Balloon catheter-assisted endoscopic resection for papillary adenoma of non-exposed protruded type (with video).

Papillary adenomas, known precursors to papillary adenocarcinoma, warrant close monitoring due to their malignant potential. Historically, surgical resection represented the mainstay of treatment for papillary adenomas with intraductal extension. However, recent advancements in endoscopic techniques have facilitated the adoption of endoscopic papillectomy as a minimally invasive alternative in carefully selected cases. We report a case of an 82-year-old woman with a diagnosis of papillary adenoma exhibiting intraductal extension. This was managed with a novel endoscopic technique, balloon catheter-assisted endoscopic resection. Due to the obscured intraductal component of the papillary mass, a balloon occlusion catheter was deployed within the common bile duct and used as traction to facilitate endoscopic visualization of the mass. Endoscopic resection via papillectomy was subsequently performed. Histopathological examination of the resected specimen revealed a villous adenoma with high-grade dysplasia. Serial endoscopic ultrasound examinations with targeted papillary biopsies were performed to monitor for disease recurrence.

Modelos de distribución de especies y estado de conservación de murciélagos amenazados en la región tumbesina de Ecuador y Perú / Species distribution models and conservation status of threatened bats in the Tumbesian region of Ecuador and Perú

Resumen Introducción: La biodiversidad se está perdiendo a un ritmo acelerado como resultado del cambio global. Herramientas como los modelos de distribución de especies (MDEs) han sido ampliamente usados para mejorar el conocimiento sobre el estado de conservación de las especies y ayudar a desarrollar estrategias de gestión para mitigar la pérdida de biodiversidad. Objetivo: Determinar cómo la distribución potencial predicha por los MDEs para ocho especies de murciélagos amenazados difiere de los mapas de distribución reportados por la UICN. También, inferir el área de distribución y estado de endemismo de cada especie, y evaluar la importancia de la región tumbesina para su conservación. Métodos: Basados en registros de presencia del rango global de las especies, usamos MDEs para evaluar el estado de conservación de estas ocho especies en la región tumbesina de Ecuador y Perú. Resultados: Las áreas estimadas por los MDEs eran 35-78 % más pequeñas para cuatro especies (Eptesicus innoxius, Lophostoma occidentale, Platalina genovensium y Lonchophylla hesperia) y 26-1 600 % más grandes para tres especies (Amorphochilus schnablii, Promops davisoni y Rhogeessa velilla) que aquellas reportadas por la UICN. Para Tomopeas ravus, el área estimada por el MDE y la UICN fue similar, pero difirió en la distribución espacial. Los MDEs coincidieron con áreas de endemismo informadas por autores previos para E. innoxius, R. velilla y T. ravus, pero fueron diferentes para A. schnablii, P. genovensium, P. davisoni y L. hesperia, debido en parte a las distribuciones proyectadas para estas últimas especies en valles secos interandinos según los MDEs. Conclusiones: La región tumbesina representa una porción significativa (40-96 %) de la distribución predicha de siete de las ocho especies estudiadas, subrayando la importancia de esta región para la conservación de murciélagos. Nuestros resultados muestran las probables distribuciones para estas especies y proporcionan una base importante para identificar vacíos de investigación y desarrollar medidas de conservación para murciélagos amenazados en el punto caliente de biodiversidad de Tumbes.

Abstract Introduction: Biodiversity is being lost at an accelerating rate because of global change. Tools such as species distribution models (SDMs) have been widely used to improve knowledge about species' conservation status and help develop management strategies to mitigate biodiversity loss. SDMs are especially important for species with restricted distributions, such as endemic species. Objective: To determine how potential distribution predicted by SDMs for eight threatened bat species differed from the distribution maps reported by the IUCN. Also, to infer the area of distribution and state of endemism of each specie, and to evaluate the importance of the Tumbesian region for their conservation. Methods: Based on presence records across the species' entire ranges, we used SDMs to assess the conservation status of these eight species in the Tumbesian region of Ecuador and Peru. Results: The areas estimated by SDMs were 35-78 % smaller for four species (Eptesicus innoxius, Lophostoma occidentale, Platalina genovensium and Lonchophylla hesperia) and 26-1 600 % larger for three species (Amorphochilus schnablii, Promops davisoni and Rhogeessa velilla) than those reported by the IUCN. For Tomopeas ravus, the area estimated by the SDM and IUCN was similar but differed in spatial distribution. SDMs coincided with areas of endemism reported by previous authors for E. innoxius, R. velilla, and T. ravus, but were different for A. schnablii, P. genovensium, P. davisoni, and L. hesperia, due in part to projected distributions for these latter species in dry inter-Andean valleys according to the SDMs. Conclusions: The Tumbesian region represents a significant portion (40-96 %) of the predicted distribution of seven of the eight species studied, underscoring the importance of this region for bat conservation. Our results show likely distributions for these species and provide an important basis for identifying research gaps and developing conservation measures for threatened bats in the Tumbes biodiversity hotspot.

The prognostic implications of radiologic extranodal extension in the lymph nodes of patients with nasopharyngeal cancer.

Objective: This study was developed to explore the prognostic relevance of radiologic extranodal extension (rENE) in lymph node-positive nasopharyngeal carcinoma (NPC) patients. Materials and methods: A retrospective review of data from 249 eligible patients with NPC was performed, with magnetic resonance imaging scans being used for rENE grading. The prognostic value of rENE was assessed through univariate and multivariate analyses. Results: Log-rank tests revealed significant differences between patients with and without rENE in terms of overall survival, progression-free survival (PFS) and distant metastasis-free survival (DMFS). G2 and G3 patients tended to exhibit worse PFS and DMFS relative to G0/G1 patients (p < 0.05). Long-term chemotherapy cycles were associated with significant improvements in the PFS and DMFS of G2 and G3 patients. Conclusion: These results suggest that higher rENE grades (G2/G3) are independently associated with worse survival outcomes among NPC patients, with more aggressive treatment strategies potentially affording greater prognostic benefits to these individuals.

[Box: see text].

Association of pancreatic atrophy patterns with intraductal extension of early pancreatic ductal adenocarcinoma: a multicenter retrospective study.

BACKGROUND: Focal pancreatic parenchymal atrophy (FPPA) and upstream pancreatic atrophy (UPA) may indicate the presence of early pancreatic cancer. In early pancreatic cancer, the tumor occasionally spreads laterally along the main pancreatic duct, presenting challenges in determining the extent of surgical resection. This study aimed to investigate the association of pancreatic atrophy pattern and intraductal cancer extension. METHODS: Thirty-two patients with early-stage pancreatic cancer who underwent surgery at five participating centers were enrolled. Pancreatic atrophy was defined as the narrowing of parenchyma compared to the surrounding parenchyma and was classified as either FPPA (partial atrophy surrounding the pancreatic duct stenosis) or UPA (global atrophy caudal to the site of duct stenosis). Intraductal cancer extension was defined as an extension exceeding 10 mm. RESULTS: Preoperative computed tomography revealed FPPA, UPA, and no parenchymal atrophy in 13, 13, and 6 patients. Cases with FPPA or UPA showed significantly longer cancer extensions than those without atrophy (P = 0.005 and P = 0.03, respectively). Intraductal cancer extension was present in all but one case of FPPA. 69% (9/13) of the cases with UPA showed intraductal cancer extension, whereas cases without atrophy showed no intraductal cancer extension. Importantly, two patients with FPPA or UPA showed positive resection margins during surgery and three patients with FPPA or UPA showed recurrence in the remnant pancreas. CONCLUSIONS: The presence of FPPA and UPA indicates lateral cancer extension in early-stage pancreatic cancer. Preoperative assessment of the pancreatic parenchyma may provide valuable insights for determining the extent of surgical resection.

The genetic advantage of healthy centenarians: unraveling the central role of NLRP3 in exceptional healthspan.

Despite extensive research into extending human healthspan (HS) and compressing morbidity, the mechanisms underlying aging remain elusive. However, a better understanding of the genetic advantages responsible for the exceptional HS of healthy centenarians (HC), who live in good physical and mental health for one hundred or more years, could lead to innovative health-extending strategies. This review explores the role of NLRP3, a critical component of innate immunity that significantly impacts aging. It is activated by pathogen-associated signals and self-derived signals that increase with age, leading to low-grade inflammation implicated in age-related diseases. Furthermore, NLRP3 functions upstream in several molecular aging pathways, regulates cellular senescence, and may underlie the robust health observed in HC. By targeting NLRP3, mice exhibit a phenotype akin to that of HC, the HS of monkeys is extended, and aging symptoms are reversed in humans. Thus, targeting NLRP3 could offer a promising approach to extend HS. Additionally, a paradigm shift is proposed. Given that the HS of the broader population is 30 years shorter than that of HC, it is postulated that they suffer from a form of accelerated aging. The term 'auto-aging' is suggested to describe accelerated aging driven by NLRP3.

Low-Cost Dynamometer for Measuring and Regulating Wrist Extension and Flexion Motor Tasks in Electroencephalography Experiments.

A brain-computer interface could control a bionic hand by interpreting electroencephalographic (EEG) signals associated with wrist extension (WE) and wrist flexion (WF) movements. Misinterpretations of the EEG may stem from variations in the force, speed and range of these movements. To address this, we designed, constructed and tested a novel dynamometer, the IsoReg, which regulates WE and WF movements during EEG recording experiments. The IsoReg restricts hand movements to isometric WE and WF, controlling their speed and range of motion. It measures movement force using a dual-load cell system that calculates the percentage of maximum voluntary contraction and displays it to help users control movement force. Linearity and measurement accuracy were tested, and the IsoReg's performance was evaluated under typical EEG experimental conditions with 14 participants. The IsoReg demonstrated consistent linearity between applied and measured forces across the required force range, with a mean accuracy of 97% across all participants. The visual force gauge provided normalised force measurements with a mean accuracy exceeding 98.66% across all participants. All participants successfully controlled the motor tasks at the correct relative forces (with a mean accuracy of 89.90%) using the IsoReg, eliminating the impact of inherent force differences between typical WE and WF movements on the EEG analysis. The IsoReg offers a low-cost method for measuring and regulating movements in future neuromuscular studies, potentially leading to improved neural signal interpretation.

2022 Equine community needs assessment survey.

To stay up-to-date with the demographics, interests, and needs of the equine community, equine extension programs commonly conduct so called "needs assessment surveys". The main goals of the 2022 Rutgers Equine Science Center (ESC) needs assessment survey were to: 1) characterize the equine community, 2) identify information sources used by the equine community, 3) assess the usefulness of selected equine-related services and programs, and 4) determine the perceived importance of selected equine-related issues. An anonymous online survey was distributed through the Rutgers ESC's email list, a press release, and social media. Analysis-eligible surveys were received from n = 493. Most participants were female (92.7 %), 36-60 years of age (48.4 %), white (88.8 %), and horse owners (87.8 %). The top three sources of equine-related information used were 1) personal knowledge (95.7 %), 2) the veterinarian (93.7 %), and 3) the farrier (83.7 %). The survey showed that the provision of horse health information is the most useful service that the Rutgers ESC specifically can provide (79.3 %). This service may also be most useful for other extension programs, but a follow-up study is needed for clarification. The five equine-related issues most often considered to be extremely important were "Lameness and Soundness" (76.5 %), "Ethical Use of Horses" (73.2 %), "Nutrition" (63.9 %), "Right to Farm" (56.8 %), and "Care of Old Horses" (55.6 %). The survey provided insights into the current demographics of the equine community, highlighted personal knowledge, veterinarians and farriers as important information sources, and elucidated "Lameness and Soundness" as the most important equine-related issue.

Monitoring SARS-CoV-2 IgA, IgM and IgG antibodies in dried blood and saliva samples using antibody proximity extension assays (AbPEA).

Using a modified proximity extension assay, total and immunoglobulin (Ig) class-specific anti-SARS-CoV-2 antibodies were sensitively and conveniently detected directly from ø1.2 mm discs cut from dried blood and saliva spots (DBS and DSS) without the need for elution. For total Ig detection, antigen probes were prepared by conjugating recombinant spike protein subunit 1 (S1-RBD) to a pair of oligonucleotides. To detect isotype-specific antibody reactivity, one antigen probe was replaced with oligonucleotide-conjugated antibodies specific for antibody isotypes. Binding of pairs of oligonucleotide-conjugated probes to antibodies in patient samples brings oligonucleotides in proximity. An added DNA polymerase uses a transient hybridization between the oligonucleotides to prime synthesis of a DNA strand, which serves as a DNA amplicon that is quantified by real-time PCR. The S1-RBD-specific IgG, IgM, and IgA antibodies in DBS samples collected over the course of a first and second vaccination exhibited kinetics consistent with previous reports. Both DBS and DSS collected from 42 individuals in the autumn of 2023 showed significant level of total S1-RBD antibodies with a correlation of R = 0.70. However, levels in DSS were generally 10 to 100-fold lower than in DBS. Anti-S1-RBD IgG and IgA in DSS demonstrated a correlation of R = 0.6.

Determinants of maize farmers willingness to pay for private extension services in Ejisu municipality, Ghana.

In recent times, private sector involvement in extension services delivery in Ghana has increased. We assessed farmers' willingness to pay (WTP) for private extension services. We used quantitative techniques and selected 385 farmers through multistage sampling technique. Farmers' had a good perception of private extension services because of its flexibility, availability, value for money, and acceptable rates. Income, secondary occupation, marital status, extension contact, amount of maize sold every season, and land tenure system have an effect on farmers' WTP and the amount to pay. Government policies should continue to encourage and support private sector participation in providing extension services.

Research on information extension of mountainous rack railway engineering based on IFC standard.

In response to the practical demands for data sharing and exchange in the field of rack railway systems engineering, as well as to address the gaps in the rack railway domain within the framework of the IFC4 standard, we extend and define the rack railway domain through entity extension and custom attribute sets. By utilizing the ongoing construction of the Dujiangyan to Mount Siguniang Railway as a case study, we validate the utility of this IFC extension and modeling approach. Leveraging IfcOpenShell, we incorporate the extended data content into the generated IFC file. We present a process for extension tailored to the characteristics of rack railway engineering. This study aims to provide broader information support for the digital construction of track structures in the design phase of rack railway engineering and to facilitate more efficient data exchange and sharing.

Corrigendum: Predictors of lateral lymph node metastasis and skip metastasis in patients with papillary thyroid microcarcinoma.

[This corrects the article DOI: 10.3389/fendo.2024.1392247.].

"The Jigsaw Puzzle Locking Technique" to Augment the Stabilization between the Septal Cartilage and Extension Graft in End-to-End Suture Fixation.

INTRODUCTION: Nasal tip stability is crucial for long-lasting results. Usage of the extension graft is one of the most reliable stabilization techniques. With a septum in the midline, the extension graft is fixed end to end. The "jig-saw puzzle technique" reinforces this end-to-end fixation. The specific protrusion on one piece of the puzzle is inserted in a groove on adjacent piece. This settlement provides stabilization between the pieces. Application of this philosophy between the nasal septum and extension graft may provide a long-term fixation. MATERIAL METHOD: Between April 2022 and March 2024, the "jig-saw puzzle technique" was applied in 26 female patients. Trapezoid-shaped protrusion was created at the septum. Similar indentation was created at the extension grafts. The protrusion is then settled in the indentation. The preop, immediate postoperative and one-year postoperative pictures are compared to assess the rotations and projections with Adobe Photoshop Program. RESULTS: All 26 patients were females with mean age 27.5 years (20-32). Satisfactory graft stabilization was obtained without loss of projection and rotation in all patients. Statistically significant difference was found between the preoperative, immediate postoperative and postoperative 1-year projection and rotation assessments of the patients (p = 0.001; p < 0.01). The results were evaluated at a 95% confidence interval and significance was evaluated at p < 0.05 level. These statistical analyses verify that both projection and rotation were preserved with jig-saw puzzle technique. CONCLUSION: The jigsaw puzzle technique may provide suture-independent, long-term end-to-end fixation opportunity of the septal cartilage and the extension graft. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Microwave Remote Sensing with Hybrid Quantum Receiver.

Detecting a microwave signal that is emitted or reflected by distant targets is a powerful tool in fundamental science and industrial technology. Solid-state spins provide an opportunity to realize quantum-enhanced remote sensing under ambient conditions. However, the weak interaction between the free-space signal and atomic size sensor limits the sensitivity. This hinders the realization of practical quantum remote sensing. Here, we demonstrate active microwave remote sensing with a diamond-based hybrid quantum receiver by combining electromagnetic field localization at nanoscale with quantum spin manipulation. A method of differential spin refocusing (DSR) is developed to overcome the challenge of reducing the impact of inhomogeneities in spin-signal interaction, while the strength of interaction is enhanced by more than 3 orders with nanostructure. It improves the coherent interaction time of quantum receiver by 30-fold, substantially enhancing the sensitivity and stability. By detecting the reflected microwave with picotesla sensitivity, diamond remote sensing monitors the real-time status of a centimeter-sized target at 2 m distance. Our method is general to various solid-state spins. The results will expand the applications of solid-state spin quantum sensors in areas ranging from medical imaging to resource survey.

Improving Circulation Half-Life of Therapeutic Candidate N-TIMP2 by Unfolded Peptide Extension.

Matrix metalloproteinases (MMPs) are significant drivers of many diseases, including cancer, and are established targets for drug development. Tissue inhibitors of metalloproteinases (TIMPs) are endogenous MMP inhibitors and are being pursued for the development of anti-MMP therapeutics. TIMPs possess many attractive properties for drug candidates, such as complete MMP inhibition, low toxicity, low immunogenicity, and high tissue permeability. However, a major challenge with TIMPs is their rapid clearance from the bloodstream due to their small size. This study explores a method for extending the plasma half-life of the N-terminal domain of TIMP2 (N-TIMP2) by appending it with a long, intrinsically unfolded tail containing Pro, Ala, and Thr (PATylation). We designed and produced two PATylated N-TIMP2 constructs with tail lengths of 100 and 200 amino acids (N-TIMP2-PAT100 and N-TIMP2-PAT200). Both constructs demonstrated higher apparent molecular weights and retained high inhibitory activity against MMP-9. N-TIMP2-PAT200 significantly increased plasma half-life in mice compared to the non-PATylated variant, enhancing its therapeutic potential. PATylation offers distinct advantages for half-life extension, such as fully genetic encoding, monodispersion, and biodegradability. It can be easily applied to N-TIMP2 variants engineered for high affinity and selectivity toward individual MMPs, creating promising candidates for drug development against MMP-related diseases.

Fundamentals of Edible Coatings and Combination with Biocontrol Agents: A Strategy to Improve Postharvest Fruit Preservation.

Challenges in global food supply chains include preserving postharvest quality and extending the shelf life of fruits and vegetables. The utilization of edible coatings (ECs) combined with biocontrol agents (BCAs) represents a promising strategy to enhance the postharvest quality and shelf life of these commodities. This review analyzes the most recent developments in EC technologies and their combination with BCAs, highlighting their synergistic effects on postharvest pathogen control and quality maintenance. Various types of ECs, including polysaccharides, proteins, and lipids, are discussed alongside coating fundamentals and the mechanisms through which BCAs contribute to pathogen suppression. The review also highlights the efficacy of these combined approaches in maintaining the physicochemical properties, sensory attributes, and nutritional value of fruits. Key challenges such as regulatory requirements, consumer acceptance, and the scalability of these technologies are addressed. Future research directions are proposed to optimize formulations, improve application techniques, and enhance the overall efficacy of these biocomposite coatings and multifunctional coatings. By synthesizing current knowledge and identifying gaps, this review provides a comprehensive understanding of the potential and limitations of using ECs and BCAs for sustainable postharvest management.

Combined Toxic Effects of Lead and Glyphosate on Apis cerana cerana.

Glyphosate (GY) is the most widely used herbicide in agriculture worldwide. Lead is a common heavy metal in the natural environment. Honeybees, as pollinators, are exposed to these pollutants. So far, few reports have evaluated the toxic effects of GY mixed with heavy metals on honeybees (Apis cerana cerana). This study found that the acute toxicity of lead (LC50 = 1083 mg/L) is much greater than that of GY (LC50 = 4764 mg/L) at 96 h. The acute toxicities of the mixed substances were as follows: LC50 = 621 mg/L of lead and LC50 = 946 mg/L of GY. The combination of lead and GY was more toxic than either of the individual substances alone. Compared to the individual toxicity, combined treatment significantly affected the bees' learning and cognitive abilities and changed the relative expression of genes related to immune defense and detoxification metabolism in A. c. cerana. The combination of lead and GY seriously affected the behavior and physiology of the studied honeybees. This study provides basic data for further research on the combined effects of GY and heavy metals on bee health. It also serves as a reference for effective colony protection.

The Role of Risk Factors for the Progression of Patients with T1b-T2 Papillary Thyroid Carcinoma (PC) during Long-Term Follow-Up.

Background/Objectives: Recurrence prediction for patients with PC and tumor sizes ranging between 1 and 4 cm, classified as T1b and T2, remains a controversial problem. We evaluated which risk factors, identified during the primary tumor surgery, might play a prognostic role in predicting disease progression. Methods: We retrospectively enrolled 363 patients with classic PC who were in follow-up (207 T1b, 156 T2), with tissue risk factors at surgery in 209/363 cases. In all cases, an 131I-whole-body scan, SPECT/CT, and US were employed to detect any metastases during follow-up, and histology was used to confirm lesions. In the absence of surgery, metastases were validated by radioisotopic and radiologic procedures, eventually culminating in a needle biopsy and sequential thyroglobulin changes. Results: Metastases occurred in 61/363 (16.8%) patients (24 T1b, 37 T2). In 50/61 cases, the following risk factors were identified: minimal extrathyroid tumor extension (mETE) alone in 12/50 patients, neck lymph node (LN) metastases in 8/50 cases, and multifocality/multicentricity (M/M) in 6/50 cases. In the remaining 24/50 cases, the risk factors were associated with each other. From a Cox regression multivariate analysis, metastasis development was significantly (p < 0.001) influenced by only mETE and LN metastases, with a shorter disease-free survival (log-rank test). Conclusions: The current study proves that mETE and neck LN metastases are associated with aggressive PC. While LN metastasis' role is known, mETE's role is still being debated, and was removed by the AJCC's eighth edition because it was considered to not be associated with an unfavorable prognosis. However, this interpretation is not supported by the present study and, according to comparable studies, we suggest a revision of the mETE classification be considered in the next AJCC edition.

Three-Dimensional Analysis of the First Metacarpal Axes in Healthy Individuals and Early-Stage Thumb Carpometacarpal Osteoarthritis Patients-Potential Implication on First Metacarpal Corrective Osteotomy.

Background: Numerous anatomical features of the first carpometacarpal (CMC I) joint have been investigated as potential predispositions for CMC I osteoarthritis (OA). Even though load transmission through the CMC I joint-and, therefore, the development of osteoarthritis-is believed to be influenced by the geometry of the first metacarpal (MC I) bone, there is no common definition of the MC I axes. Methods: CT scans of twenty healthy volunteers and pre- and postoperative CT scans of six patients with CMC I OA undergoing Wilson osteotomy were analyzed. We proposed a calculation method based on anatomical landmarks for the proximal joint surface axis (PA) angle and the definition of an anatomical (AA) and a mechanical (MA) longitudinal axis. We hypothesized that for an MC I extension osteotomy to be effective, the AA and MA need to be aligned surgically. Results: To align AA and MA, an average correction angle of 22.60° (SD 2.53°) at 1 cm and 26.73° (SD 2.55°) at 1.5 cm distal to the CMC I joint line is required. Conclusions: The hereby proposed method for patient-specific calculation of the correction can be used to improve the surgical technique.

A V-Band Wideband Power Amplifier with High Gain in a 130 nm SiGe BiCMOS Process.

This paper introduces a high-gain wideband power amplifier (PA) designed for V-band applications, operating across 52 to 65 GHz. The proposed PA design employs a combination of techniques, including pole-gain distribution, base-capacitive peaking, and the parallel configuration of multiple small-sized transistors. These strategies enable significant bandwidth extension while maintaining high gain, substantial output power, and a compact footprint. A two-stage PA using the combination technique was developed and fabricated in a 130 nm SiGe BiCMOS process. The PA prototype achieved a peak gain of 27.3 dB at 64 GHz, with a 3 dB bandwidth exceeding 13 GHz and a fractional bandwidth greater than 22.2%. It delivered a maximum saturated output power of 19.7 dBm and an output 1 dB compression point of 18 dBm. Moreover, the PA chip occupied a total silicon area of 0.57 mm2, including all testing pads with a compact core size of 0.198 mm2.