Expulsion Time Research Articles

Mechanism analysis of the differences in relieving constipation in a Balb/c constipation model mouse fed human milk probiotics or fermented milk.

Consumers require fermented milk that possesses constipation-relieving functions. To cater to the 'natural and additive-free' consumption habit, this study is dedicated to developing probiotic fermented milk with constipation-relief effects. Previously, we isolated two Lactobacillus strains, Lactobacillus MWLp-12 and Lactobacillus MWLf-4, from breast milk. This study evaluated the efficacy of these strains and their fermented milk in alleviating constipation in a Balb/c mouse model of constipation. The evaluation criteria included fecal water content, time for first black feces expulsion and propulsion rate of the small intestine. The mechanisms of constipation relief were investigated using gastrointestinal regulatory peptides, colonic tissue pathology, short-chain fatty acid levels and gut microbiota analyses. Fecal water content, time for first black feces expulsion and small intestine propulsion rate indicated that both MWLp-12 and MWLf-4, as well as their fermented milk, could alleviate constipation in mice. Fermented milk exhibited superior effectiveness for relieving constipation compared to that of the strains alone. The results related to gastrointestinal regulatory peptides and short-chain fatty acids suggest that the mechanisms of constipation relief by the strains and their fermented milk may involve increased levels of 5-hydroxytryptamine and substance P in the mouse serum, higher concentrations of short-chain fatty acids in the intestines and decreased vasoactive intestinal peptide levels in the serum. MWLp-12, MWLf-4 and fermented milk relieve constipation in mice. © 2024 Society of Chemical Industry.

Geology of Mudstones Atop the Sangonghe Formation, Shuixigou Group, Turpan‐Hami Basin: New Insights and Their Implications for Petroleum Geology

ABSTRACTAs the exploration of deep‐seated oil and gas resources in the Turpan‐Hami Basin intensifies, there is an urgent need to thoroughly depict the geological characteristics of newly uncovered, underexplored strata in sub‐sag centers. This study undertakes the inaugural systematic geochemical analysis of mudstones atop the Sangonghe Formation, including palynological identification, maceral identification, biomarker analysis, total organic carbon (TOC) analysis, and pyrolysis. The findings reveal that the mudstone sequence, as the target layer, was deposited in a warm and moist paleoclimate and a weakly reducing to weakly oxidising saline water environment, fostering the growth of prolific algae and bacteria, thus ensuring substantial foundational materials for source rock formation. The organic matter in the mudstone sequence displays pronounced laminar accumulation. Despite the overall modest abundance, the organic matter features notable hydrocarbon‐generating potential per unit of organic carbon and favourable types. Humic‐sapropelic kerogens (type II1) are found in the mudstones, with organic matter generally reaching a mature to highly mature stage. These characteristics establish the mudstones as effective source rocks, furthermore, the hydrocarbon expulsion in the Xishanyao Formation precedes that of the Sangonghe Formation and that both formations constitute a sequential process in terms of hydrocarbon generation and expulsion timing and hydrocarbon contribution. Reanalyzing this mudstone sequence not only revises prior geological understanding of it as direct cap rocks, but also facilitates the reclassification of deep‐seated strata into three distinct petroleum systems. Centered around this source rock layer, dual modes, namely the “lower‐source rock and upper‐reservoir” and the “ lower‐reservoir and upper‐source rock” modes can be formed. These new insights will offer profound implications for hydrocarbon resource evaluation and future hydrocarbon exploration endeavours in the Shuixigou Group within the Taibei sag.

The effect of pre-partum shearing of Corriedale ewes on placental and lamb development and neonatal behaviour.

To evaluate the effects of early and late pre-partum shearing of Corriedale ewes carrying single fetuses on placental and lamb development and neonatal lamb behaviour. At 70 days of gestation, 37 multiparous Corriedale ewes with known gestation dates were randomly allocated into three groups: S70 (n = 12) and S110 (n = 12), shorn at Day 70 and 110 of gestation, and US (n = 13), that were not shorn pre-partum. Gestation length, lambing duration, placental expulsion time, placental weight, number and weight of cotyledons, and placental efficiency (lamb weight/placental weight) were determined. At birth, body temperature, weight, morphometric measurements, ponderal index (lamb weight/lamb crown-rump length) and behaviour were recorded, with weight remeasured 72 hours later. Four male lambs per group were slaughtered immediately after parturition, and organ weight and perirenal brown fat weight and energy content recorded. Pre-partum shearing, regardless of timing, increased total dried placental weight per ewe. Pre-partum shearing at Day 70 of gestation increased the number and mean weight of the > 2 to ≤ 3-cm cotyledons, while pre-partum shearing at Day 110 of gestation increased only the weight of these cotyledons. At birth and at 72 hours, lambs from ewes shorn either at 70 days of gestation (birth: 5.5 (95% CI = 4.6-6.4) kg, p = 0.001; 72 hours: 6.4 (95% CI = 6.1-6.8) kg, p = 0.002) or at 110 days of gestation (birth: 5.4 (95% CI = 4.4-6.4) kg, p = 0.001; 72 hours: 6.5 (95% CI = 5.9-7.1) kg, p = 0.001) were heavier than lambs from unshorn ewes (birth: 4.0 (95% CI = 3.3-4.8) kg; 72 hours: 4.8 (95% CI = 3.5-6.1) kg). Lambs born to S70 and S110 ewes suckled sooner (31.5 (95% CI = 14.5-48.5) minutes, p = 0.001; and 39.3 (95% CI = 23.7-55.0) minutes, p = 0.001 respectively), than lambs born to the US group (70.3 (95% CI = 38.6-102.1) minutes). There was no evidence for an effect of pre-partum shearing on gestation length, parturition length, time of placental expulsion, placental efficiency, weight and energy of perirenal brown fat, and lamb temperature at birth. Shearing ewes pre-partum may lead to placental changes affecting lamb development and behaviour and associated with higher survival. The findings suggest pre-partum shearing may improve lamb survival, farm profitability and sustainability.

The potential of oviduct tags and fine-scale acoustic telemetry to reveal the timing and location of spawning in Arctic salmonids (Salvelinus spp.).

Identifying and characterizing spawning locations are paramount for the protection of critical fish habitats but can be challenging, particularly in remote locations. Using the underexplored oviduct-tagging technique, we aimed to identify the timing and location of spawning for wild Arctic char (Salvelinus alpinus) and lake trout (Salvelinus namaycush) in two high-Arctic lakes in Nunavut. Specifically, Innovasea V7 acoustic telemetry transmitters were inserted into the oviducts of 13 Arctic char and 4 lake trout, and the timing and location of tag expulsion were determined using a fine-scale positioning system. Twenty Arctic char and 20 lake trout were also tagged with abdominal V16 transmitters, and 10 of them were paired with the oviduct tags, to further study the behavior of individual fish during the spawning season. Oviduct tags from four Arctic char and one lake trout could be used to assess the timing and location of spawning. Spawning anadromous Arctic char drastically reduced their activity and remained proximate to their presumed spawning location immediately before and for months after spawning. In contrast, a non-anadromous (i.e., freshwater resident) Arctic char and a lake trout showed little to no reduction in activity around presumed spawning events. Because of the highlighted sedentary behavior of inferred spawning anadromous Arctic char implanted with both abdominal and oviduct tags, we could also infer potential spawning based on the behavior of individuals equipped only with abdominal tags. Spawning areas identified via telemetry also aligned well with Inuit knowledge of those lakes. This is the first field study to use acoustic oviduct and abdominal tags coupled with a fine-scale positioning system. Despite a limited success rate of ejection, the study reveals the strong potential of the method to study spawning habitat and timing, particularly in remote areas.

Efficacy of Low-Dose Deflazacort with Tamsulosin in the Medical Expulsive Therapy of Distal Ureterolithiasis: A Randomized Controlled Trial

Introduction: Distal ureterolithiasis, characterized by stones in the lower ureter, poses significant challenges in clinical management. Medical expulsive therapy (MET) using Tamsulosin is a common non-invasive treatment, but its efficacy can be limited, especially for stones larger than 5 mm. Deflazacort, a corticosteroid with anti-inflammatory properties, may enhance the effectiveness of Tamsulosin by reducing ureteral inflammation and facilitating stone passage. Methods: This prospective, randomized controlled trial enrolled 80 patients with distal ureteral stones <8 mm. Participants were randomly assigned to receive either Tamsulosin alone or Tamsulosin with Deflazacort for 28 days. Primary outcomes included stone expulsion rate and time, while secondary outcomes were pain reduction, analgesic use, and adverse effects. Results: The combination therapy group showed a higher expulsion rate (85% vs. 70%) and significantly faster expulsion time (10.1 days vs. 13.9 days, p=0.006). Pain reduction was greater in the Deflazacort group, with fewer colic episodes and reduced analgesic requirements. Adverse effects were comparable between the groups, with no significant increase in major side effects in the combination therapy group. Conclusion: The addition of low-dose Deflazacort to Tamsulosin significantly improves stone expulsion rates, reduces expulsion time, and lowers pain levels in patients with distal ureterolithiasis, without increasing major adverse effects. This combination may represent a superior treatment option in MET for distal ureteral stones.

Comparing the efficacy and safety of monotherapy and combination therapy with tadalafil, tamsulosin, and silodosin for distal ureteral stones: A systematic review and meta-analysis

ObjectiveMedical expulsive therapy (MET) is a suitable option for facilitating stone expulsion in patients with distal ureteral stones. This meta-analysis was conducted to compare the efficacy of tamsulosin, silodosin, tadalafil monotherapy, and combinations on stone expulsion rate (SER) and stone expulsion time (SET), as well as their comparative safety, number of colic pain episodes, and need for analgesics. MethodsRandomized controlled trials were retrieved by searching PubMed, Scopus, and Web of Science up to November 27, 2023. Papers in-English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones ≤10 mm were included. ResultsIn total, 27 studies were identified. More than half of them (n=15, 55.6%) were conducted in India. SER significantly improved with silodosin compared with tamsulosin (odds ratio [OR] 2.24, p<0.001), whereas the difference in SET was non-significant. Tadalafil achieved a significantly higher SER compared with tamsulosin (OR 1.42, p=0.040) without any difference in SET. Subgroup analysis of 5- and 10-mg doses of tadalafil showed no significant difference in SER and SET. We found no significant difference in need for analgesic (mean difference [MD −53.73, p=0.200) or the mean number of colic episodes (MD −0.42, p=0.06) between tadalafil and tamsulosin. SER and SET were not significantly different between silodosin and tadalafil. Tadalafil plus tamsulosin led to a significantly higher SER (OR 1.87, p<0.001) and SET (MD −2.99, p=0.002) compared with tamsulosin, without any significant difference in the adverse effects. ConclusionCompared with tamsulosin, SER significantly improved with silodosin, tadalafil, and the combination of tadalafil plus tamsulosin. Meanwhile, the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin. It appears that tadalafil and silodosin have similar efficacy in SET and SER. All METs had comparable safety.

Efficacy of Silodosin and Tadalafil monotherapy versus combination of both drugs as MET for distal ureteric stones: A prospective, double blinded, randomized clinical trial

ABSTRACT Objective To assess efficacy and safety of silodosin, tadalafil, versus combination of both medications as medical expulsive therapy (MET) for distal ureteric stones. Methods This prospective, double blinded, randomized clinical trial included 128 patients aged 18 years or more irrespective of gender who are presented to emergency department or outpatient with distal ureteric stones ranging in size from 5–10 mm, randomized into three groups: Group I (n = 42) received Silodosin 8 mg once daily, Group II (n = 44) received Tadalafil 5 mg once daily, and Group III (n = 42) received Silodosin 8 mg combined with Tadalafil 5 mg one daily. All participants underwent thorough history-taking, routine laboratory investigations, and clinical examinations. The primary end point included expulsion rate and time and treatment tolerance. Secondary end points were number pain episodes, need for emergency room visit, amount of analgesia, need for intervention. Results The expulsion rate was 71.4% for silodosin, 61.4% for tadalafil and 88.1% for combined therapy (p = 0.018). Expulsion time was significantly shorter after combined therapy 10.4 + 3.5 days, while after silodosin 14.1 + 4 days, while 17.8 + 3.4 days after tadalafil (p < 0.001). The number of pain episodes, emergency room visits, and the amount of analgesia were significantly in favour of combined therapy (p value 0.004, 0.010, and <0.001) respectively. Conclusions A combination of Silodosin with Tadalafil as a MET for distal ureteric stones is more effective than monotherapy with tolerable side effects.

Cryptic female choice in response to male pheromones in Drosophila melanogaster

Females control the paternity of their offspring by selectively mating with males they perceive to be of high quality. In species where females mate with multiple males in succession, females may bias offspring paternity by favoring the sperm of one male over another, a process known as cryptic female choice.1 While evidence of cryptic female choice exists in multiple taxa, the mechanisms underlying this process have remained difficult to unravel.2 Understanding cryptic female choice requires demonstration of a female-driven post-mating bias in sperm use and paternity and a causal link between this bias and male cues.3 In this study, we present evidence of cryptic female choice in female Drosophila melanogaster. Through experiments utilizing transgenic males expressing fluorescent sperm, we observed that exposure to attractive males between matings prompts females to expel the ejaculate of their initial mate more rapidly than in the presence of less attractive males. While doing so, females exhibit a bias in sperm storage against their first mate, thereby favoring the paternity of their subsequent mate. Our findings reveal that females adjust the timing of ejaculate expulsion in response to male pheromones in their environment, specifically heptanal and 11-cis-vaccenyl acetate, which are sensed by females through specific odorant receptors. We provide a cryptic female choice mechanism allowing a female to modulate the share of paternity of her first mate depending on the sensing of the quality of potential mates in her environment. These findings showcase that paternity can be influenced by events beyond copulation.

Efficacy of sexual stimulation in the treatment of distal ureteral stones: A meta-analysis

IntroductionThis study aimed to compare the clinical efficacy of sexual stimulation with that of placebo in the treatment of distal ureteral stones. MethodsWe searched PubMed, Web of Science, Cochrane Library, and Google Scholar from January 1, 2000 to December 31, 2022 for studies comparing the efficacy of sexual stimulus with that of placebo for the treatment of distal ureteral stones. RevMan 5.3 software was used to pool the data. The study protocol was registered on PROSPERO (Registration Number: CRD42023432408). ResultsA total of six randomized controlled trials comprising 535 cases of distal ureteral stones were included in this study. Among these, 273 cases were associated with sexual intercourse or masturbation 3–4 times a week, while 262 cases only received symptomatic treatment. The pooled results showed that the 2-week [risk ratios (RR) = 1.77, 95 % confidence interval (CI): 1.34, 2.33] and 4-week [RR = 1.48, 95 % CI: 1.29, 1.69] ureteral stone expulsion rates of the sexually stimulated group were significantly higher than those of the placebo group (ps < 0.01). Additionally, sexual stimulation was associated with a shorter ureteral stone expulsion time [weighted mean differences (WMD) = −3.74, 95 % CI: −6.27, −1.22, p < 0.01] and a decreased prevalence of renal colic attacks [WMD = −0.61, 95 % CI: −1.01, −0.22, p < 0.01] compared with those of the placebo group. ConclusionAppropriate sexual stimulation can enhance the spontaneous expulsion of distal ureteral stones in patients presenting with tolerable pain.

Effect of Alpha-Blocker on Distal Ureteric Calculi: A Comparative Study

Introduction Silodosin is a recently introduced selective alpha- blocker in Medical Expulsive Therapy for the management of distal ureteric calculi. The efficacy and safety of silodosin compared to tamsulosin are controversial, however the former is considered to be more effective. The objective of the study is to assess the efficacy and safety of silodosin compared to tamsulosin in the treatment of ureteral stones less than 10mm.  Methods This prospective randomized study was conducted in the Department of General Surgery, Navodaya Medical College, Raichur, Karnataka. Sixty patients were included in the study who presented with abdominal or loin pain and were diagnosed with unilateral solitary distal ureteric stone measuring &lt;10mm with no complications. Participants in Group I received Tablet Silodosin 8mg OD until the passage of stone or up to two weeks, and Group II received Tablet Tamsulosin 0.4mg OD until the passage of stone or up to two weeks. Analgesic Tablet Diclofenac sodium 50mg was given to both patients on demand.  Results A total of 60 patients were included in the study, divided into 30 patients in each group of Silodosin and tamsulosin respectively. In Group I (silodosin), out of 30 patients, 25 patients expelled the calculus, whereas in Group II (tamsulosin), out of 30 patients, 15 patients expelled the calculus. Group I showed a significantly higher rate of expulsion, with a p-value of 0.005. Stone expulsion time was notably shorter in Group I compared to Group II, with averages of 4.73 days versus 6.33 days (p=0.009). Additionally, analgesic use during the medical expulsive therapy was lower in Group I, averaging 8.25 compared to 4.13 (p=0.0001) in the tamsulosin group. Significant differences were observed in the outcomes such as stone expulsion time, and analgesic requirement. However, no significant differences were found when comparing the groups based on age, gender, stone size, and side of the ureter involved. The 20 patients who failed the medical management underwent ureterorenoscopy with 100% clearance. 3 patients in Group II experienced orthostatic hypotension, and zero patients experienced any side effects in Group I. Compared to tamsulosin, silodosin provides significantly higher stone expulsion rates, fewer colic episodes, and shorter stone expulsion duration than tamsulosin.

Optimum combined MET according to tolerability with efficacy, Silodosin Tadalafil versus Silodosin Vardenafil for distal ureteric stone: a prospective, double blinded, randomized clinical trial.

To determine the optimum combination therapy of Silodosin-Tadalafil versus Silodosin-Vardenafil in terms of both tolerability and efficacy for the management of distal ureteric stones. This prospective, double blinded, randomized clinical trial included 140 patients with distal ureteric stones, randomized into two groups: Group I (n = 67) received Silodosin 8mg once daily combined with Tadalafil 5mg once daily, and Group II (n = 68) received Silodosin 8mg once daily combined with Vardenafil 10mg once daily. The primary outcome was the tolerability of the combination therapies, assessed through the incidence of adverse events. Secondary outcomes included stone expulsion rate, expulsion time, and the need for analgesics. Both combination therapies demonstrated similar efficacy, with no significant differences in stone expulsion rate (70.1% vs. 67.6%, P = 0.754), expulsion time (19 ± 3days for both groups, P = 0.793), and analgesic requirements (P > 0.05). However, the Silodosin-Tadalafil combination showed a significantly lower occurrence of adverse events, with notable differences in headache (23.9% vs. 57.4%, P < 0.001), dizziness (32.8% vs. 60.3%, P = 0.001), and gastrointestinal upset (9% vs. 66.2%, P < 0.001), and other adverse effects. The overall occurrence of any adverse event was significantly lower in the Silodosin-Tadalafil group (88.1% vs. 98.5%, P = 0.017). Both Silodosin-Tadalafil and Silodosin-Vardenafil therapies are effective in managing distal ureteric stones. However, the Silodosin-Tadalafil combination is associated with a significantly lower incidence of adverse events, making it a more tolerable option for patients.

Spanish Experience with Latero-Lateral Duodeno-Ileostomy + Sleeve Gastrectomy with Magnet Anastomosis System.

The partial diversion of intestinal contents facilitates achieving and maintaining weight loss and improving glycemic control in patients with obesity and with or without T2DM. The purpose of this study is to report our experience and 1-year follow-up with novel modification of SADI-S. This study is a part of a multicentric trial of patients that underwent primary side-to-side duodeno-ileostomy and sleeve gastrectomy (SG) with GT metabolic solutions magnetic anastomosis system. Feasibility, safety, and initial efficacy were evaluated. The mean age of the patients included was 48 ± 8.75years and the preoperative BMI was 43.32 ± 2.82kg/m2. The complications were present in 30% of patients. The anastomosis patency was confirmed by the passage of radiological contrast under fluoroscopy at a mean of 17days (17-29days), and the mean expulsion time was 42days (32-62). The mean diameter of the anastomosis after the magnet expulsion was 13.8 × 11.4mm. The percentage of total weight lost at 1year was 38.68 ± 8.48% (p < 0.001). The percentage of excess weight loss 82.5 ± 18.44% (p < 0.001) and improvements in glucose profiles were observed. Mean baseline HbA1c 5.77 ± 0.31% was reduced to 5.31 ± 0.26% (p < 0.024). Latero-lateral duodeno-ileostomy + SG with magnetic duodenal bipartition is afeasible and reasonably safe technique and induces weight loss in patients with obesity and improvement of glycemic control. This modification could be considered as an option to standard SADI-S or as a first step in two stages procedure. However, larger studies are needed. Clinicaltrials.gov Identifier: #NCT05322122.

Role of low-dose deflazacort with tamsulosin versus tamsulosin alone for medical expulsive therapy of ureteric stone

Background: Urolithiasis is a common condition in daily urological practice. Medical Expulsive Therapy (MET) is non-invasive approach for removal of ureteric stone. In MET, alpha-blocker Tamsulosin is commonly used in treating urolithiasis but it does not address the pathology of inflammation presents in such condition. With addition of low dose Deflazacort as anti-inflammatory agent, there may have a potential to improve the pathology and outcome of the treatment. Aims and Objectives: This study aims to find the efficacy of low-dose deflazacort combined with tamsulosin in the MET for distal ureterolithiasis. Materials and Methods: This prospective randomized controlled trial was conducted from December 2022 to December 2023 in Rampurhat Government Medical College and Hospital. A total of 130 patients with ureteric stone ≤10 mm were randomized into two groups. Tamsulosin group received tamsulosin (0.4 mg once daily for 28 days). Deflazacort group received tamsulosin (0.4 mg once daily for 28 days) with deflazacort (12 mg once daily for 10 days). All subjects were reviewed on 14 days and 28 days. Stone expulsion rate, time to stone expulsion, analgesic use, number of colic episodes, and hospitalization were recorded. Adverse effects of drugs were noted. Results: Among 130 patients randomized, 4 patients were lost to follow-up and 8 patients required early intervention. Deflazacort group had similar rate of stone expulsion (88% vs. 80%, P=0.548). There were significantly shorter expulsion time (10.15 days vs. 14.28 days, P&lt;0.001) and less number of colic episodes (33 episodes vs. 21 episodes, P=0.026) and less analgesic requirements (65% vs. 82.5%, P=0.022) in deflazacort group. No significant side effects were noted during the study. Conclusion: Low-dose deflazacort added to tamsulosin provides a significant advantage in ureteric stone expulsion without any extra side effects. With a comparable rate of stone passage, there are more rapid stone expulsion, low analgesic requirement, and less colic episodes when low-dose deflazacort is added to tamsulosin for ureteric stone ≤10 mm.

Fusion pore flux controls the rise-times of quantal synaptic responses.

The release of neurotransmitter from a single synaptic vesicle generates a quantal response, which at excitatory synapses in voltage-clamped neurons is referred to as a miniature excitatory postsynaptic current (mEPSC). We analyzed mEPSCs in cultured mouse hippocampal neurons and in HEK cells expressing postsynaptic proteins enabling them to receive synaptic inputs from cocultured neurons. mEPSC amplitudes and rise-times varied widely within and between cells. In neurons, mEPSCs with larger amplitudes had longer rise-times, and this correlation was stronger in neurons with longer mean rise-times. In HEK cells, this correlation was weak and unclear. Standard mechanisms thought to govern mEPSCs cannot account for these results. We therefore developed models to simulate mEPSCs and assess their dependence on different factors. Modeling indicated that longer diffusion times for transmitters released by larger vesicles to reach more distal receptors cannot account for the correlation between rise-time and amplitude. By contrast, incorporating the vesicle size dependence of fusion pore expulsion time recapitulated experimental results well. Larger vesicles produce mEPSCs with larger amplitudes and also take more time to lose their content. Thus, fusion pore flux directly contributes to mEPSC rise-time. Variations in fusion pores account for differences among neurons, between neurons and HEK cells, and the correlation between rise-time and the slope of rise-time versus amplitude plots. Plots of mEPSC amplitude versus rise-time are sensitive to otherwise inaccessible properties of a synapse and offer investigators a means of assessing the role of fusion pores in synaptic release.

Efficacy of hysteroscopic levonorgestrel‑releasing intrauterine device fixation in the treatment of adenomyosis: A cohort study.

The present study aimed to investigate the efficacy of hysteroscopic levonorgestrel-releasing intrauterine device (LNG-IUD) fixation surgery in the treatment of adenomyosis through a cohort study. The cohort study was performed at the Affiliated Jinhua Hospital of Wenzhou Medical University (Jinhua, China). A total of 31 women with adenomyosis were initially recruited from June 2020 to June 2022 and divided into an experimental group and a control group. The experimental group underwent hysteroscopic LNG-IUD fixation surgery and the control group underwent conventional implantation of the levonorgestrel-releasing intrauterine system. The assessed efficacy outcomes included the time of LNG-IUD expulsion, postoperative vaginal bleeding time, dysmenorrhea, and the menstrual blood loss score (MBLS). A total of 31 participants completed the research. The LNG-IUD expulsion rate was 6.25 and 60% (P<0.05) in the experimental and control group, respectively. The LNG-IUD in place time was 20.50 months (Q1, 15.75; Q3, 24.00) in the experimental group and 10.00 months (Q1, 6.50; Q3, 15.00) in the control group (P<0.05); the time of vaginal bleeding after surgery in the experimental and control groups were 12.50 days (9.25, 16.25) and 120.00 days (75.00, 120.00), respectively (P<0.05). Multiple-factor Cox regression analysis revealed that the LNG-IUD expulsion in patients with adenomyosis is associated with the hysteroscopic LNG-IUD fixation surgery [hazard ratio (HR), 1954.09], uterine cavity depth (HR, 16.63), MBLS (HR, 1.14), history of gonadotropin-releasing hormone agonist treatment in the previous 6 months (HR, 2.10), history of vaginal delivery (HR, 1.79) and history of cervical laceration (HR, 3.69). In conclusion, hysteroscopic LNG-IUD fixation reduces the rate of LNG-IUD expulsion, prolongs the time of LNG-IUD in the uterine cavity, reduces the time of postoperative vaginal bleeding, relieves the symptoms of dysmenorrhea and reduces the menstrual volume in the patients with adenomyosis. The present trial was retrospectively registered in the Chinese Clinical Trial Registry on 28th December 2023 (registration no. ChiCTR2300079233).

Methods for assessing and removing non-specific photoimmunotherapy damage in patient-derived tumor cell culture models.

Tumor-targeted, activatable photoimmunotherapy (taPIT) has been shown to selectively destroy tumor in a metastatic mouse model. However, the photoimmunoconjugate (PIC) used for taPIT includes a small fraction of non-covalently associated (free) benzoporphyrin derivative (BPD), which leads to non-specific killing invitro. Here, we report a new treatment protocol for patient-derived primary tumor cell cultures ultrasensitive to BPD photodynamic therapy (BPD-PDT). Based on free BPD efflux dynamics, the updated invitro taPIT protocol precludes non-specific BPD-PDT by silencing the effect of free BPD. Following incubation with PIC, incubating cells with PIC-free medium allows time for expulsion of free BPD whereas BPD covalently bound to PIC fragments is retained. Administration of the light dose after the intracellular free BPD drops below the threshold for inducing cell death helps to mitigate non-specific damage. In this study, we tested two primary ovarian tumor cell lines that are intrinsically chemoresistant, yet ultrasensitive to BPD-PDT such that small amounts of free BPD (afew percent of the total BPD dose) lead to potent induction of cell death upon irradiation. The modifications in the protocol suggested here improve invitro taPIT experiments that lack invivo mechanisms of free BPD clearance (i.e., lymph and blood flow).

Anal Pathologies during Pregnancy and Postpartum: Diagnosis and Treatment at the Kalaban Coro Referral Health Center

Pregnancy and childbirth are generally considered to be happy episodes in women's lives, these events can be marred by anal affections. The exact epidemiology of anal pathologies is difficult to define, due to the reluctance of patients to discuss their symptoms and to be examined. In most cases, their diagnosis is delayed and their management is inadequate or inappropriate. Aim: To study anal pathologies during gravido-puerperality at the CS Ref of Kalaban Coro. Methods: This was a single-center descriptive and analytical prospective study with prospective data survey at the CS Ref of Kalaban Coro. The study was conducted over a 9-month period from January 1 to September 30, 2019. Results: During the study period, we identified 151 pregnant women. Of these pregnants, 88 or 58.27% had anal pathology. The different anal pathologies encountered were, hemorrhoidal disease (30.68%), anal fissure (30.68%) and anal incontinence (27.27%). The offending factors were dominated by constipation, a newborn weight &gt; 3500g, a foetal expulsion time &gt; 20 minutes. The clinic was conducted by interrogation and proctological examination. Clinical signs were anal pain, rectorrhagia, and pruritus. Treatment primarily includes the regulation of intestinal transit and topical topicals, analgesics, and those that improve blood circulation (Veinobiase, Daflon).

Efficacy and safety comparison between silodosin and tamsulosin as medical expulsive therapy for distal ureteral stones

BACKGROUND Ureteral stones are a common urological condition causing significant discomfort and morbidity. Medical expulsive therapy (MET) is a noninvasive approach to facilitate the passage of stones. This study aimed to compare the efficacy and safety of silodosin and tamsulosin as MET in patients with distal ureteral stones (DUS).&#x0D; METHODS We searched CINAHL, Cochrane Library, PubMed, and ScienceDirect for randomized controlled trials (RCTs) on the administration of silodosin and tamsulosin for DUS. The primary outcomes analyzed were stone expulsion rates and expulsion times, measured as risk ratio (RR) and mean difference (MD), respectively. Statistical analyses were performed using Review Manager 5.4 and STATA 17.&#x0D; RESULTS 14 RCTs comprising 1,535 patients (770 received silodosin) met the inclusion criteria. The silodosin group had notably higher stone expulsion rates (RR 1.20, 95% confidence interval [CI] 1.13–1.27, p&lt;0.00001, I² = 37%), shorter expulsion times (MD −2.98, 95% CI −4.35–−1.62, p&lt;0.01, I² = 85%), and fewer colicky pain episodes (MD −0.35, 95% CI −0.59–−0.10, p&lt;0.01, I² = 83%) than the tamsulosin group. Retrograde ejaculation was the only adverse event that had a significant difference between both groups, statistically favoring tamsulosin (RR 1.61, 95% CI 1.12–2.33, p = 0.01, I² = 0%).&#x0D; CONCLUSIONS Silodosin should be preferred as the first-line MET agent for DUS owing to its better expulsion rate, shorter stone expulsion time, and fewer colicky pain episodes. However, tamsulosin may be used in selected cases where patients experience retrograde ejaculation after receiving silodosin.

Defecatory disorders are a common cause of chronic constipation in Parkinson disease.

Up to 50% of patients with Parkinson disease have constipation (PD-C), but the prevalence of defecatory disorders caused by rectoanal dyscoordination in PD-C is unknown. We aimed to compare anorectal function of patients with PD-C versus idiopathic chronic constipation (CC). Anorectal pressures, rectal sensation, and rectal balloon expulsion time (BET) were measured with high-resolution anorectal manometry (HR-ARM) in patients with PD-C and control patients with CC, matched for age and sex. We identified 97 patients with PD-C and 173 control patients. Eighty-six patients with PD-C (89%) had early PD, and 39 (40%) had a defecatory disorder, manifest by a prolonged rectal balloon expulsion time (37 patients) or a lower rectoanal pressure difference during evacuation (2 patients). PD-C patients with a prolonged BET had a greater anal resting pressure (p = 0.02), a lower rectal pressure increment (p = 0.005), greater anal pressure (p = 0.047), and a lower rectoanal pressure difference during evacuation (p < 0.001). Rectal sensory thresholds were greater in patients with abnormal BET. In the multivariate model comparing CC and PD-C (AUROC = 0.76), PD-C was associated with a lower anal squeeze increment (odds ratio [OR] for PD-C, 0.93 [95% CI, 0.91-0.95]), longer squeeze duration (OR, 1.05 [95% CI, 1.03-1.08]), lower rectal pressure increment (OR per 10 mm Hg, 0.72 [95% CI, 0.66-0.79]), and negative rectoanal gradient during evacuation (OR per 10 mm Hg, 1.16 [95% CI, 1.08-1.26]). Compared with CC, PD-C was characterized by impaired squeeze pressure, longer squeeze duration, lower increase in rectal pressure, and a more negative rectoanal gradient during evacuation.

Shale gas play of the silurian hot shale, Ghadames Basin, North Africa: Insights from integrated geochemistry and basin modeling

The lower Silurian hot shale in the Ghadames Basin was investigated to provide a regional assessment of the future prospects of shale gas play as an important unconventional resource system in one of the top African superglobal petroliferous sedimentary basins. The unconventional natural gas potential of the hot shale was studied based on regional improved organofacies assessment, thermal maturity, the timing of generation and expulsion, and sweet gas spot analysis, such as gas in place (GIP), total expelled gas (TEG), and total retained gas (TRG). The integration between regional geology and organic geochemistry, together with the proper regional utilization of the multi-dimensional basin modeling to better appreciate the importance of the Silurian hot shale as a key future shale gas unconventional-rich petroleum system (URPS) in the Ghadames Basin. The relationship between the richness and thermal parameters, such as the total organic carbon indicator (%TOC), hydrogen index (HI), measured and time step (calibrated models) vitrinite and equivalent vitrinite (%VRo) reflectance were used to develop quality control models for the regional natural gas spots of the Silurian hot shale were present-day mapping presentations are utilized as well for each parameter to better appreciate the lateral variability of the dry gas volumes. Regional basin control parameters from several key wells, such as heat flow levels, formation pressure system, and basin porosity were successfully utilized for the hot shale gas play resource screening (sweet spots) study utilizing multi-dimensional modeling approaches. The established regional spatial type B marine organofacies of the hot shale with excellent geochemical properties (∼18 %TOC) and regionally sufficient thermal maturation (∼2.45 %VRo, post-mature stage) indicate a significant amount of natural gas expelled and retained that has occurred in the Silurian hot shale system. The estimated GIP of the hot shale is about 120 bcf/km2 (equivalent to 320 bcf/section). The maximum expelled gas (TEG) amount is defined with values up to 88 bcf/section and the total estimated volume of the retained gas (TRG) is up to 96 bcf/km2, with the current geological architecture, geochemical properties, volumes, and distribution of the hot shale dry gas sweet spot in the Ghadames Basin. The hot shale can be considered in the near future for extensive further studies and exploration and development plans in Libya, Algeria, or Tunisia.