Awareness of Menstrual Hygiene Management Rights and Perception of Risks, Self-Efficacy, and Behavior.

BACKGROUND: Menstrual Hygiene Management stands as a critical health concern for girls entering reproductive age on a global scale. This transition often induces fear and anxiety due to inadequate knowledge about menstruation and a lack of resources to comprehend bodily changes. Notably, school-aged girls in marginalized communities face formidable barriers to MHM, given the insufficient facilities, supplies, and awareness in educational institutions. METHODS: A Mixed method study was conducted adopting a mixed-methods approach. It engaged 562 respondents across five local levels of Bajura district, including three municipalities (Badimalika, Budhiganga, and Tribeni) and two rural municipalities (Gaumul and Khaptad Chhedaha). RESULTS: The study unveiled over 90% awareness on on five out of seven MHM rights related statements and over 85% self-efficacy on 5 out of 8 statements regarding MHM among female adolescent respondents. However, their actual practices fell short of expectations, marked by the prevalence of restrictive norms and perceived risks pertinent to MHM. Notably, 27% (N=154) expressed fear of divine consequences for not adhering to menstrual customs. Malpractices were observed, including 66% using cloth during menstruation, inadequate pad changing frequencies, and some girls staying in Chhaugoth during menstruation. Despite a high awareness (97%) of menstrual rights, behavioral practices did not consistently align with this awareness. CONCLUSIONS: The study highlights high awareness and self-efficacy in menstrual hygiene management among female adolescents, yet challenges persist due to cultural norms, perceived risks, and insufficient infrastructure, necessitating multifaceted solutions for behavioral change and access to resources.

The effects of KRAS Mutations on the Prognosis of Rectal Cancer Following Neoadjuvant Chemoradiotherapy and Surgery.

BACKGROUND: Rectal cancers with mutations in the KRAS gene have worse prognoses than wild-type malignancies. Variants at codon 12 of KRAS have particularly detrimental effects on prognosis. We aimed to analyze whether KRAS mutations act as adverse prognostic factors following neoadjuvant concurrent chemoradiotherapy (CRT) and surgery for rectal cancer treatment. METHODS: We analyzed the effects of KRAS mutations on disease-free survival (DFS) and locoregional recurrence-free survival (LRFS) in 125 patients with cT2-4N0-2M0 rectal cancer who underwent surgery following CRT between June 2014 and March 2023 Inje University Busan Paik Hospital. RESULTS: The median follow-up period was 39.7 (range, 7.5-98.2) months. There were 25 patients (20.0%) who harbored KRAS mutations. Among them, 22 patients (17.6%) had codon 12 variants. Overall, 43 patients (34.4%) showed recurrence, of which 10 (8.0%) had locoregional recurrence and 35 (28.0%) had distant metastases (two occurred simultaneously). DFS was significantly reduced in the patients with KRAS mutations (p = 0.005). LRFS was also reduced in patients with KRAS mutations (p = 0.039). DFS and LRFS were also relatively low in the subgroup with KRAS mutations at codon 12 (n = 22) (p = 0.003 and p = 0.017, respectively). However, pathologic complete response rate following CRT was not affected by KRAS mutations (p = 0.197). Overall survival was also not associated with KRAS mutations (p = 0.486). CONCLUSION: KRAS mutation is related to decreased DFS and LRFS, when surgery is performed following neoadjuvant CRT to treat rectal cancer. These effects are particularly pronounced for KRAS mutations at codon 12.

Lymphedema after regional nodal irradiation for breast cancer: a retrospective cohort study.

Purpose: We aimed to analyze the occurrence of lymphedema as a side effect in patients who underwent regional nodal irradiation (RNI) following surgery for breast cancer. Methods: This retrospective study was conducted on patients with breast cancer who underwent surgery from July 2014 to October 2020 at Inje University Busan Paik Hospital. The analysis included 113 cT1-3N1-3M0 breast cancer patients who underwent RNI as part of radiotherapy (RT). Mostly, surgeries were performed using breast-conserving surgery (n = 99, 87.6%), except for 14 patients with modified radical mastectomy. The total RT dose for RNI was 45-60 Gy, and the fraction size was 1.8-2.0 Gy. Most patients underwent chemotherapy (n = 98, 86.7%), including taxanes (n = 92, 81.4%). Results: The median follow-up was 61.1 months (range, 5.0-110.5 months). Lymphedema occurred in 54 patients (47.8%) after surgery. Twenty of them (17.7%) developed a new onset of lymphedema after RT, while 34 (30.1%) detected lymphedema before the completion of RT. Over the follow-up, 16 patients (14.2%) experienced recurrence. High radiation dose (>50.4 Gy) for RNI (P = 0.003) and taxane use (P = 0.038) were related to lymphedema occurrence after RT. Moreover, lymphedema occurrence after RT was also related to recurrence after surgical resection (P = 0.026). Breast-conserving surgery was related to early-onset lymphedema before the completion of RT (P = 0.047). Furthermore, the degree of lymph node dissection (≤4) was related to the overall occurrence of lymphedema (P = 0.045). Conclusion: Considering a reduction in RNI dose may be beneficial in mitigating the incidence of lymphedema after RT in patients with breast cancer.

Effect of Epidermal Growth Factor Receptor Mutation on Positron Emission Tomography/Computed Tomography in Lung Cancer.

BACKGROUND/AIM: This study analyzed the effect of epidermal growth factor receptor (EGFR) mutations on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) results in lung cancer and the pathological findings in patients subjected to surgery. PATIENTS AND METHODS: A total of 210 patients diagnosed with lung cancer by F-18 FDG PET/CT at Inje University Busan Paik Hospital between January 2018 and December 2023 were recruited. EGFR mutation tests were performed on biopsy specimens. Overall, 78 patients (37.1%) with EGFR mutations were included in this study. Twenty-seven patients (12.9%) had distant metastases at the time of diagnosis. Of all patients, 69 (32.9%) underwent surgery at our hospital, and their pathological findings were analyzed. RESULTS: The maximum standardized uptake value (SUVmax) of F-18 FDG PET/CT was <10 in patients with EGFR mutations. Patients with EGFR mutations were not commonly diagnosed with diabetes. When analyzing the pathological findings after surgery in the 69 patients, adenocarcinoma was more common in those with EGFR mutations. In contrast, perineural invasion was more common in patients without EGFR mutations. When analyzing the results of 69 patients with postoperative pathology, 25 relapsed during the median follow-up of 21.7 months (range=0.9-58.4 months). Patients who underwent surgery and had EGFR mutations (n=26) exhibited lower recurrence rates compared to those without EGFR mutations. Disease-free survival was longer in patients with EGFR mutations. CONCLUSION: In non-small-cell lung cancer with an EGFR mutation, the F-18 FDG PET/CT SUVmax value and the probability of recurrence were lower. EGFR mutations are associated with low-glucose metabolism.

In Vitro Anti-Rotaviral Activity of Bavachin Isolated from Psoralea corylifolia L. (Fabaceae).

Rotavirus is the main causative agent of viral gastroenteritis among young animals worldwide. Currently, no clinically approved or effective antiviral drugs are available to combat rotavirus infections. Herein, we evaluated the anti-rotaviral activities of extracts and bavachin isolated from Psoralea corylifolia L. (Fabaceae) (P. corylifolia) against the bovine rotavirus G8P[7] and porcine rotavirus G5P[7] in vitro. Two assay strategies were performed: (1) a virucidal assay to reduce viral infectivity by virus neutralization and (2) a post-treatment assay to assess viral replication suppression. The results from the virucidal assay showed that the extracts and bavachin did not exert anti-rotaviral activities. In the follow-up analysis after treatment, bavachin exhibited robust antiviral efficacy, with 50% effective concentration (EC50) values of 10.6 µM (selectivity index [SI] = 2.38) against bovine rotavirus G8P[7] and 13.0 µM (SI = 1.94) against porcine rotavirus G5P[7]. Bavachin strongly suppressed viral RNA synthesis in the early (6 h) and late stages (18 h) after rotaviral infection. These findings strongly suggest that bavachin may have hindered the virions by effectively inhibiting the early stages of the virus replication cycle after rotaviral infection. Furthermore, confocal imaging showed that bavachin suppressed viral protein synthesis, notably that of the rotaviral protein (VP6). These results suggest that bavachin has strong antiviral activity against rotaviruses, inhibits viral replication, and is a candidate natural therapeutic drug targeting rotaviral infection. The utilization of bavachin isolated from P. corylifolia may contribute to decreased mortality rates, lower medication expenses, and enhanced economic viability in domestic farms.

Distribution and pathogen prevalence of field-collected ticks from south-western Korea: a study from 2019 to 2022.

Hard ticks are known vectors of various pathogens, including the severe fever with thrombocytopenia syndrome virus, Rickettsia spp., Coxiella burnetii, Borrelia spp., Anaplasma phagocytophilum, and Ehrlichia spp. This study aims to investigate the distribution and prevalence of tick-borne pathogens in southwestern Korea from 2019 to 2022. A total of 13,280 ticks were collected during the study period, with H. longicornis accounting for 86.1% of the collected ticks. H. flava, I. nipponensis and A. testudinarium comprised 9.4%, 3.6%, and 0.8% of the ticks, respectively. Among 983 pools tested, Rickettsia spp. (216 pools, 1.6% MIR) were the most prevalent pathogens across all tick species, with R. japonica and R. monacensis frequently detected in I. nipponensis and Haemaphysalis spp., respectively. Borrelia spp. (28 pools, 0.2% MIR) were predominantly detected in I. nipponensis (27 pools, 13.8% MIR, P < 0.001). Co-infections, mainly involving Rickettsia monacensis and Borrelia afzelii, were detected in I. nipponensis. Notably, this study identified R. monacensis for the first time in A. testudinarium in South Korea. These findings offer valuable insights into the tick population and associated pathogens in the region, underscoring the importance of tick-borne disease surveillance and prevention measures.

3-O-Substituted Quercetin: an Antibiotic-Potentiating Agent against Multidrug-Resistant Gram-Negative Enterobacteriaceae through Simultaneous Inhibition of Efflux Pump and Broad-Spectrum Carbapenemases.

The discovery of safe and efficient inhibitors against efflux pumps as well as metallo-ß-lactamases (MBL) is one of the main challenges in the development of multidrug-resistant (MDR) reversal agents which can be utilized in the treatment of carbapenem-resistant Gram-negative bacteria. In this study, we have identified that introduction of an ethylene-linked sterically demanding group at the 3-OH position of the previously reported MDR reversal agent di-F-Q endows the resulting compounds with hereto unknown multitarget inhibitory activity against both efflux pumps and broad-spectrum ß-lactamases including difficult-to-inhibit MBLs. A molecular docking study of the multitarget inhibitors against efflux pump, as well as various classes of ß-lactamases, revealed that the 3-O-alkyl substituents occupy the novel binding sites in efflux pumps as well as carbapenemases. Not surprisingly, the multitarget inhibitors rescued the antibiotic activity of a carbapenem antibiotic, meropenem (MEM), in NDM-1 (New Delhi Metallo-ß-lactamase-1)-producing carbapenem-resistant Enterobacteriaceae (CRE), and they reduced MICs of MEM more than four-fold (synergistic effect) in 8-9 out of 14 clinical strains. The antibiotic-potentiating activity of the multitarget inhibitors was also demonstrated in CRE-infected mouse model. Taken together, these results suggest that combining inhibitory activity against two critical targets in MDR Gram-negative bacteria, efflux pumps, and ß-lactamases, in one molecule is possible, and the multitarget inhibitors may provide new avenues for the discovery of safe and efficient MDR reversal agents.

Injectable and Self-Curing Single-Component Hydrogel for Stem Cell Encapsulation and In Vivo Bone Regeneration.

An ideal hydrogel for stem cell therapy would be injectable and efficiently promote stem cell proliferation and differentiation in body. Herein, an injectable, single-component hydrogel with hyaluronic acid (HA) modified with phenylboronic acid (PBA) and spermidine (SM) is introduced. The resulting HAps (HA-PBA-SM) hydrogel is based on the reversible crosslinking between the diol and the ionized PBA, which is stabilized by the SM. It has a shear-thinning property, enabling its injection through a syringe to form a stable hydrogel inside the body. In addition, HAps hydrogel undergoes a post-injection "self-curing," which stiffens the hydrogel over time. This property allows the HAps hydrogel to meet the physical requirements for stem cell therapy in rigid tissues, such as bone, while maintaining injectability. The hydrogel enabled favorable proliferation of human mesenchymal stem cells (hMSCs) and promoted their differentiation and mineralization. After the injection of hMSCs-containing HAps into a rat femoral defect model, efficient osteogenic differentiation of hMSCs and bone regeneration is observed. The study demonstrates that simple cationic modification of PBA-based hydrogel enabled efficient gelation with shear-thinning and self-curing properties, and it would be highly useful for stem cell therapy and in vivo bone regeneration.

MicroRNA396 negatively regulates shoot regeneration in tomato.

Numerous studies have been dedicated to genetically engineering crops to enhance their yield and quality. One of the key requirements for generating genetically modified plants is the reprogramming of cell fate. However, the efficiency of shoot regeneration during this process is highly dependent on genotypes, and the underlying molecular mechanisms remain poorly understood. Here, we identified microRNA396 (miR396) as a negative regulator of shoot regeneration in tomato. By selecting two genotypes with contrasting shoot regeneration efficiencies and analyzing their transcriptome profiles, we found that miR396 and its target transcripts, which encode GROWTH-REGULATING FACTORs (GRFs), exhibit differential abundance between high- and low-efficiency genotypes. Suppression of miR396 functions significantly improved shoot regeneration rates along with increased expression of GRFs in transformed T0 explants, suggesting that miR396 is a key molecule involved in the determination of regeneration efficiency. Notably, we also showed that co-expression of a miR396 suppressor with the gene-editing tool can be employed to generate gene-edited plants in the genotype with a low capacity for shoot regeneration. Our findings show the critical role of miR396 as a molecular barrier to shoot regeneration in tomato and suggest that regeneration efficiency can be improved by blocking this single microRNA.

Prevalence Ratio of Primary Angle-Closure and Primary Open-Angle Glaucoma in Asian Population: A Meta-Analysis and Multiple Meta-Regression Analysis.

PURPOSE: To investigate the prevalence ratio of primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) in the Asian population. METHODS: Systematic searches of PubMed, Embase, and Cochrane databases for population-based studies in Asia published until August 5, 2022. We conducted a meta-analysis for PACG to POAG prevalence ratio using inverse variance-weighted random-effects meta-analyses so as to combine the study-specific measures of association. Between-study outcome variation (i.e., heterogeneity) was quantified with the I2 statistic. The multiple meta-regression analyses were performed in order to further account for the reasons for heterogeneity. RESULTS: Twenty studies, with a total study population of 52,522 individuals, had been conducted in 13 countries. The pooled PACG to POAG prevalence ratio was 2.204 (95% confidence interval, 1.617-3.004) with high heterogeneity (p < 0.001). In multiple meta-regression model, prevalence of POAG is the most important predictor for heterogeneity (model importance, 0.954), followed continent (0.508), and publication year (0.222). For every additional elevation of POAG prevalence (i.e., increase of 1.0%), the PACG to POAG prevalence ratio is expected to rise by 0.471. CONCLUSIONS: We estimated the pooled PACG to POAG prevalence ratio in the Asian population. The POAG prevalence is the most important factor to determine the PACG to POAG prevalence ratio.