Clinical characteristics and treatment of different types of cesarean scar pregnancy

Objectives: The purpose of this study was to evaluate the clinical characteristics and compare the treatment efficacy ofdifferent types of cesarean scar pregnancy (CSP).Material and methods: We performed a retrospective chart review of 66 women (69 cases) with CSP who received treatmentwith mifepristone/methotrexate (MTX) plus curettage, uterine artery embolization (UAE) plus curettage, additionalMTX, or laparotomy, and compared the clinical characteristics, treatment efficacy, and occurrence of complications among3 types of CSP (partial, complete, and mass type).Results: Review of the 69 cases revealed a considerable increase of gestational duration(p < 0.001), sac/lesion size(p < 0.001)and vaginal bleeding (p < 0.05) in patients with mass-type CSP compared to that of other types. All CSP cases were successfullytreated, 4 cases of mass-type received laparotomy and none of the cases required a hysterectomy. Severe bleedingwas observed in 2 cases of partial-type and complete-type, respectively, and 3 cases for mass-type. Moreover, bleedingoccurred during initial treatment with mifepristone plus curettage in partial-type cases, but not with UAE plus curettage.Conclusions: UAE plus curettage is a more effective treatment option for partial- and complete-type of CSP than mifepristoneplus curettage. The cases of mass-type often need surgery and are prone to have longer gestational duration, largerlesions, and more vaginal bleeding

Insecurity of detector-device-independent quantum key distribution

Detector-device-independent quantum key distribution (ddiQKD) held the promise of being robust to detector side-channels, a major security loophole in QKD implementations. In contrast to what has been claimed, however, we demonstrate that the security of ddiQKD is not based on post-selected entanglement, and we introduce various eavesdropping strategies that show that ddiQKD is in fact insecure against detector side-channel attacks as well as against other attacks that exploit device's imperfections of the receiver. Our attacks are valid even when the QKD apparatuses are built by the legitimate users of the system themselves, and thus free of malicious modifications, which is a key assumption in ddiQKD.Comment: 7 pages, 5 figures, 1 tabl

Phylogeny of the genus Morus (Urticales: Moraceae) inferred from ITS and trnL-F sequences

Both nuclear ribosomal ITS and chloroplast trnL-F sequences were acquired from 13 mulberry genotypes belonging to nine species and three varieties, and one paper mulberry. The later belongs to genus B. papyrifera, designed as outgroup, and were analyzed. Within the genus Morus, the sequence diversity of ITS was much higher than that of trnL-F. The results of phylogenetic analyses based on these data (separately or combined) show that the genus Morus is monophyletic group. Strict consensus tree obtained through the Neighbor-joining method can be divided into five major clades in the genus Morus, according to combined sequence data. M. bombycis, M. alba var. venose formed clades A and B, respectively. Clade C comprises of 5 species; M. rotundiloba, M. atropurpurea, M. mongolica, M. australi, and M. mongolica var. diabolica. Clade D comprises of 3 species; M. wittiorum, M. laevigata, and M. alba. Clade E comprises of 2 species; M. multicaulis, and M.alba var. macrophylla. The results from cluster analysis were basically in agreement with the existing morphologic classification.African Journal of Biotechnology Vol. 4 (6), pp. 563-569, 200

Thermodynamically modulated partially double-stranded linear DNA probe design for homogeneous real-time PCR

Real-time PCR assays have recently been developed for diagnostic and research purposes. Signal generation in real-time PCR is achieved with probe designs that usually depend on exonuclease activity of DNA polymerase (e.g. TaqMan probe) or oligonucleotide hybridization (e.g. molecular beacon). Probe design often needs to be specifically tailored either to tolerate or to differentiate between sequence variations. The conventional probe technologies offer limited flexibility to meet these diverse requirements. Here, we introduce a novel partially double-stranded linear DNA probe design. It consists of a hybridization probe 5′-labeled with a fluorophore and a shorter quencher oligo of complementary sequence 3′-labeled with a quencher. Fluorescent signal is generated when the hybridization probe preferentially binds to amplified targets during PCR. This novel class of probe can be thermodynamically modulated by adjusting (i) the length of hybridization probe, (ii) the length of quencher oligo, (iii) the molar ratio between the two strands and (iv) signal detection temperature. As a result, pre-amplification signal, signal gain and the extent of mismatch discrimination can be reliably controlled and optimized. The applicability of this design strategy was demonstrated in the Abbott RealTime HIV-1 assay

Insect-Specific microRNA Involved in the Development of the Silkworm Bombyx mori

MicroRNAs (miRNAs) are endogenous non-coding genes that participate in post-transcription regulation by either degrading mRNA or blocking its translation. It is considered to be very important in regulating insect development and metamorphosis. We conducted a large-scale screening for miRNA genes in the silkworm Bombyx mori using sequence-by-synthesis (SBS) deep sequencing of mixed RNAs from egg, larval, pupal, and adult stages. Of 2,227,930 SBS tags, 1,144,485 ranged from 17 to 25 nt, corresponding to 256,604 unique tags. Among these non-redundant tags, 95,184 were matched to the silkworm genome. We identified 3,750 miRNA candidate genes using a computational pipeline combining RNAfold and TripletSVM algorithms. We confirmed 354 miRNA genes using miRNA microarrays and then performed expression profile analysis on these miRNAs for all developmental stages. While 106 miRNAs were expressed in all stages, 248 miRNAs were egg- and pupa-specific, suggesting that insect miRNAs play a significant role in embryogenesis and metamorphosis. We selected eight miRNAs for quantitative RT-PCR analysis; six of these were consistent with our microarray results. In addition, we searched for orthologous miRNA genes in mammals, a nematode, and other insects and found that most silkworm miRNAs are conserved in insects, whereas only a small number of silkworm miRNAs has orthologs in mammals and the nematode. These results suggest that there are many miRNAs unique to insects

POST‐UK (Adjunctive Intra‐Arterial Urokinase After Successful Endovascular Thrombectomy in Patients With Large‐Vessel Occlusion Stroke): Study Protocol of a Multicenter, Prospective, Randomized, Open‐Label, Blinded‐End Point Trial

BACKGROUND Intra‐arterial infusion of an adjunctive thrombolytic agent after macrovascular recanalization by endovascular thrombectomy was regarded as a promising strategy to promote outcomes of patients with stroke. Given the characteristics of urokinase as an affordable, available, and widely applied medication, especially in Eastern countries, this trial aims to assess the safety and efficacy of intra‐arterial urokinase as adjunct to endovascular thrombectomy in improving outcomes among patients with anterior large‐vessel occlusion stroke after excellent to complete reperfusion. METHODS The POST‐UK (Adjunctive Intra‐Arterial Urokinase After Successful Endovascular Thrombectomy in Patients With Large Vessel Occlusion Stroke) trial is a multicenter, prospective, randomized, open‐label, blinded‐end point trial conducted in China. The planned sample size is 498. Those eligible patients with anterior circulation large‐vessel occlusion stroke and achieving excellent to complete reperfusion by endovascular thrombectomy are planned to be consecutively randomized in a 1:1 ratio to the experimental group (a single dose of intra‐arterial urokinase) or to standard of care. RESULTS The primary outcome is a freedom from disability (modified Rankin Scale score of 0–1) at 90±7 days. The safety outcomes are mortality within 90±7 days and symptomatic intracranial hemorrhage within 48 hours. CONCLUSION The POST‐UK trial will provide valuable insight of efficacy and safety of intra‐arterial urokinase in patients with large‐vessel occlusion stroke after achieving excellent to complete reperfusion by endovascular thrombectomy

Adjunctive intra-arterial tenecteplase after successful endovascular thrombectomy in patients with large vessel occlusion stroke (POST-TNK): Study rationale and design

Rationale: Adjunct intra-arterial alteplase has been shown to potentially improve clinical outcomes in patients with large vessel occlusion (LVO) stroke who have undergone successful endovascular thrombectomy. Tenecteplase, known for its enhanced fibrin specificity and extended activity duration, could potentially enhance outcomes in stroke patients after successful reperfusion when used as an adjunct intra-arterial therapy. Aim: To explore the safety and efficacy of intra-arterial tenecteplase after successful endovascular thrombectomy in patients with LVO stroke. Sample size: To randomize 498 participants 1:1 to receive intra-arterial tenecteplase or no intra-arterial adjunctive thrombolysis therapy. Methods and design: An investigator-initiated, prospective, randomized, open-label, blind-endpoint multicenter clinical trial. Eligible patients with anterior circulation LVO stroke presenting within 24 h from symptom onset (time last known well) and excellent to complete reperfusion (expanded Thrombolysis In Cerebral Infarction (eTICI) scale 2c–3) at endovascular thrombectomy are planned to be randomized. Outcomes: The primary outcome is freedom from disability (modified Rankin Scale, mRS, of 0–1) at 90 days. The primary safety outcomes are mortality through 90 days and symptomatic intracranial hemorrhage within 48 h. Discussion: The POST-TNK trial will evaluate the efficacy and safety of intra-arterial tenecteplase in patients with LVO stroke and excellent to complete reperfusion

Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke

Importance It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023.InterventionsEligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability.Trial RegistrationChiCTR.org.cn Identifier: ChiCTR210005172

A Review of Security Evaluation of Practical Quantum Key Distribution System

Although the unconditional security of quantum key distribution (QKD) has been widely studied, the imperfections of the practical devices leave potential loopholes for Eve to spy the final key. Thus, how to evaluate the security of QKD with realistic devices is always an interesting and opening question. In this paper, we briefly review the development of quantum hacking and security evaluation technology for a practical decoy state BB84 QKD system. The security requirement and parameters in each module (source, encoder, decoder and detector) are discussed, and the relationship between quantum hacking and security parameter are also shown