Risk-reducing Salpingo-oophorectomy consults and practices during the COVID-19 pandemic.

Objective: Investigate the impact of the COVID-19 pandemic on risk-reducing salpingo-oophorectomies (RRSO) consults. Methods: Survey sent out to 1,127 full members of the Society of Gynecologic Oncology in August 2021. Survey data included physician characteristics, practice location, and self-reported subjective and objective data about their RRSO consults. Results: We received 70 responses; half of the respondents were female; the mean age of respondents was 46 (range 35-65). 86% of providers transitioned RRSO consults to telehealth. There was no correlation between uptake of telemedicine by age (R2 = 0.09) or gender (p = 0.80), but there was increased use in the West Coast region (p < 0.01). There was a small decrease in average time spent discussing sexual function over telehealth (35 s). Most providers felt comfortable discussing sexual health and function via telehealth. Conclusions: Overall, telemedicine is now commonly used for RRSO consults and physicians noted very few barriers to its uptake. Discussion of sexual function was similar between modalities, the loss of the pelvic exam or private setting did not affect the time providers spent discussing sexual health, however sexual health topics discussed were limited.

Is transportation a risk factor for African swine fever transmission in Australia: a review.

African swine fever (ASF) is a viral disease of the pigs that was first described in Africa during the early part of the twentieth century. The disease has periodically occurred outside of Africa, including an ongoing epidemic in Europe and Asia that started in 2007; the disease has never occurred in Australia or New Zealand. Once introduced into a country, spread can occur through direct and indirect routes of transmission. Infected feral pig populations have the potential to act as a long-term reservoir for the virus, making eradication difficult. Just before and throughout the period of clinical signs, ASF virus is shed in oronasal fluids, urine, faeces and blood. This results in contamination of the pig's environment, including flooring, equipment and vehicles. Transportation-related risk factors therefore are likely to play an important role in ASF spread, though evidence thus far has been largely anecdotal. In addition to the existing AUSVETPLAN ASF plan, efforts should be made to improve transportation biosecurity, from the time a pig leaves the farm to its destination. Collection of data that could quantify the capabilities and capacity of Australia to clean and disinfect livestock trucks would help to determine if private and/or public sector investment should be made in this area of biosecurity. No peer-reviewed research was identified that described a specific process for cleaning and disinfecting a livestock truck known to be contaminated with ASF virus, though literature suggests that transportation is an important route of transmission for moving the virus between farms and countries.

African swine fever: a New Zealand perspective on epidemiological risk factors for its occurrence.

This article reviews key epidemiological and clinical features of African swine fever (ASF). We identify particular aspects of New Zealand's pig populations (commercial, non-commercial, and wild) that may affect the risk of disease entry or spread. Review of published literature is supplemented by analysis of demographic and spatial aspects of the New Zealand commercial, non-commercial, and feral pig populations to provide context around risk factors for the disease that are most relevant to New Zealand. The current Eurasian outbreak of ASF, including recent spread into Oceania, has increased the risk of an incursion of the disease into New Zealand. Large volumes of fresh pork importation (including from countries affected by ASF), large non-commercial pig populations with substantial spatial overlap with the country's commercial industry, limited monitoring of compliance with waste food feeding regulations, and lack of mandatory premises identification for non-commercial pig holdings would likely contribute to the risk of spread of ASF in the event of an incursion. Awareness amongst veterinarians of these risk factors will contribute to national biosecurity and disease preparedness efforts in New Zealand.

Anti-proliferative potential of sodium thiosulfate against HT 29 human colon cancer cells with augmented effect in the presence of mitochondrial electron transport chain inhibitors

Objective: To compare the anti-proliferative effect of sodium thiosulfate on human colorectal cancer cells (HT-29) and normal small intestine cells (IEC6). Methods: Cells (HT-29 and IEC6) were treated with different concentrations of sodium thiosulfate ranging from 0.5 mM to 80 mM for 24 h. Cell viability was measured via crystal violet and MTT assays. HT-29 cells were further treated in the presence and absence of mitochondrial electron transport chain (ETC) inhibitors, KATP channel opener and closer and H2S inhibitors for 24 h followed by sodium thiosulfate in order to study their respective roles in the anti-proliferative activity of sodium thiosulfate. Results: The IC50 values of sodium thiosulfate on HT-29 cells were 40.93 mM and 42.45 mM by crystal violet and MTT assay whereas, in the case of IEC6 cells, the values were 45.17 mM and 47.22 mM. The inhibition of endogenous H2S enzymes and KATP channel induced no change in the anti-proliferative capacity of sodium thiosulfate. However, the anti-proliferative activity of sodium thiosulfate was enhanced in the presence of mitochondrial ETC inhibitors. Conclusions: HT-29 cell growth is effectively attenuated by sodium thiosulfate and the anti-proliferative activity of sodium thiosulfate is enhanced in the presence of mitochondrial ETC inhibitors.

Solvent effect in sonochemical synthesis of metal-alloy nanoparticles for use as electrocatalysts.

Nanomaterials are now widely used in the fabrication of electrodes and electrocatalysts. Herein, we report a sonochemical study of the synthesis of molybdenum and palladium alloy nanomaterials supported on functionalized carbon material in various solvents: hexadecane, ethanol, ethylene glycol, polyethylene glycol (PEG 400) and Ionic liquids (ILs). The objective was to identify simple and more environmentally friendly design and fabrication methods for nanomaterial synthesis that are suitable as electrocatalysts in electrochemical applications. The particles size and distribution of nanomaterials were compared on two different carbons as supports: activated carbon and multiwall carbon nanotubes (MWCNTs). The results show that carbon materials functionalized with ILs in ethanol/deionized water mixture solvent produced smaller particles sizes (3.00 ±â€¯0.05 nm) with uniform distribution while in PEG 400, functionalized materials produced 4.00 ±â€¯1 nm sized particles with uneven distribution (range). In hexadecane solvents with Polyvinylpyrrolidone (PVP) as capping ligands, large particle sizes (14.00 ±â€¯1 nm) were produced with wide particle size distribution. The metal alloy nanoparticles produced in ILs without any external reducing agent have potential to exhibit a higher catalytic activity due to smaller particle size and uniform distribution.

Janus structured Pt-FeNC nanoparticles as a catalyst for the oxygen reduction reaction.

We present a new Janus structured catalyst consisting of Pt nanoparticles on Fe-N-C nanoparticles encapsulated by graphene layers for the ORR. The ORR activity of the catalyst increases under potential cycling as the unique Janus nanostructure is further bonded due to a synergetic effect. The present study describes an important advanced approach for the future design of efficient, stable, and low-cost Pt-based electrocatalytic systems.

Enhancing Electrocatalytic Performance of Bifunctional Cobalt-Manganese-Oxynitride Nanocatalysts on Graphene.

We report the synthesis and characterization of graphenesupported cobalt-manganese-oxynitride nanocatalysts (CoMnON/G) as bifunctional electrocatalysts for the oxygen reduction reaction (ORR) and oxygen evolution reaction (OER). A nitriding treatment of spinel compound CoMnO increased the ORR activity considerably, and the most active material catalyzed the ORR with only a 30 mV half-wave potential difference from the commercial carbon-supported platinum (Pt/C) in alkaline media. In addition to high activity, the catalyst also exhibited an intrinsic stability that outperformed Pt/C. An appropriately designed nitridation thus facilitates new directions for developing active and durable non-precious-metal oxynitride electocatalysts.

Increasing Stability and Activity of Core-Shell Catalysts by Preferential Segregation of Oxide on Edges and Vertexes: Oxygen Reduction on Ti-Au@Pt/C.

We describe a new class of core-shell nanoparticle catalysts having edges and vertexes covered by refractory metal oxide that preferentially segregates onto these catalyst sites. The monolayer shell is deposited on the oxide-free core atoms. The oxide on edges and vertexes induces high catalyst stability and activity. The catalyst and synthesis are exemplified by fabrication of Au nanoparticles doped by Ti atoms that segregate as oxide onto low-coordination sites of edges and vertexes. Pt monolayer shell deposited on Au sites has the mass and specific activities for the oxygen reduction reaction about 13 and 5 times higher than those of commercial Pt/C catalysts. The durability tests show no activity loss after 10 000 potential cycles from 0.6 to 1.0 V. The superior activity and durability of the Ti-Au@Pt catalyst originate from protective titanium oxide located at the most dissolution-prone edge and vertex sites and Au-supported active and stable Pt shell.

Off-Label Uses of Topical Calcineurin Inhibitors.

Topical calcineurin inhibitors (TCIs) have been proposed as an alternative, long-term treatment option to topical corticosteroids, without the side effects commonly associated with steroid use. Currently, TCIs are only approved for treatment of atopic dermatitis in patients 2 years of age or older. This article reviews the off-label uses of TCIs and their efficacy in the treatment of cutaneous diseases. Studies show that TCIs may be effective in treating/managing a variety of skin conditions. The strongest evidence based support on clinical outcomes has been reported for allergic contact dermatitis, lichen planus, psoriasis, seborrheic dermatitis and vitiligo.

Gold-promoted structurally ordered intermetallic palladium cobalt nanoparticles for the oxygen reduction reaction.

Considerable efforts to make palladium and palladium alloys active catalysts and a possible replacement for platinum have had a marginal success. Here we report on a structurally ordered Au10Pd40Co50 catalyst that exhibits comparable activity to conventional platinum catalysts in both acid and alkaline media. Electron microscopic techniques demonstrate that, at elevated temperatures, palladium cobalt nanoparticles undergo an atomic structural transition from core-shell to a rare intermetallic ordered structure with twin boundaries forming stable {111}, {110} and {100} facets via addition of gold atoms. The superior stability of this catalyst compared with platinum after 10,000 potential cycles in alkaline media is attributed to the atomic structural order of PdCo nanoparticles along with protective effect of clusters of gold atoms on the surface. This strategy of making ordered palladium intermetallic alloy nanoparticles can be used in diverse heterogeneous catalysis where particle size and structural stability matter.

Rosacea: an update on medical therapies.

Rosacea is a common, chronic cutaneous condition that affects the face. Two topicals and one oral medication are currently approved for the treatment of rosacea, including azelaic acid, metronidazole, and sub-antimicrobial dose of doxycycline. Identification of subtypes can help guide treatment strategies. It is essential for psychosocial implications of rosacea to be considered and conservative management, such as nonpharmacologic routine skin care, must form an important part of the overall care. Recently, new insights into the pathophysiology of rosacea have led to the emergence of etiologically oriented treatments. Ivermectin, an acaricidal agent that has been shown to be effective against rosacea refractory to other therapies, is currently in Phase 3 trials. Brimonidine, which was US FDA approved last year and recently sanctioned by Health Canada, has filled an essential therapeutic void in the targeted treatment of diffuse facial erythema.

Comparative study of flexible nasoendoscopic and rigid endoscopic examination for patients with upper aerodigestive tract symptoms.

INTRODUCTION: The objective of the current study was to compare the outcomes of rigid endoscopic procedures with those of pre-operative flexible nasoendoscopy. METHODS: A total of 253 patients who had undergone rigid endoscopic examination under anaesthesia between 6 January 2010 and 31 August 2011 were identified. Their clinical, surgical and histological records were evaluated. RESULTS: A total of 213 patients had a flexible nasoendoscopic procedure performed and recorded pre-operatively, and 82 in this cohort had a specific lesion or area of concern identified. There were 21 confirmed malignant biopsy results, the majority of which were squamous cell carcinoma. No patient with a negative pre-operative endoscopy had a malignant lesion discovered on endoscopic biopsy. The sensitivity and specificity of pre-operative nasoendoscopy were 100 per cent and 66.3 per cent, respectively. CONCLUSION: Diagnostic rigid endoscopic examination of the upper aerodigestive tract remains an important tool for excluding malignancy in high-risk patients, but is an unnecessary procedure in those low-risk patients with normal pre-operative findings.

Wait only to resuscitate: early surgery for acutely presenting paraesophageal hernias yields better outcomes.

INTRODUCTION: Incarceration and obstruction of an intrathoracic stomach are potentially devastating complications of paraesophageal hernias (PEH). Gastric decompression and resuscitation are important elements of preoperative management of acutely presenting PEH. The optimal time for surgical repair after decompression is unknown. We hypothesized that in obstructed PEH, early surgery may improve outcomes. METHODS: From the 2005-2010 National Surgical Quality Improvement Project database, we selected PEH repairs with a diagnosis of obstruction. Patients were divided by time to surgery: ≤1 day of admission (early) or >1 day (interval). Outcomes were mortality and morbidity. Multivariable regression controlled for age and cardiopulmonary comorbidities. RESULTS: Of 224 patients, 149 (67%) were early and 75 (33%) were interval, with mean 3.6 days. Repairs were 89% transabdominal, 9% included fundoplication, and 18% gastrostomy. Early and interval groups experienced similar morbidity 23 versus 31% (p = 0.2) and mortality 5.4 versus 4% (p = 0.7). Pulmonary, wound, or VTE complications were equivalent. Sepsis was less (2.7 vs. 13%, p = 0.002) and length of stay was shorter (5 vs. 11 days, p < 0.001) for early vs. interval patients. On adjusted analysis, the early group had an 80% reduction in sepsis (95% confidence interval (CI), 0.05-0.6, p = 0.005). Odds of overall or other morbidity or mortality were statistically similar between groups. CONCLUSIONS: Patients who required emergency surgery for PEH have disease complicated by strangulation, perforation, bleeding, or sepsis. Emergency surgery for PEH repair is inherently high-risk and preoperative resuscitation and decompression is critical. In our analysis, patients with an obstructed PEH had less postoperative sepsis and fewer days in the hospital if surgery was performed within the first hospital day. However, there was no difference in mortality between early and delayed treatment. Deferring surgery for resuscitation permits optimization, but prolonged delay may worsen patient outcomes.

Nitride stabilized PtNi core-shell nanocatalyst for high oxygen reduction activity.

We describe a route to the development of novel PtNiN core-shell catalysts with low Pt content shell and inexpensive NiN core having high activity and stability for the oxygen reduction reaction (ORR). The PtNiN synthesis involves nitriding Ni nanoparticles and simultaneously encapsulating it by 2-4 monolayer-thick Pt shell. The experimental data and the density functional theory calculations indicate nitride has the bifunctional effect that facilitates formation of the core-shell structures and improves the performance of the Pt shell by inducing both geometric and electronic effects. Synthesis of inexpensive NiN cores opens up possibilities for designing of various transition metal nitride based core-shell nanoparticles for a wide range of applications in energy conversion processes.

Laparoscopic ventral hernia repair in the elderly: does the type of hernia matter?

PURPOSE: Assess the impact of age and type of hernia on the outcomes of laparoscopic ventral hernia repair (LVHR). METHODS: Operating room database of all laparoscopic ventral hernias performed from April 2001 to July 2010 was analyzed retrospectively. Patients were divided into two groups: primary hernias (Group 1) and incisional hernias (Group 2). These groups were further stratified into patients <65 years of age (Groups 1A and 2A) and patients >65 years of age (Groups 1B and 2B). Patient demographics, hernia characteristics, perioperative outcomes, and disposition at discharge were compared. p-values <0.05 were considered significant. RESULTS: 325 patients, with a mean age of 56.6 years (24-93 years) underwent LVHR. The mean length of stay (LOS) was longer (2.7 days vs 1.7 days, p value = 0.02), and the rate of same day discharge was also significantly lower (12 vs. 25 %, p = 0.02) for Group 2B when compared to Group 2A. Three patients in Group 2B, who had been living independently, were discharged to a skilled nursing facility, which proved significantly different when compared with Group 2A. There was no statistically significant difference in perioperative outcomes between younger and older subgroups with primary hernias. CONCLUSIONS: LVHR in the elderly with incisional hernias have longer LOS and have a higher need for post-discharge nursing care unlike their counterparts with primary hernias. Identifying this cohort of patients early on helps the health-care providers to optimize the outcomes.

Development of an enzyme-linked immunosorbent assay for the serological detection of exposure of poultry in New Zealand to Erysipelothrix rhusiopathiae and their serological response to vaccination.

AIMS: To modify and validate an existing swine erysipelas ELISA for use with poultry serum and to assess the safety of a swine erysipelas vaccine for use in New Zealand layer birds. METHODS: An existing swine erysipelas ELISA was modified for use in domestic poultry and was validated using sera from birds injected with either 2 mL of a commercially available killed swine erysipelas vaccine (low-dose; n=12 birds), 4 mL of vaccine (high-dose; n=11 birds), or 2 mL saline (control; n=11 birds) on Day 0 and again on Day 21. Blood samples were collected on Days 0, 21, 42, and 63, and safety of the vaccine for use in layer birds was determined by assessing cloacal temperature and injection site reactions in birds at 0, 4, 24, 48, 72 and 96 h post-vaccination. RESULTS: The ELISA that was developed had a diagnostic sensitivity and specificity of 93% and 98%, respectively, after being optimised for a positive cut-off at an optical density (OD) ≥ 1.50 read at 450-nm wavelength. OD readings were higher on Days 21, 42, and 63 than Day 0 in both the low-dose and high-dose groups (p<0.05), and differed amongst the three groups on Days 21, 42, and 63 (p<0.05), suggesting that vaccination using either dose induced detectable levels of antibody, even after a single dose. In addition, the high-dose protocol induced higher levels of antibody production than the low-dose protocol. No local or systemic reactions to the vaccine were observed and cloacal temperatures remained in the normal biological range after vaccination. CONCLUSIONS: The ELISA that was developed had satisfactory diagnostic performance characteristics and the vaccine appeared to be safe for use in layer birds. However, the study design did not permit an assessment of the vaccine's efficacy to protect birds from clinical erysipelas. CLINICAL RELEVANCE: A diagnostic ELISA has been developed for determining the exposure of layer birds to E. rhusiopathiae. The test will be useful for monitoring flock-level erysipelas, response to vaccination, and in epidemiological studies designed to identify risk factors for exposure to the disease.

Serological survey of exposure to Erysipelothrix rhusiopathiae in poultry in New Zealand.

AIMS: To estimate the seroprevalence of antibodies to Erysipelothrix rhusiopathiae in chickens in New Zealand, and to estimate the effect of housing type, geographical location and age on seroprevalence. METHODS: A cross-sectional serological survey of a convenience sample of 545 broiler, breeder, and layer chickens in 55 flocks was conducted in 2010-2011. Birds were aged 5-83 weeks; housing types were free-range, shed, caged, and unknown; and flocks were located in the Auckland, Manawatu, North Canterbury, Otago, Taranaki, Waikato, and Wairarapa regions of New Zealand. An ELISA was used to measure antibodies to E. rhusiopathiae. Samples with an optical density reading ≥ 1.50 were considered to be positive. Logistic regression analysis was used to model the effect of housing type, geographical location and flock age on the prevalence of samples positive for antibodies to E. rhusiopathiae. RESULTS: The overall prevalence of samples with antibodies to E. rhusiopathiae was 39.8 (95% CI=35.68-44.06)% for the 545 samples, and 46/55 (84%) farms that were tested had at least one positive sample. Mean seroprevalence for types of housing was 44.2 (95% CI=37.79-50.70)% for free-range (n=240 birds), 23.7 (95% CI=17.83-30.38)% for shed (n=190), 73 (95% CI=56-86)% for caged (n=37) and 50 (95% CI=38-62)% for unknown (n=78). The disease was present in all seven geographical locations from which samples were obtained for this study. Seroprevalence increased with increasing age of birds (p<0.001); for birds ≤ 12 weeks of age it was 2 (95% CI=0.3-8)% (n=91), 13-24 weeks 29.1 (95% CI=23.34-35.46)% (n=230), 25-36 weeks 47 (95% CI=32-64)% (n=40), 37-48 weeks 75 (95% CI=51-91)% (n=20), >48 weeks 63.8 (95% CI=54.78-72.12)% (n=127). Neither housing type nor geographical location had a significant effect on the likelihood of samples being positive for antibodies to E. rhusiopathiae. CONCLUSIONS: The results of this study suggest the prevalence of erysipelas under New Zealand field conditions may be higher than expected and that the disease is significantly associated with increasing age. Housing type and geographical location appear to be unrelated to seroprevalence. CLINICAL RELEVANCE: Further study of the epidemiology of E. rhusiopathiae in chickens in New Zealand should be considered in order to minimise the extent of birds' exposure to the organism. These findings will assist in the design of further studies.