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Bullying has been identified as the most common form of aggression experienced by school-age youth. However, it is still unclear about the family’s influence on school bullying. Therefore, the current study aimed to explore the associations between sibling bullying and school bullying, sibling victimization and school victimization, and parental acceptance–rejection and school bullying victimization. The study was cross-sectional and conducted on a sample of students aged between 11 and 20 years recruited from middle schools in Algeria. The study used a survey adopted from the scale of Sibling Bullying, Student Survey of Bullying Behavior—Revised 2, and the Survey of parental acceptance–rejection in collecting the data. The model’s results assessing the association between sibling bullying and school bullying demonstrated that the effect of sibling physical and sibling verbal victims on school victimization was statistically significant. Despite the non-significant effect of sibling emotional victims on school victimization, the effect of sibling physical and sibling verbal bullying on school bullying was statistically significant. However, the effect of sibling emotional bullying on school bullying was not statistically significant. The direct effect of parental acceptance on school victimization was not statistically significant, whereas the effect of parental rejection on school victimization was statistically significant. The direct effect of parental acceptance on school bullying was not statistically significant, while the effect of parental rejection on school bullying was statistically significant. Based on the results, this study provides insights into the understanding of how the family and siblings contribute to school bullying. In particular, sibling victimization, sibling bullying, and parental acceptance–rejection are predictive factors of school bullying among adolescents. Future research should take into account factors based on family to explore the risks of school bullying.

Coronavirus disease 2019 (COVID-19) continues to ravage world economies, and with its recent mutations, countries worldwide are finding ways of ramping up their vaccination programmes. This cross-sectional design study, therefore, examined the predictors of COVID-19 stress and COVID-19 vaccination acceptance among adolescents in Ghana. A total of 817 participants were conveniently selected to respond to measures on fear of COVID-19, perceived stigma from COVID-19, self-stigma from COVID-19, believing COVID-19 information, COVID-19 infection prevention behaviours, COVID-19 stress, and COVID-19 vaccination acceptance. It was found that females believed COVID-19 information and accepted COVID-19 vaccination more than males did. Moreover, there were significant relationships between the majority of the COVID-19-related variables. Furthermore, fear of COVID-19, self-stigma from COVID-19, and COVID-19 infection prevention behaviours were found to be significant predictors of COVID-19 stress. Additionally, believing COVID-19 information, danger and contamination fears (a subscale of COVID-19 stress), and traumatic stress (a subscale of COVID-19 stress) were significant predictors of COVID-19 vaccination acceptance. These findings imply that different factors influence different COVID-19 variable. Therefore, careful considerations and research should be employed by health authorities and policymakers in preparing COVID-19 information to target different age groups and for different COVID-19 purposes.

Sialylation of glycoproteins is modified by distinct sialyltransferases such as ST3Gal, ST6Gal, ST6GalNAc, or ST8SIA with α2,3-, α2,6-, or α2,8-linkages. Alteration of these sialyltransferases causing aberrant sialylation is associated with the progression of colon cancer. However, among the ST8- sialyltransferases, the role of ST8SIA6 in colon cancer remains poorly understood. In this study, we explored the involvement of ST8SIA6 in colon cancer using multiple gene databases. The relationship between ST8SIA6 expression and tumor stages/grades was investigated by UALCAN analysis, and Kaplan–Meier Plotter analysis was used to analyze the expression of ST8SIA6 on the survival outcome of colon cancer patients. Moreover, the biological functions of ST8SIA6 in colon cancer were explored using LinkedOmics and cancer cell metabolism gene DB. Finally, TIMER and TISMO analyses were used to delineate ST8SIA6 levels in tumor immunity and immunotherapy responses, respectively. ST8SIA6 downregulation was associated with an advanced stage and poorly differentiated grade; however, ST8SIA6 expression did not affect the survival outcomes in patients with colon cancer. Gene ontology analysis suggested that ST8SIA6 participates in cell surface adhesion, angiogenesis, and membrane vesicle trafficking. In addition, ST8SIA6 levels affected immunocyte infiltration and immunotherapy responses in colon cancer. Collectively, these results suggest that ST8SIA6 may serve as a novel therapeutic target towards personalized medicine for colon cancer.

Insufficient lymph node harvest (12) may lead to incorrect classification of stage I and II disease. Many studies have indicated a poor prognosis with inadequate lymph node harvest in stages I to III, but few studies have demonstrated the relationship between low lymph node harvest and T4 disease. This study aimed to identify the influence of insufficient number of lymph nodes harvested on survival in T4N0 colorectal cancer. We enrolled patients with T4N0 colorectal cancer who underwent radical resection between 2010 and 2016. A total of 155 patients were divided into 2 groups; 142 patients had ≥ 12 harvested lymph nodes, and the other 13 had 12 lymph nodes. All patients were followed up for at least 5 years. The primary outcome was the impact of the number of lymph nodes harvested on disease-free survival and overall survival, which were investigated using Kaplan-Meier survival techniques. There were no significant differences in recurrence rate, emergent or elective surgery, laparoscopic or open surgery, or chemotherapy between the 2 groups. Kaplan-Meier analyses showed no statistical differences in 5-year disease-free survival (P = .886) and 5-year overall survival (P = .832) between the groups. There were no significant differences in disease-free survival and overall survival between patients with adequate (≥ 12) and inadequate (12) lymph node harvest in T4N0 colorectal cancers.

Data mining of a public transcriptomic rectal cancer dataset (GSE35452) from the Gene Expression Omnibus, National Center for Biotechnology Information identified the melanophilin (MLPH) gene as the most significant intracellular protein transport-related gene (GO:0006886) associated with a poor response to preoperative chemoradiation. An MLPH immunostain was performed on biopsy specimens from 172 rectal cancer patients receiving preoperative chemoradiation, samples were divided into high- and low-expression groups by H-scores. Subsequently, the correlations between MLPH expression and clinicopathologic features, tumor regression grade, disease-specific survival (DSS), local recurrence-free survival (LRFS), and metastasis-free survival (MeFS) were analyzed. MLPH expression was significantly associated with CEA level (p = 0.001), pre-treatment tumor status (p = 0.022), post-treatment tumor status (p &lt, 0.001), post-treatment nodal status (p &lt, 0.001), vascular invasion (p = 0.028), and tumor regression grade (p &lt, 0.001). After uni- and multi-variable analysis of five-year survival, MLPH expression was still associated with lower DSS (hazard ratio (HR), 10.110, 95% confidence interval (CI), 2.178–46.920, p = 0.003) and MeFS (HR, 5.621, 95% CI, 1.762–17.931, p = 0.004). In conclusion, identifying MLPH expression could help to predict the response to chemoradiation and survival, and aid in personal therapeutic modification.

Some studies showed that when distant metastasis or locally advanced tumors were observed, the participation of 2 or more operating surgeons (combined surgery) in the operation could improve the prognosis of patients. The multispecialty operative team would perform combined surgery in colon cancer patients with some complications since 2015. The goal of this study is to confirm performing combined surgery would improve the outcomes of colon cancer patients. A retrospective observational study was conducted, which involved all colon cancer patients between November 2015 and December 2019 at one would-be medical center. Patients were divided into 3 cohorts: those with complicated cases and had combined surgery (C_2S), those with complicated cases and had surgery performed by a single surgeon (C_1S), and those with uncomplicated cases and had surgery performed by a single surgeon (NC_1S). Overall survival and disease-free survival were compared among the 3 groups. A total of 296 colon cancer patients during the study period. Among them, 35 were C_2S, 87 were C_1S, and 174 were NC_1S. Patients in the NC_1S group had significantly higher 12-, 24-, and 36-month OS rates compared to those in the C_1S group (P.01). In contrast, there was no significant difference in overall survival among patients in the NC_1S and C_2S group (P =.15). The quality of surgery must be impact the prognosis, especially in the individual who was complicated case, the survival in patients who had surgery performed by multispecialty operative team would be improved.

Phthalates are widely used as plasticizers. Humans can be exposed to phthalates through ingestion, inhalation, or treatments that release di(2-ethylhexyl) phthalate (DEHP) and its metabolite, mono(2-ehylhexyl) phthalate (MEHP), into the body from polyvinyl chloride-based medical devices. Phthalate exposure may induce reproductive toxicity, liver damage, and carcinogenesis in humans. This study found that colon cancer cells exposed to DEHP or MEHP exhibited increased cell viability and increased levels of P-glycoprotein, CD133, Bcl-2, Akt, ERK, GSK3β, and β-catenin when treated with oxaliplatin or irinotecan, as compared to control. The P-glycoprotein inhibitor, tariquidar, which blocks drug efflux, reduced the viability of DEHP- or MEHP-treated, anti-cancer drug-challenged cells. DEHP or MEHP treatment also induced colon cancer cell migration and epithelial-mesenchymal transformation. Elevated stemness-related protein levels (β-catenin, Oct4, Sox2, and Nanog) and increased cell sphere sizes indicated that DEHP- or MEHP-treated cells were capable of self-renewal. We also found that serum DEHP concentrations were positively correlated with cancer recurrence. These results suggest phthalate exposure enhances colon cancer cell metastasis and chemotherapeutic drug resistance by increasing cancer cell stemness, and that P-glycoprotein inhibitors might improve outcomes for advanced or drug-resistant colon cancer patients.

Di(2-ethylhexyl)phthalate (DEHP) may cause carcinogenicity in the liver; however, few have detailed on the potential effects of DEHP exposure on colorectal cancer. Male Sprague-Dawley rats received i.p. injections of 1,2-dimethylhydrazine (DMH) once-a-week for the first 4 weeks, and rats in each group were treated with DEHP through oral gavage daily for either 7, 10 or 15 weeks; after which, all rats were euthanized and their colons were assessed (a) morphologically for aberrant crypt foci (ACF) or tumors, (b) cytologically for mitotic index (MI), and (c) immunohistochemically for the expression of β-catenin, cyclooygenase (COX)-2, vascular endothelial growth factor (VEGF), proliferating cell nuclear antigen (PCNA), cyclin D1, and c-myc. Our results indicated that the mean total ACF, tumor incidence, and MI were significantly higher in the DEHP-treated DMH compared to control and the DEHP-alone groups. The level of β-catenin and cyclin D1 was increased in DEHP-exposed rats. Expression of β-catenin, COX-2, VEGF, and cyclin D1 was significantly higher in the combined DMH and DEHP-treated rats by comparison to that of the DMH group. In conclusion, this study indicates that exposure to DEHP may exacerbate DMH-induced colon tumorigenesis and provides impetus to evaluate the effect of DEHP in conjunction with other carcinogens.

Objectives To assess the impact of minor, major and individual complications on prolonged length of hospital stay in patients with colorectal cancer (CRC) after surgery using multivariate models. Methods This was a retrospective review of data from patients who underwent surgery for stage I–III CRC at two medical centres in southern Taiwan between 2005–2010. Information was derived from four databases. Multivariate logistic regression methods were used to assess the impact of complications on prolonged length of stay (PLOS) and prolonged postoperative length of stay (PPOLOS). Results Of 1658 study patients, 251 (15.1%) experienced minor or major postsurgical complications during hospitalizations. Minor and major complications were significantly associated with PLOS (minor, odds ratio [OR] 3.59; major, OR 8.82) and with PPOLOS (minor, OR 5.55; major, OR 10.00). Intestinal obstruction, anastomosis leakage, abdominal abscess and bleeding produced the greatest impact. Conclusions Minor and major complications were stronger predictors of prolonged hospital stay than preoperative demographic and disease parameters. Compared with the PLOS model, the PPOLOS model better predicted risk of prolonged hospital stay. Optimal surgical and medical care have major roles in surgical CRC patients.

Di(2-ethylhexyl) phthalate (DEHP) is widely used as a plasticizer in the manufacture of polyvinylchloride plastics and has been associated with concerns regarding male reproductive toxicity. In this study, we hypothesized that maternal exposure to DEHP induces transgenerational inheritance of adult-onset adverse reproductive outcomes through the male germline in the F1, F2, and F3 generations of male offspring. Pregnant rats were treated with 5 or 500 mg of DEHP/kg/day through gavage from gestation day 0 to birth. The offspring body weight, anogenital distance (AGD), anogenital index (AGI), sperm count, motility, and DNA fragmentation index (DFI) were measured for all generations. Methyl-CpG binding domain sequencing was performed to analyze sperm DNA methylation status in the F3. DEHP exposure at 500 mg/kg affected AGD, AGI, sperm count, mean DFI, and %DFI in the F1, AGD, sperm count, and mean DFI in the F2, and AGD, AGI, mean DFI, and %DFI in the F3. DEHP exposure at 5 mg/kg affected AGD, AGI, sperm count, and %DFI in the F1, sperm count in the F2, and AGD and AGI in F3. Compared with the control group, 15 and 45 differentially hypermethylated genes were identified in the groups administered 5 mg/kg and 500 mg/kg DEHP, respectively. Moreover, 130 and 6 differentially hypomethylated genes were observed in the groups administered 5 mg/kg and 500 mg/kg DEHP. Overall, these results demonstrated that prenatal exposure to DEHP caused transgenerational epigenetic effects, which may explain the observed phenotypic changes in the male reproductive system.

Genes associated with protein folding have been found to have certain prognostic significance in a subset of cancers. The aim of this study is to evaluate the clinical impact of DNAJC12 expression in patients with rectal cancers receiving neoadjuvant concurrent chemoradiotherapy (CCRT) followed by surgery. Through data mining from a public transcriptomic dataset of rectal cancer focusing on genes associated with protein folding, we found that DNAJC12, a member of the HSP40/DNAJ family, was the most significant such gene correlated with the CCRT response. We further evaluated the expression of DNAJC12 by immunohistochemistry in the pre-treatment tumor specimens from 172 patients with rectal cancers. From this set, we statistically analyzed the association of DNAJC12 expression with various clinicopathological factors, tumor regression grade, overall survival (OS), disease-free survival (DFS) and local recurrence-free survival (LRFS). High expression of DNAJC12 was significantly associated with advanced pre- and post-treatment tumor status (P0.001), advanced pre- and post-treatment nodal status (P0.001), increased vascular invasion (P=0.015), increased perineural invasion (P=0.023) and lower tumor regression grade (P=0.009). More importantly, high expression of DNAJC12 was found to be correlated with poor prognosis for OS (P=0.0012), DFS (P0.0001) and LRFS (P=0.0001). In multivariate analysis, DNAJC12 overexpression still emerged as an independent prognosticator for shorter OS (P=0.040), DFS (P0.001) and LRFS (P=0.016). The data indicate that DNAJC12 overexpression acts as a negative predictive factor for the response to neoadjuvant CCRT and was significantly associated with shorter survival in patients with rectal cancers receiving neoadjuvant CCRT followed by surgery.

Indium, a Group IIIA element of the periodic chart and a rare earth metal characterized by high plasticity, corrosion resistance, and a low melting point, is widely used in the electronics industry where released streams can contaminate the environment. Consequently, indium can reach humans mainly by natural ways, which could result in a health hazard. Although reproductive toxicities have been surveyed in some studies in animal models, the infertility effects of sperm function induced by indium compounds have not been greatly investigated. We designed a study to investigate the toxicities of subacute exposure to indium compounds on male sperm function and the process of spermatogenesis in a rodent model. Fourteen Sprague-Dawley rats on postnatal Day (PND) 84 were randomly divided into exposure and control groups, and weekly received intraperitoneal injections of indium chloride (1.5 mg/kg body weight) and normal saline, respectively, for 8 weeks. Cauda epididymal sperm count, motility, morphology, chromatin DNA integrity, mitochondrial membrane potential (MMP), reactive oxygen species (ROS) generation, and testis DNA content were investigated. The indium chloride exposed group showed significant toxicity to sperm function, as well as an increased percentage of sperm morphological abnormality and chromatin DNA damage. Furthermore, positive correlations between abnormal sperm morphology, chromatin DNA damage, and superoxide anion generation were also noted. The results of this study demonstrated the toxic effect of subacute low dose indium exposure during sexual maturation on sperm function, resulting in sperm chromatin DNA damage through an increase in sperm ROS generation in a rodent model.

Indium, a rare earth metal characterized by high plasticity, corrosion resistance, and a low melting point, is widely used in the electronics industry, but has been reported to be an environmental pollutant and a health hazard. We designed a study to investigate the effects of subacute exposure of indium compounds on male reproductive function. Twelve-week old male Sprague-Dawley rats were randomly divided into test and control groups, and received weekly intraperitoneal injections of indium acetate (1.5 mg/kg body weight) and normal saline, respectively, for 8 weeks. Serum indium levels, cauda epididymal sperm count, motility, morphology, chromatin DNA structure, mitochondrial membrane potential, oxidative stress, and testis DNA content were investigated. The indium acetate-treated group showed significant reproductive toxicity, as well as an increased percentage of sperm morphology abnormality, chromatin integrity damage, and superoxide anion generation. Furthermore, positive correlations among sperm morphology abnormalities, chromatin DNA damage, and superoxide anion generation were also noted. The results of this study demonstrated the toxic effect of subacute low-dose indium exposure during the period of sexual maturation on male reproductive function in adulthood, through an increase in oxidative stress and sperm chromatin DNA damage during spermiogenesis, in a rodent model.

BACKGROUND Whether patients with inflammatory bowel disease (IBD) exhibit a higher risk of developing acute coronary syndrome (ACS) remains debatable. METHODS From the inpatient claims of Taiwan's National Health Insurance Research Database, we identified 11,822 patients with IBD symptoms in the 1998-2010 period and 47,288 control patients without the disorder, frequency matched by age, sex, and admission year. Both cohorts were followed-up until the end of 2010 to estimate the risk of ACS. RESULTS The incidence of ACS was 87% higher in the patients with IBD than in the control patients (5.76 versus 3.08 per 1000 person-years). The multivariable Cox proportional hazards regression model measured adjusted hazard ratios of ACS at 1.72 (95% confidence interval, 1.53-1.94) for the patients with IBD. The age-specific data showed that the adjusted hazard ratio for patients with IBD, compared with control patients, was the highest for the 20- to 39-year age group, at 3.28 (95% confidence interval, 1.73-6.22), which decreased to 1.70 (95% confidence interval, 1.45-1.99). Patients with IBD who, on average, required 2 or more hospitalization per year were nearly 20-fold more likely to have ACS than those who required 1 hospitalization per year (80.7 versus 4.10 per 1000 person-years). CONCLUSIONS The absolute risk of ACS increases sharply with age for patients with IBD, but young patients are at greater relative risk for the consequence. The risk of ACS was proportional to the severity of IBD. Careful follow-up observation and effective therapy should be sought for patients with IBD to reduce the risk of ACS.

Urinary retention is a common complication among patients after haemorrhoidectomy. Although Crede's method is recommended for urinary retention in nursing practice textbooks, its effects require further examination. The purpose of this study was to investigate the rate of urine voiding within the first 8 h following haemorrhoidectomy and to examine the effects of Crede's method on this postoperative outcome. A two-group comparison study was conducted. All participants were over 20 years of age, and each had undergone haemorrhoidectomy. Outcome measurements included patients' self-reported urine voiding within 8 h of surgery, personal demographics and disease-related data. Before the surgical procedure, participants were divided into Crede's group and non-Crede's group, and written educational materials were given. Patients in the Crede's group were taught Crede's method for application in the event that they were unable to void urine after haemorrhoidectomy. The non-Crede's group patients were taught traditional methods without Crede's method. We examined urine voiding within the first 8 h after haemorrhoidectomy. The mean rate of urine voiding within 8 h of surgery was 60·9% overall, with 91·3% (21/23) in the Crede's group and 30·4% (7/23) in the non-Crede's group reporting successful voiding. After controlling for the two groups' personal characteristics and disease-related variables, age, educational level and perioperative fluid administration were treated as covariates and included in the multinomial logistic regression model. The odds ratio of urine voiding within the first 8 h after surgery was 52·70-fold higher in the Crede's group than in the non-Crede's group (p < 0·01). This study shows that Crede's method is an effective strategy to aid in urine voiding within the first eight postsurgical hours among patients following haemorrhoidectomy. Clear and concise information about urinary retention and related management strategies should be given to patients before haemorrhoidectomy.

Aims and objectives. The purpose of this study was to explore the prevalence and risk factors of urine retention among posthaemorrhoidectomy recipients. Background. Haemorrhoids are one of the most common functional disorders of the anus. The Haemorrhoidectomy surgical procedure is one of the primary treatments for more severe haemorrhoidal occurrences, such as for third- and/or fourth-degree haemorrhoid conditions. Urine retention is a common acute complication after operation, but rare study conducted by nurses in Taiwan to explore the prevalence and risk factors. Design. A retrospective chart review was conducted. Methods. Data from a prospectively maintained database on patients who had undergone haemorrhoidectomy between April 2004 – August 2008 were retrospectively analysed. A total of 469 charts were used in this analysis. The following outcomes were studied: patient profiles, haemorrhoid type and severity, anaesthesia methods, length of operating room stay, urine retention and management, intravenous fluid given during operation and length of stay. Results. The overall urinary retention rate was 32·8% (n = 153). Significant risk factors associated with postoperative urinary retention included severity of haemorrhoid and anaesthesia methods. Logistic regression analysis revealed that epidural anaesthesia (p = 0·008), spinal anaesthesia (p = 0·016) and haemorrhoids with a severity of three degrees or higher (p = 0·017) were predictors of urinary retention post haemorrhoidectomy. Conclusions. Acute urinary retention can have an adverse effect on a patient’s quality of care. Careful follow-up of patients with these risk factors can help nurses spot posthaemorrhoidectomy urinary retention early. Relevance to clinical practice. The prevalence of acute urinary retention post haemorrhoidectomy is common. Surgical ward nurses should therefore take the responsibility regarding the impact of urinary retention and seeking appropriate nursing interventions of induced urination.

Gastrointestinal stromal tumors are rare soft-tissue neoplasms, the incidence of which is 1–3% of all malignant gastrointestinal tumors. Tumor size is reported to be a major determinant of recurrence in patients with resectable gastrointestinal stromal tumors. Here, we describe our experience in managing a large extra-gastrointestinal stromal tumor arising from the retroperitoneum.

One of the merits of endoscopic surgery is that it can be performed through small remote incisions made in inconspicuous areas. To improve cosmetic outcomes of surgical treatment of benign breast lesions, we performed endoscopic surgery through minimally sized axillary incisions with the goal of achieving scar-free breasts. From August 2007 to August 2008, 18 patients with 20 benign breast lesions underwent endoscopic breast excision in our institution. Endoscopic resection of benign breast lesions was performed via the retromammary route with video assistance. Cosmetic results were evaluated using the five-item, four-step ABNSW scoring system, assessing breast asymmetry, breast shape, nipple shape, skin condition, and wound scars. The median age of the patients was 27 years (IQR 23.0, 29.0). Median resected lesion size was 3.3 cm (IQR 2.9, 3.9). Median operative time was 85.0 min (IQR 70.0, 100.0). A marginally significant difference in operative times was noted between fibroadenoma and/or juvenile fibroadenoma cases and mastopathy or benign phyllodes cases (80.0 vs. 100.0; p

Focused on the reverse movements of moving axes along five-axis tool paths, this study presents a procedure of removing a gouge phenomenon on impeller surfaces in five-axis machining. That is, when an impeller of a centrifugal compressor is being cut in finish milling, reverse movements and/or other linearization problems of moving axes along a five-axis interference-free tool path may make a cutter leave tool marks on the impeller surfaces. For generating interference-free cutter location (CL) data needed in rough, semi-finish and finish five-axis cutting processes, first, a simple yet useful approach is proposed. To identify the potential gouge area and to solve the problem for a tool path having reverse motion directions with its moving axes in finish milling, the CL data are further smoothed to remove the reverse movements about its rotating and tilting axes. The effectiveness of this procedure has been experimentally confirmed by successful five-axis finish milling of an impeller without leaving tool marks on its surfaces. In addition, with the spline tool paths, the machining time can be saved up to 23.57%.

PURPOSE The purpose of this study was to explore the prevalence of fecal incontinence (FI) and its impact on health-related quality of life in rectal cancer patients following low anterior resection surgery for colorectal cancer. DESIGN Descriptive, cross-sectional study. SUBJECTS AND SETTING Patients who were diagnosed with rectal cancer and underwent low anterior resection were recruited from a 1264-bed hospital in southern Taiwan. Potential participants were mailed a questionnaire survey. They were followed up 8 to 16 months postoperatively. Some clinical data were collected via retrospective review of their medical records. METHODS Questionnaires were mailed to 172 patients, and 71 with colorectal cancer underwent low anterior resection and agreed to participate and completed questionnaires in the research, reflecting a return rate of 41%. Data were collected on demographic characteristics and disease-related variables. Participants were asked if they had experienced FI during the past week. Fecal incontinence health-related quality of life was measured using the Cleveland Clinic Incontinence Score (CCIS) and the Fecal Incontinence Quality of Life Index. Completion of the questionnaire required approximately 15 minutes. RESULTS More than half of the 71 participants (n = 45; 63.4%) experienced incontinence of flatus, 42.3% (n = 30) reported incontinence of liquid stool, and 14.1% (n = 10) stated that they experienced incontinence of solid stool. Based on mean CCIS scores, 35.2% (n = 25) experienced moderate to severe FI. One-third wore pads to contain FI and 21.1% changed daily activities because of FI. Nearly two-thirds reported FI during the week prior to completing the research questionnaire. The average Fecal Incontinence Quality of Life Index cumulative score was significantly lower in the FI group (2.62 ± 0.61) than in the without-FI group (3.32 ± 0.77; P < .001), as were all subscale mean scores (all P < .01-.001). CONCLUSIONS Fecal incontinence is prevalent among persons undergoing low anterior resection for colorectal cancer. Persons with FI report poor health-related quality of life compared to persons who retained fecal continence. Health care providers should assess these patients for FI and treat or refer those who experience this common problem.

Background. Peritoneal dialysis (PD) can induce fibrosis and functional alterations in PD patients’ peritoneal membranes, due to long-term unphysiological dialysate exposure, partially occurring via triggering of epithelial-to-mesenchymal transition (EMT) in peritoneal mesothelial cells (MCs). Vitamin D can ameliorate these negative effects; however, the mechanism remains unexplored. Therefore, we investigated its possible links to MCs EMT inhibition.Methods. Peritoneal fibrosis was established in Sprague-Dawley rats by chlorhexidine gluconate (CG) intraperitoneal injection for 21 days, with and without 1α,25(OH)2D3treatment. Morphological and functional evaluation and western blot analysis of EMT marker were performed upon peritoneum tissue.In vitrostudy was also performed in a primary human peritoneal MC culture system; MCs were incubated with transforming growth factor-β1 (TGF-β1) in the absence or presence of 1α,25(OH)2D3. EMT marker expression, migration activities, and cytoskeleton redistribution of MCs were determined.Results. 1α,25(OH)2D3ameliorated CG-induced morphological and functional deterioration in animal model, along with CG-induced upregulation ofα-SMA and downregulation of E-cadherin expression. Meanwhile, 1α,25(OH)2D3also ameliorated TGF-β1-induced decrease in E-cadherin expression, increase in Snai1 andα-SMA expression, intracellular F-actin redistribution, and migration activityin vitro.Conclusion. 1α,25(OH)2D3can ameliorate CG-induced peritoneal fibrosis and attenuate functional deterioration through inhibiting MC EMT.

A procedure that can be used to inspect planar cam contours and to evaluate their follower displacement, velocity, and acceleration curves with a higher degree of accuracy, without the aid of approximating follower displacements in traditional methods, is constructed. Based on the geometric relationships at the contact point between a planar cam profile and its follower, analytical descriptions that can be utilized to determine the follower displacement curve and its derivatives are first identified. To verify the feasibility and accuracy of the proposed procedure, analytical results generated from a theoretical design are compared to those obtained by the application of the procedure. To demonstrate the effectiveness and usefulness of the developed procedure, a measuring test bed has been constructed for a practical application example. Furthermore, the results obtained by using the developed procedure with the built measuring test bed are also compared to those obtained by using a coordinate measuring machine with the proposed algorithms.

Background It is unclear whether patients with inflammatory bowel disease (IBD) have higher risks of developing mesenteric ischemia. Methods We enrolled 9,363 patients who had been hospitalized because of IBD between January 1998 and December 2010, along with 37,452 control patients who were matched at a 1:4 proportion for age, sex, and index year. We accounted the cumulative incidences and hazard ratios (HRs) of developing mesenteric ischemia during the 13-year study period. Results Patients with IBD had a considerably higher incidence rate of subsequent mesenteric ischemia compared with the controls (22.7 vs 3.09 per 10,000 person-years), with adjusted HR of 6.33 (95% confidence interval: 4.75 to 8.43). A multivariate stratified analysis showed that the mesenteric ischemia risk after adjustment for comorbidities is significantly higher in patients of all age groups, particularly in patients younger than 44 years (adjusted HR: 48.0; 95% confidence interval: 11.3 to 203.9). Moreover, patients with IBD were at highest risk of developing mesenteric ischemia within the first year of follow-up. Conclusions Careful follow-up and effective therapy are necessary to reduce the excessive risk in these patients.

Indium, a rare earth metal characterized by high plasticity, corrosion resistance, and a low melting point, is widely used in the electronics industry, but has been reported to be an environmental pollutant and a health hazard. We designed a study to investigate the effects of subacute exposure of indium compounds on male reproductive function. Twelve-week old male Sprague-Dawley rats were randomly divided into test and control groups, and received weekly intraperitoneal injections of indium acetate (1.5 mg/kg body weight) and normal saline, respectively, for 8 weeks. Serum indium levels, cauda epididymal sperm count, motility, morphology, chromatin DNA structure, mitochondrial membrane potential, oxidative stress, and testis DNA content were investigated. The indium acetate-treated group showed significant reproductive toxicity, as well as an increased percentage of sperm morphology abnormality, chromatin integrity damage, and superoxide anion generation. Furthermore, positive correlations among sperm morphology abnormalities, chromatin DNA damage, and superoxide anion generation were also noted. The results of this study demonstrated the toxic effect of subacute low-dose indium exposure during the period of sexual maturation on male reproductive function in adulthood, through an increase in oxidative stress and sperm chromatin DNA damage during spermiogenesis, in a rodent model.

Aim Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide. In this study, we explored the anti-cancer activity of WYC02-9, a synthetic protoapigenone, on human HCT116 CRC cells. Main methods The anti-cancer activity of WYC02-9 and its underlying mechanisms were analyzed using XTT cell proliferation assays, colony formation assays, FACS analysis, annexin V staining, immunoblotting analysis, reactive oxygen species (ROS) generation assays, soft agar assays, a nude mice xenograft study and immunohistochemistry assays. Key findings Data showed that WYC02-9 suppressed CRC cell growth by arresting cells at G2/M and inducing cell death via apoptotic pathways. Further analysis demonstrated that WYC02-9-induced apoptosis was mediated by the activation of a ROS-mediated MAPK14 pathway. An in vivo xenograft study revealed that WYC02-9 enhanced MAP2K3/6 and MAPK14 phosphorylation, induced apoptosis, and suppressed CRC tumor growth. Significance WYC02-9 exerts its anti-tumor effect via ROS/MAPK14-induced apoptosis and has the potential to be developed as a chemotherapeutic agent for CRC.

The purpose of this study was to explore the prevalence and risk factors of urine retention among posthaemorrhoidectomy recipients. BACKGROUND. Haemorrhoids are one of the most common functional disorders of the anus. The Haemorrhoidectomy surgical procedure is one of the primary treatments for more severe haemorrhoidal occurrences, such as for third- and/or fourth-degree haemorrhoid conditions. Urine retention is a common acute complication after operation, but rare study conducted by nurses in Taiwan to explore the prevalence and risk factors.A retrospective chart review was conducted.Data from a prospectively maintained database on patients who had undergone haemorrhoidectomy between April 2004 - August 2008 were retrospectively analysed. A total of 469 charts were used in this analysis. The following outcomes were studied: patient profiles, haemorrhoid type and severity, anaesthesia methods, length of operating room stay, urine retention and management, intravenous fluid given during operation and length of stay. Results. The overall urinary retention rate was 32.8% (n = 153). Significant risk factors associated with postoperative urinary retention included severity of haemorrhoid and anaesthesia methods. Logistic regression analysis revealed that epidural anaesthesia (p = 0.008), spinal anaesthesia (p = 0.016) and haemorrhoids with a severity of three degrees or higher (p = 0.017) were predictors of urinary retention post haemorrhoidectomy.Acute urinary retention can have an adverse effect on a patient's quality of care. Careful follow-up of patients with these risk factors can help nurses spot posthaemorrhoidectomy urinary retention early.The prevalence of acute urinary retention post haemorrhoidectomy is common. Surgical ward nurses should therefore take the responsibility regarding the impact of urinary retention and seeking appropriate nursing interventions of induced urination.

The paper deals with the procedure of removing a gouge phenomenon on impeller surfaces in 5-axis machining. That is, when an impeller of a centrifugal compressor is being cut, tool marks on its surfaces may exist in finish milling due to reverse movements of moving axes along a 5-axis interference-free tool path. For generating interference-free cutter location (CL) data needed in rough and semi-finish 5-axis cutting processes, first, a simple yet useful approach is proposed. To identify the potential gouge area and to solve the problem for a tool path having reverse motion directions with its moving axes in finish milling, the CL data are further smoothed to remove the reverse movements about its rotating and tilting axes. The effectiveness of this procedure has been experimentally confirmed by successful 5-axis finish milling of an impeller without leaving tool marks on its surfaces.Copyright © 2008 by ASME

To increase productivity of marine propellers by raising machining efficiency, this paper presents the zigzag/spiral tool paths generation algorithm based on the arc base curve approach for three-axis machining of curved surfaces of propellers. By considering the shapes of selected cutters with different types of tool paths generated by the proposed procedure, machining efficiency can be calculated and simulated. To verify the accuracy and effectiveness of the developed approach, numerical and experimental results of machining of propeller surfaces are compared. It was proved that the machining time can be cut down up to 19% by using zigzag tool paths with a toroidal cutter. In addition, the machining knowledge revealed here can be accumulated for benefit evaluation in the manufacturing process with existing CAD/CAM systems. From the cost model, design, and process views, the overall cost savings after 5 years are investigated, and the expected benefit yield is about 45%.Copyright © 2008 by ASME

A measuring system that can be used to inspect planar cam contours and to evaluate their follower displacement, velocity, and acceleration curves with a higher degree of accuracy without the aid of approximating follower displacements in traditional methods is constructed. Based on the geometric relationships at the contact point between a planar cam profile and its follower, analytical descriptions that can be utilized to determine the follower displacement curve and its derivatives are first identified. To verify the feasibility and accuracy of the algorithms proposed for the measuring system, analytical results generated from a theoretical design are compared to those obtained by the application of the computing procedure. To demonstrate the effectiveness and usefulness of the developed procedure, a measuring test bed has been constructed for a practical application example. Furthermore, the results obtained by using the built measuring system are also compared to those obtained by using a coordinate measuring machine (CMM) with the proposed algorithms.Copyright © 2004 by ASME

A design procedure for increasing the indexing accuracy of intermittent grooved globoidal cam mechanisms is presented. It is based on the synthesis of asymmetrical dwell-rise-dwell (D-R-D) roller-follower turret motions to improve the kinematic and dynamic performance of the globoidal cam-turret devices for high-speed applications. Such asymmetrical turret motion curves are defined and tuned by nonparametric rational B-splines. Favorable results of kinematic characteristics, geometric properties including pressure angles and curvatures of cam surfaces, torques, and residual vibrations are revealed and compared to those obtained by traditional methods. Together with experimental results, a practical application example is given to demonstrate the usefulness and effectiveness.Copyright © 2002 by ASME

Background Peritoneal dialysis (PD) therapy is known to induce morphological and functional changes in the peritoneal membrane. Long-term exposure to conventional bio-incompatible dialysate and peritonitis is the main etiology of inflammation. Consequently, the peritoneal membrane undergoes structural changes, including angiogenesis, fibrosis, and hyalinizing vasculopathy, which ultimately results in technique failure. The epithelial-to-mesenchymal transition (EMT) of mesothelial cells (MCs) plays an important role during the above process; however, the clinical parameters associated with the EMT process of MCs remain to be explored. Methods To investigate the parameters impacting EMT during PD therapy, 53 clinical stable PD patients were enrolled. EMT assessments were conducted through human peritoneal MCs cultured from dialysate effluent with one consistent standard criterion (MC morphology and the expression of an epithelial marker, cytokeratin 18). The factors potentially associated with EMT were analyzed using logistic regression analysis. Primary MCs derived from the omentum were isolated for the in vitro study. Results Forty-seven percent of the patients presented with EMT, 28% with non-EMT, and 15% with a mixed presentation. Logistic regression analysis showed that patients who received persistent PD therapy (dwelling time of 24 h/day) had significantly higher EMT tendency. These results were consistent in vitro. Conclusions Dwelling time had a significant effect on the occurrence of EMT on MCs.