Malignant melanoma of the uterus: a rare cause of postmenopausal bleeding

Background: Malignant melanoma of the uterus is a very rare disease entity bearing potentially serious consequences with an unpredictable and poor prognosis. Case: A 64-year-old woman who had a longstanding, slow-growing blackish mass of the right big toe for more than a decade, presented with postmenopausal bleeding. Histopathologic examination confirmed the diagnosis of a likely secondary malignant melanoma of the uterus. Results: She was treated successfully without any complications via total laparoscopic hysterectomy and bilateral salpingo-oophorectomy (TLHBSO). Even though malignant melanoma of the uterus has a poor prognosis, the patient was alive and disease-free at a 1-year regular follow-up. Conclusions: A malignant melanoma of the uterus is very rare and has a poor prognosis. However, laparoscopic excision of the uterus and adjacent organs in selected patients could be a superior option, especially in terms of rapid recovery and minimal tumor spillage. A combined multidisciplinary approach is highly recommended for dealing with malignant melanoma–related diseases for optimal care and a better clinical outcome

The role of relatedness in student learning experiences

Failure in addressing students’ needs in the context of student learning experiences may lead to negative impact on the image of higher education. Framed in self-determination theory, this study examined students’ relatedness on most satisfying experiences in their respective universities. Participants’ (N=1974) responses to open-ended questions were inductively coded to understand relatedness principles of student learning experiences to emerge from the data. The findings revealed that students valued the role of lecturers in professional and personal contexts, peers for friendship and teamwork and academic and non-academic experiences resulted from projects and activities. Given this, to provide a positive learning environment for students, university management needs to address and support lecturers’ well-being, pay attention to student relations on campus and support academic and non-academic activities. By understanding the roles of connecting students to lecturers, students to students and students to administrative staff, we could build a dynamic and functional campus environment for each party to live and care about each other

Subchronic toxicity, immunoregulation and anti-breast tumor effect of Nordamnacantal, an anthraquinone extracted from the stems of Morinda citrifolia L.

Background: Morinda citrifolia L. that was reported with immunomodulating and cytotoxic effects has been traditionally used to treat multiple illnesses including cancer. An anthraquinone derived from fruits of Morinda citrifolia L., nordamnacanthal, is a promising agent possessing several in vitro biological activities. However, the in vivo anti-tumor effects and the safety profile of nordamnacanthal are yet to be evaluated. Methods: In vitro cytotoxicity of nordamnacanthal was tested using MTT, cell cycle and Annexin V/PI assays on human MCF-7 and MDA-MB231 breast cancer cells. Mice were orally fed with nordamnacanthal daily for 28 days for oral subchronic toxicity study. Then, the in vivo anti-tumor effect was evaluated on 4T1 murine cancer cells-challenged mice. Changes of tumor size and immune parameters were evaluated on the untreated and nordamnacanthal treated mice. Results: Nordamnacanthal was found to possess cytotoxic effects on MDA-MB231, MCF-7 and 4T1 cells in vitro. Moreover, based on the cell cycle and Annexin V results, nordamnacanthal managed to induce cell death in both MDA-MB231 and MCF-7 cells. Additionally, no mortality, signs of toxicity and changes of serum liver profile were observed in nordamnacanthal treated mice in the subchronic toxicity study. Furthermore, 50 mg/kg body weight of nordamncanthal successfully delayed the progression of 4T1 tumors in Balb/C mice after 28 days of treatment. Treatment with nordamnacanthal was also able to increase tumor immunity as evidenced by the immunophenotyping of the spleen and YAC-1 cytotoxicity assays. Conclusion: Nordamnacanthal managed to inhibit the growth and induce cell death in MDA-MB231 and MCF-7 cell lines in vitro and cease the tumor progression of 4T1 cells in vivo. Overall, nordamnacanthal holds interesting anti-cancer properties that can be further explored

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

Background: The EMPA KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. Methods: EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. Findings: Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5–2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62–0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16–1·59), representing a 50% (42–58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). Interpretation: In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. Funding: Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council

Effect of spindle speed and feed per tooth in feed rate perspective on inconel HX cutting force

Reducing feed rate during end-milling of nickel-based superalloys for lowcutting force has always been a common approach. This is due to these alloys having superior properties, making them widely regarded as difficultto-machine materials. As feed rate is tied to spindle speed and feed per tooth, it is crucial to comprehend whether spindle speed, feed per tooth or the interaction between spindle speed and feed per tooth has a significant factor on cutting force reduction when increasing the feed rate. Accordingly, this manuscript presents an effect of spindle speed and feed per tooth in feed rate perspective on Inconel HX cutting force. Half-immersion down-milling and full-immersion down-milling was conducted experimentally using solid ceramic end-mill cutter. The results indicate that cutting force decreases and then increases after further increase in spindle speed, while cutting force increases with an increase in feed per tooth. Optimum spindle speed and optimum feed per tooth for low-cutting force were 21,400 rpm and 0.013 mm/tooth. Furthermore, feed per tooth was the significant factor which influenced the cutting force, whereas spindle speed, and the interaction between spindle speed and feed per tooth were not significant

Cloud computing applications and platforms: a survey

The implementation of cloud computing application takes the higher necessity, especially after suffering from modern problems, such as providing proper funds for social service and purchasing programs. For that, the cloud computing applications propose a promising solution to solve such issues. In this paper, we will discuss the implemention of cloud computing over Smart Grid system; a reliable, cost effective guaranteed and efficient system, it is expected to be Long Term Evolution (LTE): which allows larger pieces of spectrum, or bands to be used furthermore with more coverage and less latency and the third technology is Vehicular network: which is an important research area because of unique features and applications that offers. In this survey, we will present an overview of the smart grid, LTE and the vehicular network when they get integrated with cloud computing, in addition we will highlight the open issues and research direction which faces these technologies with cloud computing implementing in terms of Energy management, Information management for smart grid. In terms of applying cloud computing platforms for 4G Networks to achieve specific criteria and finally in terms of Architectural formation and Privacy and security for Vehicular cloud computing

In vitro anti-hyperglycemic, antioxidant activities and intestinal glucose uptake evaluation of endiandra kingiana extracts

Optimal control of postprandial hyperglycemia is essentially important in the management of diabetes mellitus. The present investigation was undertaken to evaluate the in vitro anti-hyperglycemic, antioxidant properties and intestinal glucose uptake inhibition of Endiandra kingiana (E. kingiana) extracts. Previously, our group has identified and characterized the bioactive compounds of E. kingiana extracts, which had discovered several polyketides; endiandric acids and kingianins. Here, the inhibitory potential of bark-ethyl acetate (BEA), bark-methanol (BM), leaf-ethyl acetate (LEA), and leaf-methanol (LM) extracts of E. kingiana against carbohydrate-hydrolyzing enzymes with their mode of inhibitions were evaluated. Further, the antioxidant activities and inhibitory potential on glucose uptake in Caco-2 human intestinal cell monolayers were determined. Our finding showed that BEA extract exhibited the most potent inhibition activities against α-amylase (IC50 = 2.32 μg/mL) and α-glucosidase (IC50 = 1.83 μg/mL) by following inhibition mode of competitive and non-competitive manners, respectively. Meanwhile, BM extract exhibited notable antioxidant capabilities, as evidenced by strongest free radical scavenging (IC50 = 1.18 μg/mL) and reducing power effect (118.53 mM Fe2+ equivalent/g extract) in couple with highest total phenolic contents (10.17 mg GAE/g extract) compared to other extracts. Mechanistically, both BEA and BM extracts of E. kingiana significantly inhibited glucose uptake in Caco-2 cell monolayers under sodium-dependent condition. Collectively, these findings suggest that BM and BEA extracts of E. kingiana exert in vitro anti-hyperglycemic and antioxidant properties, which can be further utilized as a potential candidate for treatment of hyperglycemia–induced oxidative stress conditions