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Minimally invasive techniques to occlude flow within blood vessels, initially pioneered in the 1970s with autologous materials and subsequently advanced with increasingly sophisticated engineered biomaterials, are routinely performed for a variety of medical conditions. Contemporary interventional radiologists have at their disposal a wide armamentarium of occlusive agents to treat a range of disease processes through a small incision in the skin. In this review, we provide a historical perspective on endovascular embolization tools, summarize the current state-of-the-art, and highlight burgeoning technologies that promise to advance the field in the near future.

Purpose: Investigate whether number of logged Accreditation Council for Graduate Medical Education (ACGME) surgical cases correlates with likelihood of Virginia Commonwealth University Health System (VCUHS) ophthalmology residents being selected as the chief resident. Design: Retrospective study. Participants: VCUHS ophthalmology residents from 2006 to 2016. Methods: Analyze association between chief resident selection and logged cases. Main outcome measures: Review number of archived logged ACGME surgical cases of all residents between the years 2006 and 2017. Review chief resident selected each year 2006-2016. Results: Our analysis correctly predicted the chief resident in 2 of the 10 years analyzed. Conclusion: Those residents performing the most surgical procedures in each respective class were not more likely to be selected as chief resident.

Citation: Carbonara U, Osardu R K, Cisu T I, Crocerossa F, Autorino R Robot-assisted simple prostatectomy for giant benign prostatic hyperplasia. www.ceju.online/journal/2020/giant-prostatic-hyperplasia-benign-prostatic-hyperplasia-2057.php Key Words: benign prostatic hyperplasia * giant prostatic hyperplasia * robotic simple prostatectomy Benign prostate hyperplasia (BPH) is a common condition causing progressive lower urinary tract symptoms in aging males. According to current guidelines, patients with symptomatic or complicated BPH unresponsive to medical therapy are candidates for surgery. [...]GPH is a rare clinical entity which can be challenging to manage.

Most data on self-poisoning in rural Asia have come from secondary hospitals. We aimed to: assess how transfers from primary to secondary hospitals affected estimates of case-fatality ratio (CFR); determine whether there was referral bias according to gender or poison; and estimate the annual incidence of all self-poisoning, and of fatal self-poisoning, in a rural developing-world setting. Self-poisoning patients admitted to Anuradhapura General Hospital, Sri Lanka, were reviewed on admission from 1 July to 31 December 2002. We audited medical notes of self-poisoning patients admitted to 17 of the 34 surrounding peripheral hospitals for the same period. A total of 742 patients were admitted with self-poisoning to the secondary hospital; 81 died (CFR 10.9%). 483 patients were admitted to 17 surrounding peripheral hospitals. Six patients (1.2%) died in peripheral hospitals, 249 were discharged home, and 228 were transferred to the secondary hospital. There was no effect of gender or age on likelihood of transfer; however, patients who had ingested oleander or paraquat were more likely to be transferred than were patients who had taken organophosphorus pesticides or other poisons. Estimated annual incidences of self-poisoning and fatal self-poisoning were 363 and 27 per 100,000 population, respectively, with an overall CFR of 7.4% (95% confidence interval 6.0-9.0). Fifty per cent of patients admitted to peripheral hospitals were discharged home, showing that CFRs based on secondary hospital data are inflated. However, while incidence of self-poisoning is similar to that in England, fatal self-poisoning is three times more common in Sri Lanka than fatal self-harm by all methods in England. Population based data are essential for making international comparisons of case fatality and incidence, and for assessing public health interventions.

Three Phanerochaete chrysosporium endo-1,4-beta-xylanase genes were cloned and expressed in Aspergillus niger. Two of these genes, xynA and xynC, encode family 10 glycoside hydrolases, while the third, xynB, codes for a family 11 glycoside hydrolase. All three xylanases possess a type I carbohydrate-binding domain connected to the catalytic domain by a linker region. The three xylanases were purified to homogeneity by weak anion or Avicell column chromatography and subsequently characterized. The XynA, XynB and XynC enzymes have molecular masses of 52, 30 and 50 kDa, respectively. Optimal activity was obtained at pH 4.5 and 70 degrees C with the family 10 xylanases and pH 4.5 and 60 degrees C with the family 11 xylanase. The measured Km when using birchwood xylan as the substrate was 3.71 +/- 0.69 mg/ml for XynA and XynC and was 9.96 +/- 1.45 mg/ml for XynB. Substrate specificity studies and the products released during the degradation of birchwood xylan suggest differences in catalytic properties between the two family 10 xylanases and the family 11 xylanase.

Yang Yie Sio,1 Tan Ching Ong,1 Yee-How Say,2 Kavita Reginald,3 Fook Tim Chew1 1Department of Biological Sciences, National University of Singapore, Singapore; 2Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR) Kampar Campus, Kampar, Perak, Malaysia; 3Department of Biomedical Sciences, Sir Jeffrey Cheah Sunway Medical School, Faculty of Medical and Life Sciences, Sunway University, Petaling Jaya, Selangor, MalaysiaCorrespondence: Fook Tim Chew, Email dbscft@nus.edu.sgBackground: Sensitization to pet dander allergens has been increasing globally, however, its clinical relevance to allergic disease exacerbation remains underexplored.Objective: We aimed to determine the prevalence of serum-specific IgE (SSIgE) response to the major dog allergen Canis familiaris 1 (Can f 1), and to evaluate its association with asthma-related symptom severity and exacerbation in a Singapore/Malaysia population.Patients and Methods: A comprehensive serological profiling of specific IgE responses to 38 common inhalant and seafood allergen sources was performed in 736 young adults from the Singapore/Malaysia Cross-sequential Genetics and Epidemiology Study (SMCGES) sub-cohort. SSIgE levels were analyzed in relation to asthma diagnosis, symptom frequency, and exacerbation history.Results: Detectable Can f 1-specific IgE was present in 13.5% of participants, predominantly at low-grade Class 1– 2 levels (0.35– 3.49 IU/mL). Individuals with pre-existing sensitization to common inhalant and seafood allergen sources, including house dust mites (HDM), cat dander (Felis domesticus 1, Fel d 1), pollen, fungi, crustaceans, mollusks, and fish, showed a significantly higher rate of Can f 1-specific IgE response. Among asthmatic subjects, elevated Can f 1 SSIgE levels were significantly associated with recent (past 12 months) wheezing (p=0.005), daytime (p=0.019) and nighttime asthma attacks (p=0.033), and asthma exacerbations (p=0.001). These associations remained to be significant and consistent in trend among asthmatic patients sensitized to HDM allergen sources.Conclusion: Sensitization to Can f 1 is associated with increased asthma-related symptom burden and exacerbation risk, particularly in individuals with pre-existing atopy among young adults in Singapore and Malaysia. These findings highlight Can f 1-specific IgE as a potential molecular marker for identifying higher-risk asthma phenotypes in the tropical environment.Keywords: allergens, allergenicity, dogs, lipocalin, immunoglobulin E

The Haitian earthquake of 2010 with its devastation of property, environment and economy resulted in death, disease and mental health issues proved to test Haitian resilience in coping with the event, as well as the lingering impacts. This study used mixed methods to study resilience in a sample of 118 Haitians who experienced the devastating earthquake of 2010 as minors living in or near the capitol of Port-au-Prince at the time. Individual resilience theory framed how experiencing this natural disaster as youths impacted participants’ perspectives over the course of their adulthood. The Creole Haitian Resilience Scale (Cénat & Derivois, 2014) was used to collect quantitative data. Concurrent open-ended interviewing yielded qualitative data to provide context. Taken together in a nested design, the data clarifies the relationship between self-appraisal of personal competence, acceptance of self/life, and autonomy, which connected interview data that yielded themes of positive views and negative feelings. Specifically, the Creole Haitian Resilience Scale resulted in an average response of 40.9 (low resilience). Within this scale, the items in Personal Competence and Autonomy explained a significant proportion of variance among resilience scores F(2, 116) = 178.60, p < .001. The phenomenological questioning produced themes of community feeling, goal-oriented mindset, lack of opportunities to improve community life, negative effect on academic development, and negative effect on the ability to function. The study contributes to the limited body of research on Haitian resilience when dealing with the resilience of the young adult survivors of the 2010 Haitian earthquake that were minors at the time of the event.

Amebic liver abscess (ALA) is a serious, but readily treatable form of hepatic infection. In order to understand the clinical features of this condition in the United States, we reviewed the medical histories of 56 patients with ALA at two large San Francisco Hospitals from 1979 to 1994. Patients were divided into the following groups based on the presumed manner in which they had acquired ALA: those born or raised in the United States, with a history of travel to an endemic area (Tr-ALA); those from an endemic area, but living in the United States for less than one year (En-ALA); and those neither from nor having traveled to an endemic area (N-ALA). We found distinct clinical patterns in patients from different epidemiological groups. Patients with Tr-ALA were a decade older than those from endemic regions, were more likely to be male, and tended to have an insidious onset. Furthermore, compared to patients with En-ALA, those with Tr-ALA were more likely to have hepatomegaly (P < 0.0001) and large abscesses (ALA > 10 cm; P < 0.01). One third of the patients studied had no associated travel history or endemic origin as risk factors. Of these, 63% had a condition consistent with severe immunosuppression, such as infection with the human immunodeficiency virus (HIV), malnourishment with severe hypoalbuminemia, or chronic infection. In patients with N-ALA, the presence of a presumed immunosuppressed state increased significantly, as compared to patients with endemic or travel risk factors for ALA. During the last five years of the study, one third of all patients diagnosed with ALA were HIV positive (including 2 with a new diagnosis of AIDS), many of whom were discovered to be HIV-infected only after presentation with ALA. We conclude that travel to and origin in an endemic area are important risk factors for the development of ALA, and patients in these different epidemiological groups appear to have distinct clinical features. Further, in the absence of recognized risk factors, the development of ALA may suggest an immunocompromised host.

In recent years, colleges and universities have witnessed an increase in the number of adult learners entering higher education (Hardin, 2008; Osgood-Treston, 2001). The growth in adult students attending college encourages institutions to better understand the specific needs of the adult learner population. While adult learners may enter higher education for a variety reasons, nontraditional learners generally face similar challenges while pursuing academic endeavors. The purpose of this study was to examine the academic, social, and environmental needs of adult learners, as perceived by adult learners and faculty, to enhance the way four-year universities address the needs of this student population. This study used quantitative measures in its design by using the survey method. The survey, with a convenience sample of 136 adult learners and 74 faculty members, was used to measure responses to each of the research questions. The dependent variables of this study were academic, social and environmental needs; whereas, the independent variables included adult learners and faculty members. To analyze the research data, three 2 x 2 Analysis of Variance (ANOVA) tests were used to compare means between adult learners and faculty perceptions to academic, social, and environmental needs of adult learners in a four-year setting. The quantitative findings of the study indicated a statistically significant interaction occurred between part-time and full-time status in relation to academic needs. The results also indicated a statistically significant interaction occurred between part-time and full-time status regarding adult learner environmental needs No other relationships were found through the analyses of participant data.

A lack of available sources has left Shepard's legacy to the elucidation of scholars. [...]Lenwood G. Davis and Janie Miller's Selected Writings and Speeches of James E. Shepard, 1896-1946: [...]this book provides an excellent source of primary documents, including newspapers articles, speeches, and correspondence, from an African American leader during the Jim Crow era.