Abstract Recent years have seen the widespread adoption of zkSNARKs constructed over small fields, including but not limited to, the Goldilocks field, small Mersenne prime fields, and tower of binary fields. Their appeal stems primarily from their efficacy in proving computations with small bit widths, which facilitates efficient proving of general computations and offers significant advantages, notably yielding remarkably fast proving efficiency for tasks such as proof of knowledge of hash preimages. Nevertheless, employing these SNARKs to prove algebraic statements (e.g., RSA, ECDSA signature verification) presents efficiency challenges, particularly in critical applications like zk-bridges and zkVMs that require verifying standard cryptographic primitives. To address this problem, we first define a new circuit model: arithmetic circuits with additional exponentiation gates . These gates serve as fundamental building blocks for establishing more intricate algebraic relations. Then we present a Hash-committed Commit-and-Prove (HCP) framework to construct Non-interactive Zero-knowledge (NIZK) proofs for the satisfiability of these circuits. Specifically, when proving knowledge of group exponentiations in discrete logarithm hard groups and RSA groups, compared to verifying complex group exponentiations within SNARK circuits, our approach requires proving only more lightweight computations within the SNARK, such as zk-friendly hash functions (e.g., Poseidon hash function). The number of these lightweight computations depends solely on the security parameter. This differentiation leads to substantial speedups for the prover relative to direct SNARK methods, while maintaining competitive proof size and verification cost.

The early diagnosis and treatment of recurrent miscarriage are essential for preventing adverse pregnancy outcomes. This study explores the value of iron apoptosis-related gene in the diagnosis of recurrent pregnancy loss (RPL). We obtained ferroptosis-related differentially expressed genes (DEGs) associated with RPL from the GEO database and the FerrDb database. Ferroptosis-related DEGs were subjected to functional analysis and protein-protein interaction analysis to obtain hub genes. A functional analysis of ferroptosis-related DEGs was performed. A protein-protein interaction network was used to identify the hub genes. In vitro experiments were used to verify their diagnostic value for RPL in our hospital. In addition, the online software Network Analyst was used to obtain miRNAs associated with core genes, and the immune landscape was explored in RPL patients and controls. In total, 2245 DEGs were obtained from the GSE26787 dataset, of which 51 were ferroptosis-related DEGs. The top 4 genes are KRAS, SRC, EGFR, and MDM2. In the training set GSE26787, only SRC was significantly upregulated in the RSA group compared with the control group, with an area under the curve of 0.92. In the validation set GSE165004, 3 genes (EGFR, KRAS, SRC) were differentially expressed, with areas under the curve of 0.776, 0.964, and 0.814, respectively. Our serum samples revealed a statistically significant difference in KRAS expression in the RPL group only, with an area under the curve of 0.77. miR-1-3p and miR-155-5p interact with all 4 ferroptosis-related DEGs. The iron apoptosis-related genes such as EGFR, KRAS, SRC, and MDM2 are valuable for the early diagnosis of recurrent miscarriage. They affect the hypoxia of the endometrium during the implantation period through the FoxO signaling pathway, leading to a reduction in the number and volume of microvessels, which in turn causes recurrent miscarriage.

BackgroundThe optimal cannulation strategy for acute type A aortic dissection (ATAAD) surgery via a minimally invasive approach remains a topic of debate. This study aimed to compare the feasibility and safety of different aortic arch branch cannulation techniques using a single upper hemisternotomy.MethodsA retrospective analysis was performed on 207 patients with ATAAD who underwent total arch replacement combined with frozen elephant trunk techniques between December 2019 and July 2023. Patients were categorized into four groups based on the cannulation site: IA group (innominate artery, n = 174), LCA group (left carotid artery, n = 21), RSA group (right subclavian artery, n = 5), and RCA group (right carotid artery, n = 7). Perioperative outcomes, including mortality, complications, and operative times, were compared using appropriate statistical methods.ResultsA total of 207 patients were included and categorized into four groups based on the site of arterial cannulation: IA (n = 174), LCA (n = 21), RSA (n = 5), and RCA (n = 7). Baseline characteristics, including age and preoperative comorbidities, were comparable across the groups. Intraoperative metrics, such as cross-clamp time, circulatory arrest time, selective cerebral perfusion time, and cardiopulmonary bypass (CPB) time, showed no statistically significant differences. Although the CPB time was numerically shorter in the IA group, this difference was not significant (p > 0.05). Perioperative mortality occurred in 25 patients (12.1%), with no statistically significant differences among the groups (IA: 12.6%, LCA: 0%, RSA: 20.0%, RCA: 28.6%; p > 0.05). Postoperative clinical outcomes, including ventilator support duration, ICU stay, and hospital length of stay, were also similar across all groups.ConclusionAortic arch branch cannulation is a feasible and safe arterial perfusion strategy for ATAAD surgery via a minimally invasive single upper hemisternotomy. Among the options, the innominate artery demonstrated favorable outcomes and was not inferior to other arch vessels, and may be considered a suitable first choice when feasible.

IntroductionReverse shoulder arthroplasty (RSA) is an option for patients with complex fractures of the proximal humerus and a salvage option for osteosynthesis failure, fracture sequelae, and hemiarthroplasty (HA) revision. The objective of this study was to compare the functional outcomes of primary RSA for proximal humerus fractures (PHFs) with those of salvage RSA for the failed treatment of PHFs. We hypothesized that patients undergoing primary RSA would experience significantly less pain and better functional outcomes than those receiving RSA as a salvage procedure.MethodsThis was a retrospective cohort study of patients with PHFs who underwent RSA initially or as a salvage procedure due to failure of conservative treatment, osteosynthesis, or HA. The demographic characteristics of the patients and the radiological features of the initial fracture were considered. Functional outcomes were assessed in terms of range of motion (ROM), the Constant-Murley score (CMS), the subjective shoulder value (SSV), and pain (visual analog scale (VAS)). For the comparative statistical analysis, the t-test and Mann-Whitney U test were used.ResultsNinety patients underwent RSA, but only 41 patients were included. There were 23 patients in the primary RSA group and 18 in the salvage RSA group, with an average follow-up of 15 months (12-80 months). The primary RSA group experienced significantly less pain (VAS: 0.5±0.13 vs. 1.8±0.40) (p=0.002) and had a better CMS functional index score (73.2±1.6 vs. 65±3.01) (p=0.01) at the end of the follow-up period. No differences in ROM (active anterior elevation and external or internal rotation) or SSV were observed between the two groups.ConclusionsIn this series of patients, ROM was similar among the patients who underwent primary RSA and those who underwent salvage RSA; however, those who underwent primary RSA had better but not clinically relevant CMS and significantly less pain.

BackgroundRecurrent spontaneous abortion (RSA) affects approximately 1–5% of childbearing women and poses a significant threat to global reproductive health. Transfer RNA-derived small RNAs (tsRNAs) are a novel class of noncoding RNAs implicated in various human diseases. However, the role and mechanism of tsRNAs in regulating trophoblast function during RSA development remain unknown.MethodsHigh-throughput sequencing was performed to analyze the differential tsRNAs in the villous tissues of patients with RSA and controls. CCK-8, transwell assay, and flow cytometry were performed to detect the effects of tRF-5028c on proliferation, migration, invasion, and apoptosis of human extravillous trophoblast cell line HTR-8/SVneo. The target genes of tRF-5028c were predicted via bioinformatic analysis and verified by dual luciferase reporter gene assay. Moreover, pregnant mice were injected with tRF-5028c mimics to confirm the findings in vivo.ResultsA total of 1907 tsRNAs were detected, of which 298 were differentially expressed in the villous tissues. tRF-5028c was significantly upregulated in the RSA group compared with control. Functionally, tRF-5028c overexpression inhibited HTR-8/SVneo cell proliferation, migration, and invasion and promoted apoptosis, whereas tRF-5028c knockdown showed opposite effects. Mechanically, tRF-5028c suppressed CRKL expression by directly binding to its 3′-untranslated region, thus inactivating the downstream C3G/Rap1 signaling pathway. Finally, tRF-5028c mimics injection increased embryo absorption rate in mice.ConclusionstRF-5028c upregulation impaired trophoblast function to facilitate RSA development by directly targeting CRKL-mediated Rap1 pathway. The findings provide the first evidence of tsRNA dysregulation in RSA pathogenesis and lay a foundation for potential targeted therapies.

Emerging research suggests that the gut microbiome plays a crucial role in stress. We assess stress-microbiome associations in two samples of healthy adults across three stress domains (perceived stress, stressful life events, and biological stress /Respiratory Sinus Arrhythmia; RSA). Study 1 (n = 62; mean-age = 37.3 years; 68% female) and Study 2 (n = 74; mean-age = 41.6 years; female only) measured RSA during laboratory stressors and used 16S rRNA pyrosequencing to classify gut microbial composition from fecal samples. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States was used to predict functional pathways of metagenomes. Results showed differences in beta diversity between high and low stressful life events groups across both studies. Study 1 revealed differences in beta diversity between high and low RSA groups. In Study 1, the low perceived stress group was higher in alpha diversity than the high perceived stress group. Levels of Clostridium were negatively associated with RSA in Study 1 and levels Escherichia/Shigella were positively associated with perceived stress in Study 2. Associations between microbial functional pathways (L-lysine production and formaldehyde absorption) and RSA are discussed. Findings suggest that certain features of the gut microbiome are differentially associated with each stress domain.

Abstract Introduction: Prostate cancer is the most frequently diagnosed cancer across 112 countries. Among American men, an estimated 299, 010 new cases and 35,250 deaths are projected for 2024. In this study, the transcriptomic profile of prostate cancer patients from geographically and ethnically diverse cohorts (USA-Caucasian, RSA-Black) were compared to identify gene expression patterns associated with prostate cancer. Methods: Whole blood samples were collected from PCa and controls. Controls had the same age-range as PCa with no clinical indication of prostatic disease and serum PSA levels below 1.5 ng/ml. RNA was isolated, sequencing was carried out on Novaseq 6000, and data analyzed using PartekFlow to identify differential gene expression patterns (RSA-PCa: 6, RSA-Control: 6, USA-PCa: 7, USA-Control: 11). qRT-PCR was undertaken on a cohort of 27 biomarkers (PROSTest) related to PCa in whole blood. Results: Differential expression analysis identified distinct patterns in USA and RSA groups. In the USA PCa cohort, 2,193 genes were differentially expressed compared to the controls with fold change (FC) >1, p-value (p) <0.05, while in the RSA PCa cohort, 1,627 genes were differentially expressed compared to the controls. Pathway analyses identified enrichment for immune responsive genes in the RSA cohorts. We identified that 26 of 27 Wren’s PROSTest genes detectable in both groups. RNAseq and normalized PCR gene expression were well- correlated (r=0.44, p=0.0012, n=30 pairs). Conclusion: Based on this RNAseq study, there may be geographic differences related to ethnicity in overall blood RNA gene expression. We specifically identified alterations in immune function gene expression between the USA and RSA. Importantly, PROSTest genes were detected in both populations and exhibited a significant correlation. Development of gene signatures for biomarker discovery should, however, consider specific ethnicities and geographical regions. Citation Format: Srinivas V Koduru, Mark Kidd, Ané Pieters, S E Nagel, Robert P Millar, Abdel B Halim. Transcriptomic analysis of whole blood samples from prostate cancer patients: A comparative study of patients from geographically diverse populations [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr B062.

A time-lock puzzle encapsulates a secret message such that the receiver needs to perform a sequential computation, which takes a specified amount of time, to recover the message. Time-lock puzzles can be used in various scenarios, such as sealed-bid auctions, fair contract signing, and so on. The time required to generate a time-lock puzzle and the time needed to solve it are asymmetric, making the verification of a time-lock puzzle crucial. Before solving the puzzle, the solver needs to verify the validity of the puzzle to avoid computing invalid time-lock puzzles. After the puzzle has been solved, it is essential for a third party to confirm the correctness of the solution. This paper proposes a framework for time-lock puzzles, providing both pre-verification and post-verification functionalities, and outlines the security requirements of this framework. Furthermore, we present a practical construction based on iterated squaring in the RSA group and analyze the security of the specific construction. Finally, we implement this construction in Python and demonstrate its efficiency in different settings when implemented in practice.

BackgroundRecurrent spontaneous abortion (RSA) is a challenging condition that affects the health of women both physically and mentally, but its pathogenesis and treatment have yet to be studied in detail. In recent years, Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs) have been shown to be effective in treating various diseases. Current understanding of RSA treatment using WJ-MSCs is limited, and the exact mechanisms of WJ-MSCs action in RSA remains largely unclear. In this study, we explored the decidual deficiencies in RSA and the therapeutic potential of WJ-MSCs at single-cell resolution.MethodsThree mouse models were established: a normal pregnancy group, an RSA group, and a WJ-MSC treatment group. Decidual tissue samples were collected for single-cell RNA sequencing (scRNA-seq) and functional verification, including single-cell resolution in situ hybridization on tissues (SCRINSHOT) and immunofluorescence.ResultsWe generated a single-cell atlas of decidual tissues from normal pregnant, RSA, and WJ-MSC-treated mice and identified 14 cell clusters in the decidua on day 14. Among these cell populations, stromal cells were the most abundant cell clusters in the decidua, and we further identified three novel subclusters (Str_0, Str_1, and Str_2). We also demonstrated that the IL17 and TNF signaling pathways were enriched for upregulated DEGs of stromal cells in RSA mice. Intriguingly, cell–cell communication analysis revealed that Str_1 cell-related gene expression was greatly reduced in the RSA group and rescued in the WJ-MSC treatment group. Notably, the interaction between NK cells and other cells in the RSA group was attenuated, and the expression of Spp1 (identified as an endometrial toleration-related marker) was significantly reduced in the NK cells of the RSA group but could be restored by WJ-MSC treatment.ConclusionHerein, we implemented scRNA-seq to systematically evaluate the cellular heterogeneity and transcriptional regulatory networks associated with RSA and its treatment with WJ-MSCs. These data revealed potential therapeutic targets of WJ-MSCs to remodel the decidual subpopulations in RSA and provided new insights into decidua-derived developmental defects at the maternal–foetal interface.

BackgroundRecurrent spontaneous abortion (RSA) is characterized by the occurrence of two or more consecutive spontaneous abortions, with a rising prevalence among pregnant women and significant implications for their physical and mental well-being. The multifaceted etiology of RSA has posed challenges in unraveling the molecular mechanisms underlying that underlie its pathogenesis. Oxidative stress and immune response have been identified as pivotal factors in the development of its condition.MethodsEleven serum samples from healthy pregnant women and 17 from RSA were subjected to liquid chromatography/mass spectrometry (LC-MS) analysis. Multivariate statistical analysis was employed to excavate system-level characterization of the serum metabolome. The measurement of seven oxidative stress products, namely superoxide dismutase (SOD), catalase (CAT), malonaldehyde (MDA), glutathione (GPx), glutathione peroxidase (GSH), oxidized glutathione (GSSG), heme oxygenase (HO-1), was carried out using ELISA.ResultsThrough the monitoring of metabolic and lipid alternations during RSA events, we have identified 816 biomarkers that were implicated in various metabolic pathways, including glutathione metabolism, phosphonate and phosphinate metabolism, nucleotide metabolism, sphingolipid metabolism, lysine degradation and purine metabolism, etc. These pathways have been found to be closely associated with the progression of the disease. Our finding indicated that the levels of MDA and HO-1 were elevated in the RSA group compared to the control group, whereas SOD, CAT and GPx exhibited a contrary pattern. However, no slight difference was observed in GSH and GSSG levels between the RSA group and the control group.ConclusionThe manifestation of RSA elicited discernible temporal alternations in the serum metabolome and biochemical markers linked to the metabolic pathways of oxidative stress and immune response. Our investigation furnished a more comprehensive analytical framework encompassing metabolites and enzymes associated with oxidative stress. This inquiry furnished a more nuanced comprehension of the pathogenesis of RSA and established the ground work for prognostication and prophylaxis.

HNRNPC mediated m6A methylation of 5-methyltetrahydrofolate-homocysteine methyltransferase and involved in the occurrence of RSA

BackgroundCatheter ablation of the atrioventricular node (AVN) is an effective treatment for patients with symptomatic atrial fibrillation. This study compares the success rate, procedure time, radiation time, and complication rates of retrograde left‐sided (LSA) and anterograde right‐sided (RSA) AVN ablation in a randomised controlled trial.MethodsThirty‐one patients undergoing AVN ablation were randomized to either LSA (15 patients) or RSA (16 patients). Crossover occurred after six unsuccessful radiofrequency (RF) applications.ResultsThe LSA cohort had a mean age of 77.00 ± 5.17 and the RSA cohort was 79.44 ± 6.08 (p = .0240). There were five crossovers from LSA to RSA and there was one crossover from RSA to LSA. There was no significant difference in ablation time between LSA and RSA (210.40 ± 179.77 vs. 192.19 ± 130.29 seconds, p = .748). There was no significant difference in procedure time, fluoroscopy time, radiation dose, or number of RF applications between the two groups. There was 1 (6.67%) serious adverse event in the LSA group and 1 (6.25%) in the RSA group due to femoral hematomas requiring blood transfusion or intervention. There was no significant difference in patient‐reported discomfort between LSA and RSA (16.43 ± 20.67 vs. 17.87 ± 28.08, p = .877). The study was stopped before full recruitment due to futility.ConclusionsRetrograde LSA of the AVN does not reduce RF applications, procedure time, or radiation exposure compared with conventional RSA and cannot be recommended as a first‐line clinical approach.

IntroductionOne current trend in the field of shoulder arthroplasty is a design shift to shorter and metaphyseal fixed humeral stem components. The aim of this investigation is to analyze complications resulting in revision surgery after anatomic (ASA) and reverse (RSA) short stem arthroplasty. We hypothesize that complications are influenced by the type of prosthesis and indication for arthroplasty.Materials and methodsA total of 279 short stem shoulder prostheses were implanted by the same surgeon (162 ASA; 117 RSA), and 223 of these prostheses were implanted as primary procedures; in 54 cases, arthroplasty was performed secondary to prior open surgery. Main indications were osteoarthritis (OA) (n = 134), cuff tear arthropathy (CTA) (n = 74) and posttraumatic deformities (PTr) (n = 59). Patients were evaluated at 6 weeks (follow-up 1; FU1), 2 years (FU2) and the time span of the last follow-up defined as FU3 with a minimum FU of 2 years. Complications were categorized into early complications (within FU1), intermediate complications (within FU2) and late complications (> 2 years; FU3).ResultsIn total, 268 prostheses (96.1%) were available for FU1; 267 prostheses (95.7%) were available for FU2 and 218 prostheses (77.8%) were available for FU3. The average time for FU3 was 53.0 months (range 24–95). A complication leading to revision occurred in 21 prostheses (7.8%), 6 (3.7%) in the ASA group and 15 (12.7%) in the RSA group (p < 0.005). The most frequent cause for revision was infection (n = 9; 42.9%). After primary implantation, 3 complications (2.2%) occurred in the ASA and 10 complications (11.0%) in the RSA group (p < 0.005). The complication rate was 2.2% in patients with OA, 13.5% in CTA and 11.9% in PTr.ConclusionsPrimary reverse shoulder arthroplasty had a significantly higher rate of complications and revisions than primary and secondary anatomic shoulder arthroplasty, respectively. Therefore, indications for reverse shoulder arthroplasty should be critically questioned in each individual case.

Constant-Size Verifiable Timed Signatures from RSA Group for Bitcoin-Based Voting Protocols

The disturbance of microbiota composition in the female reproductive tract (FRT) can result in several reproductive disorders. Spermatozoa express toll like receptors (TLRs) and may encounter many types of microbiota in the FRT, however no study has been performed regarding the interaction between spermatozoa TLRs and FRT microbiota in unexplained recurrent spontaneous abortion (URSA) and fertile couples. In this study, we investigate the interaction of vaginal lactobacillus casei probiotic as a representative of FRT microbiota with TLR2 and 4 on spermatozoa. Ten fertile couples and ten URSA couples were involved in this study. Untreated and lactobacillus casei probiotic treated purified spermatozoa were evaluated for TLR2 and 4 expression by flow cytometry. Vaginal lactobacillus casei probiotic treatment of spermatozoa led to increased expression of TLR4 and decreased expression of TLR2 on spermatozoa in both URSA and fertile couples. Vaginal lactobacillus casei probiotic led to an increase in TLR4 expression and a decrease in TLR2 expression on spermatozoa in fertile and URSA groups. However, the disturbed expression of TLR2 and 4 was not completely correct, and further studies with other types of vaginal lactobacilli are needed. In contrast to our expectation, vaginal lactobacillus casei probiotic could not improve the disturbed expression of TLR2 and TLR4 in the RSA group. This could be due to small sample size and the use of one type of lactobacillus. Therefore, further study needs to be performed with other types of lactobacilli to determine the effect of microbiota and probiotics on spermatozoa function such as motility, acrosome reaction, sperm capacitation, sperm and egg fusion and spermatozoa motility and apoptosis and etc. Nevertheless, this study can provide a first step to investigate the effectiveness of vaginal microbiota on spermatozoa, and consequently design new strategies for RSA couples.

BackgroundRecurrent spontaneous abortion (RSA) is a common and complicated pregnancy-related disease that lacks a suitable biomarker to predict its recrudescence.MethodsTandem mass tag (TMT) analysis was conducted to obtain quantitative proteomic profiles in follicular fluid from patients with a history of RSA and from control group. ELISA validation of candidate differentially expressed proteins was conducted in a larger group of patients.ResultsA total of 836 proteins were identified by TMT analysis; 51 were upregulated and 47 were downregulated in follicular fluid from cases of RSA versus control group. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis revealed several important pathways were enriched, involving a dysregulated immunoglobulin Fc receptor signaling pathway and overactivated complement cascade pathways. ELISA validated the differential expression of two proteins, histidine-rich globulin (HRG) and complement C4-B (C4B), which were downregulated and upregulated, respectively, in follicular fluid of patients with RSA. We performed receiver operating characteristic curve analysis of the ELISA results with the outcomes of current IVF cycles as classification variables. The area under the curve results for HRG alone, C4B alone and HRG-C4B combined were 0.785, 0.710 and 0.895, respectively.ConclusionsTMT analysis identified 98 differentially expressed proteins in follicular fluid from patients with RSA, indicating follicle factors that act as early warning factors for the occurrence of RSA. Among them, HRG and C4B provide candidate markers to predict the clinical outcomes of IVF/ICSI cycles, and the potential for modeling an early detection system for RSA.

Objective: Explored the expression of miR-29a in puerpera with RSA and its influencing mechanism. Method: 52 patients with RSA group were divided into 30 cases representing ≤3 abortions and 22 cases with ≥4 abortions,thirty healthy women who had induced abortion during the same period as the control group. The differences in the expression levels of miR-29a, FKBP52 mRNA, VEGF, MVD, and HIF-lα were compared between the groups by conducting a correlation analysis. Results: The expression levels of miR-29a, VEGF, MVD, and HIF-lα in the chorionic villus were significantly higher among patients in the group with ≥4 abortions than in those in the group with ≤3 abortions (P < 0.05), and the expression levels of FKBP52 mRNA were lower in the former than in the latter (P < 0.05). A Spearman correlation analysis revealed that the expression levels of miR-29a were positively correlated with the levels of VEGF, MVD, and HIF-lα (P < 0.05) and negatively correlated with the expression level of FKBP52 mRNA (P < 0.05). Conclusion: MiR-29a may be involved in the pathogenesis of RSA by inhibiting the protein expressions of FKBP52 and VEGF, promoting the apoptosis of trophoblasts, and impairing neovascularization, resulting in placental vascular dysplasia..

Return to sports after joint arthroplasty is mainly evaluated for lower limbs procedures. When a return to a specific sport is mentioned, no technical approach nor level consideration are specified. We suggested that patients who undergo total shoulder arthroplasty will be able to maintain playing golf at same high level. We performed a retrospective study on active golf players who have undergone shoulder arthroplasty. Inclusion criteria were: (1) over 50years old (2) handicap < 54 (3) playing golf before the procedure (4) minimum follow-up of 1year. Patients were divided into two groups: ASA group and RSA Group. A clinical assessment was performed using the following scores: Constant, ASES and QuickDash. Sixty-one patients were retrospectively included in the cohort. Mean age was 69.1years old. Mean follow-up was 79months. Preoperative golf frequency and handicap were similar between the two groups. Surgery resulted in significant pain relief in both groups. No difference was shown between the two groups in clinical assessment. Satisfaction rate was 95%. Return to golf time was done progressively from the twentieth week for putting until the twenty-seventh week for playing on the course. Handicap analysis did not show any difference between the level before surgery and the current level in ASA group (23.7 vs. 22.9,p = 0.33) and RSA group (24.2 vs. 23.3,p = 0.63). Our study suggested that both patients with ASA or RSA can maintain an active lifestyle with moderate to high frequencies of participation after surgery, particularly in golf. Surgeons can reassure their patients about their recovery and show confidence with regard to their ability to return to a similar golf practice also after RSA. Prospective study with larger cohort is required to confirm the results. Level IV, cases study.

PurposeTolerance to shrimp has been reported in some patients with a history of shrimp allergy. The predictors of the natural resolution of shrimp allergy have not been widely explored. This study aimed to investigate the role of specific IgE (sIgE) and specific IgG4 (sIgG4) to shrimp extracts and the cross-reactive shrimp allergens tropomyosin (TM), arginine kinase (AK) and myosin light-chain (MLC), as markers of persistent or resolved shrimp allergy (PSA or RSA).MethodsSeventeen patients with a 10-year history of allergy to Penaeus monodon (Pm) and/or Macrobachium rosenbergii (Mr) were recruited. Oral shrimp challenges identified 10 patients with PSA and 7 patients with RSA. Sera from these patients were evaluated for sIgE and sIgG4 to Mr and Pm extracts as well as to TM, AK and MLC.ResultsThe levels of sIgE to Mr and Pm extracts were lower in the RSA than in the PSA groups (P = 0.05 and P = 0.008, respectively), but sIgG4 or sIgG4:sIgE ratio did not show statistical significance. The sIgE to AK and MLC, but not TM, were lower in the RSA group than in the PSA group (P = 0.009 and P = 0.0008, respectively). There was no difference in sIgG4 to TM, AK and MLC between both groups. The ratio of sIgG4:sIgE to MLC, but not TM or AK, was higher in the RSA than in the PSA group (P = 0.02). A higher diversity of sIgE to shrimp components was found in the PSA group than in the RSA group (P = 0.006).ConclusionsSpecific bioassays can be used to identify patients with RSA. Oral shrimp challenges in these patients may provide a higher rate of passing the challenges and finally reintroducing shrimp in their diet.

Differential expression of urine-circulating micro-RNAs in Chlamydia trachomatis-induced recurrent spontaneous aborters