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Background: The Latarjet procedure was developed for the treatment of anterior shoulder instability in young, high-demand patients with attritional glenoid bone loss, whose risk of redislocation following primary dislocation may exceed 90%. Coracoid graft osteolysis and prominent screws are commonly observed in late computed tomography (CT) scans of patients who re-present following the procedure, but the clinical relevance of osteolysis in the overall Latarjet cohort is undetermined. We aimed to evaluate clinical and radiological outcomes in patients who underwent the Latarjet procedure, and to determine if severe coracoid graft osteolysis compromised clinical outcomes. Methods: This was a retrospective analysis of patients who underwent the open Latarjet procedure. Patients were invited via an e-questionnaire that contained a Western Ontario Shoulder Instability Index (WOSI), and queried about redislocation and reoperation since index surgery. Preoperative glenoid bone loss was calculated on CT using the best-fit circle method. Osteolysis was graded (0, screw head buried in graft; 1, screw head exposed; 2, threads exposed; 3, complete resorption/severe osteolysis) at the level of the proximal and distal screws respectively, on axial CT scans performed ≥ 12 months postoperatively. Results: Between 2011 and 2022, a single surgeon performed 442 Latarjet procedures. One hundred fifty eight patients responded to the questionnaire at median (interquartile range [IQR]) 44 (27-70) months postoperatively, among whom the median (IQR) WOSI score was 352 (142-666) points (0 = best, 2100 = worst). Recurrent anterior instability occurred in 3/158 (2%) patients. One patient required reoperation for this indication. Among patients who had CT scans ≥ 12 months postoperatively (median [IQR] 40 [29-69] months), 1 patient developed severe osteolysis around both screws (WOSI = 90), 17/62 (27%) patients developed severe osteolysis around 1 screw, all of which were proximal (median [IQR] WOSI = 235 [135-644]), and 44/62 (71%) patients did not develop severe osteolysis around either screw (median [IQR] WOSI = 487 [177-815]). There were no statistically significant differences in WOSI scores between groups based on the presence of severe osteolysis. Conclusion: The Latarjet is reliable procedure that has a low rate of redislocation and reoperation. Severe coracoid graft osteolysis occurs with time, and always affects the proximal graft first. The presence of severe osteolysis did not compromise clinical outcomes.

Objectives: This study aimed to investigate whether oocyte retrieval from PCOS patients affects the morphokinetics or the incidence of abnormalities in early embryonic development, using time-lapse imaging analysis. Methods: This was a prospective study in total of 39 PCOS patients and 67 women with normal ovarian function, underwent a GnRH antagonist protocol of controlled ovarian stimulation and fertilization by ICSI. 402 zygotes from the PCOS group and 449 zygotes from the control group were observed by time-lapse monitoring for 48 h following sperm injection. Results: Patients with PCOS showed a significantly higher number of retrieved oocytes, and a significantly higher number of metaphase II oocytes per cycle than that of the non-PCOS group (18.85 ± 9.41 vs. 11.48 ± 5.51 and 14.97 ± 7.43 vs. 9.51 ± 4.7, respectively). However, oocyte maturation rate and morphologically assessed embryo quality did not differ between two groups. After 48 h of the embryo culture using time-lapse video recording, most of the embryos in both groups had reached the 4-cell stage (353/449 vs. 314/402 embryos). There were no significant differences between the control and PCOS group regarding the time-points of the successive events in early embryonic development from the appearance of 2 polar bodies to the 6-cell stage. However, the percentage of t2 stages which fell in “optimal range” (>24 h and ≤28 h) was significantly lower in the PCOS group than in the control group (37.8% vs. 48.1%, P = 0.004). The proportion of embryos manifesting abnormal fertility, multinucleation, direct cleavage and reverse cleavage were not significantly different between the two groups. Conclusion: Our data indicated that PCOS does not affect the morphokinetics or incidence of abnormalities in early embryonic development. Keywords: PCOS, Time-lapse monitoring, Morphokinetics, Embryo cleavage, Early development

The research aims to investigate the support suppliers’ decision making for Textile and Garment Vietnamese Enterprises based on using association rules mining. In order to increase the competitive advantage over other enterprises, Vietnamese enterprises are gradually shifting their production methods from CMT (Cut-Make-Trim) to FOB (Free On Board), ODM (Original Design Manufacturing), and OBM (Original Brand Manufacturing). One of the important steps for this transformation is to be self-sufficient in sourcing raw materials from selected suppliers with sufficient capabilities, meeting the requirements of price, and CSR (corporate social responsibility) to enable Vietnamese enterprises to enjoy tax incentives. The Vietnamese Enterprises participate in the textile and garment production process through importing raw materials from other countries such as China, Korea, etc. Therefore, the selection supplier issue is very important to them to enhance their business products. This study researches on finding positive ARs and negative ARs in Textile and Garment data domain via three scenarios to define the relationship of alternative criteria for selection suppliers. By using alternative method of ARM (Association Rule Mining), the experimental results show that Textile and Garment enterprises in Vietnam appreciate the CSR factor highly. This is completely in line with the previous survey research on the new factor in the supplier selection criteria of Textile and Garment enterprises in Vietnam. In another word, in this field, the CSR plays as an important role to reflect company’s image and it is the first of decision choice. The other criteria are considered after including Cost, Quality, and Delivery respectively. The remain factors of Service, Capability, Relationship, and Sourcing Country are not highly evaluated via the experiments. With different scenarios along with the association rules mined, they reflect different sets of criteria that textile and garment enterprises use to select their suppliers. Furthermore, the rare rules show situations that are very unlikely but have high reliability in reality. Based on the findings, the factors will show the essentials for suppliers to improve themselves to meet the requirements.

Background: Mislabelled penicillin allergies are associated with a myriad of adverse outcomes and development of anti-microbial resistance. With the overwhelming need for specialist allergy services, pharmacist initiatives such as the Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) have been advocated. However, evidence of their effectiveness, safety and impact on health-related quality-of-life (HR-QoL) are lacking.To assess and compare the effectiveness, safety and improvements on HR-QoL of pharmacists vs allergists in a pilot low-risk penicillin allergy delabelling initiative. Methods: All adult patients referred for low-risk penicillin allergy were randomized and evaluated by either pharmacists or allergists in a 1:3 ratio. Outcomes and changes in Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) scores were compared. Results: Of 323 patients referred, 96.3% (311/323) completed penicillin allergy evaluation (pharmacists: 83 [24.3%] vs allergists: 228 [66.7%]). Overall, 93.6% (291/311) were delabelled with no difference between evaluations by pharmacists and allergists (92.8% vs 93.9%, p = 0.729). There were no severe or systemic reactions in either cohort. Patients evaluated by either pharmacists (43.4 [SD:29.1] to 10.5 [SD:5.93], p

Background: Radial head subluxation, known as pulled elbow or nursemaid’s elbow, is a common pediatric condition that occurs when a longitudinal traction force is applied to an extended elbow. The purpose of our study was to demonstrate and quantify the axial traction force required to produce a nursemaid’s elbow in a pediatric cadaver specimen and to review the current relevant literature. Methods: We performed a literature search to identify relevant articles describing the nursemaid’s elbow injury, as well as relevant biomechanical studies of the radiocapitellar joint. For the biomechanical model, 2 fresh-frozen cadaveric elbows from a single 3-year-old male donor were dissected by a fellowship-trained orthopedic surgeon. An Instron 5,944 testing machine with a 2 kN load cell was used to perform uniaxial testing. The radius and humerus were mounted to the Instron machine and loaded in the axial direction with the elbow in full extension. Loading occurred at a rate of 10 mm/second for 4 seconds, during which the force and actuator displacement were continuously recorded. The local instantaneous load and extension displacement at the time of subluxation were recorded. Results: The load to failure required to produce the nursemaid’s elbow injury in our first specimen was 31 N, with a failure displacement of 4.6 mm. The second specimen demonstrated a load to failure of 26 N, with a failure displacement of 4.6 mm. After subluxation, we reduced the annular ligament from the first specimen. The elbow was then retested and demonstrated a load to failure of 20 N, with a failure displacement of 2.6 mm. Conclusions: Axial traction applied to a pediatric elbow results in subluxation of the annular ligament into the radiocapitellar joint, at relatively low loads. We demonstrated a mean load to failure in a pediatric cadaveric model of 28.5 N, and a lower load to failure was required to produce a recurrent subluxation in a previously injured specimen. Key Concepts: (1) Radial head subluxation, known as pulled elbow or nursemaid’s elbow, is a common pediatric condition that occurs when a longitudinal traction force is applied to an extended elbow. (2) This study is the first to demonstrate and quantify the axial traction force required to produce a nursemaid’s elbow in a pediatric cadaver specimen. (3) Axial traction applied to a pediatric cadaver specimen results in subluxation of the annular ligament into the radiocapitellar joint. (4) The mean load to failure is 28.5 N, and a lower load to failure is required to produce a recurrent subluxation in a previously injured specimen. (5) Literature supports that the nursemaid’s elbow injury is a result of subluxation of the annular ligament into the radiocapitellar joint, though this may involve a spectrum of injury to the annular ligament itself.

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare, benign type of ossifying fibroma. JPOFs predominantly present as rapidly growing masses with a high recurrence rate. We report a 40-year-old male patient who suffered from a large tumor with multiple invasions into the paranasal sinuses. Total excision was performed, and significant relief of clinical symptoms was recorded after 4 months of follow-up. Multi-departmental management involving radiologists, neurology surgeons, craniofacial surgeons, pathologists, and otolaryngologists is vital for JPOF treatment. First-line treatment options include total or partial resection, depending on the patient's condition.

ABSTRACT: Objectives: This study aimed to investigate the in vitro activities of tigecycline (TGC) and the underlying molecular mechanisms of TGC stress response and resistance in clinical Enterococcus faecalis isolates from China. Methods: Antimicrobial susceptibility and antibiofilm activities of TGC in 399 E. faecalis isolates were evaluated. Heteroresistance was evaluated by population analysis profiling. Resistance and heteroresistance mechanisms were investigated by identifying genetic mutations in tetracycline (tet) target sites and through analysis of efflux protein inhibitors (EPIs). Furthermore, quantitative proteomics was used to investigate the global proteomic response of E. faecalis to TGC stress, as well as the resistance mechanisms of TGC within in vitro induced resistant isolate. Results: TGC minimum inhibitory concentrations (MICs) against clinical E. faecalis isolates were ≤0.5 mg/L. TGC displayed remarkable inhibitory activity against biofilm formation. The occurrence rate of TGC heteroresistance was 1.75% (7/399), and the increased TGC MIC values of heteroresistance-derived clones could be reversed by EPI. TGC resistance was associated with mutations in the 16S rRNA site or 30S ribosomal protein S10. A total of 105 and 356 differentially expressed proteins was identified after being exposed to 1/2× MIC concentrations of TGC, while 356 differentially expressed proteins was identified in TGC-resistant isolate. The differentially expressed proteins were enriched in the translation and DNA replication process. In addition, multiple adenosine triphosphate (ATP)-binding cassette (ABC) transporters were upregulated. Conclusions: TGC exhibited excellent activity against a substantial proportion of clinical isolates from China. However, E. faecalis exhibited a strong adaptation mechanism during TGC exposure: mutation of TGC target sites and elevated expression of efflux pumps under TGC selection, resulting in TGC resistance.

Background: Several countries have implemented control measures to limit SARS-CoV-2 spread, including digital contact tracing, digital monitoring of quarantined individuals, and testing of travelers. These raise ethical issues around privacy, personal freedoms, and equity. However, little is known regarding public acceptability of these measures. Methods: In December 2020, we conducted a survey among 3635 respondents in Singapore, Hong Kong, and Malaysia to understand public perceptions on the acceptability of COVID-19 control measures. Findings: Hong Kong respondents were much less supportive of digital contact tracing and monitoring devices than those in Malaysia and Singapore. Around three-quarters of Hong Kong respondents perceived digital contact tracing as an unreasonable restriction of individual freedom;

Background: The increasing number of reports on cutaneous reactions following COVID-19 vaccination has led to growing concerns among certain groups. Objective: We reviewed the published reports of cutaneous lesions after COVID-19 vaccination. Methods: We conducted a literature search for original and review articles published between January 1, 2020, and September 27, 2021. Results: Eleven cutaneous reactions associated with COVID-19 vaccines were determined; the most prevalent reactions were local injection site reactions, delayed local reactions, urticaria, angioedema, and morbilliform eruptions. There were more reports on skin reactions following the administration of messenger RNA-based vaccines than on those following the administration of adenoviral vector or inactivated whole-virus vaccines, in part, due to their higher administration rate. Most reported skin reactions occurred after the first vaccine dose. Limitations: A reporting bias could not be excluded, and skin biopsy results were not available for most included individuals. Moreover, given that the included trials focused on vaccine efficacy, there was a lack of details concerning cutaneous reactions and participant information. Conclusion: Not all cutaneous reactions observed after COVID-19 vaccination are hypersensitivity reactions. Different cutaneous reactions may reflect underlying immune responses to the vaccines. A large majority of COVID-19 vaccination reactions were mild and self-limiting, and people should be encouraged to complete their vaccination regimen.

Nanomedicine has been widely studied for the diagnosis and treatment of hepatocellular carcinoma (HCC). How to synthesize a nanoplatform possessing a high synergistic therapeutic efficacy remains a challenge in this emerging research field. In this study, a convenient all-in-one therapeutic nanoplatform (FTY720@AM/T7-TL) is designed for HCC. This advanced nanoplatform consists of multiple functional elements, including gold-manganese dioxide nanoparticles (AM), tetraphenylethylene (T), fingolimod (FTY720), hybrid-liposome (L), and T7 peptides (T7). The nanoplatform is negatively charged at physiological pH and can transit to a positively charged state once moving to acidic pH environments. The specially designed pH-responsive charge-reversal nanocarrier prolongs the half-life of nanodrugs in blood and improves cellular uptake efficiency. The platform achieves a sustained and controllable drug release through dual stimulus-response, with pH as the endogenous stimulus and near-infrared as the exogenous stimulus. Furthermore, the nanoplatform realizes in situ O2 generation by catalyzing tumor over-expressed H2O2, which alleviates tumor microenvironment hypoxia and improves photodynamic therapy. Both in vitro and in vivo studies show the prepared nanoplatform has good photothermal conversion, cellular uptake efficiency, fluorescence/magnetic resonance imaging capabilities, and synergistic anti-tumor effects. These results suggest that the prepared all-in-one nanoplatform has great potential for dual-modal imaging-guided synergistic therapy of HCC.

A fundamental goal across the neurosciences is the characterization of relationships linking brain anatomy, functioning, and behavior. Although various MRI modalities have been developed to probe these relationships, direct comparisons of their ability to predict behavior have been lacking. Here, we compared the ability of anatomical T1, diffusion and functional MRI (fMRI) to predict behavior at an individual level. Cortical thickness, area and volume were extracted from anatomical T1 images. Diffusion Tensor Imaging (DTI) and approximate Neurite Orientation Dispersion and Density Imaging (NODDI) models were fitted to the diffusion images. The resulting metrics were projected to the Tract-Based Spatial Statistics (TBSS) skeleton. We also ran probabilistic tractography for the diffusion images, from which we extracted the stream count, average stream length, and the average of each DTI and NODDI metric across tracts connecting each pair of brain regions. Functional connectivity (FC) was extracted from both task and resting-state fMRI. Individualized prediction of a wide range of behavioral measures were performed using kernel ridge regression, linear ridge regression and elastic net regression. Consistency of the results were investigated with the Human Connectome Project (HCP) and Adolescent Brain Cognitive Development (ABCD) datasets. In both datasets, FC-based models gave the best prediction performance, regardless of regression model or behavioral measure. This was especially true for the cognitive component. Furthermore, all modalities were able to predict cognition better than other behavioral components. Combining all modalities improved prediction of cognition, but not other behavioral components. Finally, across all behaviors, combining resting and task FC yielded prediction performance similar to combining all modalities. Overall, our study suggests that in the case of healthy children and young adults, behaviorally-relevant information in T1 and diffusion features might reflect a subset of the variance captured by FC.

Background: Vietnam is one of the countries most impacted by disasters in Asia- Pacific. Floods, droughts and storms are the most common catastrophes. These risks endanger millions of lives and create massive financial and production losses. Objective: This study aims at reviewing the disaster risk management (DRM) system in Vietnam, identifying progress and challenges of this system, hence making recommendations for improving the system for better responding with natural hazards. Method: The study uses PSR model (Pressure- State- Response) in combination with DRM management framework by United Nations Development Program (UNDP) to evaluate DRM system in Vietnam with 5 aspects: (i) DRM regulatory framework (ii) DRM organization (iii) DRM financial resources (iv) DRM integration in to plans at central and local levels (v) Disaster warning and education. The data collection consists of reviewing existing literature and interviewing key informants in DRM. Results: Disasters is a serious threat to Vietnam’s socio economic development. To respond, Vietnam has made many efforts including develop a comprehensive legal framework for DRM which Law on Disaster Prevention and Control takes the key role. Vietnam has also established a fairly well organized DRM system from the central to local levels. The financial sources for DRM are arranged from State budget and sources outside State budget. Vietnam has developed major policies for integrating DRM into development plans centrally and locally. The disaster information and warning system is being modernized with the integration of disaster education in training programs. Challenges in DRM are identified, including institutional, financial and information issues. In addition, Vietnam is facing the increase of disasters and extreme climate events due to climate change. Covid 19 and its socio-economic consequences also lead to a lack of resources for DRM. Economic development moreover results in the decline of ecosystem-based disaster mitigation works and put more pressures on DRM. Recommendations: In the future, Vietnam should develop an information-sharing network between ministries, sectors, localities and NGOs to support the policy formulation process and enhance the coordination of multi-stakeholders. The country should also establish more proper funding allocation mechanisms to fulfill DRM’s demands, especially for disaster preparedness and reconstruction phases.

Multiple myeloma (MM) is a blood cancer in which monoclonal plasma cells cause end organ damage resulting in hypercalcemia, renal failure, anemia, and bone lesions. MM is considered incurable, however, recent advances in treatment have improved survival. Historically, MM has been treated with immunomodulatory drugs (IMiDs), proteosome inhibitors (PIs), and corticosteroids. While newer therapeutic approaches such as monoclonal antibodies and cellular therapies have broadened the treatment horizon, the selection and sequencing of these therapies has become more complex. This review aims to help advanced practice providers navigate through the diagnosis, staging, treatment, and supportive care considerations in the MM space.

Responses from stock markets to the Covid-19 pandemic appear to change over time. Recent responses might differ as herd mentality in stock markets tends to become herd immunity to the pandemic. This study revisits the pandemic's effects on the Asia-Pacific countries' market volatility over the past 25 months. Primarily, we examine the changes of the impacts of the pandemic on volatility between the first pandemic period (2020) and the second period (January 2021–January 2022). Our findings indicate that implementing pandemic control measures helps reduce market volatility at the country and region levels. The effects of new Covid-19 cases and pandemic control measures on market volatility have been dramatically fading since 2021. The Toda-Yamamoto causality test and the panel impulse response functions from panel VAR estimation are also used for robustness analysis. Based on our findings, it appears that the current pandemic may no longer be blamed for stock market volatility in the Asia-Pacific region.

Merkel cell carcinoma (MCC), a rare and aggressive skin tumor, has a tendency to occur in association with hematologic malignancies, in particular chronic lymphocytic leukemia (CLL). The permissive immunologic environment and Merkel cell polyoma virus infection has been postulated as part of MCC pathogenesis. A collision tumor consisting of follicular lymphoma (FL) and MCC has never been described. Here we report an unusual case of nodal MCC of unknown primary arising in an immunocompetent patient who had FL involving multiple lymph nodes. Similar to the FL, PAX-5 and BCL2 were also expressed in the MCC. Cytogenetic and molecular studies showed that the two neoplastic processes are clonally unrelated. We also demonstrated a pathogenic PTEN mutation that has not been previously reported in MCC, associated with loss of heterozygosity due to monosomy 10. Our mutation data suggests that MCC of unknown primary may be pathogenetically related to typical cutaneous MCC.

Origin of the COVID-19 virus (SARS-CoV-2) has been intensely debated in the scientific community since the first infected cases were detected in December 2019. The disease has caused a global pandemic, leading to deaths of thousands of people across the world and thus finding origin of this novel coronavirus is important in responding and controlling the pandemic. Recent research results suggest that bats or pangolins might be the hosts for SARS-CoV-2 based on comparative studies using its genomic sequences. This paper investigates the SARS-CoV-2 origin by using artificial intelligence (AI)-based unsupervised learning algorithms and raw genomic sequences of the virus. More than 300 genome sequences of COVID-19 infected cases collected from different countries are explored and analysed using unsupervised clustering methods. The results obtained from various AI-enabled experiments using clustering algorithms demonstrate that all examined SARS-CoV-2 genomes belong to a cluster that also contains bat and pangolin coronavirus genomes. This provides evidence strongly supporting scientific hypotheses that bats and pangolins are probable hosts for SARS-CoV-2. At the whole genome analysis level, our findings also indicate that bats are more likely the hosts for the COVID-19 virus than pangolins.