Total PE Research Articles

A retrospective cohort study of hypertension, cardiovascular disease, and metabolic syndrome risk in women with history of preterm and term preeclampsia five years after delivery.

To evaluate maternal hypertension, risk of cardiovascular disease (CVD), and metabolic syndrome five years after delivery in preterm preeclampsia (P-PE), term preeclampsia (T-PE), and normal pregnancy. This was a retrospective cohort study of women who delivered at Dr. Soetomo Academic Hospital (Indonesia) in 2013 with a diagnosis of PE and were compared with women with normal pregnancies. Blood pressure, National Cholesterol Education Program Adult Treatment Panel III criteria for metabolic syndrome (NCE-ATP III), and Framingham Risk Score (FRS). In this study, 92 women participated. They were divided into the P-PE (27), T-PE (35), and control groups (30). Women with a history of PE, P-PE, or T-PE had higher blood pressure five years after delivery than those in the control group (p<0.05). Systolic blood pressure (SBP)>140mmHg was seen in 66.7% of P-PE and 25.7% of T-PE, while 55.6% of P-PE and 34.3% of T-PE had diastolic blood pressure (DBP)>90mmHg (p<0.05). Women with P-PE had the highest risk of developing hypertension (Relative risk (RR): 20; 95% Confidence interval [CI]: 2.85-139.92). Women with history of P-PE (RR: 1.85; 95% CI: 0.77-4.41), T-PE (RR: 1.28; 95% CI: 0.51-3.19), and total PE (RR: 1.53; 95% CI: 0.68-3.43) had an increased risk of positive NECP-ATP III five years after delivery. Women with history of P-PE (RR: 5.17; 95% CI: 0.26-103.22; p=0.282) and T-PE (RR: 6.03; 95% CI: 0.32-112.22; p=0.228) are at a greater risk of having an FRS>10% compared to the control group (p=0.04). History of PE, P-PE, and T-PE increased the risk of hypertension and CVD five years after delivery. The results also showed a tendency toward an increased risk of metabolic syndrome in women with a previous history of PE and P-PE.

A Multicenter Cohort Study in Patients With Primary Empty Sella: Hormonal and Neuroradiological Features Over a Long Follow-Up.

Objectiveprimary empty sella (PES) represents a frequent finding, but data on hormonal alterations are heterogeneous, and its natural history is still unclear. Our aim was to evaluate the pituitary function of patients with PES over a long follow-up.Designmulticenter retrospective cohort study enrolling patients referred between 1984-2020 to five Pituitary Units, with neuroradiological confirmed PES and a complete hormonal assessment.Methodswe analyzed hormonal (including basal and dynamic evaluations), clinical and neuroradiological data collected at diagnosis and at the last visit (at least 6 months of follow-up).Resultswe recruited 402 patients (females=63%, mean age=51.5 ± 16 years) with PES (partial, total, undefined in 66%, 13% and 21%, respectively). Hypopituitarism was present in 40.5% (hypogonadism=20.4%, hypoadrenalism=14.7%, growth hormone deficiency=14.7%, hypothyroidism=10.2%, diabetes insipidus=1.5%; multiple deficiencies=11.4%) and hypeprolactinemia in 6.5%. Interestingly, hormonal alterations were diagnosed in 29% of incidental PES. Hypopituitarism was associated with male sex (p=0.02), suspected endocrinopathy (p<0.001), traumatic brain injury (p=0.003) and not with age, BMI, number of pregnancies and neuroradiological grade. A longitudinal assessment was possible in 166/402 (median follow-up=58 months). In 5/166 (3%), new deficiencies occurred, whereas 14/166 (8.4%) showed a hormonal recovery. A progression from partial to total PES, which was found in 6/98 patients assessed with a second imaging, was the only parameter significantly related to the hormonal deterioration (p=0.006).Conclusionsthis is the largest cohort of patients with PES reported. Hypopituitarism is frequent (40%) but hormonal deterioration seems uncommon (3%). Patients need to be carefully evaluated at diagnosis, even if PES is incidentally discovered.

A modern approach to the treatment of cancer-associated venous thromboembolic complications: a lecture

Cancer-associated venous thromboembolic complications are one of the main topical problems in the system of practical healthcare. Having overlapping pathogenetic mechanisms of development, thromboembolic complications accompany the oncological process and often act as its manifesting sign. Treatment of onco-associated venous thromboembolic complications is not an easy task, which is determined by the multiplicity of the pathogenetic mechanisms of hemostatic system disorders in the cohort of patients under consideration, who are threatened both in terms of the development of total PE and fatal bleeding. In addition to the features of the treatment phases, their duration, an important point in the treatment of cancer-associated thrombosis is a limited list of recommended drugs, as well as the permitted dosage regimens. The article analyzes the results of research aimed at studying the effectiveness of apixaban in the treatment of cancer-associated thromboembolic complications. Now the gold standard for the treatment of venous thromboembolic complications is dalteparin. However, low compliance in the use of dalteparin leads to premature termination of treatment or the patient's independent transition to alternative drugs. The appearance of direct oral anticoagulants has significantly changed the treatment paradigm in this morbid group of patients, while leaving a number of unresolved issues.

Clinical Evaluation of Pink Esthetic Score of Immediately Impressed Posterior Dental Implants.

While comparative outcome results for peri-implant crestal bone levels, mucosal margin position, and peri-implant indices have been reported, no studies are available that evaluate and compare the esthetic result of impressions performed immediately at implant placement with that of impressions performed on healed implants. The purpose of this cross-sectional study was to evaluate the pink esthetic score of posterior implants restored with an immediate impression workflow compared to implants restored with a delayed impression workflow. Twenty-eight eligible participants who had received a single implant crown either in the premolar or molar regions at least 4 months before the study, were identified by an electronic health record review and scheduled for a single-visit study appointment. Esthetic outcomes were measured using the pink esthetic score. Several local- and prosthesis-related factors were recorded and their association with the selected outcome was assessed. Two-sample t-test was used for comparisons between the groups. Pink esthetic score ranged between 4 and 12 (mean: 8). No significant difference between immediate (8.36 ±1.12) and delayed (7.76 ±2.14) impression workflow groups were seen for the total PES (p = 0.25). In addition, individual comparisons between immediately and delayed impressed implants for mesial papilla (1.27 ±0.47; 0.88 ±0.78), distal papilla (0.73 ±0.65; 0.76 ±0.83), tissue margin (1.73 ±0.47; 1.47 ±0.51), tissue contour (1.27 ±0.65; 0.82 ±0.64), alveolar process (0.82 ±0.60; 1.00 ±0.87), color (1.27 ±0.65; 1.29 ±0.69), and texture (1.36 ±0.50; 1.53 ±0.62) did not show significant differences. The current study suggests that the pink esthetic score is not significantly different between single posterior implants impressed with immediate and delayed implant workflows.

Do immediately placed implants have better outcomes when placed with a minimal split-thickness envelope flap?

Design Randomised, controlled, single-blind, single-centre clinical trial.Case selection Adult patients in need of a single tooth extraction in the anterior maxillary and premolar region. Full mouth plaque scores below 25% and bleeding scores below 10%, with no active periodontal disease. As assessed by cone beam computed tomography; intact buccal plate, adequate mesiodistal space and adequate quality of bone.Data analysis Patients had immediate implant placement following extraction, either with a flap with no vertical releasing incision (control group) or a minimal split-thickness envelope flap (test group). The trial compared clinical, radiographic, aesthetic and patient-reported outcomes of immediately placed implants. Primary outcomes were measured using the pink (PES) and white (WES) aesthetic score. JMP Pro 13 was the statistical software used. Statistical comparisons were conducted at a 0.05 level of significance.Results In total, 28 patients were enrolled in the study, after exclusions. The total PES and WES scores were similar in the control and test groups. Implant survival and success rate after 12 months was 100%. Buccal plate thickness at 12 months post-loading was 2.78 mm in the control group and 2.54 mm in the test group, so there was no statistically significant difference between them. The majority of patients in both groups responded as 'positive' in the patient satisfaction questionnaire and visual analogue scale.Conclusions When comparing PES/WES scores, success/modified success rate, survival, mean buccal plate resorption and patient satisfaction, there were no differences between immediate implants placed with a flap or with a minimal split-thickness envelope flap.

Dietary phytoestrogen intake and lung cancer risk: an analysis of the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial

Phytoestrogens (PEs) have estrogen-like activity and were found to lower incidences of several hormone-dependent cancers. Emerging evidence suggests that estrogen may play a role in lung cancer carcinogenesis. We aim to evaluate dietary PE intake and lung cancer risk using data from the Prostate, Lung, Colorectal and Ovarian cancer screening trial. A total of 1706 lung cancer cases were identified. The association between lung cancer risk and PE intake (in quartiles) was calculated using the Cox proportional hazard models adjusting for potential confounders. Stratified analyses by smoking status, sex and histology were also performed. The highest quartile of total PE intake was associated with a reduced risk of lung cancer compared with the lowest quartile [hazard ratio (HR) = 0.85, 95% confidence interval (CI): 0.73-0.99 for >1030 μg/day versus <290 μg/day] (P trend = 0.56). Similar patterns were observed among ever smokers (HR = 0.84, 95% CI: 0.71-0.98), non-small cell histology (HR = 0.84, 95% CI: 0.72-0.99), male (HR = 0.84, 95% CI: 0.69-1.03) and female (HR = 0.80, 95% CI: 0.64-0.99 for 510-1030 μg/day, HR = 0.84, 95% CI: 0.67-1.06 for >1030 μg/day versus <290 μg/day) subjects with no significant linear trend observed. Despite a lower consumption compared with the Asian population, increased PE intake still appears to decrease lung cancer risk in a Caucasian-dominant population. Future studies are needed to replicate these results in independent cohorts and shed a light on the potential mechanism of the protective effect of PEs on lung carcinogenesis and the interaction between PEs, smoking and endogenous estrogens.

Pituitary Volume in Patients with Primary Empty Sella and Clinical Relevance to Pituitary Hormone Secretion: A Retrospective Single Center Study.

Background According to neuroradiological findings, empty sella seems to be deprived of pituitary tissue in sella turcica. Changing size of the pituitary volume is closely related to the occurrence of primary empty sella. The aim of the study is to determine pituitary dysfunction in patients with partial or total primary empty sella and the significance of pituitary volume measurements in these patients.Methods This study was designed retrospectively. 67 patients (55 females, 12 males) diagnosed with primary empty sella syndrome between the years of 2015-2019 were included in the study. Patients were divided into two groups: partial (PES) and total (TES) empty sella by magnetic resonance imaging (MRI). Basal anterior pituitary and its hormones were assessed. We also included 26 healthy control subjects (19 females, 7 males) to compare the differences in pituitary volumes. Volumes were measured by using Osirix Dicom Viewer (Pixmeo SARL, Geneve, Swiss) in 3.0 Tesla scanner MRI.Results82.1% (n=55) of all patients were PES and the others were (n=12) TES. Hypopituitarism, known as one or more pituitary hormones deficiency, was found in 12 patients (17.9%). While 9 of them had total PES, the others had partial PES. Secondary adrenal insufficiency and gonadotropin deficiency were more prevalent in patients with TES. Mean volume measurements of patients with TES, PES and healthy subjects were 0.23±0.17, 0.35±0.15, 0.54±0.17 cm3, respectively. Except for IGF1 values (p=0.026), there was not any significant correlation found between the anterior pituitary hormones and volume measurements.ConclusionAlthough volume measurement has helped in the diagnosis of pituitary empty sella (partial or total), it does not seem to have any significant correlation with pituitary secretory function.

Effect of irradiation treatment on the lipid composition and nutritional quality of goat meat

The knowledge of the changes in the lipid species in irradiated goat meat is expected to clarify the beneficial effects of irradiation on meat preservation. This study explored the characteristic lipid composition and the changes in irradiated goat meat based on quantitative lipidomics strategy by LC–MS. Totally, 12 subclasses of 174 lipids were identified with significant differences (p < 0.05, VIP > 1), and the absolute quantitative analysis of characteristic lipids was achieved. Significant lipid variables were involved in the major pathways of glycerophospholipid and sphingolipid metabolism. Moreover, significant increases during irradiation were found in total TG, PC, PE, LPE, Cer, LPC and SPH, while the total DG, PS, PG, PI and SM decreased after irradiation. Noteworthily, DHA-enriched PC (18:4/22:6) + H, a core nutrient for human health, exhibited an increase in the irradiated group. These results provide a basis for lipid quantitative alterations in irradiated goat meat and application of irradiation in meat preservation.

Clinical presentation, evaluation and case management of primary empty sella syndrome: a retrospective analysis of 10-year single-center patient data

BackgroundPrimary Empty Sella (PES) syndrome is an increasingly common disorder, mostly diagnosed as an incidental finding during brain imaging scans. We intended to review the clinical management and hormonal profile of patients with PES.MethodsThe study included ten-year retrospective analysis of registry containing PES cases in the period 2007 to 2017, from a single tertiary care center. The keyword ‘primary empty sella’ was used to retrieve patient details from the radiology unit. The clinical and biochemical profile of PES patients was analyzed. Case management of PES patients and their rate of referral to endocrinologists was explored.ResultsThe registry had 765 cases with a male: female ratio of 1:3.8 suggesting female predominance by almost four times. Although not significant, the onset of disease was earlier for males [Mean ± standard deviation (SD) (46.7 years ±17.3 vs 48.8 years±14.1), p = 0.110]. Almost 79% of the cases were found as an incidental finding during Magnetic Resonance Imaging. Of the total PES cases, only 20% were referred to the endocrinologists and the rest were handled by general physicians. Only 1–2.5% of the cases were evaluated for gonadal, growth and adrenal hormones by the general physicians. The hormonal evaluation by the endocrinologists was also found to be sub-optimal. Headache and visual disturbances were the most common presenting complaints followed by menstrual abnormalities. Endocrine abnormalities like thyroid dysfunction, hyperprolactinemia, hypogonadism and hypocortisolism were highly prevalent among those assessed.ConclusionThere is a gross under-evaluation of hormonal assessment and minimal case-referral to Endocrinologists. PES is associated with varying degrees of hormonal dysfunction, and hence early assessment and management is needed. Establishing a standard protocol for diagnosis and case management is essential with the involvement of a multidisciplinary team consisting of endocrinologists, neurologists, primary care phys icians and ophthalmologists.

Impact of phenol on the glycerophospholipid turnover and potential role of circadian clock in the plant response against this pollutant in tobacco hairy roots

Glycerophospholipids (GPLs) from cell membranes (CM) are a proper source for the synthesis of lipid messengers able to activate signal pathways that will define the plant survival under changing and stressful environmental conditions. Little is known about how GPLs metabolism (GPLsM) is regulated and the effects of phenol treatment on GPLs composition. In this work, we studied the effects of phenol both on GPLs turnover and on the expression of GPLsM-related genes potentially regulated by the circadian clock, using tobacco hairy root cultures (HRC). Phenol decreased the total PC levels and increased PE, PG and CL levels in the dark phase. Different molecular species of PC and PE showed the same trend than the total PC and PE upon phenol treatment. Besides, significant differences in the expression of all studied genes related to GPLsM were found. NtCCT2 expression was affected at all analyzed times while NtPECT1 and NtAAPT1 showed similar expression patterns. NtCDS1, NtPGPS2 and NtCLS genes showed significant and differential expression profiles both in untreated and treated HRC. PECT1 and NtPGPS2 genes seem to conserve a circadian expression profile mainly in untreated HRC. However, phenol was able to modify the GPLs composition and the expression of genes related to GPLs synthesis. The GPLs modification could be explained by the up-regulation of NtPECT1, NtAAPT1 and NtCLS genes during the dark phase, suggesting for being a crucial moment for HRC to trigger an adaptive response against this organic pollutant.

Psychological Empowerment and Organizational Commitment among Nurses

Background- Psychological empowerment plays an important role in behavioral, emotional and cognitive constructs, such as Job Satisfaction and organizational citizenship behavior. Aim- The study aimed to identify the relationships between Psychological Empowerment and Organizational Commitment among nurses. Methods and Materials - A cross-sectional, descriptive and correlational study design carried out in a period from 5th of September/2017 till 30th of May/2018 at five Public Hospitals in Mosul/Iraq. Non-probability sampling technique and accidental sampling method depended to select the sample of the study, which accounted for (317) nurse. Two instruments were used to collect data via an interview method with each subject “Psychological Empowerment Questionnaire and Organizational Commitment Questionnaire”. The findings of the study presented by mean, standard deviation, while the relationships among variables presented through stepwise regression. Results- Total PE and its domains had significant relations to total OC and its Affective and Normative domains.

Direct oral anticoagulants for thromboprophylaxis in ambulatory patients with cancer

ABSTRACT Background: Venous thromboembolism (VTE) is a common complication in cancer patients. We aim to evaluate the effect and safety of direct oral anticoagulants (DOACs) as primary prophylaxis in ambulatory cancer patients. Methods: We conducted a literature search in PubMed, EMBASE and ClinicalTrials for studies that evaluated DOACs for thromboprophylaxis in cancer patients. RevMan 5.3 software was used for this meta-analysis. Results: Three randomized controlled trials (RCTs) with a total of 1465 patients were pooled in the meta-analysis. DOACs significantly reduced the symptomatic VTE incidence during intervention period (RR 0.23, CI 0.11-0.47, P<0.0001, I2 =9%). Significantly lower total VTE incidence (RR 0.53, CI 0.36-0.78, P = 0.001, I2 =30%) and PE incidence (RR 0.50, CI 0.28-0.89, P = 0.02, I2 =5%) were found during the observation period, and a trend for less symptomatic DVT events was found in the DOACs group (RR 0.62, CI 0.37-1.04, P = 0.07, I2 =5%). No differences for all-cause mortality were found between groups (RR 0.92, CI 0.74-1.15, P = 0.47, I2 =14%). DOACs did not significantly increase major bleeding risks (RR 1.66, CI 0.72-3.83, P = 0.24, I2 =0%) during the intervention period or clinically relevant non-major bleeding events (RR 1.50, CI 0.90-2.49, P = 0.12, I2 =0%) and total bleeding events during the observation period (RR 1.50, CI 0.98-2.29, P = 0.06, I2 =0%). Conclusion: DOACs are effective for thromboprophylaxis in ambulatory cancer patients, but there is a potential risk of bleeding. DOACs may be recommended in selected patients at high risk of VTE. More high-quality studies are needed to further validate our results. Abbreviations: CAT: cancer-associated thrombosis; CI: confidence interval; DOAC: direct oral anticoagulant; DVT: deep vein thrombosis; LMWH: low molecular weight heparin; NNH: number needed to harm; NNT: number needed to treat; PE: pulmonary embolism; RCT: randomized controlled trials; RR: risk ratio; RD: rate difference; VTE: venous thromboembolism.

Fatty Acid, Lipid Classes and Phospholipid Molecular Species Composition of the Marine Clam Meretrix lyrata (Sowerby 1851) from Cua Lo Beach, Nghe An Province, Vietnam.

This study aims to analyze compositions of fatty acids and phospholipid molecular species in the hard clams Meretrix lyrata (Sowerby, 1851) harvested from Cua Lo beach, Nghe An province, Viet Nam. Total lipid of hard clams Meretrix lyrata occupied 1.7 ± 0.2% of wet weight and contained six classes: hydrocarbon and wax (HW), triacylglycerol (TAG), free fatty acids (FFA), sterol (ST), polar lipid (PoL), and monoalkyl diacylglycerol (MADAG). Among the constituents, the proportion of PoL accounted was highest, at 45.7%. In contrast, the figures for MADAG were lowest, at 1.3%. Twenty-six fatty acids were identified with the ratios of USAFA/SAFA was 2. The percentage of n-3 PUFA (ω-3) and n-6 PUFA (ω-6) was high, occupying 38.4% of total FA. Among PUFAs, arachidonic acid (AA, 20:4n-6), eicosapentaenoic acid (EPA, 20:5n-3), docosapentaenoic acid (DPA, 22:5n-3), and docosahexaenoic acid (DHA, 22:6n-3) accounted for 3.8%, 7.8%, 2.2% and 12.0% of total lipid of the clam respectively. Phospholipid molecular species were identified in polar lipids of the clams consisting six types: phosphatidylethalnolamine (PE, with 28 molecular species), phosphatidylcholine (PC, with 26 molecular species), phosphatidylserine (PS, with 18 molecular species), phosphatidylinositol (PI, with 10 molecular species), phosphatidylglycerol (PG, with only one molecular species), and ceramide aminoethylphosphonate (CAEP, with 15 molecular species). This is the first time that the molecular species of sphingophospholipid were determined, in Meretrix lyrata in particular, and for clams in general. Phospholipid formula species of PE and PS were revealed to comprise two kinds: Alkenyl acyl glycerophosphoethanolamine and Alkenyl acyl glycerophosphoserine occupy 80.3% and 81.0% of total PE and PS species, respectively. In contrast, the percentage of diacyl glycero phosphatidylcholine was twice as high as that of PakCho in total PC, at 69.3, in comparison with 30.7%. In addition, phospholipid formula species of PI and PG comprised only diacyl glycoro phospholipids. PE 36:1 (p18:0/18:1), PC 38:6 (16:0/22:6), PS 38:1 (p18:0/20:1), PI 40:5 (20:1/20:4), PG 32:0 (16:0/16:0) and CAEP 34:2 (16:2/d18:0) were the major molecular species.

Pelvic exenteration in gynecologic cancer: complications and oncological outcome

IntroductionPelvic exenteration (PE) is indicated in cases of unresponsive, recurrent pelvic cancer or for palliative intent. Despite the fact that the surgery is associated with a high rate of morbidity, it is currently the only real option that can effect a cure.Material and methodsPatients who underwent PE between January 2011 and July 2017 in our centre were retrospectively reviewed. Data related to surgery, complications and outcomes were recorded.ResultsTwenty-three patients were included. PE was performed due to recurrent gynaecological cancer, persistence of disease and after first diagnosis in 19 (82%), 2 (9%) and 2 patients (9%), respectively. Total PE was performed in 15 cases (65%), followed by anterior PE in 5 cases (22%) and posterior PE in 3 cases (13%). Early grade II, III and IV complications occurred in 15 (65%), 5 (22%) and 2 patients (9%), respectively. No mortality was observed within 30 days. Medium-late grade II, III, IV and V complications occurred in 15 (65%), 11 (48%), 3 (13%) and 2 cases (9%), respectively. Two patients died after > 30-day period from surgery-related complications. The overall survival (OS) and disease-free survival (DFS) at 48 months after PE was 41.6% and 30.8% respectively.ConclusionsPE provides about a 40% 4-year survival chance in a selected group of patients. The early-complications rate and 30-day mortality were acceptable. Nevertheless, the medium-late complication grades II–V were 65, 48, 18 and 9%, respectively. We must focus on identifying those patients who could potentially benefit most from PE.

Prediction of short-term surgical complications in women undergoing pelvic exenteration for gynecological malignancies

ObjectivePelvic exenteration (PE) is an extensive surgery associated with high rates of postoperative morbidity and mortality. The absence of well-defined preoperative selection criteria to identify patients eligible for PE prompted the assessment of pre-operative predictors of 30-day major surgical complications. MethodsDemographics and surgical characteristics of patients undergoing PE for gynecologic cancer in a single institution between 01/2004–12/2016 were reviewed. Postoperative complications within 30 days following surgery were graded using the Accordion grading system. Logistic regression was used to analyze potential risk factors for severe postoperative complications. ResultsA total of 138 patients were included in the cohort. Forty-five patients underwent total PE, 52 anterior PE, and 41 posterior PE. Among the 137 patients with follow-up, a severe postoperative complication was experienced by 37 patients (27.0%) and 3 patients (2.2%) experienced death within 90 days. The most frequent grade 3 complications were complications of urinary reconstruction (n = 15), wound dehiscence (n = 9), and abdominal abscess requiring intervention with drain or return to the operating room (n = 6). On multivariable analysis, independent predictors of severe postoperative complications were anterior or total PE (adjusted odds ratio (aOR): 11.66, 95% CI 2.56–53.18), pre-operative hemoglobin ≤10 mg/dl (aOR 2.70, 95% CI 1.02–7.14) and presence of 3+ comorbidities (aOR: 2.76, 95% CI 1.07–7.10). ConclusionsMajor complications after exenteration are common. Surgical complexity and patient selection play a considerable role in predicting complications. These data can be used to better risk stratify patients undergoing PE.

Spatial heterogeneity contributes more to portfolio effects than species variability in bottom-associated marine fishes.

Variance of community abundance will be reduced relative to its theoretical maximum whenever population densities fluctuate asynchronously. Fishing communities and mobile predators can switch among fish species and/or fishing locations with asynchronous dynamics, thereby buffering against variable resource densities (termed 'portfolio effects', PEs). However, whether variation among species or locations represent the dominant contributor to PE remains relatively unexplored. Here, we apply a spatio-temporal model to multidecadal time series (1982-2015) for 20 bottom-associated fishes in seven marine ecosystems. For each ecosystem, we compute the reduction in variance over time in total biomass relative to its theoretical maximum if species and locations were perfectly correlated (total PE). We also compute the reduction in variance due to asynchrony among species at each location (species PE) or the reduction due to asynchrony among locations for each species (spatial PE). We specifically compute total, species and spatial PE in 10-year moving windows to detect changes over time. Our analyses revealed that spatial PE are stronger than species PE in six of seven ecosystems, and that ecosystems where species PE is constant over time can exhibit shifts in locations that strongly contribute to PE. We therefore recommend that spatial and total PE be monitored as ecosystem indicators representing risk exposure for human and natural consumers.

Prospective assessment of patient-reported outcomes in gynecologic cancer patients before and after pelvic exenteration

ObjectivePelvic exenteration (PE) is a surgical procedure associated with significant morbidity offered to select women with locally advanced or recurrent gynecologic cancers. This ongoing study examines an array of patient-reported outcomes and satisfaction with PE. MethodsSince February 2009, prospectively enrolled participants completed questionnaires evaluating body image (BIS), depression (CESD), social support (DUFSS), symptoms (MDASI), sexual function (SAQ), functional status (SF-12), quality of life (The Stoma-QOL), satisfaction with decision (SWD) and an investigator-designed survey at baseline, 6, and 12months after PE. Mann-Whitney and Wilcoxon signed-rank tests were used to evaluate the data. ResultsFifty-four women enrolled. Median age was 56years (31, 85). Median BMI was 30.7kg/m2 (16.8, 54.4). The majority of patients (78%) were white. Cancer diagnoses included 41% cervix, 22% uterus, 19% vagina, 17% vulva and 2% ovary. Most surgeries were total PEs (76%).Patients were satisfied with their decision to undergo PE at 6 and 12months. One year after exenteration, 79% of women stated they would have a PE again. Sexual pleasure decreased from baseline to 12months after PE (p=0.02), while sexual discomfort remained unchanged (p=0.42). Body image worsened over time (p=0.003). Physical functioning (SF-12) declined (p=0.001), while mental functioning remained stable (p=0.46). There were no significant changes in stoma-related QOL, social support, or depression scores. ConclusionsDespite a decrease in physical functioning, persistent low body image and sexual pleasure, most women were satisfied with their decision and would undergo pelvic exenteration again. This study identifies survivorship issues that should be addressed after PE.

Determination of phthalate esters in seawater of Chabahar Bay using dispersive liquid-liquid microextraction coupled with GC-FID.

Phthalate esters (PEs), a group of environmental pollutants which are possibly carcinogenic to humans, have been detected in seawater. Seven PEs in seawater were quantitatively determined by using gas-chromatography flame ionizing detection after executing dispersive liquid-liquid microextraction. The suggested method is optimized for microextraction and determination of PEs in artificial sea water. Factors affecting the microextraction procedure such as the type and volume of extracting and dispersive solvents (carbon tetrachloride, 20 μL; methanol, 0.5 mL), extraction time and pH (7) were investigated. Under optimum conditions, the limit of detection of the analytes were obtained between 0.04 and 4.52 μg·L-1, and linearity and linear range were of 0.999 ≥ R2 ≥ 0.994 and 10-560 μg·L-1 respectively. Enrichment factors were found in the range of 761-827 fold, while the relative standard deviations of the analytes were between 0.17 and 7.5% (n = 6) for real sea water samples. Using this method, total PEs content of seawater from several locations in Chabahar Bay (the southeast part of Iran) was estimated 2.33-90.45 μg·L-1.

Private Equity and Devaluation in Emerging Countries

Abstract: Using a comprehensive database with 51 emerging countries studied over a 13 year period, we find that devaluation increases the PE investment. More years of annual devaluation have a higher impact in promoting PE investment. Conclusions are confirmed for total and high technology PE investments, but not for early stage PE investments. Devaluation does not benefit PE investment in firms in the early stages of development. Devaluation itself is not sufficient to encourage the appetite of investors; however, some country-level competitiveness variables are indispensable for making a country more fertile for PE investment when a devaluation occurs – the high relevance of competiveness increasing in the long term.

Esthetic Assessment of Implants Placed into Fresh Extraction Sockets for Single-Tooth Replacements Using a Flapless Approach.

To validate the concept of immediate implant placement and nonfunctional loading for use in the esthetically sensitive anterior maxilla, clinical trials should ideally include objective esthetic criteria. This study analyzed procedural results as graded by the pink esthetic score and white esthetic score (PES/WES). Thirty-nine suitable patients (mean follow-up 44.82 ± 28 months) were evaluated. Thirty-eight implants fulfilled stringent criteria for successful osseointegration: absence of peri-implant radiolucency, implant mobility, suppuration, and pain. The mean total PES/WES was 15.50 ± 2.67 (range: 10-20). The mean total PES of 7.92 ± 1.60 (range: 5-10) indicated favorable overall peri-implant soft-tissue conditions. Root convexity and texture (1.63 ± 0.54) and curvature of the facial mucosa (1.68 ± 0.47) and distal papilla (1.66 ± 0.48) had the highest mean values, whereas acceptable levels of facial tissue (1.53 ± 0.73) and mesial papilla (1.42 ± 0.64) were the most difficult to fully achieve. The mean mesial and distal bone loss at data collection was, was 1.19 ± 0.54 and 1.15 ± 0.51, respectively. Periodontal disease severity (advanced chronic and aggressive periodontitis) was significantly associated with a low total PES (p = .048). Objective PES/WES assessment validated immediate anterior maxillary single-tooth replacement and restoration as being a successful and esthetically predictable treatment modality in sites where the buccal bone had been preserved during the extraction at 1 year of follow-up.