts. Previous studies have reported that dorzolamide/timolol-fixed combination (DTFC) can be used in treating POAG. However, there are still inconsistent results. Z-LEHD-FMK Thus, this study will systematically investigate the efficacy and safety of DTFC on POAG.

A comprehensive search will be carried out in Cochrane Library, MEDLINE, EMBASE, CINAHI, ACMD, China National Knowledge Infrastructure, and WANGFANG database from origin to the present. There are no limitations related to the language and publication status. Only randomized controlled trials that assessed the efficacy and safety of DTFC for the treatment of POAG will be included. Two researchers will independently undertake record selection, data extraction, and study quality assessment. Any divisions will be solved by discussion with a third researcher. We will perform statistical analysis using RevMan 5.3 software RESULTS This study will summarize the present evidence to identify the efficacy and safety of DTFC in treating POAG through mean intraocular pressure, best corrected visual acuity, contrast sensitivity, bioelectric activity of the retina, rate of progression of glaucoma, quality of life, and adverse events.

The results of this study will provide evidence of DTFC for the treatment of POAG.

INPLASY202040120.
INPLASY202040120.
Diabetic neuropathic pain (DNP) is a common complication of diabetes mellitus, it severely affects the quality of life of Diabetic patients. Acupuncture is proofed to have favorable effects in treating DNP, however, evidence needs to be gathered and interpreted. We will make a comprehensive review of clinical trials concerning acupuncture in treating DNP and do meta-analysis if possible.

The following databases will be searched from the inception to September 2020 PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wan-Fang Database, and Chinese Scientific Journal Database. RCTs that evaluated acupuncture for patients with DNP will be included. The primary outcome will be patient-reported pain intensity using validated scales or verbal reporting. The secondary outcomes including the Toronto clinical scoring system, Sensory Nerve Conduction Velocity, Motor Nerve Conduction Velocity, and quality of life. The study selection, data extraction, and study quality evaluation will be performed independently by 2 researchers. A meta-analysis will be performed using RevMan V5.3 statistical software if possible; otherwise, descriptive analysis or subgroup analysis will be conducted. The quality of evidence for outcomes will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

This study will evaluate the effect and safety of acupuncture in treating DNP.

The evidence we generated from the present study will provide more options for DNP management in clinical practice.

INPLASY202090043.
INPLASY202090043.
Sudden hearing loss is an emergency health problem in the Department of Otolaryngology that must be treated in a timely manner, or may cause lifelong regrets. The application of postauricular injection of glucocorticoid is a popular treatment to recover patients hearing level in recent years. However, the effectiveness and safety of postauricular injection of glucocorticoid needs to be assessed systematically.

The purpose of the study is to undertake a systematic review and meta-analysis on the effectiveness and safety of postauricular injection of glucocorticoid to treat patient diagnosed with sudden hearing loss. We will search the following databases from the date of publication to July 1, 2020 PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, Wanfang databases, the Chinese Biomedical Literature Database (CBM), the Chinese Science and Technology Periodical Database (VIP) and the Chinese Cochrane Centre's Clinical Trial Registry Platform. Observational studies regarding the association between postauricular injection of glucocorticoid and sudden hearing loss were written in English and Chinese were included. RevManV.5.3 software will be used for meta-analysis. According to the heterogeneity of the research results, fixed effects model, random effects model, subgroup analysis, sensitivity analysis, and others will be used. Ethics approval was not required for this protocol. The findings will be disseminated through journal articles and conference presentations.

Objectively, evaluate the efficacy and safety of postauricular injection of glucocorticoid for sudden hearing loss.

To provide evidence-based medicine for glucocorticoid treatment methods in patients with sudden hearing loss.

DOI 10.17605/OSF.IO/N5RV3.
DOI 10.17605/OSF.IO/N5RV3.Z-LEHD-FMK

Attributes of rectangle-shaped side to side lines in the semi-preparative counter-current chromatography bobbin.

Sargent Dunn — Sat, 25 Jan 2025 09:13:17 +0000

Neurogenic bowel dysfunction (NBD) is a common comorbidity of myelomeningocele (MMC), the most common and severe form of spina bifida. The National Spina Bifida Patient Registry (NSBPR) is a research collaboration between the CDC and Spina Bifida Clinics. Fecal continence (continence) outcomes for common treatment modalities for NBD have not been described in a large sample of individuals with MMC. NSBPR patients with MMC and NBD were studied to determine variation in continence status and their ability to perform their treatment independently according to treatment modality and individual characteristics.

Continence was defined as < 1 episode of incontinence per month. Eleven common treatments were evaluated. Inclusion criteria were established diagnoses of both MMC and NBD, as well as age ⩾ 5 years (n= 3670). Chi-square or exact statistical tests were used for bivariate analyses. Logistic regression models were used to estimate the odds of continence outcomes by age, sex, race/ethnicity, level of motte. Ability to carry out a treatment independently increased with age. Multivariable logistic regression showed significantly higher odds of continence among individuals aged ⩾ 12 years, female, non-Hispanic white, and with private insurance.
This study's aim is to evaluate lung ultrasound (LUS) efficacy in detecting opening and closing lung pressures and its correlation with the tracheal interleukin 6 (IL-6) level.

This single-blinded randomized controlled study was done at Ain Shams University Children's Hospital neonatal intensive care units, Egypt. It consists of 44 mechanically ventilated preterm neonates with Respiratory Distress Syndrome (RDS). Initial LUS assessment was done followed by randomization to one of 2 groups; group I 22 patients underwent LUS guided RM and group II 22 patients underwent non-ultrasound guided RM. Tracheal IL-6 level was measured before and after RM in both groups.

The LUS scores showed a sensitivity of 86.7% , specificity of 62.10% and accuracy of 70.45% at the cut-off point >B1 grade. After RM, there was a higher percentage of changes in mean airway pressure (p = 0.03), FiO2 (p = 0.01), PaO2/FiO2 ratio (p = 0.01), and IL-6 (p < 0.01) in group I. The duration of oxygen requirement (6 vs.13.5 days, p = 0.01), invasive ventilation (3 vs.5.5 days, p = 0.03), non-invasive ventilation (2.5 vs. 5 days, p = 0.02) and NICU stay (21.5 vs. 42.5 days, p = 0.03) was less in group I. A positive correlation between reaeration score and the duration of O2 requirement (p = 0.002), duration of invasive ventilation (p = 0.001), NICU length of stay (p = 0.002) and negative correlation with PaO2/FiO2 ratio before RM (p = 0.012). The best cut-off point for the reaeration score is >21 with a sensitivity of 75% , specificity of 71.43% and area under the curve of 78.1% .

LUS-guided RM achieved earlier lowest FiO2, shorter O2 dependency, lesser NICU stay and marked decrease in lung inflammation by decreasing atelectotrauma and shortening the duration of invasive ventilation.
LUS-guided RM achieved earlier lowest FiO2, shorter O2 dependency, lesser NICU stay and marked decrease in lung inflammation by decreasing atelectotrauma and shortening the duration of invasive ventilation.Postnatally acquired cytomegalovirus (CMV) is commonly acquired via breast milk, with premature infants more frequently developing symptoms of CMV infection in comparison to term infants. Meningitis is a rare clinical manifestation of CMV infection. The diagnosis of meningitis is difficult to make in infants, particularly those who are preterm. Consequentially, broad-spectrum empiric antimicrobial coverage is often administered for several days while waiting for current gold standard CSF testing to result. The BioFire FilmArray (BFA) simultaneously tests for 14 different pathogens, including CMV, allowing for quicker diagnosis and shorter time to definitive treatment. Here, we report a very low birth weight infant with postnatally acquired CMV meningitis, the first to our knowledge to be diagnosed using the BioFire FilmArray.
Disseminated intravascular coagulation (DIC) with Kasabach-Merrit syndrome from a large hepatic hemangioma is life-threatening. We report a case of giant hepatic hemangioma of the newborn with KMS.

The patient was born at 37 gestational weeks and 2 days via cesarean section; weight at birth was 2952 g. Congenital duodenal atresia was noted during the fetal period. DIC developed after delivery and a giant liver hemangioma was diagnosed via abdominal CT. The cause of DIC was Kasabach-Merritt syndrome owing to a giant hepatic hemangioma. First, combination therapy of 2 mg/kg/day of prednisolone and 0.2 mg/kg/day of propranolol was initiated form enterostomy. this website However, the size of the hepatic hemangioma did not alter, as observed via image evaluation. Therefore, 0.3 mg/kg/day of everolimus was administered frorm enterostomy. Subsequently, the size of the hepatic hemangioma was assessed via image evaluation. Although it did not alter, blood flow to the hepatic hemangioma decreased and thrombocytopenia was also suppressed. We performed hepatic lateral segmentectomy, radical operation for duodenal atresia. The pathological diagnosis of the removed tumor was infantile hemangioma.

We report everolimus may be useful when PSL and propranolol are ineffective.
We report everolimus may be useful when PSL and propranolol are ineffective.
Evidence supports delayed cord clamping (DCC) in preterm infants. However, practice variation exists, and many preterm infants do not receive DCC despite multiple benefits and lack of harm. We aim to 1) study the rate of DCC in preterm infants, 2) compare the difference between infants who received DCC and those who did not receive DCC and 3) investigate the reasons for not performing DCC.

We conducted this retrospective study to evaluate DCC practice at our institution since its implementation in September 2015. We collected and analyzed the data on DCC of 30-45 sec duration in inborn infants < 35 weeks gestation admitted to the neonatal intensive care unit from June 2016- June 2019. The primary outcome was the rate of delayed cord clamping.

Of the 447 infants, 275 (62%) received DCC. The rate of DCC was 36% , 54% , and 66% in infants < 27 weeks, 27-29 weeks and > 30 weeks gestation, respectively (p = 0.001). Infants not receiving DCC were smaller, of lower gestational age, and more likely to be delivered via cesarean section than those who received DCC (p < 0.this website

Molecular-Level Examination of Amorphous Reliable Distribution Dissolution.

Sargent Dunn — Thu, 23 Jan 2025 09:15:36 +0000

n was safe and associated with clinical improvement and reduction in BNP level in AdvHF patients hospitalized due to HF decompensation, although the mortality and re-hospitalization rate during the one-year follow-up remains high.
Kidney diseases are the main causative factors of secondary hypertension (HTN) in children. Although primary HTN is less common in the pediatric population, its increasing prevalence, especially among teenagers, makes early diagnosis an emerging issue.

To analyze the potential differences between primary HTN and HTN secondary to renal diseases, in order to tailor diagnostic procedures to pediatric patients with suspicion of HTN.

A retrospective evaluation was performed of medical records of 168 children (aged from 1 month to 18 years) diagnosed with arterial HTN in the Pediatric Nephrology Department of Wroclaw Medical University (Poland). The comparative analysis concerned demographics, causes of HTN, clinical picture, laboratory tests, and parameters of ambulatory blood pressure monitoring (ABPM).

Out of 168 children, 47% were diagnosed with primary HTN and 53% with secondary renal HTN. The patients with primary HTN were significantly older than those with HTN secondary to renal disease. Among the crs. The diagnostics of HTN secondary to kidney disease have revealed risk factors worsening the prognosis, including higher values of cholesterol or of parameters connected with DBP. iFSP1 concentration Primary HTN risk factors include obesity and a tendency towards higher PP values.
Novel materials used for dentin hypersensitivity (DH) treatment, including hydroxyapatite-based desensitizers, are not only effective in occluding dentinal tubules, but are also biocompatible and non-toxic. A newly formulated desensitizer containing hydroxyapatite was evaluated in comparison to commercially available desensitizers.

To compare the occluding efficacy and durability of 3 commercially available desensitizing agents with a pharmaceutical composition developed by the authors based on hydroxyapatite (HAp).

For the experiment, 40 disc-shaped dentin specimens (5 mm thick) were obtained from extracted human teeth. Each disc was divided into 4 sections, so that each desensitizing agent could be applied to each specimen and prepared for further evaluation in most homogenous conditions. The chemical composition of the dentin surfaces was analyzed using scanning electron microscopy (SEM) equipped with an energy-dispersive X-ray spectroscope (EDS), Fourier-transform infrared (FTIR) and Raman spectra tiocompatible hydroxyapatite effectively occluded dentinal tubules and therefore exhibits a potential for reducing the pain and discomfort caused by dentin hypersensitivity.
Glioma, the most common primary tumor in the central nervous system, originates from glial cells and has a poor prognosis.

This experimental laboratory study was designed to explore the role of epithelial cell adhesion molecule (EpCAM) in the metastasis of glioma.

Serum samples were collected from patients with non-metastatic or metastatic glioma (n = 20 per group), and healthy volunteers (n = 8). Exosomes were isolated from the serum and the morphological characteristics were observed under a scanning electron microscope (SEM). The expression of CD81 and CD63 was measured to identify exosomes. Glioma tissue and the adjacent normal tissue samples were obtained from patients with non-metastatic or metastatic glioma (n = 12 per group). Meanwhile, 4 normal brain tissue samples were collected. The expression of CD44, hyaluronan-mediated motility receptor (HMMR), and matrix metalloproteinase-9 (MMP-9) was determined in each group using immunohistochemistry. The protein expression of CD44, HMMR, matrix metalloproteinase-2 (MMP-2), MMP-9, and selectin E (SELE) was measured with western blotting.

Exosomes were present in the serum, and the proteins CD81 and CD63 were expressed in all 3 groups. CD44 was highly expressed in the non-metastasis and metastasis groups. The expression of HMMR and MMP-9 in the Adj-metastasis and Adj-non-metastasis groups was high, while in the other groups, the levels were low. The expression of CD44 in the metastasis and non-metastasis groups was significantly higher than that of the negative control (NC) group, and the expression in the metastasis group was higher than that of the non-metastasis group. The MMP-2 and MMP-9 were not found in either the metastasis or non-metastasis group. The protein expression of HMMR and SELE was high in all groups.

Exosome EpCAM promoted the metastasis of glioma by targeting CD44.
Exosome EpCAM promoted the metastasis of glioma by targeting CD44.
Clinical trials indicate an increased risk of osteoporosis and bone fractures in people infected with human immunodeficiency virus (HIV). The pathogenesis of bone disturbances in HIV-positive patients is unknown, but it is suggested that antiretroviral drugs may be involved.

To assess the effects of efavirenz (EF) and tenofovir (T) on bone remodeling in rats.

The study involved 36 male Wistar rats divided into 3 groups, receiving normal saline (control group - group C), efavirenz (group EF) or tenofovir disoproxil (group T).

After 24 weeks of the study, the following observations were made In blood serum of the EF group compared to group C, there were increased levels of tartrate-resistant acid phosphatase form 5b (TRAP) and inorganic phosphorus. In the densitometric examination, group T showed a lower total body (TB) bone mineral density (BMD) than group C. In the immunohistochemical assessment, group EF showed a higher intensity and extension of anti-tartrate resistant acid phosphatase antibodies (abTRAP) compared to group C. In the histopathological examination of the second lumbar vertebra (L2), group EF showed a lower bone surface/volume ratio (BS/BV) and higher trabecular thickness (Tb.Th) than the control group. In the histopathological examination of the femur, a lower bone surface/tissue volume (BS/TV) and lower trabecular number (Tb.N) were found in group T compared to in group C. A lower value of the Young's modulus was observed in the four-point bending trial in groups EF and T compared to group C.

The results of this study indicate that EF affects bone microarchitecture and leads to impaired biomechanical properties of bones in rats. Additionally, the negative effect of T on bone tissue was confirmed.
The results of this study indicate that EF affects bone microarchitecture and leads to impaired biomechanical properties of bones in rats. Additionally, the negative effect of T on bone tissue was confirmed.iFSP1 concentration

Stakeholder idea and supervision: Comprehending longitudinal collaboration sites.

Sargent Dunn — Sun, 19 Jan 2025 08:47:17 +0000

The novel coronavirus disease (COVID-19) quickly spread to all continents. However, data regarding all the signs and symptoms of COVID-19 are insufficient. Patients with COVID-19 might present higher susceptibility to fungal coinfections. Mucormycosis is a rare and often life-threatening fungal disease characterized by vascular invasion by hyphae, resulting in thrombosis and necrosis. This is the first case report of mucormycosis in a COVID-19 patient. An 86-year-old male patient was admitted to the emergency room with acute diarrhea, cough, dyspnea, and fever from 5 days prior. Blood tests revealed a hemoglobin level of 14.3 mg/dL. Five days following the admission, the patient presented with melena and a hemoglobin level of 5.6 mg/dL. A transfusion of three units of red blood cells was required. Esophagogastroduodenoscopy revealed two giant gastric ulcers with necrotic debris and a deep hemorrhagic base without active bleeding. Furthermore, biopsies confirmed mucormycosis. Despite intensive care, the patient died 36 hours after the esophagogastroduodenoscopy.Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis and cirrhosis. find more Accurate assessment of liver fibrosis is important for predicting disease outcomes and assessing therapeutic response in clinical practice and clinical trials. Although noninvasive tests such as transient elastography and magnetic resonance elastography are preferred where possible, histological assessment of liver fibrosis via semiquantitative scoring systems remains the current gold standard. Collagen proportionate area provides more granularity by measuring the percentage of fibrosis on a continuous scale, but is limited by the absence of architectural input. Although not yet used in routine clinical practice, advances in second harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy imaging show great promise in characterising architectural features of fibrosis at the individual collagen fiber level. Quantification and calculation of different detailed variables of collagen fibers can be used to establish algorithm-based quantitative fibrosis scores (e.g., qFibrosis, q-FPs), which have been validated against fibrosis stage in NAFLD. Artificial intelligence is being explored to further refine and develop quantitative fibrosis scoring methods. SHG-microscopy shows promise as the new gold standard for the quantitative measurement of liver fibrosis. This has reaffirmed the pivotal role of the liver biopsy in fibrosis assessment in NAFLD, at least for the near-future. The ability of SHG-derived algorithms to intuitively detect subtle nuances in liver fibrosis changes over a continuous scale should be employed to redress the efficacy endpoint for fibrosis in NASH clinical trials; this approach may improve the outcomes of the trials evaluating therapeutic response to antifibrotic drugs.Early postoperative anastomotic obstruction after colorectal surgery rarely develops. Herein, we present a case of a 50-year-old healthy woman who had an early postoperative anastomotic obstruction which was revealed caused by a blood clot and successfully managed by endoscopic approach. The patient was discharged after laparoscopic anterior resection and visited the emergency department one day after because of abdominal pain. Computed tomography showed that the anastomosis site was obstructed with low-density material. Intraoperative endoscopy was performed under general anesthesia and blood clot filling the lumen were identified. As the scope was advanced to the blood clot with air inflation, the blood clot was evacuated. The anastomosis site could be obstructed by blot clot with mucous debris albeit it is a rare condition. An endoscopic approach seems to be the first option in the diagnosis and treatment of postoperative obstruction at the anastomosis site and it could prevent unnecessary laparotomy.
Elderly population will comprise a substantial proportion of colorectal cancer (CRC) patients. We examined patients older than 80 years according to their clinical and pathological characteristics to fully understand the elderly patients.

CRC patients, 60 years or older at diagnosis, admitted between 2009 and 2014 at our hospital were enrolled. The patients were divided into 2 groups elderly (aged > 80 years, n = 133), and controls (aged 60 to 79 years, n = 596). Patient's demographics, risk factors for prognosis of CRC, Clinicopathological parameters, treatment, and survival rates were compared.

The mean ages were 83.9 and 64.8 years, respectively. Male-to-female ratio and tumor sidedness were comparable in both groups. Prognostic factors found in univariate analysis; differentiation, stage, lymphovascular invasion, and carcinoembryonic antigen showed no statistical difference. The microsatellite instability status and number of retrieved lymph nodes were also similar (17.2 vs 21.6, P = 0.505). A significant difference was found in the treatment approach for chemotherapy as the elderly patients with stage III and IV tend to have omitted adjuvant (43.6% vs. 92.8%, P < 0.001) or palliative (35.8% vs. 89.4%, P = 0.016) chemotherapy. Except in stage I, elderly patients showed significantly lower overall survival rates.

Current study shows far-elderly patients with CRC were less likely to receive standard treatments, which might have resulted in an inferior outcome. As the number of elderly patients with CRC increase, our results provide a basis for further clinical and molecular investigations of elderly CRC patients.
Current study shows far-elderly patients with CRC were less likely to receive standard treatments, which might have resulted in an inferior outcome. As the number of elderly patients with CRC increase, our results provide a basis for further clinical and molecular investigations of elderly CRC patients.Despite the technical limitations of minimally invasive surgery, laparoscopic total mesorectal excision (LTME) for rectal cancer has short-term advantages over open surgery, but the pathological outcomes reported in randomized clinical trials are still in controversy. Minimally invasive robotic total mesorectal excision (RTME) has recently been gaining popularity as robotic surgical systems potentially provide greater benefits than LTME. Compared to LTME, RTME is associated with lower conversion rates and similar or better genitourinary functions, but its long-term oncological outcomes have not been established. Although the operating time of RTME is longer than that of LTME, RTME has a shorter learning curve, is more convenient for surgeons, and is better for sphincter-preserving operations than LTME. The robotic surgical system is a good technical tool for minimally invasive surgery for rectal cancer, especially in male patients with narrow deep pelvises. Robotic systems and robotic surgical techniques are still improving, and the contribution of RTME to the treatment of rectal cancer will continue to increase in the future.find more