The diagnostic utility of endocytoscopy for the detection of gastric cancer: a systematic review and meta-analysis.

BACKGROUND/AIMS: Endocytoscopy (ECS) is an evolving technology that utilizes ultra-high power magnification for real time cellular imaging without the need for physical biopsy. Its application for gastric cancer (GC) detection is not well evaluated at the current time, but there is potential that ECS can make a real time histopathological diagnosis to differentiate neoplastic from benign lesions. We aimed to investigate the diagnostic utility of ECS for GC detection. METHODS: Literature searches through multiple databases were performed for studies using ECS for GC detection until November 2021. Measured outcomes included the pooled sensitivity, specificity and accuracy. Quality assessment of diagnostic studies tool was used to assess the risk of bias. RESULTS: Four studies (n=245) were included. The pooled sensitivity was 83.5% (95% CI: 75% - 89%, I2: 0) and specificity was 91.7% (95% CI: 79% - 97%, I2: 58%). The pooled accuracy was 89.2% (95% CI: 83% - 94%, I2: 38%). There was a low risk of bias. CONCLUSIONS: ECS is an accurate diagnostic modality and has the potential to serve as a complimentary tool in screening for GC. Larger prospective studies are needed to validate these findings before its further widespread use.

Electrically Conducting Pullulan-Based Nanobiocomposites Using Carbon Nanotubes and TEMPO Cellulose Nanofibril.

Hybrid nanobiocomposite films are prepared using a solution casting by incorporating TEMPO cellulose nanofibrils (TOCNs) and carbon nanotubes (CNTs) into an aqueous solution of pullulan (PULL). The presence of CNT is confirmed by XRD characterization, and the prepared film shows an increased degree of crystallinity after the addition of TOCNs and CNT. The maximum degree of crystallinity value is obtained for CNT 0.5 % (59.64%). According to the Fourier-transform infrared spectroscopy, the shifts of the characteristic -OH peak of PULL occurred after the addition of TOCNs and aqueous CNT (3306.39 to 3246.90 cm-1), confirming interaction between the TOCNs, CNTs, and PULL matrix. The prepared films show enhanced material properties including higher tensile strength (65.41 MPa at low CNT content (0.5%)), water barrier properties, and reduced moisture susceptibility (5 wt.% CNT shows the lowest value (11.28%)) compared with the neat PULL film. Additionally, the prepared films are almost biodegradable within 64 days and show excellent electrical conductivity (0.001 to 0.015 S/mm for 0.5-5% CNT), which suggests a new approach to transform natural polymers into novel advanced materials for use in the fields of biosensing and electronics.

An Infertile Couple's Long and Expensive Path to Varicocele Repair.

OBJECTIVE: To characterize the pathways to care that infertile couples requiring varicocele repair (VR) pursue prior to presenting to a male fertility clinic. METHODS: An IRB-approved single center retrospective review of patients undergoing VR after presentation to an academic male fertility clinic was performed. Patients whose charts included partner histories were assessed for duration of attempting conception, prior workup, and assisted reproductive technology (ART) use. RESULTS: A total of 405 couples were included. At presentation, mean age was 34.4 (SD ± 6.5) years for men and 31.1 (SD ± 4.3) years for women (P < .0001). A couple's first visit to a physician was a gynecologist in 59% (198/334) of couples, a reproductive endocrinologist (REI) in 25% (83/334) of cases, with 14% (47/334) presenting without a previous female workup and were self-referred, and 2% (6/334) seeing both a gynecologist and REI prior to presentation. On average, couples attempted pregnancy for 22.3 (SD ± 21.1, range 0-120) months prior to presentation. Eighteen percent of couples underwent ART prior to presentation. Couples who had undergone ART had lower pre-VR total motile sperm counts compared to couples not pursuing ART prior to presentation (P = 0.031). The majority (70.4%) of females had no abnormality in their workup, making varicocele the only correctable factor for infertility in the couple. CONCLUSIONS: Our findings show a significant delay in referral of infertile men requiring VR. Eighteen percent of couples underwent costly ART prior to an inexpensive male workup. In an era of medical cost containment, early referral to a male infertility specialist is imperative.

Electrospinning Fabrication of Poly(vinyl alcohol)/Coptis chinensis Extract Nanofibers for Antimicrobial Exploits.

Coptis chinensis (CC) is used in conventional Chinese medicine. The main active components of CC are isoquinoline alkaloids, including berberine, coptisine, palmatine, and magnoflorine; all these are known to have several pharmacological properties. Poly(vinyl alcohol) (PVA) is a well-known synthetic biocompatible polymer suitable for a range of pharmaceutical uses; it can be used as a matrix for the incorporation of functional materials and has a wide range of applications in the cosmetics, food, pharmaceutical, and packaging industries. In this study, PVA-based electrospun nanofibers containing CC extract were successfully fabricated. Furthermore, the effects of different CC extract contents on the morphologies, and antimicrobial and antifungal properties of PVA/CC extract nanofibers were investigated. Morphological changes were observed using different molecular weights of PVA. For characterization, field-emission scanning electron microscopy, thermogravimetric analysis, and Fourier transform infrared analysis were performed. The effectiveness of these nanofibers has been demonstrated by evaluating the thermal stability against Staphylococcus aureus, antimicrobial activity against Staphylococcus aureus and Staphylococcus epidermidis, and the antifungal activity against the fungi Aureobasidium pullulans and Penicillium pinophilum. The PVA/CC extract nanofibers were found to have excellent antibacterial and antifungal activity and thermal stability; hence, their use in medicinal sectors is highly recommended.

The Impact of Microsurgical Repair of Subclinical and Clinical Varicoceles on Total Motile Sperm Count: Is There a Difference?

OBJECTIVE: To determine if subclinical varicocele repair produces similar results to palpable varicocele repair. METHODS: Retrospective review was performed on 190 infertile men who underwent a microsurgical varicocele repair by two surgeons from 2009 to 2017. Improvement in total motile sperm count (TMC) that enables men limited to in vitro fertilization (IVF) or intrauterine insemination (IUI) to undergo IUI or natural conception (upgrade) is clinically meaningful. Using TMC, men were grouped into three pre- and postoperative categories: IVF, (TMC < 5 million), IUI (TMC 5-9 million), or natural pregnancy (TMC > 9 million). Changes in category after varicocele repair were assessed. We compared the proportion of men in each category with clinical varicoceles to those with subclinical varicoceles. RESULTS: Men with clinical and subclinical varicoceles had improvements in TMC after surgery (change in TMC of 9.3 ± 19.5, 7.7 ± 22.6 million, P < 0.001 for both, respectively). There was no difference in TMC improvement between men with clinical and subclinical varicoceles (P = 0.66). Of men initially limited to IVF, 11% improved to IUI, and 38% to natural pregnancy. Of patients starting in IUI category, 22% transitioned to natural pregnancy category. No difference exists in the proportion of men who "upgraded" between palpable or subclinical varicoceles. CONCLUSION: Men with subclinical varicoceles have similar, clinically meaningful improvement in TMC after varicocele repair compared with men with palpable varicoceles.

Optimum Conditions for the Fabrication of Zein/Ag Composite Nanoparticles from Ethanol/H2O Co-Solvents Using Electrospinning.

The optimum conditions for the fabrication of zein/Ag composite nanoparticles from ethanol/H2O cosolvents using electrospinning and the properties of the composite were investigated. The zein/Ag nanoparticles were characterized using field-emission scanning electron microscopy, transmission electron microscopy (TEM), X-ray diffraction (XRD), and thermogravimetric analysis. The antibacterial activity of the zein/Ag composite nanoparticles was also investigated. The XRD patterns and TEM images indicate the coexistence of a zein matrix and well-distributed Ag nanoparticles.