关键词： 光动力   尖锐湿疣   人乳头瘤病毒   复发因素  

摘要： 目的探讨光动力(ALA-PDT)单独或联合其他传统方法治疗尖锐湿疣(condy-loma acuminata, CA)后可能的复发因素,为临床防治工作提供可行性建议。方法收集本院150例自2019年1月-2020年6月临床和/或病理确诊为CA,并依据皮疹大小及发病部位不同使用ALA-PDT或ALA-PDT+液氮冷冻或ALA-PDT+微波治疗的CA患者临床资料,治疗后随访6个月,根据CA是否复发分为未复发组和复发组,统计患者一般资料、人乳头瘤病毒(human papillomavirus, HPV)感染情况及其他可能的危险因素(生活习惯、皮损情况等),分析影响CA复发的危险因素。结果实际纳入CA患者147例,65例完成HPV基因分型检测,62例阳性,3例阴性。Logistics多因素结果分析显示:治疗及随访期间有熬夜史(P=0.024,OR=17.931)、合并肛门和/或生殖器区域糜烂(P=0.009,OR=61.754)、有性生活史(P=0.015,OR=36.144)、性伴侣个数≥2(P=0.045,OR=11.952)、性伴侣HPV感染(P=0.014,OR=66.520)、合并其他性传播疾病或免疫系统相关疾病(P=0.021,OR=19.164)均是影响CA治疗后复发的独立危险因素(P<0.05,OR>1)。性生活时佩戴安全套(P=0.003,OR=0.003)是CA治疗后复发的保护因素(P<0.05,OR<1)。结论 CA患者治疗及随访期间有熬夜史、合并肛门和/或生殖器区域糜烂、有性生活史或与多个性伴侣有不洁性行为、性伴侣HPV感染、合并其他性传播疾病或免疫系统相关疾病时更容易引起治疗后CA复发,而性生活时佩戴安全套可有效降低CA复发风险。

关键词： maternal health services   quality improvement   length of stay   patient satisfaction  

摘要： Background Patients in remote communities who risk premature delivery require transfer to a tertiary care centre for obstetric and neonatal care. Following stabilisation, many patients are candidates for outpatient management but cannot be discharged to their home communities due to lack of neonatal intensive care unit (ICU) support. Problem Without outpatient accommodation proximal to neonatal ICU, these patients face prolonged hospitalisation-an expensive option with medical, social and psychological consequences. Therefore, we sought to establish an alternative accommodation for out-of-town stable antepartum patients. Methods Quality Improvement approaches were used to identify process strengths and opportunities for improvement on the antepartum ward in a tertiary care centre. Physician and patient surveys informed outpatient accommodation programme development by a multidisciplinary team. The intervention was implemented using a plan-do-study-act cycle. Barriers to patient discharge and enrolment in the programme were analysed by completing thematic and strengths-weaknesses-opportunities-threats (SWOT) analysis. Results Physicians broadly supported safe outpatient management, whereas patients were hesitant to leave the hospital even when physicians assured safety. Our alternative accommodation was pre-existing and cost-effective, however, we encountered significant barriers. The physical space limited family visits and social interaction, lacked desired amenities,and the programme proved inconvenient to patients. The thematic and SWOT analysis identified aspects of the intervention which can be optimised to develop future actionable strategies. Conclusion The utilisation of acute care beds is costly for the healthcare system and must be allocated judiciously. Patient needs, experience and health system barriers need to be considered when establishing alternative outpatient accommodations and strategies for stable antepartum patients.

关键词： dryland   India   Prosopis   restoration   woody plant-encroachment  

摘要： Woody plant encroachment is a pervasive global driver impacting grassland structure and functioning, and we know very little about efficacies of management techniques for restoring woody plant-encroached tropical grasslands. In the Banni grasslands of India, which are extensively encroached by an invasive woody legume, Prosopis juliflora, we test the efficacies of two Prosopis management methods-mechanical removal and lopping-to restore native grasslands. Across eight sites in the Banni, using a randomized block design, we monitored herbaceous plant recovery in the two Prosopis management treatments, and an unmanipulated control for 4 years. We also sampled four reference grasslands. We found native herbaceous plant richness and cover to be threefold (mean = 6 species) and sixfold (mean = 18% cover) higher, respectively, in the mechanical-removal treatment compared to the control (mean richness = 2 species, cover = 3%), but found no significant differences between the lopping trsuseatment (mean richness = 5 species, cover = 11%) and the control. While mechanical-removal increased plant diversity, neither management treatment changed the species composition, and both of these treatments were still missing perennial grasses that dominate the reference grasslands. Our data highlight the efficacy of mechanical removal over lopping in restoring native grasslands. However, mechanically removing Prosopis is costly, especially at larger scales. Apart from its detrimental impact on grasslands, Prosopis also has benefits varying with stakeholder groups, and its removal involves complex trade-offs. Until we fully understand the trade-offs involved, it may therefore be better to manage this social-ecological landscape as a mosaic of restored grassland and Prosopis-invaded patches.

关键词： Apparent total tract digestibility   Degradation kinetics   Equine   In-situ   Roughage  

摘要： To evaluate the effect of substituting hay with alternative fibrous feedstuffs, the total collection of faeces was used to measure the apparent total tract digestibility (ATTD). Nutrient disappearance and digestion kinetics were examined with the mobile bag technique (MBT) and marker passage measurements. Four caecally-cannulated horses (body weight (BW) 558 +/- 32 kg) were used in a cross-over design experiment with two periods of 14 days adaptation and four days of faecal collection. Horses were fed three times a day with either a hay-only (HAY) diet or a mixture of hay:supplement (MIX) (15.1 and 8.4:6.7 g dry matter (DM)/kg BW/day, respectively). The hay used in both treatments (HAY and MIX) was mainly of Timothy and first cut. The MIX supplement diet consisted of oat hulls, alfalfa-, sugar beet pulp-(SBP), grass-and soya hull pellets, each given in 0.44 g DM/kg BW/meal. On day 15 in each period, 20 bags of either hay or SBP and 6-12 bags (1x2x12 cm;37 mu m pore size;0.5 g feed) of each feedstuff and ytterbium (Yb, 3 g) were placed in the stomach or caecum, respectively. Bags were harvested from the caecum every hour and faeces were checked for bags every fourth hour, collection time was noted and data from the bags were used to estimate pre-caecal, hindgut and total tract nutrient disappearance. Further, faecal sub samples of 300 g were collected, weighed and stored for Yb analysis and further estimation of feed mean retention time. Rate and extent of feed degradation were estimated from the MBT assuming exponential degradation. The ATTD of DM was similar between the two diets (P > 0.05), but the HAY diet had higher ATTD of crude protein (CP) (P = 0.001), neutral detergent fibre assayed with heat-stable amylase and expressed inclusive of residual ash (aNDF) (P = 0.006), acid detergent fibre (ADF) (P = 0.017), hemicellulose (P = 0.001) and celluloseNDF (P < 0.001). The hindgut mean retention time (MRT) for Yb was longer for the MIX than the HAY diet (P < 0.001).

关键词： Language   Functional laterality   Brain neoplasms   Cerebellum   Magnetic resonance imaging  

摘要： Objectives Crossed cerebro-cerebellar BOLD activations have recently come to light as additional diagnostic features for patients with brain tumors. The covert verb generation (VG) task is a widely used language paradigm to determine these language-related crossed activations. Here we demonstrate these crossed activations in two additional language paradigms, the semantic and phonological association tasks. We propose the merit of these tasks to language lateralization determination in the clinic as they are easy to monitor and suitable for patients with aphasia. Methods Patients with brain tumors localized at different cortical sites (n = 71) performed three language paradigms, namely the VG task as well as the semantic (SA) and phonological (PA) association tasks with button-press responses. Respective language activations in disparate cortical regions and the cerebellum were assigned laterality. Agreements in laterality between the two new tasks and the verb generation task were tested using Cohen's kappa. Results Both tasks significantly agreed in cortical and cerebellar lateralization with the verb generation task in patients. Additionally, a McNemar test confirmed the presence of crossed activations in the cortex and the cerebellum in the entire subject population. Conclusion We demonstrated that the semantic and phonological association tasks resulted in crossed cerebro-cerebellar language lateralization activations as those observed due to the covert verb generation task. This may suggest the possibility of these tasks being used conjointly with the traditional verb generation task, especially for subjects that may be unable to perform the latter.

关键词： alternative splicing   carcinogenesis   chemotherapy   cholangiocarcinoma   hepatocellular carcinoma   metastasis   multidrug resistance  

摘要： Simple Summary Among the top ten deadly solid tumors are the two most frequent liver cancers, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma, whose development and malignancy are favored by multifactorial conditions, which include aberrant maturation of pre-mRNA due to abnormalities in either the machinery involved in the splicing, i.e., the spliceosome and associated factors, or the nucleotide sequences of essential sites for the exon recognition process. As a consequence of cancer-associated aberrant splicing in hepatocytes- and cholangiocytes-derived cancer cells, abnormal proteins are synthesized. They contribute to the dysregulated proliferation and eventually transformation of these cells to phenotypes with enhanced invasiveness, migration, and multidrug resistance, which contributes to the poor prognosis that characterizes these liver cancers. The two most frequent primary cancers affecting the liver, whose incidence is growing worldwide, are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA), which are among the five most lethal solid tumors with meager 5-year survival rates. The common difficulty in most cases to reach an early diagnosis, the aggressive invasiveness of both tumors, and the lack of favorable response to pharmacotherapy, either classical chemotherapy or modern targeted therapy, account for the poor outcome of these patients. Alternative splicing (AS) during pre-mRNA maturation results in changes that might affect proteins involved in different aspects of cancer biology, such as cell cycle dysregulation, cytoskeleton disorganization, migration, and adhesion, which favors carcinogenesis, tumor promotion, and progression, allowing cancer cells to escape from pharmacological treatments. Reasons accounting for cancer-associated aberrant splicing include mutations that create or disrupt splicing sites or splicing enhancers or silencers, abnormal expression of splicing factors, and impaired signaling pathways af

关键词： multisystem inflammatory syndrome in children (MIS-C)   COVID-19   pediatrics   diagnosis   management   New York  

摘要： On March 20, 2021, the Columbia University Department of Anesthesiology hosted the Papper virtual event dedicated to an academic discussion of various aspects of coronavirus disease-2019. Dr. Eva Cheung, a pediatric intensivist and pediatric cardiologist, spoke about the clinical challenges associated with tackling multisystem inflammatory syndrome in children, a novel clinical entity in pediatric patients related to coronavirus disease-2019, and the experience with confronting multisystem inflammatory syndrome in children in New York.

关键词： Genomics   RNA   RNA metabolism   Life Sciences   general   Biochemistry   Protein Structure   Membrane Biology   Biological Microscopy  

摘要： Analogous to alternative splicing, alternative polyadenylation (APA) has long been thought to occur independently at proximal and distal polyA sites. Using fractionation-seq, we unexpectedly identified several hundred APA genes in human cells whose distal polyA isoforms are retained in chromatin/nuclear matrix and whose proximal polyA isoforms are released into the cytoplasm. Global metabolic PAS-seq and Nanopore long-read RNA-sequencing provide further evidence that the strong distal polyA sites are processed first and the resulting transcripts are subsequently anchored in chromatin/nuclear matrix to serve as precursors for further processing at proximal polyA sites. Inserting an autocleavable ribozyme between the proximal and distal polyA sites, coupled with a Cleave-seq approach that we describe here, confirms that the distal polyA isoform is indeed the precursor to the proximal polyA isoform. Therefore, unlike alternative splicing, APA sites are recognized independently, and in many cases, in a sequential manner. This provides a versatile strategy to regulate gene expression in mammalian cells. New data reveal a sequential mode of alternative polyadenylation. Distal polyA sites are processed first and the resultant transcripts are retained in the nuclear-chromatin matrix for subsequent cleavage and polyadenylation at proximal polyA sites.

关键词： mitochondrial potassium channels   cytoprotection   mitochondria   potassium channel openers  

摘要： Mitochondrial potassium channels control potassium influx into the mitochondrial matrix and thus regulate mitochondrial membrane potential, volume, respiration, and synthesis of reactive oxygen species (ROS). It has been found that pharmacological activation of mitochondrial potassium channels during ischemia/reperfusion (I/R) injury activates cytoprotective mechanisms resulting in increased cell survival. In cancer cells, the inhibition of these channels leads to increased cell death. Therefore, mitochondrial potassium channels are intriguing targets for the development of new pharmacological strategies. In most cases, however, the substances that modulate the mitochondrial potassium channels have a few alternative targets in the cell. This may result in unexpected or unwanted effects induced by these compounds. In our review, we briefly present the various classes of mitochondrial potassium (mitoK) channels and describe the chemical compounds that modulate their activity. We also describe examples of the multidirectional activity of the activators and inhibitors of mitochondrial potassium channels.

关键词： APEX   Calf weight gain algorithm   Multiple-paddock rotation grazing   Continuous grazing   Economic income   Stocking density  

摘要： CONTEXT: Simulation tools are increasingly used to inform grazing management decisions by assessing livestock performance, as well as environmental and economic impacts. Ability to represent the grazing of multiple pastures (i.e., paddocks) that differ in soil, hydrology, vegetation, and management is critical for reliable grazing management decision support. OBJECTIVE: The main objectives of this study were to: 1) modify APEX (Agricultural Policy/Environmental eXtender) for sub-daily grazing, cow-calf weight gain, and supplemental hay, and 2) evaluate the APEX modifications in terms of simulating biomass, calf weight gain, economic impacts of alternative cow-calf grazing management strategies. METHODS: APEX was modified to enhance its ability to simulate alternative grazing management strategies by including sub-daily grazing among multiple paddocks, supplemental hay estimation, and optional simulation of cow-calf weight gain based either on energy or total digestible nutrients (TDN). Simulation results were evaluated against a 5-year experimental data set from Central Texas comparing multi-paddock rotational grazing and conventional continuous grazing. RESULTS AND CONCLUSION: The modified APEX model adequately simulated the responses of vegetation biomass (coefficient of determination, R-2 = 0.60-0.70), hay consumption (R-2 = 0.94-0.95), calf weaning weight (R-2 = 0.52-0.65), costs (R-2 = 0.98), and profits (R-2 = 0.89) to the two grazing treatments across years. Simulations with the energy-based weight gain algorithm showed more pronounced effects on above-ground biomass, whereas the TDN-based algorithm had a more pronounced weight gain response to forage intake and hay quality. No significant differences (p > 0.05) in biomass and calf weaning weight were observed between treatments across the years for measured data and for energy-based APEX simulation;however, the TDN-based algorithm simulated lower calf weaning weight in multi-paddock rotational grazing than i