Fourth Day Research Articles

Curing of chronic hepatitis C combined with coronavirus disease 2019 in a couple over 85 years old: a case series study.

Data on the management of patients aged more than 85 years with chronic hepatitis C virus (HCV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequential infections are lacking. The current study described the management of an older couple aged more than 85 years with these above-mentioned two diseases treated with 12 weeks of sofosbuvir/velpatasvir (Epclusa®) and 5 days of nirmatrelvir/ritonavir (Paxlovid®) sequentially. The effectiveness and safety profiles were closely monitored during therapy and till 9 months posttreatment. In late March 2023, the husband with the main complaint of repeated gingival bleeding and asymptomatic wife were 86 and 85 years old, and had HCV RNA levels of 91,800 and 6,630,000 IU/mL, respectively. On the fourth day of sofosbuvir/velpatasvir treatment, the husband had a moderate headache, and the wife had severe headache and moderate fever and dizziness. We then found that their SARS-CoV-2 test results were positive. After careful consideration, the expert panel decided to treat the couple with oral nirmatrelvir/ritonavir (300 mg/100 mg, twice daily) beginning on the fifth day of sofosbuvir/velpatasvir treatment for 5 days. During the 5 days of nirmatrelvir/ritonavir treatment, the patient's symptoms and signs gradually improved, and the patient was negative for SARS-CoV-2 RNA on the fifth day of nirmatrelvir/ritonavir therapy. Meanwhile, the husband's HCV RNA was not detectable after one week of sofosbuvir/velpatasvir treatment till posttreatment month 9, and his ALT level was normal beginning at week 1 of sofosbuvir/velpatasvir treatment. Moreover, the wife's HCV RNA was not detectable after week 4 of sofosbuvir/velpatasvir treatment till posttreatment month 9. Notably, no other symptoms or signs occurred during the treatment or follow-up period, and other serum biochemical parameters remained stable until 9 months after the discontinuation of sofosbuvir/velpatasvir treatment. The older couple aged more than 85 years with chronic HCV and SARS-CoV-2 sequential infection were safely cured by the sofosbuvir/velpatasvir and nirmatrelvir/ritonavir sequential treatment. This study suggested that old age should not be a barrier to HCV/SARS-CoV-2 treatment. Given that the proportion of older HCV-infected patients is increasing, clinical trials of direct-acting antiviral agents should include older HCV-infected individuals.

Influence of phenotypic variation of Paenibacillus polymyxa E681 on growth promotion in cucumbers.

The goal of the current study is to better understand how bacteria may adapt to survive under adverse environmental conditions by altering and improving their phenotypes. In this study, we report the consequences of phenotypic variation in Paenibacillus polymyxa E681 (E681), a plant growth-promoting rhizobacterium (PGPR), isolated from winter barley root that has a variety of advantageous effects on crop plants. In our previous study, two different types of bacterial cells in E681 were distinguished. We used the term F-type for the variant that doesn't produce endospores and B-type for the endospore-producing wild type. Under the circumstances of our experiment, the cucumber rhizosphere soil and the surface of the seeds produced phenotypic variance. On tryptic soy agar (TSA) plates, the B-type spontaneously converted into the F-type, but the reverse was not reversible. Intriguingly, the plant growth promotion test displayed that cucumber seedlings treated with F-type cells had characteristics resembling those of the untreated control. Whereas, growth promotion of cucumber seedlings treated with B-type depends on temperature conditions. In particular, an increased growth promotion was observed at a low temperature of 20°C. The phenotypic change from B-type to F-type did not occur at 20°C for 6 days in the growth curve analysis of E681, but it did occur on the fourth and second days at 30 and 37°C, respectively. Therefore, before using PGPR strains as a bacterial inoculant for sustainable agriculture, it is imperative to resolve phenotypic variance in these strains.

Effect of post-mating GnRH or TAK-683 (Kisspeptin analog) treatment on the reproductive performance and serum progesterone concentration in ewes during the non-breeding season

This study was designed to evaluate the effect of post-mating GnRH or TAK-683 (kisspeptin analog) treatment on serum progesterone (P4) concentrations and fertility parameters of ewes during the non-breeding season. One hundred and twenty multiparous, lactating Awassi ewes were used. For estrus synchronization, vaginal sponges containing 60 mg of medroxyprogesterone acetate (MAP) were inserted into the vagina and kept there for nine days. On the day of sponge removal (day 0), 500 IU of eCG and 75 µg of d-cloprostenol were given intramuscularly. Rams were introduced in the flock 24 h after sponge removal and kept with the ewes for 26 days, allowing a second mating period after synchronized estrus. On the fourth day after mating (day 6) the ewes mated by the rams between the 24th and 72nd hours (n = 105) were randomly divided into three groups. Control group (n = 36) received 1 ml of saline solution subcutaneously; GnRH group (n = 34) received 4 μg of buserelin acetate intramuscularly; TAK-683 group (n = 35) received 5 μg of TAK-683 acetate subcutaneously. Blood samples were taken to measure serum P4 concentrations (ng/ml) at sponge insertion and on the 6th, 9th, 12th, 15th, 19th, 35th, and 50th days after sponge removal. Pregnancy diagnosis was conducted via serum P4 concentration measurement on the 19th day and transrectal ultrasonography on days 35 and 50. The results showed that GnRH treatment (4.823 ± 0.238; 2.151 ± 0.272) increased (P<0.05) the mean P4 concentration (ng/ml) in pregnant and non-pregnant ewes during the first mating period compared to Control (3.708 ± 0.207; 1.515 ± 0.164), while TAK-683 treatment (4.457 ± 0.181; 1.967 ± 0.213) was not different between groups. GnRH (58.82 %) and TAK-683 (42.10 %) treatments increased the pregnancy rate in the second mating period in comparison to the Control group (17.39 %) (P<0.05). Cumulative pregnancy and fecundity rates were higher in GnRH (79.41 %; 120.58 %) and TAK-683 (68.57 %; 100.0 %) groups than in the Control group (17.39 %; 58.33 %) (P<0.05). There was no difference in late embryonic loss rate among the groups (P>0.05), whereas early fetal loss rate tended to be lower in the TAK-683 (0 %) and GnRH (0 %) groups than in the Control group (15.38 %) (P=0.07). The total pregnancy loss rate (from day 19 to day 50 post-mating) was lower in GnRH (0 %) and TAK-683 (0 %) groups relative to the Control group (21.42 %) (P<0.05). There were no statistical differences among the groups in terms of the first mating period pregnancy rate, twinning rate, and litter size (P>0.05). As a result, treatment with GnRH and TAK-683 on the fourth day after mating increased fecundity in lactating ewes outside the breeding season by preventing total pregnancy losses (from day 19 to day 50) and increasing second mating pregnancy rates.

Safety of high-dose amikacin in the first week of all-oral rifampicin-resistant tuberculosis treatment for the prevention of acquired resistance (STAKE): protocol for a single-arm clinical trial

IntroductionAn effective rifampicin-resistant tuberculosis (RR-TB) treatment regimen should include prevention of resistance amplification. While bedaquiline (BDQ) has been recommended in all-oral RR-TB treatment regimen since 2019, resistance is rising at...

Transcatheter closure of perimembranous ventricular septal defect using the cocoon membranous VSD occluder

BackgroundTranscatheter device closure is a well-established treatment for suitable ventricular septal defects (VSDs). The Cocoon Membranous VSD Occluder is a relatively new device specifically designed for perimembranous VSDs. Existing research on the Cocoon Membranous VSD Occluder for closing PM VSD is limited. ObjectiveThis study aimed to describe a single-center experience using the Cocoon Membranous VSD Occluder for perimembranous VSD. MethodsWe retrospectively analyzed data from patients who underwent device closure of perimembranous VSD using the Cocoon occluder between May 2023 and April 2024. Procedural success, complications, and short-term outcomes were evaluated. ResultsBetween May 2023 and April 2024, 13 patients with perimembranous VSD and left-to-right shunt underwent device closure with the Cocoon Membranous VSD Occluder. Twelve patients (92.3 %) achieved successful VSD closure. The mean age was 8.06 years with standard deviation (SD) of 7.24 years. The mean weight was 11.98 kg with SD of 18.93 kg. The mean VSD size was 4.96 mm with SD of 0.92 mm. The VSD was crossed from the right ventricle in 5 patients and from the left ventricle in 9 patients. All patients had successful device placement from the right ventricle approach. The Cocoon Membranous VSD device size ranged from 6 to 4 mm to 12–4 mm. In one smaller patient, the device was electively removed due to significant flow through an additional exit, and the patient subsequently underwent surgery. Another patient developed hemoglobinuria on the fourth day, which resolved by the tenth day with hydration therapy. Two patients experienced trivial to mild aortic regurgitation, and one had Wenckebach phenomenon that resolved the next day. In the short-term follow-up (mean duration of 4.33 months), all patients were doing well, had good device performance, and showed no evidence of heart block. ConclusionsDevice closure of perimembranous VSD in infants with the Cocoon Membranous VSD Occluder appears to be safe and effective in carefully selected patients during short-term follow-up. Larger studies with long-term data are necessary for future recommendations.

Does Dyadic Practice Interfere with the Type of Motor Learning Promoted by Analogy Instructions?

We investigated whether allowing individuals to exchange verbal information during dyadic practice changed the effect of analogy instructions intended to strengthen explicit motor learning by an implicit means. Forty-three right-handed college students performed golf putting, aiming at a target three meters away. Participants were assigned to one of two groups: Dyadic Practice Analogy Instruction or Individual Practice Analogy Instruction. Participants in the Dyadic Practice group were allowed to communicate with one another about the task during their practice. Before practice, participants performed a working memory capacity test. Both groups performed 180 trials of golf distributed across three days. On each day, there were four blocks of 15 trials. On the third day, participants reported the explicit rules they used to learn the task and they completed the Intrinsic Motivation Inventory. On the fourth day, they took three learning tests: retention, dual-task transfer, and social pressure transfer tests. Results of the retention test indicated that both groups learned the task comparably. Similarly, there were no significant group differences between the participants' number of explicit rules learned and their motivation levels on either of the transfer tests. Finally, only the participants in the Dyadic Practice Analogy Group showed a significant correlation between their performance on the dual-task transfer test and their working memory capacity. Overall, we found that dyadic practice did not interfere with the implicit type of motor learning promoted by analogy instruction (i.e., implicit learning).

Repetitive active and passive cognitive stimulations induce EEG changes in patients with Rett syndrome.

Despite being considered a rare disease, Rett syndrome is a leading cause of profound cognitive impairment in females. This study explores game-based cognitive stimulation to enhance attention during learning tasks, offering an alternative treatment perspective. Fifteen diagnosed Rett syndrome girls participated in four 24-minute sessions, including a 5-minute initial resting state recording. Primary indicators for analysis included relative power and spectral entropy. Significant findings indicated variations among conditions (resting state, active task, passive task) in response to stimulation. Notably, over four days, evolution occurred, characterized by decreasing delta power and increasing theta and beta power. Topographic maps confirmed these shifts, highlighting affected brain areas. Linear regression emphasized the most significant impact on the first day, with subsequent shifts towards higher frequencies, particularly during the resting state. By the fourth day, resting-state patterns resembled those during cognitive activities. Findings suggest cognitive stimulation induces substantial EEG spectral changes, potentially linked to cognitive enhancements in Rett syndrome. The shift towards higher frequency bands and increased spectral entropy align with enhanced brain activation during cognitive sessions, underscoring the potential of cognitive stimulation therapies and calling for further research to optimize abilities in individuals with Rett syndrome. Game-based cognitive stimulation induces substantial EEG changes in individuals with Rett syndrome, enhancing cognitive functions, notably attention during learning. This study conducts a distinctive examination, assessing the habituation paradigm through the combination of game-based cognitive stimulation and learning, providing valuable insights into enhancing attention in Rett syndrome. Impacting understanding of cognitive processes in Rett syndrome, this research reveals significant EEG variations during tasks, emphasizing the potential of cognitive stimulation for attention enhancement and the need for further research in tailored interventions.

Juvenile Crested Gecko (Correlophus ciliates) Growth Rate on a Calcium-dusted Dubia Roach and Papaya Diet Versus a Commercial Diet

Crested Geckos (Correlophus ciliatus) are common in the United States pet trade despite limited information on their specific physiology and nutrition. Suboptimal husbandry may be detrimental to animal growth, quality of life, and lifespan. Commercial diets are available; however, many hobbyists prefer feeding calcium-dusted fruit and insect alternatives. There is a general lack of published literature evaluating the effect of either option on gecko development. A food trial was conducted for 5 weeks on juvenile Crested Geckos fed a diet of calcium-dusted Dubia Roaches and fresh papaya (n = 30) or a commercial diet (Pangea Crested Gecko Diet; n = 30). Body length and weight were measured weekly on their fourth feeding day. Animals on both diets grew in length and weight over the 5-week feeding trial (p &lt; 0.05) however the roach/papaya-fed geckos experienced almost twice the weight gain 0.81 g (24.35%) than the commercially fed geckos (0.42 g) and (13.07 %; p = 0.002). No differences in behavior of activity were noted between either diet. These results suggest that a calcium-dusted Dubia Roach and papaya diet may be more advantageous than a commercial diet during Crested Gecko juvenile development.

Identification and expression analysis of four sHsp genes in Sogatella furcifera under abiotic stress

Sogatella furcifera is a typical r-strategist insect with strong adaptability and one of the major pests in rice cultivation. Small heat shock proteins (sHsp) play a vital role in insects responding to external abiotic stress. However, little is known about the role of sHsp in the defense against abiotic stress in S. furcifera. In this study, four sHsp genes (SofHsp20.7, SofHsp21.6, SofHsp21.7, and SofHsp21.8) were identified from S. furcifera, and their gene expression patterns were analyzed at different developmental stages, temperature stress, insecticide exposure, and UV-A irradiation. The results indicated that four sHsp were expressed at various developmental stages of the S. furcifera, with the highest transcription levels in the first-instar nymphs, fourth day fifth instar nymphs, third-day adult females, and eggs, respectively. High-temperature stress (30 °C and 40 °C) significantly induced the expression of all four sHsp genes, while low-temperature stress (10 °C) reduced their expression. Sublethal concentrations (LC10 and LC25) of buprofezin increased the expression levels of SofHsp20.7 and SofHsp21.8. Under UV-A irradiation, the S. furcifera also significantly induced the expression of all four sHsp genes, with the highest expression observed at 90 min after exposure to the stress. These results suggest that sHsp genes are essential for the resistance or tolerance of S. furcifera to high temperature, buprofezin, and UV-A irradiation. This research provides a foundation for understanding the molecular mechanisms underlying the S. furcifera adaptation to abiotic stress.

Uncovering a hidden danger: a case report of diffuse coronary spasm concealing spontaneous coronary artery dissection

BackgroundOver recent years, spontaneous coronary artery dissection (SCAD) has emerged as a no longer rare cause of acute coronary syndrome (ACS). On the other hand, coronary artery spasm (CAS) is the main cause of ischemic heart disease with non-obstructive coronary lesions. Clinical manifestations of both vary from stable angina to ACS or, rarely, sudden cardiac death. These entities may be underdiagnosed on a coronary angiography.Case presentationWe report the case of a young woman presenting with acute chest pain and no coronary risk factors. Angiography revealed a focal subcritical stenosis of the right coronary artery. Coronary wiring resulted in diffuse and critical spasm. However, optical coherence tomography (OCT) and intravascular ultrasound (IVUS) showed extensive SCAD. She was therefore treated conservatively. On the fourth day, cardiac computed tomography angiography (CCTA) excluded disease progression, and then she was discharged on medical therapy.ConclusionsCombined IVI plays a vital role in providing accurate and detailed visualization of the coronary anatomy and thus allowing for more precise diagnosis, risk stratification, and treatment planning. CCTA can be considered a valuable tool in the noninvasive follow-up of SCAD.

Effectiveness of Lactation Counseling on Lactation Outcome among Primipara Mothers: A Pilot Study

Abstract Introduction The World Health Organization encourages initiation of breastfeeding soon after birth, exclusive breastfeeding (EBF) for the first 6 months, and continued breastfeeding up to 2 years of age. Material and Methods This pilot study was done on 30 primiparous women between 37 and 40 weeks of gestation. Mothers of intervention group were given lactation counseling using a module and a demo before delivery and face-to-face counseling for 3 days, whereas mothers of control group received routine care. Immediate initiation of breastfeeding and lactation outcome was measured using structured validated tools. Results Significant difference was found at the initiation of breastfeeding between the groups (t = 8.529; p &lt; 0.001) and in the lactation outcome, which was observed by the infant breastfeeding observation tool on the third day (Z = –4.269), fourth day (Z = –4.681), and fifth day (Z = –4.667) at p &lt; 0.001 level. None of the babies of mothers who received lactation counseling and immediate initiation of breastfeeding had exaggerated jaundice whereas 53.33% of infants in the control group (group 1) developed exaggerated jaundice within the first 48 hours. All the babies of the intervention group were on EBF up to 6 months whereas only 46.66% of infants of the control group had EBF for the first 3 months and 40% in the 4th month and 20% in 5th and 6th month. Conclusion Our research supports the need of lactation counseling for better initiation of breastfeeding and lactation.

Establishment of a promising vitiligo mouse model for pathogenesis and treatment studies

AimsVitiligo is a chronic dermatological condition characterized by the progressive loss of melanocytes, for which traditional therapy has shown limited efficacy. This study aimed to establish a vitiligo model with easy operability, high repeatability, and stable depigmentation to provide a foundation for studying the pathogenesis and developing novel therapies for vitiligo.Methods(1) Establishing vitiligo model: Firstly, deliver B16F10 cells to the back skin of C57BL/6 J via intradermal injection (day 0), and the CD4 depletion antibody was injected intraperitoneally on day 4 and 10. Secondly, the melanoma was surgically removed on day 12. Thirdly, CD8 antibody was administered intraperitoneally every fourth day till day 30. (2) Identification of vitiligo model: H&E staining, immunohistochemistry, and immunofluorescence were used to detect the melanocytes. The melanin was detected by transmission electron microscopy (TEM), Lillie ferrous sulfate staining and L-DOPA staining.Results(1) The back skin and hair began to appear white on day 30. Melanin loss reached peak on day 60; (2) Hematoxylin and eosin (H&E) staining, immunohistochemistry and immunofluorescence results showed melanocytes were reduced. L-DOPA staining, Lillie ferrous sulfate staining and TEM results showed that melanin decreased in the epidermis.ConclusionWe successfully establishment a vitiligo mouse model which can be more capable to simulate the pathogenesis of human vitiligo and provide an important basis for the study of pathogenesis and therapy of vitiligo.

A Comparative Histological Study Between the Protective and the Therapeutic Effect of Probiotic on Cisplatin Induced Nephrotoxicity in Adult Male Albino Rat

Abstract Introduction Although cisplatin (CP) is one of the most effective chemotherapies, it is associated with significant nephrotoxicity (Acute kidney injury). Lactobacillus plantarum is often used as a probiotic on its own for its beneficial properties and anti-inflammatory activity. Aim to compare the protective and therapeutic role of probiotics on the microscopic structure of the kidney in a model of cisplatin-induced nephrotoxicity. Material and Methods thirty-five adult male albino rats weighing (200-220gm) were divided into 4 groups. Group I (control group), Group II (Cisplatin group): rats received intraperitoneal injection of CP (7.5 mg/kg) for 3 days. Group III (protective group): Rats received 1 mL of probiotic orally for 7 days. From the fifth day, the rats received intraperitoneal injections of CP (7.5mg/kg) for 3 days. Group IV (Therapeutic group): Rats received intraperitoneal injection of CP for 3 days. From the fourth day, the rats received probiotic L. plantarum orally at a dose of (1 mL/day) for 14 days. The concentration of probiotics in group III and group IV was 109 Colony forming units (CFU)/mL/100 g of body weight. Kidney specimens were proceeded for light microscopic examination, as well as Morphometrical and statistical analyses. Results H&amp;E-stained sections of Group II showed marked renal affection in which most glomeruli showed atrophy. Renal tubules were mostly distorted, necrotic, and degenerative with interstitial hemorrhage, congestion, and cellular infiltration. PAS-stained sections showed marked increased reaction in glomerular and tubular Basement membranes with an apparent loss of Brush borders of most of the PCTs. Masson`s trichrome-stained sections showed a marked increase in collagen fibers in renal interstitia mostly around blood vessels. Immunohistochemically stained sections showed a marked increase in positive cytoplasmic reaction to caspase -3 antibodies mostly in renal tubules. On the other hand, the renal structure of The protective group showed marked improvement which appeared nearly comparable to that of the control group while the therapeutic group showed minimal improvement. Conclusion The protective effect of probiotics on cisplatin-induced Acute Kidney Injury (Nephrotoxicity) was markedly better than the therapeutic effect as detected by microscopic, morphometric, and statistical studies.

P-654 A first in class potentiating therapeutic antibody as a new treatment for female fertility

Abstract Study question Can we improve controlled ovarian stimulation (COS) outcome in female by increasing FSH activity with a potentiating antibody? Summary answer IGYXOS developed a first in class potentiating antibody that improves COS treatments’ outcome by increasing FSH efficacy in vivo as demonstrated in non-human primates (NHP). What is known already For a COS in IVF cycles, FSH-containing preparations are injected to patients in order to obtain mature and fertilizable oocytes. However, the efficacy of these treatments is still limited and several attempts are needed before reaching a pregnancy and a live birth. One of the parameters that could be improved to avoid several attempts is the number of mature and thus fertilizable oocytes. It was previously demonstrated that breeding animals treated with gonadotropins could develop anti-gonadotropin antibodies that enhance their bioactivity instead of inhibiting it. These females had a high kidding rate and were hyperprolific. Study design, size, duration IGYXOS developed a monoclonal antibody (mAb) IGX12, a humanized IgG4, directed against human FSH. IGX12 was selected based on its ability to increase FSH activity in vitro and in vivo in rat., It was tested in mature cynomolgus female monkeysthat were treated as women undergoing ovarian stimulation for IVF with FSH alone or in combination with IGX12. Participants/materials, setting, methods IGX12 was tested in vitro on HEK 293 cells expressing the human FSH receptor. In vivo, the mAb was tested according to the Steelman and Pohley protocol. The potentiating effect was further investigated in NHP treated with mAb combined to a standard FSH treatment, under an agonist protocol. After hCG injection, oocytes were retrieved and their quality was analyzed. Blood was collected for hormonal assessments. Main results and the role of chance In vitro on HEK 293 cells expressing the human FSH receptor, IGX12 combined to FSH improves both the potency (EC50) and the efficacy (Emax) of FSH by increasing the cyclic AMP production at all tested FSH concentrations. The potentiating activity was confirmed in vivo in the Steelman and Pohley bioassay. Immature female rats received hCG+FSH alone or combined to mAb, twice a day, during 3 days. The animals were sacrificed the fourth day of treatment and the weight of the ovaries was compared. Ovaries weight was increased significantly in the group treated with hCG/FSH+IGX12 compared to hCG/FSH only. To further analyze the potential benefit of a IGX12 on human fertility, its effect was investigated in mature cynomolgus monkeys. IGX12 combined to a standard FSH treatment stimulated the follicular growth better than FSH only, and tripled the number of collected mature oocytes. Improved follicular growth correlated well with increased estradiol secretion during follicular phase and progesterone secretion during luteal phase. Limitations, reasons for caution After several proofs of concept and regulatory safety and toxicology evaluation in different animal models, IGX12 safety and tolerability is now assessed in a randomized, double blinded clinical phase I study on healthy men and women volunteers. Wider implications of the findings This first in class potentiating antibody IGX12 represents an innovative and promising new therapy to better stimulate patients with limited response to classical FSH treatments in order to improve the outcome of COS, and for normo-responders to avoid repetition of treatments. Trial registration number not applicable

P-297 Intensive luteal phase support regimens for endometriosis and adenomyosis patients in hormone replacement therapy frozen embryo transfer cycles – subcutaneous or intramuscular progesterone treatment?

Abstract Study question Does subcutaneous (SC) progesterone treatment provide progesterone levels comparable to intramuscular (IM) progesterone when using a cut-off level of 118nmol/l(37.1ng/ml) during intensive luteal phase support? Summary answer As part of an intensive luteal phase support regimen SC progesterone provides higher P4 levels compared to the use of IM progesterone. What is known already Low serum progesterone (P4) levels in HRT-FET cycles negatively impact reproductive outcomes. This effect is particularly pronounced in patients with endometriosis and adenomyosis, due to reduced progesterone actions and progesterone resistance at the receptor level. Therefore, higher serum P4 levels are required to maintain an optimal reproductive outcome during HRT-FET. A P4 cut-off of 118nmol/l (37.1ng/ml) or above has been suggested, a level four times higher than that of the non-endometriosis patient. To achieve high P4 levels, intensive luteal phase support (LPS) regimen has been suggested. This includes vaginal progesterone administration and additional treatment via IM, SC or rectal administration. Study design, size, duration This cohort study includes 380 HRT-FET cycles in endometriosis/adenomyosis patients. Patients were treated from January 2016 until August 2019 with one type of intensive LPS regimen (n = 262) and from January 2000 to January 2023 with two different LPS regimens depending on whether serum P4 levels were lower or higher than 118nmol/l on the day of blastocyst transfer (BT) (n = 118). P4 was measured in a standardised manner. Participants/materials, setting, methods Patients received treatment in a public university affiliated fertility clinic. Endometrial priming involved the use of estradiol followed by vaginal progesterone. From the fourth day of progesterone, one of the following intensive LPS regimens were added: A) 50mg IM progesterone, B) 25mg SC progesterone BD, or C) 25mg SC progesterone BD plus 400mg rectal rescue progesterone BD if P4&amp;lt;118nmol/l. Blastocyst transfer (BT) and P4 measurement were performed on the sixth day of progesterone administration. Main results and the role of chance The overall pregnancy rate, live birth rate (LBR) and total pregnancy loss rates for the whole cohort were 63%, 41% and 36%, respectively. For the three groups A, B and C the mean serum P4 levels on the day of BT were 103.1 ±44.4nmol/l, 170.5 ±62.9nmol/l and 90.1 ±21.5nmol/l. In Group A (IM) 67% of patients (176/262) had P4 levels &amp;lt;118 nmol/l whereas only 36% (43/118; p &amp;lt; 0.001) had P4 &amp;lt;118 nmol/l in the groups of patients treated with SC progesterone (Group B and C). The unadjusted LBR was not significantly different between groups, 39%, 39%, 51%, (p = 0.32). However, a sub-group analysis showed that comparing patients with serum P4 levels &amp;lt;118nmol/l on the BT day in Group A with patients with P4 levels &amp;lt;118nmol/l in Group C a significantly higher LBR was found if intensive LPS included both SC and rectally administered progesterone compared to IM progesterone, only: 51% (44/86) vs 34% (59/176), p = 0.03. The adjusted odds ratio for live birth was 2.04 (95% CI [1.00, 4.16], p = 0.05) after adjusting for age, vitrification day 5 or 6, blastocyst quality and numbers of blastocysts transferred, if intensive LPS included SC and rectal rescue compared to IM, only in patients with P4 levels &amp;lt;118nmol/l. Limitations, reasons for caution This cohort study was conducted over two different time periods. Single embryo transfer was performed only during the later period. The bio-pharmacological profiles of SC and IM progesterone differ, which can influence serum P4 levels. However, in the present study, all blood samples were collected in a standardised manner. Wider implications of the findings This study is the first to report reproductive outcomes following different intensive LPS regimens in a cohort of endometriosis/adenomyosis patients. To increase reproductive outcomes, individualisation of the HRT-FET cycle may be beneficial and, importantly, rectal progesterone administration can be used as a rescue regimen in addition to SC progesterone. Trial registration number Due to the retrospective study design no ethical approval was needed.

Time efficiency and match optimization in scheduling Pencak Silat matches: a case study of the Sleman Regency Student Pencak Silat Championship in 2023

The issue of this research is that many pencak silat matches in Indonesia still use manual calculations in several dis-tricts/regencys, then the calculation data is inputted into the system. This will take a lot of time, so the pencak silat match schedule spends a lot of time. The data used is the number of parties at the Sleman Regency Student Pencak Silat Championship in 2023. This research aims to find calculations to maximize the number of parties/matches/match numbers per day in a martial arts match. The method that can be used is the Preemptive Multiple Bounded Knapsack Problem (PMBKP). PMBKP involves distributing the quanti-ty of different types of items to a group of knapsacks with their respective priorities and capacity limits. The PMBKP results obtained in the 2023 Sleman District Pencak Silat Championship problem using the Branch and Bound algorithm are 175 parties on the first day, 133 parties on the second day, 128 parties on the third day, 127 parties on the fourth day, and 72 parties on the fifth day. These results can be said to be effective if applied to pencak silat matches that aim to nurture achievements, such as introductions and district/regency level matches. Keywords: Pencak Silat, Competition, Sports Schedule

The Potential of Infrared Thermography for Early Pregnancy Diagnosis in Nili-Ravi Buffaloes.

This study was designed to explore the potential of infrared thermography (IRT) as an alternate approach for early pregnancy diagnosis in buffaloes. The surface temperature (ST) of different regions (eyes, muzzle, flanks, and vulva) was determined in 27 buffaloes using IRT from the day of artificial insemination (AI; Day 0), and measurement was repeated every fourth day until Day 24 post-AI. From all regions, the ST in each thermograph was recorded at three temperature values (maximum, average, minimum). Pregnancy status was confirmed through ultrasonography on Day 30, and animals were retrospectively grouped as pregnant or non-pregnant for analysis of thermographic data. In pregnant buffaloes, all three values of ST were significantly greater (p ≤ 0.05) for the left flank, while, in the left eye and vulva, only the maximum and average values were significantly greater. By contrast, the maximum ST of the muzzle was significantly lower (p ≤ 0.05) in pregnant buffaloes compared to non-pregnant buffaloes. However, the ST of the right eye and right flank did not show significant temperature variation at any value. These findings suggest that IRT has the potential to identify thermal changes associated with pregnancy in buffaloes at an early stage.

Unusual cause of urinary retention in an infant

Introduction: Gastrointestinal tract duplication cysts constitute a rare group of malformation. Patients with presacral mass present with a diagnostic challenge due to the less obvious presentation. Case Report: We report a 7-month-old boy, who presented with constipation and acute intermittent urinary retention. On per-rectal examination, a palpable mass was felt posteriorly with a narrow base, raising a query of pre-sacral/pelvic mass. Ultrasound pelvis revealed a well-defined, rounded oval-shaped cystic mass noted in the center of the lower pelvis, posteriorly. Computed tomography (CT) scan abdomen confirmed a cystic pelvis mass anterior to the rectum causing mass effect. Magnetic resonance imaging (MRI) of the pelvis was done to define its relationship to the sacral spine. A high-intensity lesion was seen on T2 imaging with no spinal involvement. Hence surgical exploration was done, and per operative diagnosis of rectal duplication was confirmed. Postoperatively child was discharged on the fourth post-operative day and doing well on follow-up. Conclusion: We emphasize a complete examination, including per rectal examination in any child presenting with acute urinary retention to exclude pre-sacral masses.

Suprapubic versus transurethral catheterization for bladder drainage in male rectal cancer surgery (GRECCAR10), a randomized clinical trial.

Bladder drainage is systematically used in rectal cancer surgery; however, the optimal type of drainage, transurethral catheterization (TUC) or suprapubic catheterization (SPC), is still controversial. The aim was to compare the rates of urinary tract infection on the fourth postoperative day (POD4) between TUC and SPC, after rectal cancer surgery regardless of the day of removal of the urinary drain. This randomized clinical trial in 19 expert colorectal surgery centers in France and Belgium was performed between October 2016 and October 2019 and included 240 men (with normal or subnormal voiding function) undergoing mesorectal excision with low anastomosis for rectal cancer. Patients were followed at postoperative days4, 30, and 180. In 208 patients (median age 66years [IQR 58-71]) randomized to TUC (n = 99) or SPC (n = 109), the rate of urinary infection at POD4 was not significantly different whatever the type of drainage (11/99 (11.1%) vs. 8/109 (7.3%), 95%CI, - 4.2% to 11.7%; p = 0.35). There was significantly more pyuria in the TUC group (79/99 (79.0%) vs. (60/109 (60.9%), 95%CI, 5.7-30.0%; p = 0.004). No difference in bacteriuria was observed between the groups. Patients in the TUC group had a shorter duration of catheterization (median 4 [2-5] vs. 4 [3-5] days; p = 0.002). Drainage complications were more frequent in the SPC group at all followup visits. TUC should be preferred over SPC in male patients undergoing surgery for mid and/or lower rectal cancers, owing to the lower rate of complications and shorter duration of catheterization. ClinicalTrials.gov identifier NCT02922647.

Effect of active composite coating based on nanochitosan-whey protein isolate on the microbial safety of chilled rainbow trout fillets packed with oxygen absorber

This study aimed to assess the effect of coating based on nanochitosan-whey protein isolate (NCH-WPI) containing summer savory essential oil (SEO) combined with oxygen absorber (OA) packaging on Pseudomonas aeruginosa, Listeria monocytogenes, and Escherichia coli O157H7, inoculated to rainbow trout fillets stored under refrigeration. Except control and OA groups, L. monocytogenes decreased (0.49–1.82 log CFU/g) in all treatment groups until the eighth day, and then increased (0.39–0.68 log CFU/g). This indicates that the treatments were ineffective to inhibit the proliferation of this bacterium. Considering the forced aerobic nature of inoculated P. aeruginosa, the counts of these bacteria become undetectable in groups packed with OA after the fourth day of storage, while the other groups showed an increase (0.99–2.23 log CFU/g) in this bacteria population during entire storage period. This growth rate was slower in the NCH-WPI + 1%SEO and NCH-WPI + 2%SEO groups. Regarding the inoculated E. coli, its count was decreased (1.48–2.41 log CFU/g) during storage, and this reduction (2.24–2.41 log CFU/g) was the highest in NCH-WPI + 1%SEO + OA and NCH-WPI + 2%SEO + OA groups. In conclusion, NCH-WPI treatments delayed the growth of all pathogenic bacteria, but the ternary treatment (NCH-WPI + SEO + OA) was the most effective treatment in this regard.