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57 (p=0.0651) in patients treated after 1996.

Our findings highlight the limitations of comparing the risk of a late event between groups with disparate rates of early deaths, despite the use of a competing risk model. When partially corrected for, patients treated in the more recent time period experienced a lower solid tumor risk.

Our findings highlight the limitations of comparing the risk of a late event between groups with disparate rates of early deaths, despite the use of a competing risk model. When partially corrected for, patients treated in the more recent time period experienced a lower solid tumor risk.

Pediatric adrenocortical carcinoma (pACC) is a rare disease with poor prognosis. Publications on radiotherapy (RT) are scarce. This review summarizes the current data on RT for pACC and possibly provides first evidence to justify its use in this setting.

We searched the PubMed and Embase database for manuscripts regarding RT for pACC.

We included 17 manuscripts reporting on 76 patients treated with RT, after screening 2961 references and 269 full articles. In addition, we added data of 4 unreported pACC patients treated by co-authors. All reports based on retrospective data. Median age at first diagnosis was 11.1years (70% female); 78% of patients presented with hormonal activity. RT was mostly performed for curative intent (78%). 88% of RT were administered during primary therapy. The site of RT was predominantly the local tumor bed (76%). Doses of RT ranged from 15 to 62Gy (median 50Gy). Information on target volumes or fractionation were lacking. Median follow-up was 6,9 years and 64% of the patients died of disease, with 33% alive without disease. In 16 of 48 patients with available follow-up data after adjuvant RT (33%) no recurrence was reported and in 3 of 9 patients palliative RT seemed to induce some benefit for the patient.

Our first systematic review on RT for pACC provides too few data for any general recommendation, but adjuvant RT in patients with high risk might be considered. International collaborative studies are urgently needed to establish better evidence on the role of RT in this rare malignancy.

Our first systematic review on RT for pACC provides too few data for any general recommendation, but adjuvant RT in patients with high risk might be considered. International collaborative studies are urgently needed to establish better evidence on the role of RT in this rare malignancy.Despite critical progress registered in the reduction of mother to child transmission (MTCT) of HIV worldwide, transmission through breastfeeding still contributes to almost 50% of pediatric HIV infections recorded every year. In this short narrative review, after development of an extensive background on HIV and breastfeeding, some directions are suggested to address the key bottlenecks. Specifically, reinforcing the prevention of MTCT through breastfeeding (BF) in order to move towards elimination of MTCT prior to 2030 may require, among others strategies tracking all women of child bearing age through HIV testing, improving testing and retesting of women during pregnancy and breastfeeding, strengthening adherence on antiretroviral therapy (ART) among pregnant and lactating women, ensuring continuum and retention in care of mother and baby-pairs up to 24 months, switching ART in non-viral suppressed mothers after improvement of adherence counseling. In addition, due to the burden of seroconversion during pregnancy or thereafter through BF, pre-exposure prophylaxis (PreP) for most at risk women should be implemented urgently. The opportunity to extend the infant prophylaxis to the whole lactating period should be assessed to address residual transmission amongst viral suppressed mothers.The resumption of work and production is one of the key issues during the novel coronavirus (COVID-19) post-epidemic phase. We used location-based service data of mobile devices to assess the work resumption of 22,098 hospitals in mainland China. The multiscale influences of the determinants on work resumption in hospitals, including medical-service capacity, human movement, and epidemic severity, were examined using the multiscale geographically weighted regression technique. This study provides a novel insight into the assessment of work resumption in hospitals and its determinants, and is flexible to be extended to evaluate the work resumption of other industries. see more The findings can introduce helpful information for other countries to implement the strategies of work recovery during the post-epidemic phase.In this study, we aim to reveal hidden patterns and confounders associated with policy implementation and adherence by investigating the home-dwelling stages from a data-driven perspective via Bayesian inference with weakly informative priors and by examining how home-dwelling stages in the USA varied geographically, using fine-grained, spatial-explicit home-dwelling time records from a multi-scale perspective. At the U.S. national level, two changepoints are identified, with the former corresponding to March 22, 2020 (9 days after the White House declared the National Emergency on March 13) and the latter corresponding to May 17, 2020. Inspections at U.S. state and county level reveal notable spatial disparity in home-dwelling stage-related variables. A pilot study in the Atlanta Metropolitan area at the Census Tract level reveals that the self-quarantine duration and increase in home-dwelling time are strongly correlated with the median household income, echoing existing efforts that document the economic inequity exposed by the U.S. stay-at-home orders. To our best knowledge, our work marks a pioneering effort to explore multi-scale home-dwelling patterns in the USA from a purely data-driven perspective and in a statistically robust manner.This research approaches the empirical study of the pandemic from a social science perspective. The main goal is to reveal spatiotemporal changes in Covid-19, at regional scale, using GIS technologies and the emerging three-dimensional bins method. We analyze a case study of the region of Cantabria (northern Spain) based on 29,288 geocoded positive Covid-19 cases in the four waves from the outset in March 2020 to June 2021. Our results suggest three main spatial processes a reversal in the spatial trend, spreading first followed by contraction in the third and fourth waves; then the reduction of hot spots that represent problematic areas because of high presence of cases and growing trends; and finally, an increase in cold spots. All this generates relevant knowledge to help policy-makers from regional governments to design efficient containment and mitigation strategies. Our research is conducted from a geoprevention perspective, based on the application of targeted measures depending on spatial patterns of Covid-19 in real time. It represents an opportunity to reduce the socioeconomic impact of global containment measures in pandemic management.

Methanol (methyl alcohol) is a form of toxic alcohol that is found in illicit alcohol as well as household products such as solvents and paint removers. The most common cause of methanol poisoning is through ingestion of adulterated alcohol; however, other routes of poisoning may also occur including cutaneous exposure and, rarely, inhalation.

We are reporting a case of a young woman with vision loss, parkinsonism and widespread cerebral artery spasms due to methanol inhalation from domestically made perfume.

Our case highlights the increased need for awareness on the part of the public and health authorities with regard to the manufacturing and use of homemade perfumes produced with poorly processed alcohol having a high methyl alcohol content.

Our case highlights the increased need for awareness on the part of the public and health authorities with regard to the manufacturing and use of homemade perfumes produced with poorly processed alcohol having a high methyl alcohol content.Heat stress (HS) has caused relative hypoxia, oxidative stress and high level of homocysteine, which contributes significantly to fertility failures in bulls. The aim of present study was to evaluate the role of dietary betaine (BET) in improving dual purpose Simmental (Fleckvieh) post-thawed semen quality especially during the hottest summer days. A total number of 16 mature bulls were randomly assigned to three equal groups including 1) Control condition (without betaine), 2) BET1 57.00 mg of betaine kg-1 per day and 3) BET2 114 mg of betaine kg-1 per day, through daily intakes for 90 days in summer. Plasma levels of homocysteine, seminal plasma antioxidants levels and sperm parameters such as DNA fragmentation, chromatin integrity, motility, viability, morphology and membrane integrity were evaluated. Under maximal HS, serum homocysteine concentrations were reached 16.67 ± 0.09 µmol L-1. Dietary betaine supplementation influenced DNA fragmentation of sperm and was higher in the control group compared to BET2 group. There were significant decreases in seminal plasma superoxide dismutase (SOD), glutathione peroxidase (GPx) activity and sperm viability and motility in bulls treated with betaine. The activity of GPx and SOD in the control group was increased up to 0.08 ± 0.00 U mg-1 protein and 0.52 ± 0.01 U mg-1 protein in seminal plasma. There were no significant differences between groups in the percentage of swollen spermatozoa, membrane integrity, sperm morphology, abnormal head morphology and percentage of spermatozoa stained with aniline blue. In conclusion, BET supplements improved semen parameters in sperm motility, sperm viability and influenced DNA fragmentation during HS with reduction in serum homocysteine concentrations.Aeromonas hydrophila is a bacterium associated with many diseases and disorders such as fin rot, skin ulcers and lethal hemorrhagic septicemia in fish. It bears several virulence factors including type III secretion system (T3SS), aerolysin, cytolytic enterotoxin and enzymes (e.g., hemolysins, lipase) that seem to play an important role in its pathogenesis. Detection of virulence markers by polymerase chain reaction (PCR) is a key procedure in defining the patho-genic ability of pathogenic bacteria and preparing a vaccine for its treatment. In this sense, this study was aimed to determine the frequency of virulence genes in isolates obtained from infected cultured carps in Khuzestan province. Out of 200 moribund carps with septicemic symptoms, 125 isolates were belonged to the motile aeromonads and 59 isolates were identified as A. hydrophila by biochemical methods. Finally, using PCR analysis, 31 isolates were identified as A. hydrophila. Five virulence genes were detected in these isolates including hemolysin, aerolysin, cytolytic enterotoxin and T3SS (aopB and ascV) by specific primers. Results showed that 23 (74.19%), 18 (58.06%), 16 (51.61%), 13 (41.63%) and 10 (32.25%) isolates possessed cytolytic enterotoxin, hemolysin, aerolysin, and T3SS genes, respectively. The results of the present study showed that among 31 isolates, only five isolates had all of dominant virulence genes. Thirteen other isolates had genotypes including hlyA +, aerA + , and act + . The remaining isolates had at least one virulence gene. This study showed that determination of the virulence genes by PCR can be a reliable method to identify a potential pathogenic Aeromonad strain.