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Purpose: To examine the ability of testicular histopathology in Non-obstructive azoospermia (NOA) in predicting sperm retrieval rate (SR), sperm quality and assisted reproductive technology success. Methods: A retrospective study recruited clinically diagnosed NOA patients between 2007 and 2015. Testicular biopsy and conventional sperm extraction (TESE) were done concomitantly. Correlation between pathological categories, SR rate, sperm quality and success of intracytoplasmic sperm injection (ICSI) was studied. FSH was measured as a predictor of fertility. Results: One hundred eighteen patients were recruited. Histopathological classification was hypospermatogenesis (HS) 45 (38%), maturation arrest (MA) 22(19%), Sertoli cell only syndrome (SCOS) 34 (29%) and normal spermatogenesis (NS) 17 (14%). FSH value was above normal level in 34 (76%) of HS, 19 (86%) of MA, 32 (94%) of SCOS and 5 (29%) of NS. Positive SR was obtained in 108 (92%) patients. The highest SR rate was seen in NS group 100% and the lowest was in SCOS 26 (77%). The worst sperm quality was found in SCOS as type C represents 46%, followed by MA 40% and HS 24%. Patients had ICSI following TESE had variable success rate as success of ICSI was seen (9/15) for HS, (0/7) for MA, (5/15) for SCOS and (8/9) for NS. FSH is strongly correlated to SR, quality of sperm and success of ICSI as positive SR in normal FSH patients was obtained in 28 (100%) of normal FSH, 70 (97%) of high FSH and 10 (56%) of double high FSH (p value < 001). The success of ICSI significantly correlates with FSH value as normal FSH has 77% success ICSI rate, high FSH (52%) and double high FSH (0%) (p value < 0.001). Conclusions: Testicular biopsy and histopathology findings in NOA are strongly correlated SR rate, quality of sperms, and success of ICSI. FSH is a strong noninvasive predictor of fertility in NOA patients. [ABSTRACT FROM AUTHOR]

The article focuses on the experience of a Palestinian living in the West, navigating a dual identity shaped by the erasure of their home and the disconnect from their heritage, which includes the emotional impact of witnessing the destruction of Gaza..

Although epidemiological data on heart failure (HF) with preserved ejection fraction (HFpEF) are scarce in the Middle East, North Africa and Turkey (MENAT) region, Lancet Global Burden of Disease estimated the prevalence of HF in the MENAT region in 2019 to be 0.78%, versus 0.71% globally. There is also a high incidence of HFpEF risk factors and co‐morbidities in the region, including coronary artery disease, diabetes, obesity, hypertension, anaemia and chronic kidney disease. For instance, 14.5–16.2% of adults in the region reportedly have diabetes, versus 7.0% in Europe. Together with increasing life expectancy, this may contribute towards a higher burden of HFpEF in the region than currently reported. This paper aims to describe the epidemiology and burden of HFpEF in the MENAT region, including unique risk factors and co‐morbidities. It highlights challenges with diagnosing HFpEF, such as the prioritization of HF with reduced ejection fraction (HFrEF), the specific profile of HFpEF patients in the region and barriers to effective management associated with the healthcare system. Guidance is given on the diagnosis, prevention and management of HFpEF, including the emerging role of sodium‐glucose co‐transporter‐2 inhibitors. Given the high burden of HFpEF coupled with the fact that its prevalence is likely to be underestimated, healthcare professionals need to be alert to its signs and symptoms and to manage patients accordingly. Historically, HFpEF treatments have focused on managing co‐morbidities and symptoms, but new agents are now available with proven effects on outcomes in patients with HFpEF. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a devastating neurodegenerative disorder for which there is no cure. Recently, several studies have reported a significant reduction in the incidence and progression of dementia among some patients receiving antihypertensive medications such as angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs). Why these drugs are beneficial in some AD patients and not others is unclear although it has been shown to be independent of their role in regulating blood pressure. Given the enormous and immediate potential of ACE-Is and ARBs for AD therapeutics it is imperative that we understand how they function. Recently, studies have shown that ACEIs and ARBs, which target the renin angiotensin system in mammals, are also effective in suppressing neuronal cell death and memory defects in Drosophila models of AD despite the fact that this pathway is not conserved in flies. This suggests that the beneficial effects of these drugs may be mediated by distinct and as yet, identified mechanisms. Here, we discuss how the short lifespan and ease of genetic manipulations available in Drosophila provide us with a unique and unparalleled opportunity to rapidly identify the targets of ACE-Is and ARBs and evaluate their therapeutic effectiveness in robust models of AD. [ABSTRACT FROM AUTHOR]

By compiling data from literature and unpublished reports a more detailed description is presented on the geographical and stratigraphic distribution of the Alum Shale Formation (ASF) and correlateable units on the East European Platform. In the northern part of Gotland, downfaulted patchy beds of the ASF indicate a former wider extension of the formation. Lower Ordovician (Tremadocian) examples of downfaulted patchy beds are the contemporaneous Sepopol and Nivenskaya formations in northeastern Poland and the Kaliningrad area, as well as the Salantai Formation in the east Baltic area. It is indicated that Furongian-Tremadocian beds, contemporaneous with the Kallavere, Türisalu, Tosna and Koporye formations, in the area of northern Estonia and the northwestern part of the Moscow Basin, extended to the Gotland and the South Bothnian Basin areas. South of Gotland, in the Swedish sector of the Baltic Basin, drill cores show evidence of tectonic movements through the presence of erosional surfaces indicating occasional subaerial exposure. In this region, variations in the areal extent and thickness of the ASF and coeval formations are suggested to be the result of epeirogenic and tectonic block movements. Tremadocian ASF is also indicated to be present south of Gotland. On Gotland, at least 5 m of the ASF is presumed to have been eroded. The Moscow Basin contains 19 m of dark shales (Koporye Formation) which is significantly thicker than in surrounding areas. [ABSTRACT FROM AUTHOR]

The present study focuses on the optimum design effectiveness in heat removal for small surfaces. Pin-fin made of solid and porous cylindrical shape forming chevron is investigated numerically using the finite element method. The design consists of 3-chevron and 5-chevron configurations connected to a heated block with fluid circulating between the chevron and above them. Variable Reynolds number and pin-fins height ranging from 2 mm to 8 mm are investigated. The full Navier–Stokes equation combined with the energy equation was solved in the presence of the solid pin-fins. The Darcy–Brinkman model with the effective energy equation is used in the presence of the porous pin-fins. The system is solved for Reynolds numbers ranging from 50 to 1000, thus remaining in the laminar regime. Results revealed that the best performance evaluation criterion is higher for the 8 mm porous pin-fins regardless of their permeability. If one ignores the pressure drop and friction contribution, a solid pin-fin having a height of 4 mm showed the best heat absorption mechanism. [ABSTRACT FROM AUTHOR]

Background: The efficacy of high flow nasal canula oxygen therapy (HFNO) to prevent invasive mechanical ventilation (IMV) is not well established in severe coronavirus disease 2019 (COVID-19). The aim of this study was to compare the risk of IMV between two strategies of oxygenation (conventional oxygenation and HFNO) in critically ill COVID 19 patients. Methods: This was a bicenter retrospective study which took place in two intensive care units (ICU) of tertiary hospitals in the Paris region from March 11, to May 3, 2020. We enrolled consecutive patients hospitalized for COVID-19 and acute respiratory failure (ARF) who did not receive IMV at ICU admission. The primary outcome was the rate of IMV after ICU admission. Secondary outcomes were death at day 28 and day 60, length of ICU stay and ventilator-free days at day 28. Data from the HFNO group were compared with those from the standard oxygen therapy (SOT) group using weighted propensity score. Results: Among 138 patients who met the inclusion criteria, 62 (45%) were treated with SOT alone, and 76 (55%) with HFNO. In HFNO group, 39/76 (51%) patients received IMV and 46/62 (74%) in SOT group (OR 0.37 [95% CI, 0.18–0.76] p = 0.007). After weighted propensity score, HFNO was still associated with a lower rate of IMV (OR 0.31 [95% CI, 0.14–0.66] p = 0.002). Length of ICU stay and mortality at day 28 and day 60 did not significantly differ between HFNO and SOT groups after weighted propensity score. Ventilator-free days at days 28 was higher in HNFO group (21 days vs 10 days, p = 0.005). In the HFNO group, predictive factors associated with IMV were SAPS2 score (OR 1.13 [95%CI, 1.06–1.20] p = 0.0002) and ROX index > 4.88 (OR 0.23 [95%CI, 0.008–0.64] p = 0.006). Conclusions: High flow nasal canula oxygen for ARF due to COVID-19 is associated with a lower rate of invasive mechanical ventilation. [ABSTRACT FROM AUTHOR]

The spatial data infrastructures (SDIs) which constitute a direct link between spatial data users and the large Earth observation industry, have a leading role in establishing market opportunities in the space sector. The spatial information supplied through various forms of SDI platforms exhibits large increases in demand volatility. The users' demand is unpredictable and the market is vulnerable to high evolution shifts. We study the effect of extreme demands for a particular type of spatial information, the satellite images. Drawing on two French SDIs, GEOSUD and PEPS, we examine the shifts occurring on their platforms and assess the probability of witnessing a spike/drop in the short term of different satellite imagery schemes: the high resolution images through GEOSUD; the Landsat (U.S.), Sentinel (Europe) and SPOT (France) images through PEPS. We analyze the market stability through the two SDIs and evaluate the probability of future records by using the Records theory. The results show that the high resolution images demand through GEOSUD, for which the classical i.i.d. model fits the most, is stable. Moreover, the Yang-Nevzorov model fits to the Landsat data, due to more records concentrated beyond the first observations. The Landsat demand is the less stable out of the other three satellite images series, and the probability of having a record in the coming years is the highest. While the use of Records theory drops mathematical constraints, it offers an alternative solution to the non-applicability of the machine learning techniques and long-term memory models. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between career decision-making self-efficacy (CDMSE) and parental attachment, dysfunctional career thoughts, and career exploration in a sample of 170 Lebanese Grade 11 students drawn from 10 private schools that provide career guidance services. The following tools were used to assess the variables: Career Decision-Making Self-Efficacy Scale – short form (CDMSE-SF), the Parent and Peer Attachment Bonds (IPPA), the Career Thoughts Inventory (CTI), and the Career Exploration survey (CES). Data were analysed using Pearson correlation and stepwise multiple regression. Regression results showed a significant association between parental attachment, dysfunctional career thoughts, career exploration and CDMSE. Career exploration accounted for the largest variance in CDMSE, followed by dysfunctional career thoughts and parental attachment. Theoretical and practical implications for career counselling are discussed. [ABSTRACT FROM AUTHOR]

The high data density on electronic medical record screens is touted as a major usability issue. However, it may not be a problem if the data is relevant and well-organized. Our objective was to test this assumption using a comprehensive set of measures that assess the three pillars of usability: efficiency (both physical and cognitive), effectiveness, and satisfaction. Physicians were asked to go through a series of tasks using two versions of the same electronic medical record: one where all the display items were separated into tabs (the original display), and one where important display items were grouped logically in one tab (the redesigned display). Results supported the hypothesis that combining relevant data in organized fashion into a smaller location would improve usability. The findings highlight the role of good display organization to mitigate the effects of high data density, as well as the importance of assessing cognitive load as part of usability studies. [ABSTRACT FROM AUTHOR]

Background. There is robust evidence that compromised parenting, stemming from persistently high stress, mediates the impact of war and displacement on children's mental health and psychosocial wellbeing. Parenting interventions generally prioritize the acquisition of parenting knowledge and skills, while under-attending to parental stress and distress. This paper describes the development of the Caregiver Support Intervention (CSI), a nine-session group intervention for conflict-affected parents of children aged 3-13, that aims to strengthen parenting both indirectly, by lowering stress and improving psychosocial wellbeing among parents, and directly, by increasing knowledge and skill related to positive parenting. Methods. We describe the multi-phase, iterative process by which we developed the CSI, and illustrate the essential role of community input in shaping the intervention and strengthening its cultural fit and perceived usefulness. We used focus group data from participants in successive cycles of implementation, feedback, and revision, as well as quantitative data and expert consultation to develop a culturally and empirically grounded intervention. Results. This mixed-method, iterative approach to intervention development enabled us to develop a psychosocial intervention for conflict-affected caregivers that is feasible, acceptable, and perceived by participants as useful in addressing their own wellbeing and their parenting. Focus group data support the underlying model in which caregiver wellbeing powerfully influences parenting. Conclusions. Programs aimed at strengthening parenting in conflict-affected communities should substantively address caregiver wellbeing. An iterative approach incorporating community feedback can help ensure intervention acceptability and feasibility. We also illustrate the feasibility of involving men in parenting interventions. [ABSTRACT FROM AUTHOR]

In vitro experimental evolution has taught us many lessons on the molecular bases of adaptation. To move towards more natural settings, evolution in the mice gut has been successfully performed. Yet, these experiments suffered from the use of laboratory strains as well as the use of axenic or streptomycin‐treated mice to maintain the inoculated strains. To circumvent these limitations, we conducted a one‐year experimental evolution in vivo using a natural isolate of E. coli, strain 536, in conditions mimicking as much as possible natural environment with mother‐to‐offspring microbiota transmission. Mice were then distributed in 24 independent cages and separated into two different diets: a regular one (chow diet, CD) and high‐fat and high‐sugar one (Western Diet, WD). Genome sequences revealed an early and rapid selection during the breastfeeding period that selected the constitutive expression of the well‐characterized lactose operon. E. coli was lost significantly more in CD than WD; however, we could not detect any genomic signature of selection, nor any diet specificities during the later part of the experiments. The apparently neutral evolution presumably due to low population size maintained nevertheless at high frequency the early selected mutations affecting lactose regulation. The rapid loss of lactose operon regulation challenges the idea that plastic gene expression is both optimal and stable in the wild. [ABSTRACT FROM AUTHOR]

Introduction: Overactive bladder (OAB) is a prevalent syndrome that is associated with multiple urinary tract symptoms and could affect the patient's quality of life and well‐being. Vitamin D is shown to be linked to OAB syndrome, which exacerbated by stress conditions. This study evaluated the relationship between vitamin D status, daily calcium intake and OAB, and the associated psychological symptoms. Methods: The study included 55 patients with OAB and 129 healthy controls. Psychological symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Serum vitamin D was measured. Patients with OAB with low vitamin D level received orally vitamin D supplementation. Urinary symptoms, psychological symptoms, and quality of life were evaluated before and after vitamin D supplementation plus dairy products. Results: Vitamin D deficiency was more prevalent in cases (80%) vs controls (34.9%). Depression (43.7% vs 20.2%) and anxiety (52.8% vs 10.9%) scores (HADS, ≥8) were also more frequent in cases vs controls, respectively. Some 85.5% of the patients' group had musculoskeletal pain vs 0.0% for the control. Depression was negatively correlated with daily calcium intake and positively with anxiety. Logistic regression analysis revealed that age, vitamin D, and anxiety scores were significant predictors of OAB. Vitamin D supplements with increased calcium intake had significant improvement in urinary symptoms, psychological distress, and quality of life. Conclusions: Vitamin D supplements and improved calcium intake may improve urinary and psychological symptoms and quality of life among patients with OAB syndrome. Assessment for vitamin D status in patients with OAB may be warranted. [ABSTRACT FROM AUTHOR]

Background/aim: Hands are commonly involved in burn trauma. Occupational therapy in the acute phase aims to reduce the risk of deformities and facilitate return to usual occupations. This study aimed to describe usual occupational therapy care at a major adult burns service, and measure recovery from hand burns in the first six months post‐acute hospital discharge. Method: To describe usual occupational therapy care, an audit of patient contact statistics over six months was undertaken, and occupational therapy staff were interviewed. To measure recovery, a prospective cohort study recruited adults hospitalised with hand/upper limb burns at the Victorian Adult Burns Service. Recruitment occurred over a four month period. Functional recovery was measured at three time points: discharge, three and six months post‐discharge. Instruments included the Quick Disabilities of the Arm, Shoulder and Hand and the Functional Assessment for Burns. Results: Usual care was calculated to be one 30 minute session of daily occupational therapy. Interventions were described using the Template for Intervention Description and Replication. Participants (N = 10) were aged 22–65 years and were treated for burns ranging from 2% to 40% total body surface area. Scores on the Functional Assessment for Burns suggested high functional independence at discharge. Quick Disabilities of the Arm, Shoulder and Hand scores improved significantly at each time point, with most substantial improvement occurring between discharge and three months. Involvement of the first web‐space was associated with poorer recovery in the first three months post‐discharge (P = 0.04). Six participants (60%) had returned to work at the three month follow‐up, and seven (70%) at six months. Conclusion: The Quick Disabilities of the Arm, Shoulder and Hand was responsive to recovery in the post‐discharge period. Further research into upper limb recovery following burns is needed, including exploration of the relationship between recovery and first web space hand burns. [ABSTRACT FROM AUTHOR]

A review of the article "Neuronal protein tyrosine phosphatase 1B hastens amyloid Beta-associated Alzheimer's disease in mice," by K. Ricke, S. Cruz, Z. Qin, K. Farrokhi, F. Sharmin, L. Zhang, M. Zasloff, A. Stewart, and H. Chen, which was published in a 2020 issue of the journal is presented.

This paper presents a new interpretation of the Levant margin, offshore Lebanon, with a review of Lebanese onshore geology and a new evaluation of the petroleum systems of the Eastern Mediterranean. Here, we divide the Lebanese onshore and offshore into four domains: the distal Levant Basin, the Lattakia Ridge, the Levant margin, and the onshore. Each domain is characterised by a particular structural style and stratigraphic architecture, resulting in different source‐reservoir‐trap configurations. This new division draws attention to specific areas of exploration interest in which there are distinct petroleum systems. Following a review of previously published data, this study presents new results from stratigraphic, structural and geochemical investigations. The results include a new interpretation of the Levant margin, focussing on the carbonate‐dominated stratigraphy of this area and its petroleum potential. New petroleum systems charts are presented for each of the four domains to refine and summarize the updated geological knowledge. [ABSTRACT FROM AUTHOR]

The aim of this paper is to explore the reasons of oil price volatility. It analyses the information function of oil future market and investigates the relation between speculation and spot oil price in the short run. Furthermore, the paper constructs a model for long run equilibrium able to produce reliable and reasonable oil price forecasts. Findings prove that in the short run, changes in oil inventories Granger cause changes in oil price. In the long run however, findings prove that, the oil demand, the oil supply, the $/SDR exchange rate, the speculation in oil future market (New York Mercantile Exchange) and the oil inventories are associated in a long run relationship. [ABSTRACT FROM AUTHOR]

Introduction: Nutcracker syndrome is a rare disease entity that is caused by entrapment of the left renal vein between the aorta and superior mesenteric artery, usually due to abnormal branching of the superior mesenteric artery from the aorta causing renal venous hypertension. The symptoms vary from asymptomatic hematuria to severe pelvic congestion. Celiacomesenteric trunk anomaly is a rare variation of splanchnic artery anomaly that occurs when the celiac trunk and superior mesenteric arteries have a common origin from the aorta. A disease involving the rarely encountered celiacomesenteric trunk anomaly is extremely uncommon. To our knowledge, association between nutcracker syndrome and celiacomesentric trunk anomaly has not been reported in the literature. Case presentation: A 14-year-old boy with no significant past medical history presented with a 3-year painless hematuria. CT-angiogram revealed anterior nutcracker syndrome with celiacomesenteric trunk anomaly. The patient was managed conservatively with close follow-up. Conclusion: Nutcracker syndrome associated with celiacomesenteric trunk anomaly is extremely uncommon and is a rare cause of hematuria in children. Whether this abnormal anatomy is the cause of nutcracker syndrome or just an association should be investigated. Moreover, awareness of this anatomical variation may help in planning therapeutic options and reducing the chance of surgical iatrogenic injuries. [ABSTRACT FROM AUTHOR]

Copyright of Arab Journal of Psychiatry is the property of Arab Federation of Psychiatrists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although microbial ecology of the gut is now a major focus of interest, little is known about the molecular determinants of microbial adaptation in the gut. Experimental evolution coupled with whole-genome sequencing can provide insights of the adaptive process. In vitro experiments have revealed some conserved patterns: intermediate convergence, and epistatic interactions between beneficial mutations and mutations in global regulators. To test the relevance of these patterns and to identify the selective pressures acting in vivo, we have performed a long-term adaptation of an E. coli natural isolate, the streptomycin-resistant strain 536, in the digestive tract of streptomycin-treated mice. After a year of evolution, a clone from 15 replicates was sequenced. Consistently with in vitro observations, the identified mutations revealed a strong pattern of convergence at the mutation, gene, operon and functional levels. Yet, the rate of molecular evolution was lower than in in vitro , and no mutations in global regulators were recovered. More specific targets were observed: the dgo operon, involved in the galactonate pathway that improved growth on D-galactonate, and rluD and gidB, implicated in the maturation of the ribosomes, which mutations improved growth only in the presence of streptomycin. As in vitro, the nonrandom associations of mutations within the same pathways suggested a role of epistasis in shaping the adaptive landscape. Overall, we show that 'evolve and sequence' approach coupled with an analysis of convergence, when applied to a natural isolate, can be used to study adaptation in vivo and uncover the specific selective pressures of that environment. [ABSTRACT FROM AUTHOR]

Congestive heart failure is a significant cause of hospitalization, rehospitalization, and death. Reducing hospital readmission rates is a national priority. Various telemonitoring devices and programs have been developed to help meet this goal. The Health Connect system incorporates monitoring of physiologic data with regular virtual provider appointments. The Health Connect system integrates traditional telemedicine with virtual provider appointments. Virtual appointments empower patients to advocate for their own health by providing numerous opportunities for education and feedback. In addition to early identification of impending decompensation, virtual appointments allow providers to address noncompliance, which is a major factor driving poor outcomes. Further research is required to confirm the benefit of the Health Connect system. [ABSTRACT FROM AUTHOR]

Sedimentary basins adjacent to plate boundaries contain key tectonic and stratigraphic elements to understand how stress is transmitted through plates. The Levant Basin is a place of choice to study such elements because it flanks the Levant Fracture System and the Africa/Anatolia boundary. This paper uses new high-quality 3-D seismic reflection data to unravel the tectonic evolution of the margin of this basin during the Cenozoic, the period corresponding to the formation of the Levant Fracture System, part of the Africa/Arabia plate boundary. Four major groups of structures are identified in the interpreted Cenozoic units: NW-SE striking normal faults, NNE-SSW striking thrust-faults, ENE-WSW striking dextral strike-slip faults, and NNE trending anticlines. We demonstrate that all structures, apart of the NW-SE striking normal faults, are inherited from Mesozoic faults. Their reactivation and associated folding started during the late Miocene prior to the Messinian salinity crisis due to a NW-SE compressional stress field. No clear evidence of shortening at present-day offshore Lebanon and no large NNE-SSW strike-slip faults parallel to the restraining bend are found indicating that the Levant Fracture System is mainly contained onshore at present day. The intermittent activity of the interpreted structures correlates with the two stages of Levant Fracture System movement during late Miocene and Pliocene. This paper provides a good example of the impact of the evolution of plate boundaries on adjacent basins and indicates that any changes in the stress field, as controlled by the plate boundary, will affect immediately the preexisting structures in adjacent basins. [ABSTRACT FROM AUTHOR]

It is important that the clinical effectiveness of referral pathways brought in to streamline patient care are critically evaluated. One such pathway for orthopaedic patients is a musculoskeletal community assessment triage service (MCATS). This study examines the service for patients with hip or knee complaints in comparison with referral directly to secondary care. A single general practice referred 432 patients with hip or knee complaints over a 5-year period: 225 through MCATS and 206 directly to secondary care. Time to initial consultation was 4 days longer, on average, in secondary care (p=0.05), but time from referral to achieving a working diagnosis was 11 days longer for MCATS patients (p<0.001), with more consultations required (p<0.001). Overall, the use of cross-sectional imaging was greater at MCATS than in secondary care (p=0.04). Patients referred directly to secondary care required surgical management more frequently (36% vs 16%; p<0.001). GPs can triage patients effectively who are likely to require surgery when referring to hip and knee services. Patients referred to MCATS require more consultations, undergo more cross-sectional imaging and wait longer before a working diagnosis is established, when compared with direct referral to secondary care. [ABSTRACT FROM AUTHOR]

This study has found numerous novel genetic variants of GA-insensitive dwarfing genes with potential agricultural value for crop improvement. The cultivar, Spica is a tall genotype and possesses the wild-type genes of Rht-A1a, Rht-B1a and Rht-D1a. The cultivar Quarrion possesses a null mutant in the DELLA motif in each of the 3 genomes. This is a first report of a null mutant of Rht-A1. In addition, novel null mutants which differ from reported null alleles of Rht-B1b, Rht-B1e and Rht-D1b have been found in Quarrion, Carnamah and Whistler. The accession, Aus1408 has an allele of Rht-B1 with a mutation in the conserved ‘TVHYNP’ N-terminal signal binding domain with possible implications on its sensitivity to GA. Mutations in the conserved C-terminal GRAS domain of Rht-A1 alleles with possible effects on expression have been found in WW1842, Quarrion and Drysdale. Genetic variants with putative spliceosomal introns in the GRAS domain have been found in all accessions except Spica. Genome-specific cis-sequences about 124 bp upstream of the start codon of the Rht-1 gene have been identified for each of the three genomes. [ABSTRACT FROM AUTHOR]

NDRG1 (N-myc downstream regulated gene-1) is a metastasis suppressor that is down-regulated in prostate cancer. NDRG1 phosphorylation is associated with inhibition of metastasis and Western blots indicate two bands at ~41 and ~46 kDa. Previous investigations by others suggest the higher band is due to NDRG1 phosphorylation. However, the current study using a dephosphorylation assay and the Phos-tag (phosphate-binding tag) SDS/PAGE assay, demonstrated that the 46 kDa NDRG1 protein band was not due to phosphorylation. Further experiments showed that the NDRG1 protein bands were not affected upon glycosidase treatment, despite marked effects of these enzymes on the glycosylated protein, fetuin. Analysis using RT-PCR (reverse transcriptase-PCR) demonstrated only a single amplicon, and thus, the two bands could not result from an alternatively spliced NDRG1 transcript. Westernblot analysis of prostate cancer cell lysates identified the 41 kDa band to be a truncated form of NDRG1, with MS confirming the full and truncated proteins to be NDRG1. Significantly, this truncated protein was not present in normal human PrECs (prostate epithelial cells). Western-blot analysis using anti-NDRG1 raised to its N-terminal sequence failed to detect the truncated protein, suggesting that it lacked N-terminus amino acids (residues 1-49). Sequence analysis predicted a pseudotrypsin protease cleavage site between Cys49-Gly50. Such cleavage of NDRG1 in cancer cells may result in loss of NDRG1 tumour suppressive activity. [ABSTRACT FROM AUTHOR]

Recently, there has been an increased interest in producing electronic courses. However, literature shows that adopting e-learning does not guarantee improved learning. This is because mixing technology and content does not necessarily yield effective learning. This paper presents a systematic design process for developing blended courses for undergraduate higher education. The instructional design process is based on instructional design theories and utilized three taxonomies: Bloom Taxonomy, Redeker Taxonomy and Guerra scale. A mapping model is proposed and embedded in the design process to develop a blended course starting from the objectives and content of a traditional course. This paper also presents a evaluation process that estimates the effectiveness of the selected technologies in the design of the blended course. This effectiveness is evaluated in terms of three dimensions: course content formats, interaction and collaboration. A case study is presented to demonstrate the proposed design approach on a System Analysis and Design blended course under development. [ABSTRACT FROM AUTHOR]

Summary: Twenty-nine children with malignancies and age, gender-matched controls were prospectively studied over 14 months. Patients had higher parathyroid hormone (PTH) levels and fat mass, lower bone mass, and bone mass increments at follow-up than controls. Lean mass, age at diagnosis, systemic and intrathecal therapy were predictors of bone mass changes on adjusted analyses. Introduction: Children with hematologic malignances have low bone mass. We prospectively investigated anthropometric, clinical, and hormonal predictors of changes in bone mass in children receiving cancer therapy. Methods: Twenty-nine children, mean age of 9 ± 2.9 years and 32 age and gender-matched controls, were studied. Seven had completed their course 40 ± 22 weeks prior, while 22 were still receiving therapy for 80 ± 28 weeks. Age at diagnosis, calcium intake, exercise activity, systemic corticosteroids in dexamethasone (Dex) dose, and methotrexate (MTX), and intrathecal MTX therapy received within follow-up period were assessed. Routine chemistries, PTH, 25-hydroxy vitamin D (25-OHD), bone remodeling markers, bone mass, and body composition were measured at baseline and 14 months. Results: Patients had lower exercise activity, sun exposure, and bone markers levels than controls. They had higher PTH levels and fat mass, lower bone mass at the spine, hip, and total body, and lower increments at these sites on follow-up. Predictors of bone mass changes on univariate analyses were: age at diagnosis ( R = −0.50 to −0.44, p < 0.05), Dex-MTX doses ( R = −0.58 to −0.41, p < 0.05), intrathecal therapy ( p < 0.03),% changes in lean mass ( R = 0.37 to 0.54, p < 0.04), 25-OHD levels ( R = 0.39, p < 0.03), and PTH levels (R = −0.47 to −0.41, p < 0.05). Lean mass, age at diagnosis, systemic and intrathecal therapy were predictors of bone mass changes on adjusted analyses. Conclusion: This study provides insight into the pathophysiology of bone loss in children receiving cancer therapy and possible interventions to optimize their skeletal health. [ABSTRACT FROM AUTHOR]

This work was conducted to evaluate the safety and efficacy of emergency ureteroscopic lithotripsy in patients with ureteral stones. From May 2003 to December 2010, 244 patients (184 men and 60 women, mean age 45.6 ± 12.7 years (range 22-73 years) were treated with emergency ureteroscopic lithotripsy for ureteral calculi. All patients were divided into three groups according to the stone location in the ureter. Intracorporeal lithotripsy when necessary was performed with the Swiss lithoclast. The overall stone-free status was defined as the complete absence of stone fragments at 4 weeks, postoperatively. A double J stent was inserted in selected patients if there was significant ureteral wall trauma, edema at the stone impaction site, suspected or proved ureteral perforation, and if the stone migrated to the kidney. The overall success rate was 90.6%. The success rates were different according to the stone site. The success rate of groups A, B and C was 69.4, 94.8 and 96.6%, respectively. The overall rate of ureteral stent insertion at the end of the procedure was 177/244 (72.5%). The rate of stent insertion was 41/49 (83.7%), 32/46 (69.6%) and 104/149 (69.8%) in groups A, B and C, respectively. The overall complication, failure, and stricture rate was 32/244 (13.1%), 23/244 (9.4%) and 0.8%, respectively. With the recent advances in ureteroscopic technology, intracorporeal probes and stone extraction devices, emergency ureteroscopy is found to be a safe and effective procedure with immediate relief from ureteral colic and ureteral stone fragmentation. [ABSTRACT FROM AUTHOR]

universities where students enjoy flexibility in selecting courses, the Registrar's office aims to generate an appropriate exam timetable for numerous courses and large number of students. An appropriate, real-world exam timetable should show fairness towards all students, respecting the following constraints: (a) eliminating or minimizing the number of simultaneous exams; (b) minimizing the number of consecutive exams; (c) minimizing the number of students with two or three exams per day (d) eliminating the possibility of more than three exams per day (e) exams should fit in rooms with predefined capacity; and (f) the number of exam periods is limited. These constraints are conflicting, which makes exam timetabling intractable. Hence, solving this problem in realistic time requires the use of heuristic approaches. In this work, we develop an evolutionary heuristic technique based on the scatter search approach for finding good suboptimal solutions for exam timetabling. This approach is based on maintaining and evolving a population of solutions. We evaluate our suggested technique on real-world university data and compare our results with the registrar's manual timetable in addition to the timetables of other heuristic optimization algorithms. The experimental results show that our adapted scatter search technique generates better timetables than those produced by the registrar, manually, and by other meta-heuristics. [ABSTRACT FROM AUTHOR]

To evaluate the influence of diabetes mellitus (DM), chronic renal failure (CRF), and malignancies on the rate of bacteriuria and double J ureteric stent bacterial colonization. One hundred and twenty patients were included in this prospective study. Midstream urine samples for culture were obtained before ureteric stent insertion. Patients with negative culture were given ciprofloxacin 500 mg orally q 12 h for 5 days as a prophylaxis. All the stents were removed or changed as indicated after having voided midstream urine sample for culture on the day of stent removal. Stents were sent for culture. Culture was obtained from the outer surface of the stent by gentle scraping with a sterile scalpel. Significant bacteriuria was defined as a count of colony-forming units per milliliter of urine of >105. The patients were between 20 and 74 years of age (mean 42.5 ± 13) and the duration of stent insertion ranged between 14 and 120 days (52.5 ± 7.2). In 29 patients (24.2%), double J stent bacterial colonization was positive (12 males and 17 females). Of these patients, 27 (22.5%) had positive urine cultures (11 males and 16 females). The most commonly isolated pathogen was Escherichia coli. DM, CRF, or malignancies showed a higher risk for bacteriuria and stent bacterial colonization. Immune-compromising diseases such as DM, CRF, and malignancies are proved to be risk factors for urinary tract infection and stent colonization in patients with ureteric stent insertion. Stent cultures are not needed as the same microorganisms grow in urine cultures. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the prevalence of ED and its health-related correlates in a nonselected population from a Mediterranean country. The abridged 5-item version of the international index of erectile function (IIEF-5) was used as a diagnostic tool. A total of 905 men aged 18 years and above from Jordan were included in the study and answered the questions about medical history, lifestyle habits and sexual behavior. A logistic regression model was used to identify significant independent risk factors for ED. In this sample the prevalence of all degrees of ED was estimated as 49.9%. In this group of men, the degree was mild in 25%, moderate in 13.5% and severe in 11.4%. The prevalence of severe ED increased from 2.7% in men in their twenties to 38.6% in their sixties and 46% in those aged 70 years and above. Age is the single most significant risk factor. Other important risk factors include lower household income, physical inactivity, obesity, smoking, diabetes mellitus hypertension and ischemic heart disease. This study provides a quantitative estimate of the prevalence and the main risk factors for ED in our region. This condition, which represents a source of distress, should be evaluated more effectively by rigorous and standardized methods, particularly as effective treatments are now available. [ABSTRACT FROM AUTHOR]

To assess the effects of two different doses of botulinum toxin A (Dysport®: 500 and 1,000 IU) injected repeatedly into the bladder for the treatment of neurogenic detrusor overactivity (NDO) in terms of safety, durability, and improvement of continence status and urodynamic parameters. In this study we analyzed the effects of successive doses of 500 or 1,000 IU of Dysport®, endoscopically injected into the detrusor muscle. Clinical, urodynamic, and satisfaction assessments were performed at baseline and 6 weeks after each injection. The results of injections and corresponding follow-ups were analyzed and compared with baseline. Twenty-two patients (13 men and 9 women) with repeated four injections were included, of whom 12 (55%) with mean age 35.7 years (range 16–52 years) received 500 IU of BTX-A and 10 (45%) with mean age 33.8 years (range 18–50 years) received 1,000 IU in each treatment. No statistically significant differences were found in efficacy duration with the two Dysport doses (500 IU: 7.7 months, 1,000 IU: 8.5 months; P > 0.05). Maximum cystometric capacity (MCC), reflex volume (RV), and bladder compliance (BC), and patient satisfaction improved significantly after each treatment compared with baseline values and there were no statistically significant differences after each retreatment for the two treatment groups ( P > 0.05). After repeated injections the effect of BTX-A remained constant. The cause of repeat treatment is relapse of overactive bladder symptoms. Results with the 500 and 1,000 IU doses were interesting and approximately equivalent in terms of duration and efficacy, with better but not significant results when 1,000 IU was used. The optimum dose of Dysport for incontinence secondary to NDO is not yet defined; 1,000 IU probably has a nonsignificant longer effect than 500 IU but may expose the patient to major complications. Further studies evaluating the clinical efficacy of 750 IU of Dysport are necessary. [ABSTRACT FROM AUTHOR]

A molecular assay with enhanced specificity and sensitivity has been developed to assist in the surveillance of Karnal bunt, a quarantineable disease with a significant impact on international trade. The protocol involves the release of DNA from spores, PCR amplification to enrich Tilletia-specific templates from released DNA and a five-plex, real-time PCR assay to detect, identify and distinguish T. indicaand other Tilletiaspecies (T. walkeri, T. ehrhartae, T. horridaand a group comprising T. caries, T. laevis, T. contraversa, T. bromiand T. fusca) in wheat grains. This fluorescent molecular tool has a detection sensitivity of one spore and thus bypasses the germination step, which in the current protocol is required for confirmation when only a few spores have been found in grain samples. The assay contains five dual-labelled, species-specific probes and associated species-specific primer pairs in a PCR mix in one tube. The different amplification products are detected simultaneously by five different fluorescence spectra. This specific and sensitive assay with reduced labour and reagent requirements makes it an effective and economically sustainable tool to be used in a Karnal bunt surveillance program. This protocol will also be valuable for the identification of some contaminant Tilletiasp. in wheat grains. [ABSTRACT FROM AUTHOR]

Objective To report a successful delivery of a healthy infant fathered by an infertile 46, XY true hermaphrodite who suffered from a seminoma. Design Case report Setting IVF unit in University hospital Patient(s) Male 41 years (true hermaphrodite), his wife 35 years Main Outcome Measures Laboratory, pathology tests and ultrasound tests Results The above patient treated and cured from seminoma, the couple had in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) using frozen testicular sperm and had a healthy baby. Conclusion This is the first case report of a successful delivery of a healthy infant fathered by an infertile 46, XY true hermaphrodite who suffered from a seminoma. Once treated and cured, the couple had IVF and ICSI using frozen testicular sperm and had a healthy baby. [ABSTRACT FROM AUTHOR]

Purpose To assess and compare the efficacy of botulinum-A toxin (BTX-A) injections into the detrusor in idiopathic and neurogenic detrusor overactivity (IDO and NDO) resistant to anticholinergic treatment with respect to patient satisfaction. Patients and Methods In a prospective study, 16 patients with IDO and 14 with NDO resistant to anticholinergic treatment were injected with 500 U of Dysport® into the detrusor. Clinical, urodynamic, and satisfaction assessments were performed at baseline and after BTX-A injections. Results In IDO as well as in NDO, there was a significant increase in median maximum cystometric capacity (MCC) from 177.5 to 262.5 ml ( P < 0.0005) and 160 to 270 ml ( P = 0.001), median bladder compliance from 24.5 to 40.0 ml/cmH2O ( P < 0.0005) and 25.5 to 44.0 ml/cmH2O ( P = 0.001) and median PVR from 15 to 80 ml ( P = 0.001) and 15.0 to 62.5 ml ( P = 0.001), respectively. Median Pdet max decreased significantly from 49 to 37 cmH2O ( P < 0.0005) and 48.5 to 37.0 cmH2O ( P = 0.001), and median Pdet Qmax from 32.0 to 20.0 ml/sec ( P < 0.0005) and 36.0 to 21.5 ml/sec ( P = 0.001), respectively. The effect of BTX-A injections lasted for a median time of 5 months in both groups. Median daytime frequency, nocturia, and number of used pads decreased significantly in both groups. More than 80% of the patients were satisfied with the effect of BTX-A. Conclusions Patients with intractable IDO respond to intradetrusor BTX-A with a significant and comparable but temporally limited effect in urodynamic and LUTS parameters as those with NDO. The majority of patients were satisfied with treatment. Neurourol. Urodynam. 26:531-536, 2007. © 2007 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

To determine whether a preliminary period of clean intermittent self-catheterization (CISC) before transurethral resection of the prostate (TURP) improves bladder contractility and surgical outcome in men with chronic urinary retention (CUR), and whether pressure-flow studies (PFS) before TURP predict the outcome. The study was a two-centre, pragmatic and randomized trial. Included were 41 men scheduled for TURP with lower urinary tract symptoms (LUTS), an International Prostate Symptom Score (IPSS) of > 7, benign prostatic enlargement and a persistent postvoid residual urine volume (PVR) of > 300 mL. They had conventional PFS using unphysiological filling. The patients then gave consent and were randomized into two treatment groups; the first had TURP after stabilizing renal function by indwelling catheterization if indicated, and the second was taught CISC. Men in both groups were reviewed at 3 and 6 months after surgery or the start of CISC, by the IPSS, urine culture and assay of plasma creatinine, and upper tract imaging and repeat PFS at 6 months. The primary outcome variables were IPSS, maximum urinary flow rate, voiding and end-filling pressures, and mean PVR; secondary variables included treatment failure, complications and other urodynamic measures. Of the 41 patients, 17 (mean age 67 years, range 52–84) were randomized to immediate TURP and 24 (mean age 69 years, range 55–85) to CISC. There was a significant improvement in IPSS and quality of life at 6 months in both groups ( P < 0.001). In the CISC group there was a significant improvement in voiding and end-filling pressures, indicating recovery of bladder function ( P < 0.001 for each). Of the 41 men, nine (22%) with voiding pressures of ≤ 45 cmH2O had no significant improvement in symptoms or urodynamic variables. Detrusor overactivity was found in 17 (41%) patients, of whom six had upper tract dilatation which resolved after treatment. The present results emphasize the usefulness of CISC in ensuring the recovery of bladder function in men with CUR. Measuring the voiding pressure before TURP can predict the surgical outcome. Both CISC and immediate TURP are effective for relieving LUTS and result in a better quality of life. A preliminary period of CISC before TURP for men with CUR and low voiding pressure may be valuable. The presence of upper tract dilatation is associated with high end-void and end-fill bladder pressures, and such men have a good outcome from surgery. [ABSTRACT FROM AUTHOR]

To evaluate the diagnostic value of the 10 systematic transrectal ultrasound-guided (TRUS) prostate biopsy compared with the sextant biopsy technique for patients with suspected prostate cancer. One hundred and fifty-two patients with suspected prostate cancer were included in the study. Patients were entered in the study because they presented with high levels of prostate specific antigen (PSA) (over 4 ng/mL) and/or had undergone an abnormal digital rectal examination (DRE). In addition to sextant prostate biopsy cores, four more biopsies were obtained from the lateral peripheral zone with additional cores from each suspicious area revealed by transrectal ultrasound. Sextant, lateral peripheral zone and suspicious area biopsy cores were submitted separately to the pathological department. Cancer detection rates were 27.6 % (42/152) and 19.7 % (30/152) for the 10–core and sextant core biopsy protocols, respectively. Adding the lateral peripheral zone (PZ) to the sextant prostate biopsy showed a 28.6 % (12/42) increase in the cancer detection rate in patients with positive prostate cancer (P< 0.01). The cancer detection rate in patients who presented with elevated PSA was 29.3 % (34/116). When serum PSA was 4–10 ng/mL TRUS-guided biopsy detected cancer in 20.6 %, while the detection rate was 32.4 % and 47.0 % when serum PSA was 10–20 ng/mL and above 20 ng/mL, respectively. The 10 systematic TRUS-guided prostate biopsy improves the detection rate of prostate cancer by 28.6 % when compared with the sextant biopsy technique alone, without increase in the morbidity. We therefore recommend the 10–core biopsy protocol to be the preferred method for early detection of prostate cancer. [ABSTRACT FROM AUTHOR]

Nitric oxide (NO) is formed from the conversion of L-arginine by nitric oxide synthase (NOS), which exists in three isoforms: neuronal (nNOS), endothelial (eNOS), and inducible (iNOS). nNOS is expressed in penile neurons innervating the corpus cavernosum, and eNOS protein expression has been identified primarily in both cavernosal smooth muscle and endothelium. NO is released from nerve endings and endothelial cells and stimulates the activity of soluble guanylate cyclase (sGC), leading to an increase in cyclic guanosine-3',5'-monophosphate (cGMP) and, finally, to calcium depletion from the cytosolic space and cavernous smooth muscle relaxation. The effects of cGMP are mediated by cGMP dependent protein kinases, cGMP-gated ion channels, and cGMP-regulated phosphodiesterases (PDE). Thus, cGMP effect depends on the expression of a cell-specific cGMP-receptor protein in a given cell type. Numerous systemic vasculature diseases that cause erectile dysfunction (ED) are highly associated with endothelial dysfunction, which has been shown to contribute to decreased erectile function in men and a number of animal models of penile erection. Based on the increasing knowledge of intracellular signal propagation in cavernous smooth muscle tone regulation, selective PDE inhibitors have recently been introduced in the treatment of ED. Phosphodiesterase 5 (PDE5) inactivates cGMP, which terminates NO-cGMP-mediated smooth muscle relaxation. Inhibition of PDE5 is expected to enhance penile erection by preventing cGMP degradation. Development of pharmacologic agents with this effect has closely paralleled the emerging science.International Journal of Impotence Research (2004) 16, 459-469. doi:10.1038/sj.ijir.3901256 Published online 1 July 2004 [ABSTRACT FROM AUTHOR]