Risk factors of high fluid absorption in patients treated with mini-PCNL: a single-center prospective study.

BACKGROUND: The factors influencing fluid absorption in mini-percutaneous nephrolithotripsy (mini-PCNL) are still unknown. We aim to investigate the factors that influence irrigation fluid absorption during mini-PCNL. METHODS: A total of 94 patients who underwent mini-PCNL were included in this prospective study. The endoscopic surgical monitoring system (ESMS) was used to measure the volume of irrigation fluid absorbed during the procedure. Irrigating time, the total volume of irrigation fluid, stone size, S.T.O.N.E. score, hemoglobin, electrolyte levels, and postoperative complications were recorded. RESULTS: A significant correlation was observed between fluid absorption and the presence of postoperative fever, and based on this phenomenon, patients were divided into low and high fluid absorption groups. The serum creatinine level in the high fluid absorption group was significantly high (7 vs. 16.5, p = 0.02). Significant differences were observed between the low and high fluid absorption groups in terms of mean stone size (21.70 mm vs. 26.78 mm), presence of stone burden ≥ 800 mm2 (4% vs. 23%), S.T.O.N.E. score > 8 (4% vs. 38%), the fluid used > 18,596 ml (19% vs. 78%), irrigation time (55.61 min vs. 91.28 min), and perfusion rate (24% vs. 45%) (all p < 0.05). The rates of postoperative fever and SIRS in the high fluid absorption group were significantly high (p < 0.05). CONCLUSIONS: Mean stone size, presence of stone burden ≥ 800 mm2, S.T.O.N.E. score > 8, the fluid used > 18596 mL, irrigation time, and perfusion rate are risk factors of intraoperative fluid absorption in mini-PCNL.

Self-management practice of people with epilepsy in Viet Nam and associated factors.

OBJECTIVES: This study aimed to determine (1) the self-management practice of people with epilepsy and (2) the associated factors, including sociodemographic and clinical variables. METHODS: This cross-sectional descriptive study was conducted at two neurology clinics in Ho Chi Minh City from October 2022 to June 2023. We included 147 adults with epilepsy and measured their self-management practices using the Vietnamese Epilepsy Self-Management Scale (V-ESMS). Additionally, we collected data on sociodemographic, clinical, and psychosocial variables through questionnaires. RESULTS: Results showed a moderate overall V-ESMS score (131.32 ± 16.53), with Medication management subscale scoring the highest and Information management scoring the lowest. Univariate analysis revealed educational level as the significant factor influencing self-management practices (p = 0.001), with higher education correlating with better scores across all subscales except Medication and Safety. CONCLUSION: Individuals with epilepsy who achieved higher education levels had better self-management practices. This finding suggests that educational interventions could significantly enhance self-management practices among people with epilepsy.

Translation and validation of the Vietnamese Epilepsy Self-Management Scale (V-ESMS).

OBJECTIVES: This study aimed to translate and validate the Vietnamese version of the Epilepsy Self-Management Scale (V-ESMS). METHODS: The translation and cross-cultural adaptation of the original version of the ESMS into Vietnamese followed the Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes Measures guideline with "forward-backward" translation and culturally adapted. The participants were recruited consecutively at neurology clinics at Nguyen Tri Phuong Hospital and University Medical Center, Ho Chi Minh City, from January 2022 to July 2022 and required to complete the V-ESMS. The validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha and intraclass correlation coefficient (ICC) were used to evaluate internal and temporal reliability, respectively. RESULTS: A total of 200 participants were recruited for analysis. The V-ESMS included 36 items and five domains. The factor loading ranged between 0.313 and 0.927; most items loaded in their hypothesized factors proved in the original scale. Using the CFA, theCMIN/DF, comparative fit index, and root mean square error of approximation were 2.883, 0.80, and 0.097, respectively. The Cronbach's alpha in each domain was 0.79-0.907; the scale was 0.936. The ICC from 0.94 to 0.98 showed excellent test-retest reliability. CONCLUSION: The 36-item V-ESMS with five domains presented good validity and reliability. This instrument could be used to assess self-management in people with epilepsy in Vietnam.

Development and validation of the Thai version of the Adult Epilepsy Self-Management Scale (Thai-ESMS).

OBJECTIVE: Self-management is an important strategy for helping people with epilepsy (PWE) control their seizures and improve their quality of life. To date, there are scarce standard measurement tools for assessing self-management practices. This study aimed to develop and validate a Thai version of the Epilepsy Self-Management Scale (Thai-ESMS) for Thai people with epilepsy. METHODS: The translation of the Thai-ESMS was created using the adaptation of Brislin's translation model. Content validity of the developed Thai-ESMS was independently assessed by 6 neurology experts and reported as item content validity index (I-CVI) and scale-CVI (S-CVI). We consecutively invited epilepsy patients at our outpatient epilepsy clinic to participate in the study from November to December 2021. Participants were asked to complete our 38-item Thai-ESMS. Based on the participant's responses, construct validity was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha coefficient was employed to evaluate internal consistency reliability. RESULTS: Overall, our 38-item Thai ESMS scale showed high content validity (S-CVI = 0.89), assessed by neurology experts. Responses from 216 patients were then used for the assessment of construct validity and internal consistency. The results showed good construct validity of 5 domains (5 factors with Eigenvalue > 1 upon EFA and good fitness index upon CFA) meaning that the developed scale is an adequate measure of the concept it was designed to evaluate and had good internal consistency (Cronbach's alpha 0.819), which both values were comparable to the original English version. However, some items or domains had poorer validity and reliability than the overall scale. CONCLUSIONS: We developed a robust 38-item Thai ESMS with high validity and good reliability to be used to help assess the magnitude of self-management skills in Thai PWE. However, more work on this measure is needed before distribution to a wider population.

Transurethral plasmakinetic resection versus enucleation for benign prostatic hyperplasia: comparison of intraoperative safety profiles based on endoscopic surgical monitoring system.

OBJECTIVE: To compare the intraoperative safety profiles of transurethral plasmakinetic resection of the prostate (PK-TURP) with transurethral plasmakinetic endoscopic enucleation of the prostate (PK-EEP) in the treatment of benign prostatic hyperplasia (BPH) based on endoscopic surgical monitoring system (ESMS). METHODS: A total of 128 patients who were diagnosed with BPH were stratified based on prostate volume (PV) and accepted PK-EEP or PK-TURP treatment at 1:1 ratio. The ESMS as a novel method was used to monitor blood loss and fluid absorption during the operation. Clinical parameters such as intraoperative blood loss volume, fluid absorption volume, operation time, tissue weight of resection, preoperative and postoperative red blood cell count (RBC), hemoglobin concentration (HB), hematocrit (HCT), electrolyte, postoperative bladder irrigation time, indwelling catheter time, hospital stay time and other associated complications were documented and compared between two groups. RESULTS: No significant differences in majority of baseline characteristics were observed among patients with different prostate volumes between two surgical methods. For patients with prostate volume < 40 ml, the average operation time of patients who received PK-EEP treatment was much more than those who received PK-TURP (P = 0.003). On the other hand, for patients with prostate volume > 40 ml, the PK-TURP surgery was associated with a significant increase in intraoperative blood loss (P = 0.021, in PV 40-80 ml group; P = 0.014, in PV > 80 ml group), fluid absorption (P = 0.011, in PV 40-80 ml group; P = 0.006, in PV > 80 ml group) and postoperative bladder irrigation time as well as indwelling catheter time but decrease in resected tissue weight compared to the PK-EEP treatment. CONCLUSION: The ESMS plays an important role in comparison of intraoperative safety profiles between PK-TURP and PK-EEP. Our data suggest that PK-TURP treatment is associated with a decreased operation time in patients with prostate volume < 40 ml and the PK-EEP treatment is associated with decreased intraoperative blood loss, fluid absorption and increased tissue resection for patients with prostate volume > 40 ml. Our results indicate that the size of prostate should be considered when choosing the right operation method.

Incorporating phosphorus cycling into global modeling efforts: a worthwhile, tractable endeavor.

324 I. 324 II. 325 III. 326 IV. 327 328 References 328 SUMMARY: Myriad field, laboratory, and modeling studies show that nutrient availability plays a fundamental role in regulating CO2 exchange between the Earth's biosphere and atmosphere, and in determining how carbon pools and fluxes respond to climatic change. Accordingly, global models that incorporate coupled climate-carbon cycle feedbacks made a significant advance with the introduction of a prognostic nitrogen cycle. Here we propose that incorporating phosphorus cycling represents an important next step in coupled climate-carbon cycling model development, particularly for lowland tropical forests where phosphorus availability is often presumed to limit primary production. We highlight challenges to including phosphorus in modeling efforts and provide suggestions for how to move forward.

Projected decline in the strength of vegetation carbon sequestration under climate change in India.

Tropical vegetation plays a critical role in terrestrial carbon budget and supply many ecological functions such as carbon sequestration. In recent decades, India has witnessed an increase in net primary productivity (NPP), an important measure of carbon sequestration. However, uncertainties persist regarding the sustainability of these land carbon sinks in the face of climate change. The enhanced NPP is driven by the strong CO2 fertilization effect (CFE), but the temporal patterns of this feedback remain unclear. Using the carbon flux data from the Earth System Models (ESMs), an increasing trend in NPP was observed, with projections of NPP to 2.00 ± 0.12 PgCyr-1 (25 % increase) during 2021-2049, 2.36 ± 0.12 PgCyr-1 (18 % increase) during 2050-2079, and 2.67 ± 0.07 PgCyr-1 (13 % increase) during 2080-2099 in Indian vegetation under SSP585 scenario. This suggests a significant decline in the NPP growth rate. To understand the feedback mechanisms driving NPP, the relative effects of CFE and warming were analyzed. Comparing simulations from the biogeochemically coupled model (BGC) with the fully coupled model, the BGC model projected a 74.7 % increase in NPP, significantly higher than the 55.9 % increase projected by the fully coupled model by the end of the century. This indicates that the consistent increase in NPP was associated with CO2 fertilization. More importantly, results reveal that the decrease in the NPP growth rate was due to the declining contribution of CFE at a rate of -0.62 % per 100 ppm CO2 increase. This decline could be attributed to factors such as nutrient limitations and high temperatures. Additionally, significant shifts in the strength of carbon sinks in offsetting the CO2 emissions were identified, decreasing at a rate of -1.15 % per decade. This decline in the strength of vegetation carbon sequestration may increase the societal dependence on mitigation measures to address climate change.

N-terminal guanidinylation of TIPP (Tyr-Tic-Phe-Phe) peptides results in major changes of the opioid activity profile.

Derivatives of peptides of the TIPP (Tyr-Tic-Phe-Phe; Tic=1,2,3,4-tetrahydroisoquinoline-3-carboxylic acid) family containing a guanidino (Guan) function in place of the N-terminal amino group were synthesized in an effort to improve their blood-brain barrier permeability. Unexpectedly, N-terminal amidination significantly altered the in vitro opioid activity profiles. Guan-analogues of TIPP-related δ opioid antagonists showed δ partial agonist or mixed δ partial agonist/µ partial agonist activity. Guanidinylation of the mixed µ agonist/δ antagonists H-Dmt-Tic-Phe-Phe-NH2 (DIPP-NH2) and H-Dmt-TicΨ[CH2NH]Phe-Phe-NH2 (DIPP-NH2[Ψ]) converted them to mixed µ agonist/δ agonists. A docking study revealed distinct positioning of DIPP-NH2 and Guan-DIPP-NH2 in the δ receptor binding site. Lys(3)-analogues of DIPP-NH2 and DIPP-NH2[Ψ] (guanidinylated or non-guanidinylated) turned out to be mixed µ/κ agonists with δ antagonist-, δ partial agonist- or δ full agonist activity. Compounds with some of the observed mixed opioid activity profiles have therapeutic potential as analgesics with reduced side effects or for treatment of cocaine addiction.

Transport of arsenolipids to the milk of a nursing mother after consuming salmon fish.

OBJECTIVE: We address two questions relevant to infants' exposure to potentially toxic arsenolipids, namely, are the arsenolipids naturally present in fish transported intact to a mother's milk, and what is the efficiency of this transport. METHODS: We investigated the transport of arsenolipids and other arsenic species present in fish to mother's milk by analyzing the milk of a single nursing mother at 15 sampling times over a 3-day period after she had consumed a meal of salmon. Total arsenic values were obtained by elemental mass spectrometry, and arsenic species were measured by HPLC coupled to both elemental and molecular mass spectrometry. RESULTS: Total arsenic increased from background levels (0.1 µg As kg-1) to a peak value of 1.72 µg As kg-1 eight hours after the fish meal. The pattern for arsenolipids was similar to that of total arsenic, increasing from undetectable background levels (< 0.01 µg As kg-1) to a peak after eight hours of 0.45 µg As kg-1. Most of the remaining total arsenic in the milk was accounted for by arsenobetaine. The major arsenolipids in the salmon were arsenic hydrocarbons (AsHCs; 55 % of total arsenolipids), and these compounds were also the dominant arsenolipids in the milk where they contributed over 90 % of the total arsenolipids. CONCLUSIONS: Our study has shown that ca 2-3 % of arsenic hydrocarbons, natural constituents of fish, can be directly transferred unchanged to the milk of a nursing mother. In view of the potential neurotoxicity of AsHCs, the effects of these compounds on the brain developmental stage of infants need to be investigated.

Chemical structure of the arabinogalactan protein from gum ghatti and its interaction with bovine serum albumin.

Exudate gums, because of their beneficial properties, have been significant items of international trade in various industries for centuries. This manuscript sets out to gain insight into the fine structural details of an arabinogalactan protein (AGP) of gum ghatti (Anogeissus latifolia gum). The presence of a highly branched 554 kDa AGP having 1,6-linked Galp, 1,2-linked Manp, 1,3-linked Araf and 1,4-linked GlcpA main chain, substituted at O-4,6 of 1,2-linked Manp, and O-3/O-3,4 of 1,6-linked Galp residues by Araf, Arap and Galp units was revealed by chemical, chromatographic, ESMS, and NMR analyses. In particular, ESMS analysis of per acetylated oligomeric fragments derived from AGP by Smith degradation followed by acetylation was described as a commanding tool for providing critical structural information on a spectrum of glycerol tagged oligosaccharides. In addition, formation of an electrostatically driven complex between the isolated AGP and bovine serum albumin resulting in changes in the microenvironment around the tryptophan residues of BSA was established. A moderate radical scavenging activity comparable with those of standard antioxidants was observed from the AGP fraction (∼94% at 1 mg/mL) that could be valuable in foods or pharmaceutical products as alternatives to synthetic antioxidants.

Determination of the trypanocidal drug melarsoprol and its conversion products in biological fluids with HPLC-ICPMS/ESMS.

Although melarsoprol, an organoarsenic compound, is widely used for the treatment of trypanosomiasis (human African sleeping sickness), very little is known about its fate in the human body, its active metabolites passing the blood-brain barrier and the mode of action. Previous pharmacological studies based on the determination of melarsoprol by HPLC-UV or by a bioassay method produced different results. We report a HPLC-ICPMS method suitable for determining melarsoprol and its metabolites in biological fluids. The arsenic selective capability of the method allowed the quantitative measurement of melarsoprol and two arsenic-containing conversion products produced when melarsoprol was incubated with human serum and blood. The major product was identified as melarsen [4-[(4,6-diamino-1,3,5-triazin-2-yl)amino]phenyl]arsonic acid by HPLC/electrospray MS, and by accurate mass measurements. Investigations about the stability of melarsoprol in serum showed that within 30 h about 10% of melarsoprol is converted to melarsen. In blood, however, most of the melarsoprol was bound to proteins and only 1% was converted to melarsen after 30 hours. The limit of detection for melarsoprol and its conversion products were in the range of 1 µg AsL(-1) (13 nmol As L(-1)) based on signal to noise ratio of 3 with a 10 µL injection volume allowing direct determination of the compounds in blood and serum (after protein precipitation) at therapeutically realistic concentrations.

A 'conovenomic' analysis of the milked venom from the mollusk-hunting cone snail Conus textile--the pharmacological importance of post-translational modifications.

Cone snail venoms provide a largely untapped source of novel peptide drug leads. To enhance the discovery phase, a detailed comparative proteomic analysis was undertaken on milked venom from the mollusk-hunting cone snail, Conus textile, from three different geographic locations (Hawai'i, American Samoa and Australia's Great Barrier Reef). A novel milked venom conopeptide rich in post-translational modifications was discovered, characterized and named α-conotoxin TxIC. We assign this conopeptide to the 4/7 α-conotoxin family based on the peptide's sequence homology and cDNA pre-propeptide alignment. Pharmacologically, α-conotoxin TxIC demonstrates minimal activity on human acetylcholine receptor models (100 µM, <5% inhibition), compared to its high paralytic potency in invertebrates, PD50 = 34.2 nMol kg(-1). The non-post-translationally modified form, [Pro](2,8)[Glu](16)α-conotoxin TxIC, demonstrates differential selectivity for the α3ß2 isoform of the nicotinic acetylcholine receptor with maximal inhibition of 96% and an observed IC50 of 5.4 ± 0.5 µM. Interestingly its comparative PD50 (3.6 µMol kg(-1)) in invertebrates was ~100 fold more than that of the native peptide. Differentiating α-conotoxin TxIC from other α-conotoxins is the high degree of post-translational modification (44% of residues). This includes the incorporation of γ-carboxyglutamic acid, two moieties of 4-trans hydroxyproline, two disulfide bond linkages, and C-terminal amidation. These findings expand upon the known chemical diversity of α-conotoxins and illustrate a potential driver of toxin phyla-selectivity within Conus.