A case report of a giant fallopian tube leiomyoma mimicking a mesenteric tumor.

Leiomyomas are benign tumors usually found in the uterus although other organs such as the vagina and the ovaries can be involved. The most common etiology of tubal disorders is infection, but tubal leiomyomas remain a rare possibility. We hereby present a case-report of fallopian tube leiomyoma undiagnosed preoperatively despite the technological progress in radiologic imaging. The diagnosis was only made at laparotomy. In this case report, diagnostic measures and the difficulties encountered are discussed.KEY WORDS: Abdominal mass- Fallopian tube fibroid - Diagnosis

Setting-up nurse-led pilot clinics for the management of non-communicable diseases at primary health care level in resource-limited settings of Africa

Background: This article describes the setting-up process for nurse-led pilot clinics for the management of four chronic diseases: asthma, type 2 diabetes mellitus, epilepsy and hypertension at the primary health care level in urban and rural Cameroon. Methods: The Biyem-Assi urban and the Bafut rural health districts in Cameroon served as settings for this study. International and local guidelines were identified and adapted to the country’s circumstances. Training and follow-up tools were developed and nurses trained by experienced physicians in the management of the four conditions. Basic diagnostic and follow-up materials were provided and relevant essential drugs made available. Results: Forty six nurses attended six training courses. By the second year of activity, three and four clinics were operational in the urban and the rural areas respectively. By then, 925 patients had been registered in the clinics. This represented a 68.5% increase from the first year. While the rural clinics relied mainly on essential drugs for their prescriptions, a prescription pattern combining generic and proprietary drugs was observed in the urban clinics. Conclusion: In the quest for cost-effective health care for NCD in sub-Saharan Africa, rethinking health workforce and service delivery has relevance. Nurse-led clinics, algorithm driven service delivery stands as alternatives to overcome the shortage of trained physicians and other issues relating to access to care

Challenges for Developing Rechargeable Room-Temperature Sodium Oxygen Batteries

© 2018 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim The development of high energy-density and low-cost energy storage devices requires new chemistry beyond the horizon of current state-of-the-art lithium-ion batteries. Recently, sodium/oxygen (Na/O2) batteries have attracted great attention as one possible battery type among the new generation of rechargeable batteries. They convince with superior energy density, a relatively simple cell reaction, and abundance of sodium. Research on Na/O2 batteries has progressed quickly in recent years. However, a fundamental understanding underpinning the complex chemical/electrochemical side reactions is still insufficient, and many challenges remain unsolved for real practical applications. Herein, recent achievements and remaining issues for the development of rechargeable Na/O2 batteries are summarized. The discussion focuses on cell reaction mechanisms as well as cathode materials, sodium anodes, and electrolytes as key components of this type of battery. Furthermore, perspectives for future research and technological advances of Na/O2 batteries are outlined

Eliciting Emotion and Action Increases Social Media Engagement: An Analysis of Influential Orthopaedic Surgeons

Purpose: The purpose of this study is to analyze the Instagram practices of current orthopaedic surgeons and the components associated with highest reach and interactions. Methods: The top 25 orthopaedic surgeon Instagram profiles using the hashtag #ortho were ranked by the number of followers. Account information regarding followers, posts, engagement percentage, average likes, average comments, average video view, average video likes, average video comments, and estimated cost per post was recorded using social media marketing tools. An analysis of each Instagram profiles\u27 top 10 posts, based on number of likes, was conducted. A coding framework was developed to categorized posting strategies utilized. Results: Twenty-five Instagram accounts and 250 Instagram posts were included in the analysis. Accounts with increased engagement rating had a significantly greater number of likes and video views. When examining post characteristics that influenced the number of likes a post generated, posts that elicited negative emotions received 52.6% and 70.7% more likes than positive emotions ( Conclusions: The present investigation found that the most effective strategies to generate more interactions on Instagram are those that elicit emotional responses and provoke viewer engagement by asking questions and directing actions. Additionally, it was found that promotional content was not well received by viewers. Clinical Relevance: Orthopaedic surgeons have an opportunity to connect with colleagues, patients, and interested viewers through social media platforms in order to enhance their practice, disseminate educational content, and contribute to the social media presence of orthopaedic surgery

3α-Hy­droxy­tirucalla-8,24-dien-21-oic acid

The title compound, C30H48O3, a triterpene isolated from the resin of canarium schweinfurthiiand, is an isomer of the previously reported triterpene 3α-hy­droxy­tirucalla-7,24-dien-21-oic acid [Mora et al. (2001 ▶). Acta Cryst. C57, 638–640], which crystallizes in the same trigonal space group. The title mol­ecule consists of four fused rings having chair, half-chair, half-chair and envelope conformations for rings A, B, C and D, respectively (steroid labelling). An intra­molecular C—H⋯O hydrogen bond generates an S(7) ring. In the crystal, mol­ecules are linked by O—H⋯O and C—H⋯O inter­actions, forming (001) sheets

A cocrystal of 3α-hy­droxy­tirucalla-8,24-dien-21-oic acid and 3β-fluoro­tirucalla-7,24-dien-21-oic acid (0.897:0.103)

The title compound, 0.897C30H48O3.0.103C30H47O2F is a co-crystal of two triterpenes isolated from the resin of Canarium schweinfurthiiand Engl. Both triterpenes consists of four trans-fused rings having chair/half-chair/half-chair and envelope conformations. The mol­ecular conformations are stabilized by intra­molecular C—H⋯O hydrogen bonds, forming rings of S(7) graph-set motif. In the crystal, mol­ecules are linked by inter­molecular O—H⋯O and C—H⋯O inter­actions, forming sheets parallel to (001). All atoms. excepting the axially-oriented hydroxyl group in the major component and the equatorially-oriented fluorine atom in the minor component, are overlapping

Temperature-dependent phenology of the parasitoid Fopius arisanus on the host Bactrocera dorsalis

Fopius arisanus (Sonan), an egg-pupal parasitoid of numerous fruit fly species, was recently introduced into Africa for the control of the Oriental fruit fly, Bactrocera dorsalis (Hendel). In this study, life-table data of F. arisanus were generated under laboratory conditions at six constant temperatures (15, 20, 25, 30, 28 and 35 °C; 75% RH, L12:D12 photoperiod) and under variable conditions in a screenhouse on B. dorsalis. Several non-linear functions were fitted to model species development, mortality, longevity and oviposition using the Insect Life Cycle Modeling (ILCYM) software. The established phenology models were stochastically simulated at variable temperatures to estimate the life table parameters. Fopius arisanus completed development from egg to adult at all the temperatures tested except at 35 °C. Mean developmental time from egg to adult was inversely proportional to the temperature. The minimum temperature threshold (Tmin) from egg to adult was 8.15 °C, while the maximum temperature threshold (Tmax) was estimated at 34.2 °C. The optimal temperature for immature stages survival was predicted for 20-30 °C. The optimum fecundity estimated was 251 eggs/female at 22 °C. Following the stochastic simulations under natural conditions of the selected agro-ecological zones, it appears that the Humid Forest with Bimodal Rainfall provides a suitable thermal condition for potential population growth of F. arisanus. The present study shows the importance of temperature on the demographic parameters of F. arisanus. Implications of present findings on the biological control of B. dorsalis under climate change scenarios is discussed

The Floor Stiffness Effect on Vulnerability Assessments and Intervention Designs of Historic Buildings: the Case Study of the “Procuratie Vecchie” in Venice, Italy

In the Italian seismic scenario, and beyond, interventions on existing buildings focused on the evaluation and reduction of seismic risk of cultural heritage have gained more and more importance in the engineering field. Therefore, for the designer it becomes increasingly useful to have a methodology that allows to carry out, in the study of an existing structure behavior, the vulnerability assessment of both the actual state and the design state, evaluating the adequacy of potential intervention of seismic improvement. In this paper some phases of this methodology are presented in the context of the restoration work started in November 2017, and currently in progress, of the historical building of Procuratie Vecchie in Piazza San Marco in Venice, with particular focus on the consolidation intervention of the timber floors which satisfy the conservation requirements imposed by the Superintendence of Venice. Actually, the influence of floor diaphragms on structural behavior of existing masonry building subjected to seismic action is critically discussed with particular reference to the effects of in-plane stiffness of floors on the seismic distribution of forces on lateral walls and on the out–of–plane mechanism of the walls

Neural Stem Cell-Derived Small Extracellular Vesicles: key Players in Ischemic Stroke Therapy – A Comprehensive Literature Review

Zhihan Zhu,1,* Qiankun Zhang,1,* Jia Feng,1 Sonia Zebaze Dongmo,1 Qianqian Zhang,1 Songze Huang,1 Xiaowen Liu,1 Guilong Zhang,2 Lukui Chen1 1Department of Neurosurgery, Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China; 2Department of Neurosurgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lukui Chen, Department of Neurosurgery, Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, People’s Republic of China, Email [email protected] Guilong Zhang, Department of Neurosurgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China, Email [email protected]: Ischemic stroke, being a prominent contributor to global disability and mortality, lacks an efficacious therapeutic approach in current clinical settings. Neural stem cells (NSCs) are a type of stem cell that are only found inside the nervous system. These cells can differentiate into various kinds of cells, potentially regenerating or restoring neural networks within areas of the brain that have been destroyed. This review begins by providing an introduction to the existing therapeutic approaches for ischemic stroke, followed by an examination of the promise and limits associated with the utilization of NSCs for the treatment of ischemic stroke. Subsequently, a comprehensive overview was conducted to synthesize the existing literature on the underlying processes of neural stem cell-derived small extracellular vesicles (NSC-sEVs) transplantation therapy in the context of ischemic stroke. These mechanisms encompass neuroprotection, inflammatory response suppression, and endogenous nerve and vascular regeneration facilitation. Nevertheless, the clinical translation of NSC-sEVs is hindered by challenges such as inadequate targeting efficacy and insufficient content loading. In light of these limitations, we have compiled an overview of the advancements in utilizing modified NSC-sEVs for treating ischemic stroke based on current methods of extracellular vesicle modification. In conclusion, examining NSC-sEVs-based therapeutic approaches is anticipated to be prominent in both fundamental and applied investigations about ischemic stroke.Keywords: neural stem cells, small extracellular vesicles, ischemic stroke, neuroprotection, neural regeneratio