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Porokeratosis ptychotropica (PP) is a rare and unusual variant of porokeratosis. There is a dearth of information on the natural history, epidemiology, and optimal treatment options. This study aimed to characterize the worldwide distribution, epidemiology, clinical features, and treatments attempted for all reported cases of porokeratosis ptychotropica. A total of 59 cases of porokeratosis ptychotropica have been reported, with most cases originating from the United States. The median age of patients affected with porokeratosis ptychotropica was 49 years. The most involved body locations are the buttocks and gluteal cleft. The risk of malignant transformation in porokeratosis ptychotropica is approximately 1.7% but there is significant bias in estimating rare occurrences in rare diseases. In conclusion, PP is an important but under-recognized variant of porokeratosis, with a likely low risk of malignant transformation. The best available treatment modality remains uncertain; however, the use of topical lovastatin/cholesterol cream appears promising. Long-term surveillance appears prudent for porokeratosis ptychotropica due to a risk of cancerization.

Jin Peng,1 Ruiying Dong,1 Jianfen Jiao,1 Min Liu,1 Xi Zhang,1 Hualei Bu,1 Ping Dong,2 Shasha Zhao,3 Naidong Xing,4 Shuai Feng,5 Xingsheng Yang,1 Beihua Kong1 1Department of Obstetrics and Gynecology, Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 2Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, People’s Republic of China; 3Department of Clinical Nutrition, Qilu Hospital, Shandong University, Jinan, People’s Republic of China; 4Department of Urology, Qilu Hospital, Shandong University, Jinan, People’s Republic of China; 5Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People’s Republic of ChinaCorrespondence: Xingsheng YangDepartment of Obstetrics and Gynecology, Qilu Hospital, Shandong University, No. 107 West Wenhua Road, Jinan, 250001, People’s Republic of ChinaEmail xingshengyang@sdu.edu.cnObjective: Enhanced recovery after surgery (ERAS) protocol has widely gained acceptance in gynecological surgery. Its safety and efficacy should be evaluated fully via well-designed, randomized, control trials. The main objective of our study is to compare the ERAS protocol with the conventional perioperative care program after gynecological oncology. Furthermore, the secondary objectives of our study are the identification of markers that allow us to evaluate the effectiveness of the application of ERAS elements in the modulation of the body’s response to surgical stress.Methods: Patients with gynecological tumors indicated for surgery were randomly assigned to either the ERAS group or the conventional group. The ERAS protocol included short fasting time, fluid restriction, early oral feeding, reduced opioid consumption and immediate mobilization after surgery. The primary endpoint was the reduction of hospital stay in the ERAS group. The day of first flatus, postoperative nausea and vomiting (PONV), maximum pain score by the visual analogue scale (VAS) and complication, readmission rate, reoperation rate, postoperative mortality, total hospital cost and systemic inflammatory response (SIR) were secondary endpoints.Results: A total of 130 patients in gynecological tumor surgery were enrolled (ERAS = 65, conventional = 65). The ERAS group had faster bowel function recovery, significantly less pain, less PONV, shorter hospital stay, and less total hospital costs. SIR markers were estimated and screened out that postoperative platelet, neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) were significantly lower in ERAS groups compared to conventional groups.Conclusion: The implementation of ERAS protocol is safe and enhances postoperative recovery after gynecological oncology surgery. We firstly reveal the beneficial effect of ERAS protocols on the alleviation of postoperative SIR, which is a reflection of the magnitude of surgical trauma. Postoperative platelet, NLR or PLR could be the novel and inexpensive markers to assess how ERAS protocols modulate gynecological oncology surgery.Trial Registration: The trial was registered in ClinicalTrials.gov (NCT03629626).Keywords: ERAS, enhanced recovery after surgery, systemic inflammatory response, gynecological oncology surgery, NLR, neutrophil-lymphocyte-ratio, PLR, platelet-lymphocyte-ratio

Zhenbai Qin, Binghui Kong, Jing Zheng, Xiantao Wang, Lang Li Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaCorrespondence: Lang LiDepartment of Cardiology, The First Affiliated Hospital of Guangxi Medical University, No. 21 Shuangyong Road, Qingxiu District, Nanning, Guangxi 530021, ChinaTel +86 0771-5331171Email drlilang@163.comObjective: Coronary microembolization (CME) results in progressive contractile dysfunction associated with cardiomyocyte apoptosis. Alprostadil injection improves microcirculation, which is effective in treating various cardiovascular disorders. However, the therapeutic effects of alprostadil in CME-induced myocardia injury remain unknown. Therefore, we evaluated the effects of alprostadil injection on cardiac protection in a rat model of CME and explored the underlying mechanisms.Methods: A rat model of CME was established by injecting polyethylene microspheres into the left ventricle. After injection of microspheres, rats in the alprostadil group received alprostadil via tail vein within 2 minutes. Cardiac function, histological alterations in myocardium, serum c-troponin I (cTnI) levels, myocardium adenosine triphosphate (ATP) concentrations, the activity of superoxide dismutase (SOD) and malondialdehyde (MDA) content in myocardium, and myocardial apoptosis-related proteins were detected 12 hours after CME modeling.Results: Compared with the Sham group, ATP concentrations, SOD activity in the myocardium, and cardiac function were significantly decreased in a rat model of CME. In addition, serum cTnI levels, MDA content, expression levels of pro-apoptotic proteins, and the number of TUNEL-positive nuclei were remarkably higher in CME group than those in the Sham group. However, alprostadil treatment notably reduced serum cTnI levels and expression levels of pro-apoptotic proteins, while noticeably improved cardiac function, and accelerated SOD activity in the myocardium following CME. Additionally, it was unveiled that the protective effects of alprostadil injection inhibit CME-induced myocardial apoptosis in the myocardium potentially through regulation of the GSK-3β/Nrf2/HO-1 signaling pathway.Conclusion: Alprostadil injection seems to significantly suppress oxidative stress, alleviate myocardial apoptosis in the myocardium, and improve cardiac systolic and diastolic functions following CME by regulating the GSK-3β/Nrf2/HO-1 signaling pathway.Keywords: coronary microembolization, alprostadil injection, apoptosis, GSK-3β/Nrf2/HO-1 signaling pathway

Background: Little is known about the relationship of blood pressure (BP) with adiposity indicators, dietary habits, physical activity, and sleep in school children in Malaysia. We aimed to study about the distribution of BP and its associated factors in primary school children. Materials and Methods: A survey was carried out on a random sample of 335 children in five primary schools. BP was measured with a mercury sphygmomanometer. Anthropometry was done by standard methods. Demographic information, dietary habits, physical activity, and duration of sleep were collected by interviews. World Health Organization classification based on body mass index (BMI) and waist circumference (WC) cut-offs were used to define overweight/obesity. Elevated BP was defined according to US reference standards. Results: A total 335 children (144 boys and 191 girls) were examined. Their mean age was 9.18 years (standard deviation [SD] = 0.28). Overall mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) were 99.32 mmHg (SD = 10.79) and 67.11 mmHg (SD = 10.76), respectively. Mean BMI and WC were 16.39 (SD = 3.58) and 57.77 cm (SD = 8.98), respectively. The prevalence of pre-hypertension was 12.23% (95% confidence intervals [CIs] 8.73, 15.75) and hypertension was 13.4% (95% CIs 9.78, 17.09). Mean SBP and DBP was higher among overweight and obese children than normal children. By multivariate linear regression analyses, BMI (β = 0.250, P = 0.049) and WC (β = 0.308, P = 0.015) were positively associated with SBP; age (β = 0.111, P = 0.017), BMI (β = 0.320, P = 0.012) were positively associated with DBP but total (weekly) hours of sleep (β = −0.095, P = 0.037) was negatively associated with DBP. Conclusion: BP was associated with BMI and WC. Health promotion activities should be initiated in primary schools.

In this paper, we present a state-of-the-art precipitation estimation framework which leverages advances in satellite remote sensing as well as Deep Learning (DL). The framework takes advantage of the improvements in spatial, spectral and temporal resolutions of the Advanced Baseline Imager (ABI) onboard the GOES-16 platform along with elevation information to improve the precipitation estimates. The procedure begins by first deriving a Rain/No Rain (R/NR) binary mask through classification of the pixels and then applying regression to estimate the amount of rainfall for rainy pixels. A Fully Convolutional Network is used as a regressor to predict precipitation estimates. The network is trained using the non-saturating conditional Generative Adversarial Network (cGAN) and Mean Squared Error (MSE) loss terms to generate results that better learn the complex distribution of precipitation in the observed data. Common verification metrics such as Probability Of Detection (POD), False Alarm Ratio (FAR), Critical Success Index (CSI), Bias, Correlation and MSE are used to evaluate the accuracy of both R/NR classification and real-valued precipitation estimates. Statistics and visualizations of the evaluation measures show improvements in the precipitation retrieval accuracy in the proposed framework compared to the baseline models trained using conventional MSE loss terms. This framework is proposed as an augmentation for PERSIANN-CCS (Precipitation Estimation from Remotely Sensed Information using Artificial Neural Network- Cloud Classification System) algorithm for estimating global precipitation.

We report a two-dimensional electron gas created at the (Ga0.5Al0.5)2O3/SrTiO3 heterointerfaces with different deposition temperatures and thicknesses by a pulsed laser deposition method. It is found that the critical deposition temperature for the metal-to-insulator transition is about 400 °C with a thickness of 43.2 nm. The carrier density and mobility of sample at the deposition temperature of 300 °C are 1012 cm−2 and 67.2 cm2 V−1 s−1 at 50 K, respectively. The thickness of the conductive layer is ∼4.0 nm estimated from the anisotropic magnetoresistance. The bandgaps of films deposited at different temperatures are in the range of 5.6–5.9 eV. Furthermore, the heterointerfaces have a strong response to 360 nm light with a relative resistance change of ∼70%. Our results are related to the charge transfer due to the oxygen defect at the interfaces, which provides a way for the development of third-generation semiconductor optoelectronic devices. [ABSTRACT FROM AUTHOR]