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Aim: to assess adaptive hemostasis changes in multiple dichorionic pregnancy after in vitro fertilization (IVF). Materials and Methods. A prospective observational randomized controlled trial was conducted by examining 58 and 46 pregnant women with multiple dichorionic diamniotic twins resulting from applying assisted reproductive technologies (ART) and spontaneous delivery (comparison group), respectively. Hemostasis parameters were studied as follows: activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen, antithrombin, protein C, protein S, functions of protein С (РrоС Global test), D-dimer, platelet aggregation with adenosine-5-diphosphate (ADP), ristocetin, and collagen. Results. A high coagulation potential was revealed, more prominent after using ART (p < 0.05). Fibrinogen level gradually increased while gestation age increased, whereas APTT, PT and TT level decreased. In the group with natural conception, fibrinogen increased by 22 % in the second trimester, reaching 4.5 g/L (95 % CI = 4,2–4,8) and by 6 % in the third trimester, reaching 4.8 g/L (95 % CI = 4,3–5,4), whereas in the IVF group – by 26 %, reaching 5.3 g/L (95 % CI = 4,7–5,6) and by 21 %, reaching (6.5 g/L; 95 % CI = 5,2–6,8) in relevant trimester of pregnancy, respectively. Antithrombin level was lower in IVF patients – 76.8 % (95 % CI = 72.6 – 81.0) in the second trimester, reaching 70.6 % (95 % CI = 64.8–76.4) in the third trimester (p < 0.001). Protein C level did not differ significantly between groups and was low within the reference range. The aggregatogram demonstrated a high platelet hemostatic potential in IVF patients (p < 0.05) as early as in the first trimester: ADP-induced aggregation – 68.3 % (95 % CI = 62.9–73.7), ristocetin-induced aggregation – 53.1 % (95 % = CI 48.7–58.5), collagen-induced aggregation – 58.4 % (95 % CI = 52.1–64.7). In the third trimester, both platelet aggregation and functional activity (ADP-induced aggregation – 64.5 % [95 % CI = 59.3–69.7], ristocetin-induced aggregation – 68.4 % [95 % CI = 63.2–73.6], collagen-induced aggregation – 50.7 % [95 % CI = 44.3–57.1]; p < 0.05) and D-dimer level persistently increased, also more prominently in the IVF group (1.60 ± 0.46 ng/ml; p < 0.05). Conclusion. Gestational adaptation in induced multiple pregnancies is at high risk of breach in compensatory mechanisms and requires monitoring for timely detection of decompensation signs and their correction to prolong pregnancy till optimal delivery time frame.

Anna Basok,1 Elvira Romanjuk,1 Boris Rogachev,1 Yosef Shmuel Haviv,1 Ruth Shaco Halevy,2 Marina Vorobiov1 1Nephrology Department, Ben Gurion University Medical Center, Beer Sheva, Israel; 2Pathology Department, Ben Gurion University Medical Center, Beer Sheva, IsraelCorrespondence: Anna Basok, Nephrology Department, Ben Gurion University Medical Center, Uchmanit 13, Beer-Sheva, 8485283, Israel, Email basok@bgu.ac.ilAbstract: We described an extraordinary case of invasive aspergillosis (IA) after commercial kidney transplantation. Massive infestation by angiotrophic fungi with morphological features of Aspergillus caused fungal arteritis of renal blood vessels with detachment of the kidney graft from the iliac artery with ipsilateral leg ischemia, necessitating graft removal and recurrent vascular surgery to restore the blood supply to the leg. A literature review comprising various features of invasive aspergillosis and ethical aspects of commercial kidney transplantations is elucidated in this paper.Keywords: invasive aspergillosis, IA, transplant tourism, TT, galactomannan

The database management system (DBMS) for any application is crucial for developers because each application needs high performance to run efficiently. Therefore, database Benchmarking is the process of performing several Defined tests on those databases to evaluate their performance. The electronic benchmarking System (EBS) facilitates and improves human resource management (HRM) in all aspects of real life. EBS designed by four different database backends and three different web technology. This paper presents a comparative evaluation of the performance of the top DBMS systems namely (MySQL, SQL Server, Oracle, and MS Access). The middleware is designed using three dynamic web technologies (PHP, ASP, and PYTHON). In order to evaluate the backend performance for the four mentioned databases system by using two Parameters Response Time (RT) and Throughput (TT) over different Tire Architectures namely: One-Tier Architecture (1TA), Two-Tier Architecture (2TA). This paper will show which of the database has a better Response time (RT) and Throughput (TT). [ABSTRACT FROM AUTHOR]

Aim: This study investigated the development of power profiles and performance-related measures from the junior level (<19 yr) via U23 (19-23 yr) to senior level (>23 yr) in 19 female and 100 male Norwegian national team cyclists. Methods: A total of 285 tests were performed in a 3-d laboratory-standardized testing regime. The tests included power profiles with shorter duration (6-60 s) and longer durations (12-30 min) together with performance-related measures: critical power (CP), work capacity above CP (W'), power output at 4 and 2 mmol·L-1 [BLa-] (L4 and L2), maximal aerobic power (Wmax), and maximal oxygen uptake (VO2max), gross efficiency (GE), and pedaling efficiency. Results: Females and males evolve similarly when maturing from junior via U23 to senior categories (all P > 0.07), except for VO2max, which increased in females (but not males) from junior to senior level (534 ± 436 mL·min-1, P = 0.013). In general, only performances of longer durations improved with age (12 and 30min, P = 0.028 and P = 0.042, respectively). Performance-relatedmeasures likeWmax, VO2max, CP, L4, L2, and pedaling efficiency in the fresh state improved with age (all P = 0.025). Importantly, performance in the semifatigued state during a 5-minmaximal testwas also improvedwith age (P = 0.045) despite a higher external energy expenditure before the test (P=0.026). Conclusions: Junior cyclists showhighly developed sprint abilities, and the primary improvements of absolute power outputs and performance-relatedmeasures are seen for durations >60 s whenmaturing toU23 and senior categories. However, the durability, i.e., the capacity tomaintain performance in a semifatigued state, is improved with age. [ABSTRACT FROM AUTHOR]

Background and purpose: Testosterone is an essential sex hormone in maintaining masculine characteristics, which is prescribed for male hypogonadism as testosterone replacement treatment (TRT). Herein, we investigated long-standing controversies about the association between TRT and major adverse cardiovascular events (MACEs), based on real world adverse event (AE) reports, registered in the Food and Drug Administration Adverse Event Reporting System (FAERS). Methods: Publicly available FAERS data from 1 January 2004 to 31 December 2022 were retrieved from the Food and Drug Administration (FDA) website. The data mining protocol including the reporting odds ratio (ROR) and the Bayesian confidence propagation neural network (BCPNN) was applied to analyze overreporting caused by risk factors and MACEs, including TRT, morbidities, and ages. The ROR and the BCPNN were also applied to investigate the annually developing trend of pharmacovigilance (PV) signals in the real world, retrospectively. Results: A total of 3,057 cases referring to MACEs, with a median age of 57 years old (yo), were identified from 28,921 cases of testosterone users. MACEs related to PV signals have emerged since 2014, including cardiac death, non-fatal myocardial infarction, and non-fatal stroke. Myocardial infarction (MI) (ROR: 9.46; IC025: 3.08), acute myocardial infarction (AMI) (ROR: 16.20; IC025: 3.72), ischemic cardiomyopathy (ROR: 11.63; IC025: 2.20), and cardiomyopathy (ROR: 5.98; IC025: 1.96) were the most significant signals generated, and weaker signals included cardiac failure acute (ROR: 4.01; IC025: 0.71), cardiac arrest (ROR: 1.88; IC025: 0.56), and ventricular fibrillation (VF) (ROR: 2.38; IC025: 0.38). The time-toonset (TTO) of MACEs was calculated with a median of 246 days for AMI. Conclusion: For myocardial infarction and cardiomyopathy, TRT statistically tended to increase the risk of MACEs, while for cardiac arrhythmia, cardiac failure, and stroke, TRT demonstrated beneficial effects among the population with morbidities, such as testosterone deficiency (TD), diabetes mellitus (DM), and hypertension. MACEs were rare but led to serious outcomes including significant increase in death and disability. Since 2018, and before 2014, reports referring to TRT associated with MACEs were relatively scarce, which indicated that there might be a considerable number of cases that went unrecorded, due to neglection. Health workers and testosterone users might pay more attention to testosterone-induced MACEs. [ABSTRACT FROM AUTHOR]

Tetanus is an acute and often fatal infectious disease caused by Clostridium tetani. Tetanus toxin (TT) is responsible for spastic paralysis observed in tetanus. Anti-tetanus antibodies obtained from horses and humans are the most antitoxins used for tetanus treatment, although some clinical side effects and disadvantages have been reported in their application. The aim of this study is the production of anti-TT IgY and evaluation of its protective effects in a mouse model. Anti-TT IgY was purified from the egg yolk using PEG6000 precipitation and water dilution methods, and its purity was verified by SDS-PAGE. Finally, the potency of purified anti-TT IgY in neutralizing the lethal effects of TT was studied in vivo using a mouse model. PEG6000 precipitation method had better results. Animal studies showed that the purified IgY neutralized the toxic effects of 100 MLD of TT and multiple intravenous-dose injections of anti-TT IgY also had a continuous effect of TT neutralization. The purified anti-TT IgY was effective in neutralizing the lethal activity of TT in a mouse model. Our results suggested that IgY could be an alternative therapeutic source for the management of tetanus in the future. Abbreviations Anti-TT, Anti-tetanus toxin; ELISA, Enzyme-linked immunosorbent assay; IgY, Immunoglobulin Y; MLD, Minimum lethal dose; PBS, Phosphate buffer solution; PEG, Polyethylene glycol; SDS-PAGE, Sodium dodecyl sulfate polyacrylamide gel electrophoresis; TIG, Tetanus immune globulin; TT, Tetanus toxin; WD, Water dilution; RT, Room temperature. [ABSTRACT FROM AUTHOR]

Objective: This study aims to assess anti-Müllerian hormone (AMH), luteinizing to follicle-stimulating hormone ratio (LH: FSH), total testosterone (TT), and prolactin (PRL) levels among PCOS. In addition, we determine if AMH can be used as a predictor of PCOS among Sudanese women. Methods: There were 600 women enrolled in this observational cross-sectional study, 300 of whom had PCOS, and 300 of whom healthy women; PCOS was diagnosed using the Rotterdam criteria. On days 2– 4 of the menstrual cycle, serum LH, FSH, AMH, TT, and PRL levels were measured for all participants. Diagnostic performance of these parameters for PCOS was determined by receiver operating characteristic (ROC) curve. Results: Significantly higher means among PCOS regarding their BMI, AMH; LH: FSH ratio; TT; PRL, whereas significantly inverse in FSH compared with normal ovulatory women. On ROC analysis, AMH had the largest operating characteristic curve at cut-off > 3.95 ng/mL; AUC = 0.999 with Youden's index 0.99%, followed by LH: FSH ratio at cut-off 0.749; AUC=0.932; Youden's index 0.813%, TT cut-off 0.82 mIU/L, AUC=0.852 with Youden's index 0.58, while PRL showed the lowest AUC=0.627 with cut-off 15.3 ng/mL, Youden's index was 0.18%, P. value< 0.001. Conclusions: Sudanese women with PCOS had higher serum AMH level, LH:FSH ratio, and TT level. Moreover, AMH level has better discriminative power and good diagnostic potency for the diagnosis of PCOS among Sudanese. [ABSTRACT FROM AUTHOR]

Background and aimsCurrent devices used for per-oral endoscopic myotomy (POEM) function predominantly to either cut tissue or coagulate vessels. When bleeding vessels are encountered within the submucosa or muscle, dedicated coagulation grasping devices are often necessary. An endoscopic "hot" scissor-type knife is available that combines coagulation and cutting functions. Scissor-type knives may therefore be helpful during the POEM procedure.MethodsWe report 4 cases of achalasia that were treated by the POEM procedure using the Stag Beetle scissor-type knife for myotomy. Patients were identified from a prospectively maintained database of patients undergoing POEM at our center between September and October 2017. A single operator (K.J.C.) performed all of the procedures using both a hybrid knife and an SB knife. Demographic and clinical data were collected for all patients.ResultsAll 4 POEM procedures were performed successfully without any adverse events. Only 3 spontaneous bleeding episodes occurred among the 4 procedures, and no perforation occurred. The patients were all doing very well at clinic follow-up at 4 weeks.ConclusionsThe technique of using the SB knife during myotomy during the POEM procedure is feasible and appears safe. Muscle tissue and blood vessels can be coagulated and cut simultaneously, reducing bleeding and improving control. Further comparative studies are warranted to evaluate the efficacy, safety, and cost effectiveness against existing techniques.

Background: Challenges in selecting the right formulation of testosterone (TE) for young males with delayed puberty (DP) arise from the fact that there is limited evidence based guidelines in recommending the most efficient and safe formulation of TE. Objective: To evaluate the existing evidence and systematically review the interventional effects of transdermal TE to other modes of TE administration for the treatment of DP among young and adolescent males. Methods: All types of methodologies published in English were searched from the data sources including MEDLINE, Embase, Cochrane Reviews, Web of Science, AMED and Scopus from 2015 till 2022. Boolean operators with keywords "types of TE", "modes of TE administration", "DP", "transdermal TE", "constitutional delay of growth and puberty, (CDGP)" "adolescent boys" and "hypogonadism" to optimize the search results. The main outcomes of concern were optimal serum TE level, body mass index, height velocity, testicular volume, pubertal stage (Tanner), The secondary outcomes included in this study were adverse events and patient satisfaction. Results: After screening 126 articles, 39 full texts were reviewed. Only five studies could be included after careful screening and rigid quality assessments. Most studies were at high or unclear risk of bias with short duration and follow up periods. Only one study was a clinical trial covering all the outcomes of interests. Conclusion: This study points out the favorable effects of transdermal TE treatment for DP in boys, while the existence of the vast gap in research needs to be acknowledged. Despite the utmost demand in an appropriate TE treatment for young males with DP, scarce efforts and trials are being undertaken to provide clear clinical guidance of treatment. Quality of life, cardiac events, metabolic parameters, coagulation profiles are important aspects of the treatment are overlooked and under evaluated in most studies. Systematic Review Registration: PROSPERO CRD 42022369699. [ABSTRACT FROM AUTHOR]

Inflammation plays a role in the pathogenesis of COPD by interfering with the protease/antiprotease and oxidant/antioxidant balance. There is no adequate data about the relationship between oxidative stress biomarkers and FEV1 values in stable COPD patients. Prospective cohort study, designed in tertiary care chest disease hospitals' outpatient clinic. COPD patients were approved informed consent were included in the study. The total antioxidant status (TAS,), total oxidant status (TOS), total thiol (TT), native thiol (NT), IL1 IL6, and TNFα levels were measured. The mean age of 33 COPD patients who joined the study was 61±9,32 years, while their average body mass index (BMI) was 27±4,31 kg/m2. There was no statistically significant difference between the groups in terms of age, gender, weight, smoking status and comorbidities. According to the results of the analysis, there was a statistically significant difference in TOS, TAS, oxidative stress index (OSI), TT, NT, DIS, IL-1β, IL-6, and TNFα between the control and COPD patient groups (p [Med-Science 2022; 11(2.000): 770-74]

Background: Recurrent Testicular Torsion (RTT) is a rarely reported event after previous testicular torsion (TT) repair. Both conditions have similar signs and symptoms. Various techniques have been attempted to reduce the incidence of retorsion. This review assesses the presentation, diagnosis, risk factors, management and outcomes associated with RTT. Methods: After PROSPERO Registration (CRD42021258997), a systematic search of PubMed, Google Scholar, Embase, Scopus, Web of Science, Cochrane Database of Systematic Reviews, Global Index Medicus and Cumulative Index to Nursing and Allied Health Literature (CIANHL) was performed using specific search terms. Study metadata including patient demographics, orchidopexy techniques, RTT rates and RTT timing were extracted. Results: Twenty‐six articles, comprising 12 case series and 14 case reports, with a total of 46 patients were included. Overall, the median (IQR) age of the pooled cohort was 18 (15–26) years, the median (IQR) time to presentation was 6 (3–36) hours from the onset of testicular pain. The most common presenting features were testicular pain (100%), testicular swelling (60.9%) and a high riding testicle (34.8%). The left testicle was most commonly affected (63.0%), RTT was on the ipsilateral side in relation to the primary episode of TT in 52.2% of cases, the median (IQR) interval between torsion and retorsion events was 4 (1.3–10.0) years, non‐absorbable sutures were the most common suture material used during orchidopexy after RTT (88.9%). Conclusion: RTT is a rare presentation to the Emergency Department. Even with a prior history of TT, RTT should be considered in patients presenting with classic symptoms. [ABSTRACT FROM AUTHOR]

Inflammation plays a role in the pathogenesis of COPD by interfering with the protease/antiprotease and oxidant/antioxidant balance. There is no adequate data about the relationship between oxidative stress biomarkers and FEV1 values in stable COPD patients. Prospective cohort study, designed in tertiary care chest disease hospitals' outpatient clinic. COPD patients were approved informed consent were included in the study. The total antioxidant status (TAS,), total oxidant status (TOS), total thiol (TT), native thiol (NT), IL1 IL6, and TNFα levels were measured. The mean age of 33 COPD patients who joined the study was 61±9,32 years, while their average body mass index (BMI) was 27±4,31 kg/m2. There was no statistically significant difference between the groups in terms of age, gender, weight, smoking status and comorbidities. According to the results of the analysis, there was a statistically significant difference in TOS, TAS, oxidative stress index (OSI), TT, NT, DIS, IL-1β, IL-6, and TNFα between the control and COPD patient groups (p<0.001 for all variables). Compared to healthy controls, COPD patients had greater TOS, OSI, disulfide (DIS), IL-1β, IL-6, and TNFα levels. Healthy controls, had considerably higher TAS, TT, and NT values than the COPD group. No significant correlation was detected between the pulmonary function test results and oxidative stress markers. In conclusion, no significant correlation was detected between the pulmonary function test results and oxidative stress markers besides TOS was increased while TAS was decreased, in accordance with the pathophysiology of COPD, oxidative stress markers can also be utilized in COPD patients. [ABSTRACT FROM AUTHOR]

Background: The NAD (P) H: quinone oxidoreductase (NQO1) C609T polymorphism has been widely thought to be associated with the risk of acute leukemia. Objective: This case-control study aimed to assess the impact of NQO1 C609T gene polymorphism in childhood acute lymphoblastic leukemia (ALL). Patients and Method: The study was carried out on one hundred de novo ALL children and one hundred apparently healthy children. Routine genotyping of NQO1C609T gene polymorphism by PCR-RFLP was done for all subjects. Results: No statistically significant difference was observed between the patient group and control group as regards wild and polymorphic genotypes. However, there was a significant difference between ALL patients with wild and polymorphic genotypes regarding their immunophenotyping diagnosis (P=0.02) and FAB classification (P=0.01). There was also a significant difference between ALL patients with wild and polymorphic genotypes regarding their response to treatment. The complete remission in the wild genotype (CC) was 69.2% while in polymorphic genotypes (TT & CT) was 29.4% (P<0.05). Conclusion: The polymorphic genotype forms of the NQO1 C609T (CT and TT) are associated with decreased response to treatment. [ABSTRACT FROM AUTHOR]

Study Objective is to evaluate prevalence of hepatitis A, B, C, E, and TT virus infection markers in highly qualified sportsmen. Study Design: multicenter open single-site clinical study.Materials and Methods: 100 blood serum samples of sportsmen (game, complex coordination, technical, etc.) were studied. Biological material (blood serum) was obtained from 54 men and 46 women aged 16 to 45 years during an in-depth medical examination. All sportsmen filled out a questionnaire, including demographic data, description of the sport, information about infection risk factors, information about the presence of acute viral hepatitis and vaccination. Anti-HAV IgG, HBsAg, anti-HBcore, anti-HCV, anti-HEV IgG, anti-HEV IgM were determined in the blood serum by enzyme immunoassay; using polymerase chain reaction — DNA Anelloviridae (TTV, TTMDV, TTMV). Study Results: Anti-HAV IgG was detected in 57/66 (86,4%) sportsmen, women (91,2%) predominated, among them a third were engaged in synchronized swimming. 7/57 (12,3%) of the examined had indications of vaccination against hepatitis A. The frequency of anti-HEV IgG did not exceed 3% (2/66). anti-HEV IgM were not detected in any case. Also, none of the examined sportsmen in the blood serum was not determined HBsAg. However, anti-HBcore (marker of latent HBV infection) was detected in 13% (13/100) of the samples. The detection rate of anti-HCV was low, combined with the presence of anti-HBcore was 2% (2/100). In addition, DNA TTV, TTMDV and TTMV, respectively, were found in serum samples from 66/100 (86%), 79/100 (79%), 71/100 of sportsmen. Conclusion: The high frequency of hepatitis virus markers was found (HAV — 74,1%, TTV/TTMDV /TTMV — 71-86%), HBV — 13%, HEV — 3%, HCV — 2%). All patients denied a history of acute viral hepatitis. Vaccination against hepatitis A and B is a modern strategy that prevents infection and the development of acute viral hepatitis. Its mandatory holding should become part of the targeted preparation of sportsmen to achieve the highest sports results.

One of the major concerns for continuous solar photovoltaic (PV) generation is partial shading. The movement of clouds, shadow of buildings, trees, birds, litter and dust, etc., can lead to partial shadow conditions (PSCs). The PSCs have caused inconsistent power losses in the PV modules. This leads to a shortage of electricity production and the presence in the PV curve of several peaks. One of the simplest solutions to PSC's is the PV configurations. The objective of this paper is modelling and simulation of solar PV system in various shading scenarios for KC200GT 200 W, 5 x 5 configurations that includes Series/Parallel (SP), Total-Cross-Tied (TCT), Triple-Tied (TT), Bridge-Link (BL) configurations. Real time PSC's such as corner, center, frame, random, diagonal, right side end shading conditions are evaluated under all PV array configurations. A comparative analysis is carried out for the parameters such as open circuit voltage, short circuit current, maximum power point, panel mismatch losses, fill factor, efficiency under all PV configurations considering PSC's. From the comparison analysis best configuration will be presented. [ABSTRACT FROM AUTHOR]

Background: Pedicle screw insertion in osteoporotic patients is challenging. Achieving more screw-cortical bone purchase and invasiveness minimization, the cortical bone trajectory and the midline cortical techniques represent alternatives to traditional pedicle screws. This study compares the fatigue behavior and fixation strength of the cement-augmented traditional trajectory (TT), the cortical bone trajectory (CBT), and the midline cortical (MC). Methods: Ten human cadaveric spine specimens (L1 - L5) were examined. The average age was 86.3 ± 7.2 years. CT scans were provided for preoperative planning. CBT and MC were implanted by using the patient-specific 3D-printed placement guide (MySpine®, Medacta International), TT were implanted freehand. All ten cadaveric specimens were randomized to group A (CBT vs. MC) or group B (MC vs. TT). Each screw was loaded for 10,000 cycles. The failure criterion was doubling of the initial screw displacement resulting from the compressive force (60 N) at the first cycle, the stop criterion was a doubling of the initial screw displacement. After dynamic testing, screws were pulled out axially at 5 mm/min to determine their remaining fixation strength. Results: The mean pull-out forces did not differ significantly. Concerning the fatigue performance, only one out of ten MC of group A failed prematurely due to loosening after 1500 cycles (L3). Five CBT already loosened during the first 500 cycles. The mean displacement was always lower in the MC. In group B, all TT showed no signs of failure or loosening. Three MC failed already after 26 cycles, 1510 cycles or 2144 cycles. The TT showed always a lower mean displacement. In the subsequent pull-out tests, the remaining mean fixation strength of the MC (449.6 ± 298.9 N) was slightly higher compared to the mean pull-out force of the CBT (401.2 ± 261.4 N). However, MC (714.5 ± 488.0 N) were inferior to TT (990.2 ± 451.9 N). Conclusion: The current study demonstrated that cement-augmented TT have the best fatigue and pull-out characteristics in osteoporotic lumbar vertebrae, followed by the MC and CBT. MC represent a promising alternative in osteoporotic bone if cement augmentation should be avoided. Using the patient-specific placement guide contributes to the improvement of screws' biomechanical properties. [ABSTRACT FROM AUTHOR]

Assessing radiation fields in the biological shield penetrations of fusion reactors is a challenging task. At the Joint European Torus (JET) the neutron field at larger distances from the torus has been calculated and measured. JET operated in 2021–22 with a tritium-tritium plasma and neutronics experiments were performed for validating in a real fusion environment the neutronics codes and nuclear data applied in ITER nuclear analyses. In particular, the fluence of neutrons passing through the penetrations of the JET vacuum vessel and the torus hall was measured and compared with calculations in order to assess the capability of state-of-the-art numerical tools to correctly predict the radiation streaming in large and complex geometries. The neutron fluence was monitored at several locations inside the torus hall at larger distances from the tokamak with activation foils and thermo-luminescent detectors. The calculations have been performed in a two-step process using the deterministic code ADVANTG to determine the variance reduction parameters and with MCNP for subsequent calculation of the neutron field with the Monte Carlo method. The paper presents results of calculations and the first comparison to experimentally obtained values. [ABSTRACT FROM AUTHOR]

Cellulitis is a bacterial infection of the deeper layers of the skin, namely, the dermis and the subcutaneous tissue. The most common organisms involved in causing cellulitis are group A β-hemolytic streptococci and Staphylococcus organisms. Rare causes include Pseudomonas aeruginosa in case of puncture wounds, anaerobes, Eikenella, Viridans streptococci in human bites. Cellulitis is mainly a clinical diagnosis but blood counts and ESR can be done to confirm its occurrence. Risk factors for cellulitis include breaks in the skin which allows an entry point for the bacteria, other risk factors include immune deficient states such as HIV/leukemia, conditions that affect the vascular system, and skin conditions such as eczema and psoriasis. Vaccination is an extremely rare cause of cellulitis with no cases of cellulitis reported since 1998 due to complication of vaccination. In our case, patients presented signs and symptoms of cellulitis 2 days after receiving the tetanus prophylaxis vaccine. He was treated with broad-spectrum antibiotics after admission and discharged once the condition settled.

Abstract Background Traditional coagulation tests are included in emergency guidelines for management of patients on direct oral anticoagulants (DOACs) who experience acute bleeding or require surgery. We determined the ability of traditional coagulation tests and fast whole blood thromboelastography (ROTEM®) to screen for anticoagulation activity of dabigatran and rivaroxaban as low as 30 ng/mL. Methods One hundred eighty-four citrated blood samples (75 dabigatran, 109 rivaroxaban) were collected from patients with non-valvular atrial fibrillation (NVAF), to perform screening tests from different manufacturers, (diluted, D) PT, aPTT, TT and ROTEM®. The activity of DOACs was quantitatively determined by clot detection assays: Hemoclot DTT and DiXaI test (Biophen), on CS2100 (Siemens). The clotting time (CT) of INTEM and EXTEM ROTEM® (Werfen) were used as test parameters. Results Dabigatran, ≥ 30 ng/mL, was accurately detected by five coagulation tests: APTT Actin FSL (93%), PT Neoplastin (93%), APTT Cephascreen, Thromboclotin, and Thrombin (all 100%), but not by PT Innovin (49%). CT-EXTEM (91%) was sufficiently sensitive, but not CT-INTEM (52%). APTT Cephascreen and Thrombin showed good linearity (R2 = 0.71,R2 = 0.72). For the other tests linearity was moderate to poor. Rivaroxaban was accurately detected by PT Neoplastin (98%) and less so by APTT Cephascreen (85%). In addition, rivaroxaban was also accurately detected by CT-INTEM (96%). PT Neoplastin showed good linearity (R2 = 0.81), all other tests had moderate to poor linearity. Conclusion In patients with NVAF, the ability of routine coagulation tests to detect the presence of significant levels of DOACs is test and reagent dependent. CT-INTEM and CT-EXTEM may be fast whole blood alternatives. Trial registration The Institutional Review Board of the MUMC approved this study (December 2011, project number 114069).

Meningococcal vaccines have been developed over the years, to control outbreaks of meningitis. There are 12 immunologically distinct serogroups of which, A, B, C, W, Y and X are predominant and invasive in nature. Meningococcal vaccines can be sorted out as, polysaccharide vaccines, polysaccharide protein conjugate vaccines or protein based (independent of polysaccharides) vaccines. Stringent quality control analysis as per the regulatory guidelines is a requirement for any vaccine manufacturer for commercial release of vaccines. Quantitation becomes challenging when it comes to analysis of multivalent vaccines. We describe the quantitation of novel pentavalent meningococcal polysaccharide conjugate vaccine manufactured at Serum Institute of India Pvt Ltd (SIIPL). Briefly, sandwich ELISA assay was developed to quantitate five different serogroups (Men A-TT, Men C-CRM, Men Y-CRM, Men W-CRM , Men X-TT) in pentavalent meningococcal polysaccharide conjugate vaccine containing two different carrier proteins (TT and CRM). ELISA reported herein showed significant reproducibility and repeatability over a range of developed standard curve with acceptable coefficient of variation (<15%) for both intra and inter assay. Furthermore analysis showed that, polysaccharide conjugate (PC) contents were within the accepted range (±30%) of the stated label claim. The immunoassay was verified for its sensitivity, accuracy and precision. Based on the relevant experimental data; it is proposed that, reported sandwich ELISA is well suited for quantitation of individual polysaccharide conjugate from pentavalent formulation. Furthermore, the ELISA was explored for forced degradation and polysaccharide spiking studies. This leads to open up an area of research for sandwich ELISA as a tool to assess the integrity of vaccine as well as for lot to lot consistency monitoring. [ABSTRACT FROM AUTHOR]

Aim. Study clinical outcomes in patients with, chronic hepatitis C depending on genotype of hepatitis C virus (HCV) and IL28B gene polymorphism. Materials and methods. 592 individuals were examined, 75 of those had HCV RNAgenotypes determined by PCR. Genotyping of single nucleotide polymorphisms (SNP) - rs 12979860 (C/T) and rs8099917 (T/G) in IL28B gene was carried out by real-time PCR. Results. HCV RNA was detected in 72 examined residents of Yakutia. HCV lb genotype was determined in 74.2% of cases, 3a - in 11.4%, la and 2 - 5.7% each. Frequency of polymorph variant rsl2979860 CC was 72.2%, CT - 27.8%, rs8099917 TT - 61.1%, TG - 23.2%. Conclusion. Combination of HCV lb with polymorphic variants of IL28B gene rs.l.2979860 CC and rs8099917 CT showed a less aggressive course of the disease. On the other hand, HCV infection of individuals with genotype 3a and polymorphism rsl2979860 CC or rs809917 TT of IL28B gene showed a more severe clinical presentation. The presence of polymorph variants rs8099917 T/G and rs 12979860 C/T showed more severe clinical outcomes of HCV infection (viral load up to 19035212 copies, cirrhosis with ascite, hepatocarcinoma).

Polycystic ovarian syndrome (PCOS) is the most common and complex endocrine disorder affecting women in the reproductive age. The etiology of this syndrome is not completely known, so there is a developing proof that supports genetic basis, PCOS has a strong familial preference. This study was carried out to investigate the effect of body mass index (BMI) on ovarian hormones in women with PCOS and healthy women. Eighty-three women aged (17-40) years were divided into two groups for testing (BMI less than 25 and more than 25). Hormonal study of Luteinizing hormone (LH), Androgen, Estradiol (E2) was done for each patient, the results of these hormones in patients compared with controls in both BMI groups with E2/T ratio showed a significant increase in patients women compared to controls in (p<0.05), While the results of Follicle stimulating hormone (FSH) and Total Testosterone (TT) showed an increase with not statistically significant. it has been concluded that the increase in BMI doesn't show to have an opposite effect on FSH, Androgen, E2, and TT levels but the result of LH shows a highly significant increase in PCOS groups compared to controls when BMI>25. [ABSTRACT FROM AUTHOR]

Exclusive DOC-HCl formulations were developed for free polysaccharide content estimation in Meningococcal serogroup A, C, Y, W and X from pentavalent meningococcal vaccine (A, C, Y, W, X). The DOC precipitation method reported herein stands as an alternative to the ultra-filtration method for free polysaccharide estimation. DOC content was optimized for all the serogroups at a single concentration, where as effective acid concentration was altered as per serogroup. Briefly, two DOC-HCl formulations were developed for intended purpose, one for TT conjugated serogroups Men A & Men X where as other for CRM conjugated serogroups Men C, Men Y and Men W with effective HCl concentration of 23 mM and 193 mM for precipitation of Protein-DOC complex respectively. Furthermore, an exclusive buffer/DOC-HCl formulation for estimation of Men X free polysaccharide in fill finished product was developed. Accuracy of the method was proven at 12.5 %, 25 %, 50 % and 100 % of test specification where recoveries were found in the range of 70–130 %. In case of repeatability, intra assay variation ranged from 2 % to 7 % whereas inter assay variation was noted to be 2–14 %. Specificity studied revealed no interference of assay components such as sample excipients, DOC, acids. Critical quality and stability-indicating characteristics were measured. Monovalent polysaccharide standards of Men A, C, Y, W and X were developed and assigned the unitage concentration 1.01, 1.10, 1.09, 1.08 and 1.00 mg/mL respectively. Linearity curve was optimized from 0.17 to 27 µg/mL for Men A and C whereas from 0.33 to 27 µg/mL for Men Y and W considering free polysaccharide content estimation. The study suggests that DOC-HCl method meets all the criteria for free polysaccharide estimation in multivalent vaccines with additional advantages of high throughput and sized independent separation hence can be used for quality control testing. • Meningococcal vaccine discussed herein is the first vaccine that carries Meningococcal serogroup X. • The vaccine carries five different serogroups (A, C, Y, W and X) conjugated to two different carrier proteins (TT & CRM). • Exceptionality of this vaccine lead to challenges in analytics, especially development of stability indicating test. • Developmental challenges regarding serogroup specific behavior of multivalent vaccine are discussed in details. [ABSTRACT FROM AUTHOR]

Artykuł jest próbą zwrócenia uwagi na zagadnienia właściwości technicznych przy eksploatacji podstawowych typów sieci elektroenergetycznych stosowanych na statkach. Celem jest porównanie ich pracy przy powszechnie występujących uszkodzeniach.

Objective: Adenomyosis patients are in a hypercoagulable state, and studies have shown that carbohydrate antigen125 (CA125) may relate to the hypercoagulability and thrombosis of patients with adenomyosis, but there is still a lack of clarity regarding the changes in CA125-related coagulation indicators. This study was to explore the changes and influencing factors of CA125-related coagulation parameters in patients with adenomyosis., Methods: Retrospective observational study conducted on 200 patients with adenomyosis (AM group), 240 patients with uterine leiomyoma (LM group) and 81 patients with cervical intraepithelial neoplasia (CIN)-III (control group), of which the coagulation parameters were detected by clinical blood sample collection and statistical method analysis and informed consent was obtained., Results: The level of CA125 in the AM group was significantly higher than that in the LM group and control group. However, thrombin time (TT) shortened in the AM group when compared with the LM and control group. Activated partial thromboplastin time (APTT) in the AM group was shorter than in the control group. Multivariate logistic regression analysis found that adenomyosis was associated with CA125 level (OR=323.860, 95% CI 90.424-1159.924, P<0.001), APTT (OR=1.295, 95% CI 1.050-1.598, P=0.016), TT (OR=0.642, 95% CI 0.439-0.938, P=0.022), menorrhagia (OR=7.363, 95% CI 2.544-21.315, P<0.001), dysmenorrhea (OR=22.590, 95% CI 8.185-62.347, P<0.001). Correlation analysis revealed that APTT (r= -0.207) and TT (r = -0.174) were negatively correlated with the level of CA125., Conclusion: The shortening of CA125-related APTT and TT indicates that it is meaningful to detect coagulation parameters of patients with elevated CA125 levels early, dysmenorrhea and menorrhagia, and maybe further discover the hypercoagulability and prevent the occurrence of thrombus in adenomyosis., Competing Interests: The authors declare that there is no conflict of interest., (© 2024 Yang et al.)

Cellulitis is a bacterial infection of the deeper layers of the skin, namely, the dermis and the subcutaneous tissue. The most common organisms involved in causing cellulitis are group A β-hemolytic streptococci and Staphylococcus organisms. Rare causes include Pseudomonas aeruginosa in case of puncture wounds, anaerobes, Eikenella, Viridans streptococci in human bites. Cellulitis is mainly a clinical diagnosis but blood counts and ESR can be done to confirm its occurrence. Risk factors for cellulitis include breaks in the skin which allows an entry point for the bacteria, other risk factors include immune deficient states such as HIV/leukemia, conditions that affect the vascular system, and skin conditions such as eczema and psoriasis. Vaccination is an extremely rare cause of cellulitis with no cases of cellulitis reported since 1998 due to complication of vaccination. In our case, patients presented signs and symptoms of cellulitis 2 days after receiving the tetanus prophylaxis vaccine. He was treated with broad-spectrum antibiotics after admission and discharged once the condition settled. [ABSTRACT FROM AUTHOR]

Highlights • QCM-D superiority over standard equipment for dose management of apixaban. • The Δf/ΔΓ of the QCM-D-aPTT assay copes the clinical challenge. • The first report of the dose management of apixaban in replacement surgery. • The first report for thrombin test for real patients' samples application on QCM-D. • A new strategy for faster injection of smaller sample volumes. Abstract Apixaban has been recently permitted for medication and the clinics lack an antidote for overturning the drug's effect. We present the first report of the safe dose management of Apixaban in the risk of bleeding connected with the specific agent in replacement surgery. For this study, an unprecedented technique of "Quartz Crystal Microbalance with Dissipation" (QCM-D) has been utilized, while the QCM-D-assays of "activated Partial Thromboplastin Time" (aPTT) and "Thrombin Time" (TT) have been evaluated in parallel with the standard assays. Here, the acoustic signals are substantial for an evaluation of visco-elasticity of the clot, while the "clinical standard" does not yield important information related to the anticoagulant. The two equipment have been subjected to 370 samples, including 220 plasma specimens of patients under medication with Apixaban (during knee or hip replacement surgery). In testing, the coagulation times of the QCM-D-assays demonstrated an attractive co-relation with those of the standard assays within analytical limits of deviations. Conclusively, the QCM-D-aPTT is the "standard assay" for a dosage management of Apixaban, where the (frequency shifts / dissipation shifts) Δf/ΔΓ ratio of the QCM-D-assay reveals that Apixiban with FVII 90 combination could offer a secure medication to control Apixaban-induced bleeding in clinics. [ABSTRACT FROM AUTHOR]

Background: Traditional coagulation tests are included in emergency guidelines for management of patients on direct oral anticoagulants (DOACs) who experience acute bleeding or require surgery. We determined the ability of traditional coagulation tests and fast whole blood thromboelastography (ROTEM®) to screen for anticoagulation activity of dabigatran and rivaroxaban as low as 30 ng/mL. Methods: One hundred eighty-four citrated blood samples (75 dabigatran, 109 rivaroxaban) were collected from patients with non-valvular atrial fibrillation (NVAF), to perform screening tests from different manufacturers, (diluted, D) PT, aPTT, TT and ROTEM®. The activity of DOACs was quantitatively determined by clot detection assays: Hemoclot DTT and DiXaI test (Biophen), on CS2100 (Siemens). The clotting time (CT) of INTEM and EXTEM ROTEM® (Werfen) were used as test parameters. Results: Dabigatran, ≥ 30 ng/mL, was accurately detected by five coagulation tests: APTT Actin FSL (93%), PT Neoplastin (93%), APTT Cephascreen, Thromboclotin, and Thrombin (all 100%), but not by PT Innovin (49%). CT-EXTEM (91%) was sufficiently sensitive, but not CT-INTEM (52%). APTT Cephascreen and Thrombin showed good linearity (R² = 0.71, R² = 0.72). For the other tests linearity was moderate to poor. Rivaroxaban was accurately detected by PT Neoplastin (98%) and less so by APTT Cephascreen (85%). In addition, rivaroxaban was also accurately detected by CT-INTEM (96%). PT Neoplastin showed good linearity (R² = 0.81), all other tests had moderate to poor linearity. Conclusion: In patients with NVAF, the ability of routine coagulation tests to detect the presence of significant levels of DOACs is test and reagent dependent. CT-INTEM and CT-EXTEM may be fast whole blood alternatives. Trial registration: The Institutional Review Board of the MUMC approved this study (December 2011, project number 114069). [ABSTRACT FROM AUTHOR]

El desarrollo de las TIC favoreció la aparición del Teletrabajo (TT) a mediados del siglo pasado, pero actualmente, tan sólo el 13,2% de las empresas españolas lo fomentan. Las diferencias culturales, sociales, y las dificultades para homogeneizar la información disponible, hacen que resulte un desafío unificar criterios para su desarrollo. Esta revisión bibliográfica pretende mostrar el marco global del TT en España, factores de riesgo, repercusión, beneficios y perjuicios, detallar las condiciones y medidas de seguridad laboral que deberían acompañar el proceso. Para obtener los artículos se ha realizado una búsqueda bibliográfica en las principales bases de datos biomédicas. Efectos beneficiosos evidenciados serían el alto nivel de autonomía, elevada satisfacción laboral, mejor relación con el supervisor, disminución de la tasa de abandono del trabajo y del conflicto familiar. Otras publicaciones indican que reforzando los recursos personales, mejora el compromiso y la eficacia de los trabajadores. Se destaca la escasa existencia de descriptores específicos DeCS-MeSH para TT, incluidos en las bases de datos bibliográficas que utilizan estos tesauros como motor de búsqueda, Medline, Cochrane Library e IBECS, lo que dificulta la recuperación de información. El desconocimiento general sobre esta modalidad de trabajo, la cultura organizacional, el sistema de control y supervisión laborales basadas en la desconfianza, no facilitan la implantación del TT en España al ritmo en el que se impone en otros países de nuestro entorno como Reino Unido, Alemania y Francia, por lo que se hace necesario un cambio de mentalidad colectiva para integrar el TT como alternativa laboral en el marco de la sociedad actual en la que nos desenvolvemos.

Two flavonoids, rutin and hesperidin, were investigated in vitro for anticoagulant activity through coagulation tests: activated partial thromboplastin time (aPTT), prothrombin time (PT) and thrombin time (TT). Only an ethanolic solution of rutin at the concentration of 830 µM prolonged aPTT, while TT and PT were unaffected. In order to evaluate whether the prolongation of aPTT was due to the decrease of coagulation factors, the experiment with deficient plasma was performed, showing the effects on factors VIII and IX. Since pharmacological activity of flavonoids is believed to increase when they are coordinated with metal ions, complexes of these flavonoids with Al(III) and Cu(II) ions were also tested. The results showed that complexes significantly prolonged aPTT and had no effects on PT and TT. Assay with deficient plasma (plasma having the investigated factor at less then 1%) revealed that complexes could bind to the coagulation factors, what may lead to a non-specific inhibition and aPTT prolongation. An effort was made to correlate stability of complexes with their anticoagulant properties.

In this study, we aimed at characterizing the structure and the anticoagulant activity of a polysaccharide fraction (AGP33) isolated from the gonads of Haliotis discus hannai Ino. AGP33 was extracted by enzymatic hydrolysis and purified by ion-exchange and gel-filtration chromatography. The backbone fraction of AGP33 (BAGP33), which appeared to contain of mannose, glucose and galactose, was prepared by partial acid hydrolysis. According to methylation and nuclear magnetic resonance (NMR) spectroscopy, the backbone of AGP33 was identified as mainly consisting of 1→3-linked, 1→4-linked, and 1→6-linked monosaccharides. AGP33 is a sulfated polysaccharide with sulfates occur at 3-O- and 4-O-positions. It prolonged thromboplastin time (APTT), thrombin time (TT) and prothrombin time (PT) compared to a saline control solution in a dosage-dependent manner. AGP33 exhibited an extension (p < 0.01) of APTT compared to the saline group at concentrations higher than 5 μg/mL. AGP33 exhibited higher anticoagulant activity than its desulfated product (AGP33-des) and BAGP33. The results showed that polysaccharide with higher molecular weight and sulfate content demonstrated greater anticoagulant activity. [ABSTRACT FROM AUTHOR]

X-ray absorption fine structure (XAFS) spectroscopy is in use as a unique fingerprinting technique. By employing spectra of well-defined chemical species (standards), XAFS can be analyzed for speciation, i.e., identification and quantification of the different chemical species present in a sample. Several approaches to analyze the XAFS data for speciation have been developed. The principal component analysis and target transformation method are the two methods generally applied to check the number and identity of components in a sample. A widely used method for quantitatively determining the percentage of the species in the sample is linear combination fitting method, which can be applied to XANES spectra, derivative XANES spectra and EXAFS spectra. Other methods include residual phase analysis, normalized difference absorption edge analysis, pre-edge analysis method, derivative spectra methods and a method based on the relative position of the edge. The aim of the present article is to review the different (nearly all) methods of speciation using XAFS. The theory and principle of the different methods have been described and the analysis procedures for the methods have been illustrated with the help of examples. Some selected studies involving different elements have been reviewed and discussed. [ABSTRACT FROM AUTHOR]

We consider the problem of fitting a low rank tensor A ∈ ℝI, I = {1,... ,n}d, to a given set of data points {Mi ∈ ℝ∣ i ∈ P}, P ⊂ I. The low rank format under consideration is the hierarchical or tensor train or matrix product states format. It is characterized by rank bounds r on certain matricizations of the tensor. The number of degrees of freedom is in O(r²dn). For a fixed rank and mode size n we observe that it is possible to reconstruct random (but rank structured) tensors as well as certain discretized multivariate (but rank structured) functions from a number of samples that is in O(log N) for a tensor having N = nd entries. We compare an alternating least squares (ALS) fit to an overrelaxation scheme inspired by the LMaFit method for matrix completion. Both approaches aim at finding a tensor A that fulfills the first order optimality conditions by a nonlinear Gauss-Seidel-type solver that consists of an alternating fit cycling through the directions µ = 1, ... , d. The least squares fit is of complexity O(r4d#P) per step, whereas each step of ADF (alternating directions fitting) is in O(r²d#P), albeit with a slightly higher number of necessary steps. In the numerical experiments we observe robustness of the completion algorithm with respect to noise and good reconstruction capability. Our tests provide evidence that the algorithm is suitable in higher dimensions (>10) as well as for moderate ranks. [ABSTRACT FROM AUTHOR]

Introduction: Poor access and utilization of antenatal and other health services continue to contribute to high maternal mortality rate along with other socioeconomic factors. Improving utilization of maternal health care services is a global challenge for the health system in low and middle income countries. Material and Methods: It was a community based descriptive cross-sectional study which was undertaken from August 2010 to July 2011 in 4 villages of Paithan taluka, of Aurangabad district. Respondent women who had less than 1 year child and should be resident of particular area for previous 2 years or more at the time of interview were included in the study. Simple random sampling was used for selection of villages. Results: In present study only 40.8% respondent women had their first antenatal visit in 1st trimester. Majority of the women 90.3% had institutional delivery. Out of 8(3.9%) deliveries assisted by untrained person in 4(1.9%) deliveries umbilical cord cut with unsterile instrument and of these 4(1.9%) deliveries in 2(1.0%) untrained person applied cow dung to umbilical stump. Conclusions: Awareness regarding three or more antenatal visits and registration of pregnancy in first trimester should be emphasized through health education campaign. In present study though negligible percentage of hazardous practice of application cow dung to the umbilical stump was observed. It should be averted through health education and promotion of institutional deliveries.