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ep towards much needed species diversification for sustainable small scale cage farming in tropical reservoirs of Asia.The methane production rate of high solid anaerobic digestion (HSAD) was poor although it was a promising technology with the advantages of small reactor, low energy consumption, and less digestate. In our research before, thermal treatment was proved to enhance HSAD's methane production rate via both batch experiments and continuous experiments of swine manure. However, the effect or investigation of thermal treatment's temperature-time combinations was not yet reported. In this study, swine manure was firstly thermally treated in 500-mL glass bottles with 400-mL work volume at 45-65 °C for 1-4 days. HSAD experiment of 10% solid content was then set up. The VS ratio of substrate to inoculum was 11. Thermal treatment at 45 °C (3 days), 55 °C (1 day), and 65 °C (3 days) could obtain the highest methane production rate, which was around 40% higher. Kinetics analysis suggested that the degradation of swine manure was quite different at different temperatures. Furthermore, energy assessment indicated that "thermal treatment + HSAD" had significant advantages in improving HSAD economic feasibility, because the improved methane production rate could compensate for the extra energy utilized for thermal treatment. Heat treatment at 45 °C (4 days) was preferred when the heating equipment was limited. Heat treatment at 55 °C (1 day) was preferred when the floor space and reactor volume were restricted. Heat treatment at 65°C (3 days) was preferred when the requirement of the digestate's sanitary condition is strict.A total of 80 rooibos tea samples from a range of brands were purchased from various registered retail shops in South Africa. The samples were bought during 2019 winter (40) and summer (40) period which are classified as 6 natural rooibos, 18 herbal rooibos samples, and 16 flavor rooibos samples and subjected for heavy metal analysis such as chromium (Cr), iron (Fe), arsenic (As), cadmium (Cd), and lead (Pb) using inductively coupled plasma mass spectrometer (ICP-MS). Human health risks were determined by estimating the daily intake non-cancer hazard quotient (THQ) and hazard index (HI) via oral exposure to toxic elements based on daily tea consumption. The concentration range of the determined heavy metals in rooibos tea samples were as follows Cr (0.17-11.98 mg/kg), Fe (31-450 mg/kg), As (ND-0.51 mg/kg), Cd (0.09-0.17 mg/kg), and Pb (0.06-2.73 mg/kg). Cr was found in higher amount when compared to the World Health Organization (WHO) permissive limit (1.3 mg/kg). The concentrations of all studied heavy metals during winter and summer period were compared using two-way Anova, and no significant differences (p = 0.832) were observed for the two seasons. GLX351322 mw Both the target risk quotient (THQ) and the hazard index (HI) levels in all analyzed tea were well below 1, implying that intake of rooibos tea with analyzed heavy metals should not cause a threat to human health. On the other hand, the continuous intake due to the high concentrations of trace metals such as Cr may pose a serious chronic health risk due to accumulation in body tissues over time. The study, therefore, suggests constant monitoring of these heavy metals in teas in order to limit the risk of exceeding the permissive limits.

Continuous positive airway pressure (CPAP) is a standard treatment for obstructive sleep apnea (OSA). However, CPAP has limitations. High-flow nasal cannula (HFNC) is already in use for various types of respiratory diseases. As HFNC generates positive airway pressure, it may be a potential candidate for OSA treatment. This prospective study compared the therapeutic effects of HFNC to CPAP in patients with OSA.

Patients whose apnea-hypopnea index (AHI) was > 5 events/h were enrolled in this study. All participants were randomly divided into two groups. The first group underwent CPAP the first night and HFNC the second night. Conversely, the second group received HFNC the first night and CPAP the second night. Their respiratory events and sleep quality were compared using baseline polysomnography, CPAP, and HFNC.

In total, 28 participants completed this study. Median [interquartile range] AHI (35.0 [20.0-48.6] vs. 10.8 [5.5-20.6] events/h; p < 0.001) was significantly improved by the HFNC. However, sleep quality was not improved. When CPAP was compared directly with HFNC, CPAP demonstrated a more favorable effect for respiratory events (AHI 5.0 [2.0-7.0] vs. 10.8 [5.5-20.6] events/h; p < 0.001) and sleep efficiency (88.1 [79.9-92.5] vs. 77.9 [69.2-86.6] %; p = 0.001).

The efficacy of CPAP was superior to HFNC for both respiratory events and sleep quality.

ClinicalTrials.gov Identifier NCT03843372; URL www.clinicaltrials.gov ; Date of registration November 2, 2019.

ClinicalTrials.gov Identifier NCT03843372; URL www.clinicaltrials.gov ; Date of registration November 2, 2019.The da Vinci® single-port (SP) and multiport (Xi) approaches to robotic-assisted radical prostatectomy (RARP) are described by different authors in the literature, primarily comparing short-term outcomes of both modalities. To our knowledge, this is the first article comparing the surgical perspective and satisfaction of patients who underwent RARP with the SP and Xi platforms. To determine the patient surgical perspective and satisfaction in terms of pain control, return to normal activity, and overall results of surgery for two groups who underwent SP and Xi radical prostatectomy. The data from 71 consecutive patients who underwent SP RARP in a single center from June 2019 to April 2020 was compared to 875 patients who underwent Xi RARP in the same period. A single surgeon performed all procedures with a transperitoneal technique. After a propensity score match, two groups of 71 patients (SP and Xi) were selected and compared in the study. Patients were contacted by phone by two interviewers and a questionne between the groups regarding the answers for SSQ-8 questionnaire; both groups were very satisfied. When assessing the number of incision sites with the GRI-1 question, patients who underwent MP had lower satisfaction rates compared to SP. These patients perceived the number of scars and their appearance as reason for lower satisfaction. We believe that future studies should consider patient's postoperative perspective when adopting new platforms in order to combine adequate treatment with patient expectations. We performed a study assessing the postoperative satisfaction and perspectives of two groups of patients who underwent radical prostatectomy with two different robots (SP and Xi). There was no difference in patient satisfaction with the results of either the da Vinci® SP or Xi RARP except for the patients' perception on their number of scars, which favored the SP group.

Immune checkpoint inhibitors (ICIs) are widely used in the treatment of many cancers as they improve clinical outcomes. However, ICIs have also been associated with the development of immune-related adverse drug reactions (ADRs). Among immune-related ADRs, cardiac immune-related ADRs are rare, but also associated with high mortality rates.

The objective of this study was to evaluate the occurrence of cardiac ADRs reported with ICIs in the European spontaneous reporting system.

We retrieved individual case safety reports on ICI-induced cardiac ADRs from the website of suspected ADR ( www.adrreports.eu ) of the European pharmacovigilance database (Eudravigilance). Data were retrieved from the date of marketing authorization of each ICI (ipilimumab, nivolumab, pembrolizumab, atezolizumab, durvalumab, avelumab, and cemiplimab) to 14 March, 2020. The reporting odds ratio and its 95% confidence interval were computed to assess the reporting frequency of cardiac ADRs for each ICI compared to all other ICIs.

his regard, further head-to-head studies are needed.

Immune checkpoint inhibitor-induced cardiac ADRs were serious and had unfavorable outcomes. In our study, nivolumab was the only ICI with a small increased reporting frequency of individual case safety reports with cardiac ADRs compared to all other ICIs. In this regard, further head-to-head studies are needed.The mechanism by which reactive oxygen species (ROS) produced by oxidative stress promote cellular senescence has been studied in detail. This study aimed to verify the preventive or therapeutic effects of mesenchymal stem cell-derived exosomes (MSC-Ex) on the production of ROS induced by oxidative stress in human skin fibroblasts and clarify the mechanisms that promote cellular senescence. In a system where H2O2 was applied to skin fibroblasts, we assessed the effects of the application of MSC-Ex before and after oxidative stress and measured the fluctuations in several signaling molecules involved in subsequent intracellular stress responses. Exosomes were isolated from MSCs (MSC-Ex) and normal human dermal fibroblasts (NHDFs, NHDF-Ex) before and after exposure to H2O2. NHDFs were treated with exosomes before and after exposure to H2O2. mRNA expression (aquaporin-1 and aquaporin-3) and hyaluronan secretion associated with skin moisturization were reduced by H2O2 treatment, whereas MSC-Ex reversed these effects. The cellular senescence induced by H2O2 was also reproduced in fibroblasts. Specifically, the downregulation of SIRT1 led to increased acetylated p53 expression over time, which induced the expression of p21, a downstream molecule of p53, and arrested the cell cycle, leading to cell senescence. MSC-Ex enhanced these signal transduction systems. MSC-Ex was also effective at blocking the increase of β-galactosidase activity and accumulation of ROS in cells. This effect was stronger than that of NHDF-Ex. MSC-Ex were found to act defensively against epidermal and cellular senescence induced by oxidative stress.Anecdotal reports from fishers in Southeast Queensland, Australia suggest that shark depredation is a significant issue, however little is known about which species are responsible for depredating catches. This research aimed to identify depredating species in Southeast Queensland line based fisheries, by undertaking a genetic analysis of depredated samples collected by commercial, charter and recreational fishers. The genetic analysis successfully identified ten depredating sharks, all from the genus Carcharhinus (19.2% success). The species identified using mitochondrial DNA included five C. leucas (bull sharks), two C. plumbeus (sandbar sharks), one C. amboinensis (pigeye shark), one C. brevipinna (spinner shark) and one unconfirmed C. plumbeus/C. altimus (bignose shark). While many species of Carcharhinus have been found to depredate catches in Australia, C. leucas has not been highlighted until this research as a potential problematic species. The optimised protocol allowed for the confident identification of shark species responsible for depredation in fisheries using frozen fish samples donated by fishers.The aim of this paper is to describe the distinctive ultrasound findings of a case of vaginal bleeding caused by the presence of a foreign body. We present the case of an infant who consulted for vaginal bleeding and foul-smelling discharge. The ultrasound revealed signs of vaginal distension due to heterogeneous-hematic contents and parietal thickening. At Doppler examination, a striking finding of increased vascularization limited to the upper two-thirds of the vaginal wall was found, which was initially interpreted as a sign of local inflammation suggesting the presence of an underlying foreign body. At direct vaginoscopic examination remains of toilet paper in the vaginal fundus were found. The presence of a foreign body in the vagina is an uncommon cause of discharge and vaginal bleeding in pediatrics, therefore, this etiology should be kept in mind when the adequate clinical context arises. Doppler ultrasound represents a first-line complementary method when this entity is suspected.