Minimally invasive surgery for uterine fibroids

The incidence of uterine fibroids, which comprise one of the most common female pelvic tumors, is almost 70–75% forwomen of reproductive age. With the development of surgical techniques and skills, more individuals prefer minimallyinvasive methods to treat uterine fibroids. There is no doubt that minimally invasive surgery has broad use for uterinefibroids. Since laparoscopic myomectomy was first performed in 1979, more methods have been used for uterine fibroids,such as laparoscopic hysterectomy, laparoscopic radiofrequency volumetric thermal ablation, and uterine artery embolization,and each has many variations. In this review, we compared these methods of minimally invasive surgery for uterinefibroids, analyzed their benefits and drawbacks, and discussed their future development

Clinical features of myasthenia gravis with neurological and systemic autoimmune diseases

Multiple reports on the co-existence of autoimmune diseases and myasthenia gravis (MG) have raised considerable concern. Therefore, we reviewed autoimmune diseases in MG to explore their clinical presentations and determine whether the presence of autoimmune diseases affects the disease severity and treatment strategies for MG. We reviewed all the major immune-mediated coexisting autoimmune conditions associated with MG. PubMed, Embase and Web of Science were searched for relevant studies from their inception to January 2023. There is a higher frequency of concomitant autoimmune diseases in patients with MG than in the general population with a marked risk in women. Most autoimmune comorbidities are linked to AChR-MG; however, there are few reports of MuSK-MG. Thyroid disorders, systemic lupus erythematosus, and vitiligo are the most common system autoimmune diseases associated with MG. In addition, MG can coexist with neurological autoimmune diseases, such as neuromyelitis optica (NMO), inflammatory myopathy (IM), multiple sclerosis (MS), and autoimmune encephalitis (AE), with NMO being the most common. Autoimmune diseases appear to develop more often in early-onset MG (EOMG). MS coexists more commonly with EOMG, while IM coexists with LOMG. In addition, MG complicated by autoimmune diseases tends to have mild clinical manifestations, and the coexistence of autoimmune diseases does not influence the clinical course of MG. The clinical course of neurological autoimmune diseases is typically severe. Autoimmune diseases occur most often after MG or as a combined abnormality; therefore, timely thymectomy followed by immunotherapy could be effective. In addition, thymoma-associated AChR MG is associated with an increased risk of AE and IM, whereas NMO and MS are associated with thymic hyperplasia. The co-occurrence of MG and autoimmune diseases could be attributed to similar immunological mechanisms with different targets and common genetic factor predisposition. This review provides evidence of the association between MG and several comorbid autoimmune diseases

Enhancing phase I dose-finding trials design through dynamic borrowing information and handling late-onset toxicity

Introduction: In recent years, there has been a growing trend among regulatory agencies to consider the use of historical controls in clinical trials as a means of improving the efficiency of trial design. In this paper, to enhance the statistical operating characteristic of Phase I dose-finding trials, we propose a novel model-assisted design method named “MEM-Keyboard”.Methods: The proposed design is based on the multisource exchangeability models (MEMs) that allows for dynamic borrowing of information from multiple supplemental data sources, including historical trial data, to inform the dose-escalation process. Furthermore, with the frequent occurrence of delayed toxicity in novel anti-cancer drugs, we extended our proposed method to handle late-onset toxicity by incorporating historical data. This extended method is referred to as “MEM-TITE-Keyboard” and aims to improve the efficiency of early clinical trials.Results: Simulation studies have indicated that the proposed methods can improve the probability of correctly selecting the maximum tolerated dose (MTD) with an acceptable level of risk, compared to designs that do not account for information borrowing and late-onset toxicity.Discussion: The MEM-Keyboard and MEM-TITE-Keyboard, easy to implement in practice, provide a useful tool for identifying MTD and accelerating drug development

Effects of nitrogen fertilization and bioenergy crop type on topsoil organic carbon and total Nitrogen contents in middle Tennessee USA

Nitrogen (N) fertilization affects bioenergy crop growth and productivity and consequently carbon (C) and N contents in soil, it however remains unclear whether N fertilization and crop type individually or interactively influence soil organic carbon (SOC) and total N (TN). In a three-year long fertilization experiment in switchgrass (SG: Panicum virgatum L.) and gamagrass (GG: Tripsacum dactyloides L.) croplands in Middle Tennessee USA, soil samples (0–15cm) were collected in plots with no N input (NN), low N input (LN: 84 kg N ha-1 yr-1 in urea) and high N input (HN: 168 kg N ha-1 yr-1 in urea). Besides SOC and TN, the aboveground plant biomass was also quantified. In addition to a summary of published root morphology data based on a separated mesocosm experiment, the root leachable dissolved organic matter (DOM) of both crops was also measured using archived samples. Results showed no significant interaction of N fertilization and crop type on SOC, TN or plant aboveground biomass (ABG). Relative to NN, HN (not LN) significantly increased SOC and TN in both crops. Though SG showed a 15–68% significantly higher ABG than GG, GG showed a 9.3–12% significantly higher SOC and TN than SG. The positive linear relationships of SOC or TN with ABG were identified for SG. However, GG showed structurally more complex and less readily decomposed root DOM, a larger root volume, total root length and surface area than SG. Collectively, these suggested that intensive N fertilization could increase C and N stocks in bioenergy cropland soils but these effects may be more likely mediated by the aboveground biomass in SG and root chemistry and morphology in GG. Future studies are expected to examine the root characteristics in different bioenergy croplands under the field fertilization experiment

Omni-Line-of-Sight Imaging for Holistic Shape Reconstruction

We introduce Omni-LOS, a neural computational imaging method for conducting holistic shape reconstruction (HSR) of complex objects utilizing a Single-Photon Avalanche Diode (SPAD)-based time-of-flight sensor. As illustrated in Fig. 1, our method enables new capabilities to reconstruct near-$360^\circ$ surrounding geometry of an object from a single scan spot. In such a scenario, traditional line-of-sight (LOS) imaging methods only see the front part of the object and typically fail to recover the occluded back regions. Inspired by recent advances of non-line-of-sight (NLOS) imaging techniques which have demonstrated great power to reconstruct occluded objects, Omni-LOS marries LOS and NLOS together, leveraging their complementary advantages to jointly recover the holistic shape of the object from a single scan position. The core of our method is to put the object nearby diffuse walls and augment the LOS scan in the front view with the NLOS scans from the surrounding walls, which serve as virtual ``mirrors'' to trap lights toward the object. Instead of separately recovering the LOS and NLOS signals, we adopt an implicit neural network to represent the object, analogous to NeRF and NeTF. While transients are measured along straight rays in LOS but over the spherical wavefronts in NLOS, we derive differentiable ray propagation models to simultaneously model both types of transient measurements so that the NLOS reconstruction also takes into account the direct LOS measurements and vice versa. We further develop a proof-of-concept Omni-LOS hardware prototype for real-world validation. Comprehensive experiments on various wall settings demonstrate that Omni-LOS successfully resolves shape ambiguities caused by occlusions, achieves high-fidelity 3D scan quality, and manages to recover objects of various scales and complexity

Oviductal extracellular vesicles from women with endometriosis impair embryo development

ObjectiveTo investigate the influence of oviductal extracellular vesicles from patients with endometriosis on early embryo development.DesignIn vitro experimental studySettingUniversity-affiliated hospital.PatientsWomen with and without endometriosis who underwent hysterectomy (n = 27 in total).InterventionsNone.Main outcome measuresOviductal extracellular vesicles from patients with endometriosis (oEV-EMT) or without endometriosis (oEV-ctrl) were isolated and co-cultured with two-cell murine embryos for 75 hours. Blastocyst rates were recorded. RNA sequencing was used to identify the differentially expressed genes in blastocysts cultured either with oEV-EMT or with oEV-ctrl. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed to identify potential biological processes in embryos that oEV-EMT affects. The functions of oEV on early embryo development were determined by reactive oxygen species (ROS) levels, mitochondrial membrane potentials (MMP), total cell numbers, and apoptotic cell proportions.ResultsExtracellular vesicles were successfully isolated from human Fallopian tubal fluid, and their characterizations were described. The blastocyst rates were significantly decreased in the oEV-EMT group. RNA sequencing revealed that oxidative phosphorylation was down-regulated in blastocysts cultured with oEV-EMT. Analysis of oxidative stress and apoptosis at the blastocysts stage showed that embryos cultured with oEV-EMT had increased ROS levels, decreased MMP, and increased apoptotic index. Total cell numbers were not influenced.ConclusionOviductal extracellular vesicles from patients with endometriosis negatively influence early embryo development by down-regulating oxidative phosphorylation

Light-Reinforced Key Intermediate for Anticoking To Boost Highly Durable Methane Dry Reforming over Single Atom Ni Active Sites on CeO₂.

Dry reforming of methane (DRM) has been investigated for more than a century; the paramount stumbling block in its industrial application is the inevitable sintering of catalysts and excessive carbon emissions at high temperatures. However, the low-temperature DRM process still suffered from poor reactivity and severe catalyst deactivation from coking. Herein, we proposed a concept that highly durable DRM could be achieved at low temperatures via fabricating the active site integration with light irradiation. The active sites with Ni-O coordination (NiSA/CeO2) and Ni-Ni coordination (NiNP/CeO2) on CeO2, respectively, were successfully constructed to obtain two targeted reaction paths that produced the key intermediate (CH3O*) for anticoking during DRM. In particular, the operando diffuse reflectance infrared Fourier transform spectroscopy coupling with steady-state isotopic transient kinetic analysis (operando DRIFTS-SSITKA) was utilized and successfully tracked the anticoking paths during the DRM process. It was found that the path from CH3* to CH3O* over NiSA/CeO2 was the key path for anticoking. Furthermore, the targeted reaction path from CH3* to CH3O* was reinforced by light irradiation during the DRM process. Hence, the NiSA/CeO2 catalyst exhibits excellent stability with negligible carbon deposition for 230 h under thermo-photo catalytic DRM at a low temperature of 472 °C, while NiNP/CeO2 shows apparent coke deposition behavior after 0.5 h in solely thermal-driven DRM. The findings are vital as they provide critical insights into the simultaneous achievement of low-temperature and anticoking DRM process through distinguishing and directionally regulating the key intermediate species

Subsequent female breast cancer risk associated with anthracycline chemotherapy for childhood cancer.

Anthracycline-based chemotherapy is associated with increased subsequent breast cancer (SBC) risk in female childhood cancer survivors, but the current evidence is insufficient to support early breast cancer screening recommendations for survivors treated with anthracyclines. In this study, we pooled individual patient data of 17,903 survivors from six well-established studies, of whom 782 (4.4%) developed a SBC, and analyzed dose-dependent effects of individual anthracycline agents on developing SBC and interactions with chest radiotherapy. A dose-dependent increased SBC risk was seen for doxorubicin (hazard ratio (HR) per 100 mg m-2: 1.24, 95% confidence interval (CI): 1.18-1.31), with more than twofold increased risk for survivors treated with ≥200 mg m-2 cumulative doxorubicin dose versus no doxorubicin (HR: 2.50 for 200-299 mg m-2, HR: 2.33 for 300-399 mg m-2 and HR: 2.78 for ≥400 mg m-2). For daunorubicin, the associations were not statistically significant. Epirubicin was associated with increased SBC risk (yes/no, HR: 3.25, 95% CI: 1.59-6.63). For patients treated with or without chest irradiation, HRs per 100 mg m-2 of doxorubicin were 1.11 (95% CI: 1.02-1.21) and 1.26 (95% CI: 1.17-1.36), respectively. Our findings support that early initiation of SBC surveillance may be reasonable for survivors who received ≥200 mg m-2 cumulative doxorubicin dose and should be considered in SBC surveillance guidelines for survivors and future treatment protocols

Cohort profile: Risk and risk factors for female breast cancer after treatment for childhood and adolescent cancer: an internationally pooled cohort.

PURPOSE The International Consortium for Pooled Studies on Subsequent Malignancies after Childhood and Adolescent Cancer was established in 2018 to address gaps in knowledge of risk and risk factors for breast cancer subsequent to childhood/adolescent cancer by pooling individual patient data from seven cohorts. Initially, the pooled cohort will focus on three clinically relevant questions regarding treatment-related subsequent breast cancer risk in female survivors, which are the risk related to low-dose radiotherapy exposure to the chest, specific chemotherapy agents and attained age. PARTICIPANTS The consortium database includes pooled data on 21 892 female survivors from seven cohorts in North America and Europe with a primary cancer diagnosis at <21 years of age, and survival ≥5 years from diagnosis. FINDINGS TO DATE This is a newly established pooled study. The cohort profile summarised the data collected from each included cohort, including childhood cancer diagnosis information and treatment details (ie, radiotherapy fields and cumulative doses, and chemotherapy agents and cumulative doses for each agent). Included cohorts' follow-up started 1951-1981 and ended 2013-2021, respectively, for a median follow-up duration of 24.3 (IQR 18.0-32.8) years since primary cancer diagnosis. The median age at primary cancer diagnosis was 5.4 (IQR 2.5-11.9) years. And the median attained age at last follow-up was 32.2 (IQR 24.0-40.4) years. In all, 4240 (19.4%) survivors were treated with radiotherapy to the chest and 9308 (42.5%) with anthracyclines. At the end of the follow-up, 835 females developed a first subsequent breast cancer, including 635 invasive breast cancer only, 184 carcinomas in situ only (172 ductal carcinomas in situ and 12 lobular carcinomas in situ), and 16 with both an invasive and in situ diagnosis at the same moment. The cumulative incidences of subsequent breast cancer (both invasive and in situ) 25 and 35 years after primary cancer diagnosis were 2.2% and 6.2%, respectively. FUTURE PLANS The consortium is intended to serve as a model and robust source of childhood/adolescent cancer survivor data for elucidating other knowledge gaps on subsequent breast cancer risk, and risk of other subsequent malignancies (including data on males) in the future