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04 ± 1.0 (p-value 0.046). Women taking estrogen had lower mean BMD at the lumbar spine 0.952 ± 0.086 g/cm2, compared to women not taking estrogen 1.023 ± 0.105 g/cm2 (p-value 0.038). Similar trends were seen at the total hip and femoral neck. Conclusion Low-dose estrogen supplementation in premenopausal women with CF was associated with lower BMD compared to no estrogen supplementation in a similar group of premenopausal young women with CF. Future studies are needed to investigate the optimal formulation, route of administration, and dose to accrue and preserve bone mass in premenopausal women with CF.Study region This study has three spatial scales global (0.5°), macro-regional, and country scale. The database of drought events has specific entries for each macro-region and country. Study focus We constructed a database of meteorological drought events from 1951 to 2016, now hosted by the Global Drought Observatory of the European Commission's Joint Research Centre. Events were detected at macro-regional and country scale based on the separate analysis of the Standardized Precipitation-Evapotranspiration Index (SPEI) and the Standardized Precipitation Index (SPI) at different accumulation scales (from 3 to 72 months), using as input the Global Precipitation Climatology Centre (GPCC) and Climatic Research Unit (CRU) Time Series datasets. The database includes approximately 4800 events based on SPEI-3 and 4500 based on SPI-3. Each event is described by its start and end date, duration, intensity, severity, peak, average and maximum area in drought, and a special score to classify 52 mega-droughts. learn more New hydrological insights for the region under study We derived trends in drought frequency and severity, separately for SPI and SPEI at a 12-month accumulation scale, which is usually related to hydrological droughts. Results show several drought hotspots in the last decades Amazonia, southern South America, the Mediterranean region, most of Africa, north-eastern China and, to a lesser extent, central Asia and southern Australia. Over North America, central Europe, central Asia, and Australia, the recent progressive temperature increase outbalanced the increase in precipitation causing more frequent and severe droughts. © 2019 The Authors.Acquired urethral diverticula in male patients are a rare finding. We report a case of a 70-year male with a past medical history of type 2 diabetes who presented with post micturition dribbling and a scrotal mass which was identified as a urethral diverticulum. We also outline the surgical management in this patient and review similar cases reported in the literature. © 2020 Published by Elsevier Inc.Reconstruction of the ureter is still regarded as a sophisticated approach demanding absolute dedication of the urologists. Similarly, iatrogenic ureteral injuries, as well as strictures, are quite common complexities of the pelvic and gynecological surgeries which if left untreated could lead to short as well as long-term issues. Presently, a case of a post-caesarian section along with hysterectomy of 40 years old woman has been presented that has resulted in distal left ureteral injury. A bilateral Boari flap was performed for the mobilization of the bladder. © 2020 The Author(s).Congenital bilateral absence of the vas deferens (CBAVD) is a rare obstructive anomaly contributing to male factor infertility. Various congenital anomalies associated with CBAVD involve the seminal vesicles and epididymis. Physical examinations are often not reliable. However, transrectal ultrasonography (TRUS) can distinguish seminal vesicle and epididymal anomalies. In this clinical report, a rare case of CBAVD without seminal vesical anomalies is presented. PE and TRUS revealed no remarkable findings. The patient underwent vaso-epididymal anastomosis for the seminal tract obstruction and was accidentally diagnosed with CBAVD. Although ultrasonography is a reliable approach, surgical methods are critical for the diagnosis of CBAVD. © 2020 Published by Elsevier Inc.Background Phenylketonuria (PKU) is a hereditary metabolic disease that can be diagnosed and successfully treated from birth with a lifelong phenylalanine-restricted dietary regimen. However, optimal adherence to diet remains an issue and often progressively decreases after adolescence. The study aimed to explore the experience of adults living with PKU in order to gain insights related to their adherence to diet and engagement in managing their condition. Methods The study adopted a qualitative methodology in sessions that combined specifically designed co-creation exercises with focus group discussion. Adults with early-treated classic PKU were enrolled for 2 different sessions - one for adherent and one for non-adherent patients. The verbatim notes of both sessions and focus group were analyzed using content analysis. Results Twelve adherent and nine non-adherent adults with PKU participated. Besides the behavioral dictates of following a strict diet, adherent adults reported a positive mental approach andr psychological intervention to improve adherence and engagement in the care process. © 2020 The Authors.Nonalcoholic fatty liver disease (NAFLD) is associated with dietary folate deficiency and mutations in genes required for one‑carbon metabolism. However, the mechanism through which this occurs is unclear. To improve our understanding of this link, we investigated liver morphology, metabolism and fuel storage in adult mice with a hypomorphic mutation in the gene methionine synthase reductase (Mtrr gt ). MTRR enzyme is a key regulator of the methionine and folate cycles. The Mtrr gt mutation in mice was previously shown to disrupt one‑carbon metabolism and cause a wide-spectrum of developmental phenotypes and late adult-onset macrocytic anaemia. Here, we showed that livers of Mtrr gt/gt female mice were enlarged compared to control C57Bl/6J livers. Histological analysis of these livers revealed eosinophilic hepatocytes with decreased glycogen content, which was associated with down-regulation of genes involved in glycogen synthesis (e.g., Ugp2 and Gsk3a genes). While female Mtrr gt/gt livers showed evidence of reduced β-oxidation of fatty acids, there were no other associated changes in the lipidome in female or male Mtrr gt/gt livers compared with controls.

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