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Omental torsion is a medical condition characterized by the twisting of the omentum along its longitudinal axis, which leads to compromised blood flow. This condition is rarely diagnosed before surgery and can present symptoms similar to other causes of acute surgical abdomen. This report details a case of primary omental torsion initially suspected to be acute appendicitis. The patient was admitted to the hospital with symptoms of lower right quadrant abdominal pain and mild fever. Computed tomography imaging revealed a twisted mass of fatty tissue with surrounding fat stranding changes, but no signs of appendicitis were found, indicating omental torsion. The patient underwent surgery to remove the twisted and necrotic omentum, leading to an improvement in symptoms. This case highlights the challenges in diagnosis and the crucial role of computed tomography imaging in managing this rare condition.

Acute appendicitis is an ordinary surgical emergency, typically attributed to luminal obstruction by fecaliths or lymphoid hyperplasia. However, ingested foreign bodies as an etiology are rare but increasingly recognized, particularly in pediatric patients. We present the case of a 9-year-old male patient who presented to the emergency department with symptoms consistent with acute appendicitis. Further investigation revealed the presence of a bone fragment within the appendix, leading to acute inflammation. Foreign body ingestion should be considered in pediatric patients with acute appendicitis. This case report underscores the importance of comprehensive clinical evaluation and appropriate diagnostic imaging modalities in guiding optimal treatment strategies.

Background: CareHPV is a highly promising screening HPV assay that functions as a simplified and rapid point-of-care test, making it particularly well-suited for low-resource areas. It exhibits high sensitivity for detecting cervical precancerous lesions in cross-sectional study design. However, there is still limited evidence on the long-term protection of careHPV testing in the practical setting. Methods: A government-led cervical cancer screening program was implemented in Ordos City, China, specifically targeting female residents aged 35–64 years since 2016. CareHPV specimens were collected and visual inspection with acetic acid and Lugol iodine (VIA/VILI) was performed in the baseline screening. Women who were HPV-positive or VIA/VILI-suspected cancer at baseline were invited for a one-year follow-up screening. At the same time, those who were HPV-negative were scheduled for a 5-year rescreening. Women diagnosed with cervical intra-epithelial neoplasia grade 2 or worse (CIN2+) would be referred to clinical treatment as per the clinical guidelines. The current study includes participants who had valid baseline screening results and attended follow-ups with valid careHPV results conducted between January 2017 and December 2021, aiming to assess the long-term risk stratification for careHPV. Cumulative incidence rate (CIRs) and hazard ratio (HRs) for CIN2+ were calculated, using survival analysis. Results: Among the 179,306 women enrolled in the baseline screening between 2016 and 2020, 12.60 % tested positive for careHPV, with 657 cases of CIN2+ identified. The final analysis included 18,562 women in our study, of whom 58.54 % were careHPV-positive at baseline. The final analysis consisted of 17,905 women who underwent screening between 2016 and 2020 and attended follow-ups from 2017 to 2021, with valid HPV results, and 657 women who identified as CIN2+ at the baseline. The 5-year CIRs were 0.003 and 0.101 among women who tested negative and positive for baseline careHPV, respectively. The 5-year CIRs for developing CIN2+ during follow-ups were 0.009, 0.009, and 0.11 for the groups of women who transitioned from careHPV-negative to positive (831, 4.64 %), careHPV-positive to negative (6688, 37.35 %), and maintained a stable positive careHPV status (3535, 19.74 %), respectively. Conclusions: Our findings support the long-term safety and protection of careHPV testing in 5-year follow-ups of screening programs. CareHPV represents a viable option for regions with limited healthcare resources.

ObjectiveTo investigate the situation and influencing factors of recall colposcopy attendance among women with positive cervical cancer screening results in Ordos city, in order to provide a reference for improving colposcopy recall compliance. MethodsFrom a cervical cancer screening program conducted at maternal and child health hospitals in different banners (districts) of Ordos city, Inner Mongolia Autonomous Region between January 2016 and December 2020, we extracted the data of 4 094 women (aged 35 – 64 years) who tested positive in the first detection. Data on the urbanization rate and gross domestic product (GDP) of the banners (districts) were also collected simultaneously. A multilevel logistic regression model was used to analyze the main factors influencing women′s attendance at for colposcopy recall. ResultsOf the 4 094 women who were recalled, 2 724 (67.0%) actually underwent the recall colposcopy. Of the 2 742 women who had a recall colposcopy, 2 681 (97.8%) had the recall examination at the original screening facilities and only 61 (2.2%) had the recall re-examination or colposcopy at other medical facilities. The multilevel logistic regression analysis showed that women aged 55 to 64 years, with an education of junior high school and above, with abnormal vaginal discharge, and with a history of cervical cancer screening were more likely to have the recall colposcopy; whereas, the women from banners with urbanization rate of more than 80% and GDP between 11 and 27 billion yuan RMB were less likely to have the recall colposcopy, in addition, those from regions with urbanization rate of 70% to 80% and GDP of 11 to 27 billion yuan and above were more likely to have the re-examination or colposcopy at medical facilities other than the original screening facilities. ConclusionAmong women with positive cervical cancer screening results in Ordos city, the recall colposcopy rate is low and is mainly influenced by individual factors such as age, education, abnormal vaginal discharge, and history of cervical cancer screening, as well as the urbanization rate and GDP of residential areas.

Background and Aims: Conventional microscopes and exoscopes currently play pivotal roles in the microsurgery or training of male infertility. However, they are expensive and unaffordable in low resource settings which limits training or application of advanced methods. The study aimed to introduce a new, low–cost exoscope system and evaluate its frugal innovation. Method: Using animal models, we evaluated a new frugal exoscope system (called DKTA) in experimental microsurgery of vas deferens repair. Five experts in male infertility surgery undertook an anonymous survey to elucidate their experience with DKTA system use. Three crucial criteria (i.e., substantial cost reduction, concentration on core functionalities, optimised performance level) were evaluated to determine whether the DKTA is effective as frugal innovation. The survey used a 5-point Likert scaling of responses to eight statements investigating surgical, ergonomic, and educational aspects. Results: The DKTA system, including an optical microscope and ultrahigh definition camera (4K), was an exoscope placed between 20–40 cm from the surgical field. It was held in position with a camera support arm on casters and connected to a 65-inches smart TV. DKTA system met the three crucial criteria of frugal innovation, including substantial cost reduction, concentration on core functionalities, and optimised performance level. Five male infertility microsurgeons reported positive evaluations of the DKTA system (use modal scores) when performing experimental vasovasostomy. Conclusions: DKTA system, a frugal innovation, has a valuable contribution to the training programme and performance of male infertility microsurgery in low–resource settings. Acknowledgements: We want to send special thanks to the Centre for Training and Scientific Research staff, Tam Anh General Hospital for their logistics support.

Background: Conventional microscopes and exoscopes currently play pivotal roles in the microsurgery or training for male infertility. However, they are expensive and unaffordable in low-resource settings, which limits training or application of advanced methods. Objectives: To introduce a new, low-cost exoscope system and to determine whether it is an effective frugal innovation. Methods: Using animal models, we evaluated a new frugal exoscope system named DKTA in experimental microsurgery of vas deferens repair. Five experts in male infertility surgery undertook an anonymous survey to elucidate their experience with DKTA system use. Three crucial criteria (i.e., substantial cost reduction, concentration on core functionalities, and optimized performance level) were evaluated to determine whether the DKTA is effective as frugal innovation. The survey used a 5-point Likert scale of responses to eight statements investigating surgical, ergonomic, and educational aspects. Results: The DKTA system, including an optical microscope and ultra-high-definition (UHD) camera (4K), was an exoscope placed between 20 and 40 cm from the surgical field. It was held in position with a camera support arm on casters and connected to a 65-in. smart TV. DKTA system met the three crucial criteria of frugal innovation. Five male infertility microsurgeons reported positive evaluations based on modal scores of the DKTA system when performing experimental vasovasostomy. Conclusions: DKTA system, a frugal innovation, has a valuable contribution to the training program and performance of male infertility microsurgery in low-resource settings.

Compromise Ranking of Alternatives from Distance to Ideal Solution (CRADIS) is a new MCDM method (discovered in 2022). It is built on a combination of three well-known methods, including Additive Ratio Assessment (ARAS), Measurement Alternatives and Ranking according to Compromise Solution (MARCOS), and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). This method has the advantage of being resistant to the rank inversion phenomenon. However, if only the available data normalization (DN) method in this method is used, this method will only be usable in some cases. This study investigated the suitability of twelve data normalization methods combined with the CRADIS method. The solutions in four cases of four different fields were ranked using these twelve combination methods. Using these methods, the ranked results were compared with those of other MCDM methods. Four DN methods were appropriate in combination with the CRADIS method. The application scope of CRADIS method can be extended when using this DN method.

BackgroundAs a theoretical framework for understanding illness self-management, the commonsense model of self-regulation (CSM) has been commonly used to promote health behaviors. However, its application to examining gambling disorder (GD) is still in an exploratory stage.ObjectivesBased on CSM, the current study aimed to address this knowledge gap and test whether illness representations (i.e., perceived consequences, illness coherence, and emotional representations) of GD are associated with gambling behaviors (i.e., responsible gambling [RG] and superstitious gambling). We also aimed to explore the potential mediating role of positive gambling beliefs (i.e., personal responsibility about gambling and gambling literacy) in such associations.MethodsAn online questionnaire survey with snowballing sampling method was administered to Chinese adult past-year gamblers, and 603 valid responses were collected. The structural equation modeling (SEM) analysis with a bootstrapping approach was utilized to test the associations of illness representations with gambling behaviors and the hypothesized mediation effects of positive gambling beliefs.ResultsWe found that (a) perceived consequences of GD had significant, positive associations with RG and negative associations with superstitious gambling, with positive gambling beliefs acting as full mediators; (b) emotional representations for GD showed significant, negative correlations with RG and positive ones with superstitious gambling, with positive gambling beliefs acting as full and partial mediators, respectively; (c) the direct effect of illness coherence of GD on superstitious gambling behaviors was unexpectedly positive, and its indirect effects via positive gambling beliefs were nonsignificant.DiscussionUnder the framework of CSM, the current findings provided new insights in understanding both controlled and at-risk gambling patterns from a perspective of illness self-management. We suggest future GD prevention campaigns may adopt psychoeducational programs to help gamblers form a better understanding about GD as an illness, which may promote RG practices and hence lower the risk of developing GD.

This study was aimed at investigating five factors of customer satisfaction and assessing the impact degree of each factor on brand loyalty for mobile telecommunications services in Ho Chi Minh City. Data were collected from 205 customers who have been using mobile telecommunications services in Ho Chi Minh City. The author uses a quantitative method to analyze Cronbach’s Alpha reliability, Exploratory Factor Analysis EFA and multiple linear regression analysis. The results indicated that satisfaction with services is the strongest factor affecting brand loyalty, followed by satisfaction with employees, satisfaction with distribution channels, satisfaction with enterprise, satisfaction with brand image and environment. The results are consistent with the hypothesis because services quality plays an important role in this industry’s existence. Research findings are about to build scientific basis for Ho Chi Minh City’s mobile telecom enterprises in developing customer loyalty that is a matter of urgency in all aspects of theory and practice.

This paper studies the efficiency improvement of AISI 4140 steel external cylindrical grinding process. Experiments were carried out with two types of grinding wheels, a conventional and the rubber-pasted grinding wheels. With each type of the wheel, nine experiments were performed. Cooling fluid, spindle speed, feed rate and depth of cut are variables in the experiments. Two outcomes used to evaluate grinding efficiency are surface roughness and material removal rate (MRR). Experimental results demonstrate that the surface roughness achieved in the grinding operation using the rubber-pasted grinding wheels is smaller than using the conventional wheel. The Data Envelopment Analysis-based Ranking (DEAR) method was applied to determine the optimal values of the input parameters for the “minimum” surface roughness and “maximum” MRR in the cases of using each grinding wheel. It is found that the optimization of the input parameters in this circumstance are equal. Several grinding experiments for examining the values of the variables were also performed for both the wheels. The results also confirm that the surface roughness in the grinding process with the rubber wheels is about 19.42% smaller than the conventional wheels.

BackgroundA number of publications have demonstrated that deep learning (DL) algorithms matched or outperformed clinicians in image-based cancer diagnostics, but these algorithms are frequently considered as opponents rather than partners. Despite the clinicians-in-the-loop DL approach having great potential, no study has systematically quantified the diagnostic accuracy of clinicians with and without the assistance of DL in image-based cancer identification. ObjectiveWe systematically quantified the diagnostic accuracy of clinicians with and without the assistance of DL in image-based cancer identification. MethodsPubMed, Embase, IEEEXplore, and the Cochrane Library were searched for studies published between January 1, 2012, and December 7, 2021. Any type of study design was permitted that focused on comparing unassisted clinicians and DL-assisted clinicians in cancer identification using medical imaging. Studies using medical waveform-data graphics material and those investigating image segmentation rather than classification were excluded. Studies providing binary diagnostic accuracy data and contingency tables were included for further meta-analysis. Two subgroups were defined and analyzed, including cancer type and imaging modality. ResultsIn total, 9796 studies were identified, of which 48 were deemed eligible for systematic review. Twenty-five of these studies made comparisons between unassisted clinicians and DL-assisted clinicians and provided sufficient data for statistical synthesis. We found a pooled sensitivity of 83% (95% CI 80%-86%) for unassisted clinicians and 88% (95% CI 86%-90%) for DL-assisted clinicians. Pooled specificity was 86% (95% CI 83%-88%) for unassisted clinicians and 88% (95% CI 85%-90%) for DL-assisted clinicians. The pooled sensitivity and specificity values for DL-assisted clinicians were higher than for unassisted clinicians, at ratios of 1.07 (95% CI 1.05-1.09) and 1.03 (95% CI 1.02-1.05), respectively. Similar diagnostic performance by DL-assisted clinicians was also observed across the predefined subgroups. ConclusionsThe diagnostic performance of DL-assisted clinicians appears better than unassisted clinicians in image-based cancer identification. However, caution should be exercised, because the evidence provided in the reviewed studies does not cover all the minutiae involved in real-world clinical practice. Combining qualitative insights from clinical practice with data-science approaches may improve DL-assisted practice, although further research is required. Trial RegistrationPROSPERO CRD42021281372; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=281372

Surgical sperm retrieval (SSR) is currently one of the most common procedures in in vitro fertilization (IVF). However, a gap between the guidelines and routine clinical practice regarding antibiotic use in SSR, which might lead to antibiotic resistance, is a challenging problem worldwide. A cross-sectional survey was conducted from May 1, 2021, to July 15, 2021, to investigate antibiotic usage by medical professionals when performing SSR in IVF centers in Vietnam. The confidential questionnaire comprised 12 items, including characteristics of the study population, awareness of antimicrobial resistance, attitude toward prescribing antibiotics, and current practice of prescribing antibiotics when performing SSR. Surveys were completed by 30 of 45 registered IVF centers (66.7%). Among 67 physicians working at those centers, the age and work-experience years (mean ± standard deviation [s.d.]) were 38.6 ± 6.6 years and 11.2 ± 7.0 years, respectively. Over 60% of them held a degree in Obstetrics and Gynecology, and over four-fifths were men. Most respondents “often/very often/always” raised awareness of antimicrobial resistance to their patients (83.3%), but only half of them “often/occasionally” prescribed antibiotics to patients with SSR in cases where the prescription would be optional. About one-tenth of respondents followed the recommendation from the American Urological Association using “prophylaxis only” for SSR patients. For more invasive SSR, physicians tended to prescribe more complicated and sometimes inappropriate regimens. In conclusion, antibiotic usage in SSR was not always appropriate among IVF centers. Further studies may define specific recommendations for regimens, intervention strategies, and programs to promote appropriate antibiotic use for SSR patients among IVF specialists.

This study contributes to anti-malarial research effort by conducting in silico assessment of 125 compounds originated from Cannabis sativa L. against plasmodium falciparum dihydrofolate reductase-thymidinesynthase (pfDHFR-TS) enzyme for potential inhibition activity. Drug-like and pharmacokinetic criteria were used to assess the drug-like properties of the studied compounds. AutoDock4.2.6 and AutoDock Vina software were used to calculate the possible binding pose of the studied compounds to pfDHFR-TS enzyme. The docking procedure was validated using two known inhibitors cycloguanil and WR99210. 65 out of 125 compounds violated no more than 2 of Lipinski’s rule of five and were sorted out as favorable for drug development. Amongst these 65 compounds, pharmacokinetic properties and toxicity evaluation identified 60 compounds that meet the criteria of drug-like properties and were subjected to further docking studies. Docking outcomes identified 10 compounds including compounds 4, 9, 19, 22, 23, 25, 30, 42, 43, and 59 as potential candidates for inhibiting the function of pfDHFR-TS at the active site through hydrogen bonds with Ile14, Asp54, and Ile 164 residues. Compound 9 is considered as the top “hit” with docking energy far more exceeding those of the standard compounds. High correlation coefficient between the docking energy of AutoDock4.2.6 and AutoDock Vina was recorded with the value of R 2 = 0.74.

During curcumin production in Vietnam, curcumin-removed turmeric oleoresin (CRTO) has been considered as a by-product. It costs to treat the by-product to prevent environmental pollution. In this study, the by-product was utilized as an active ingredient for preparing a botanical fungicide-based nano-emulsion and evaluated for its in vitro and in vivo control efficacy against Colletotrichum gloeosporioides, a causal agent of anthracnose of litchi, in the laboratory as well as a field trial. The nano-emulsion is colloidally stable and uniform with particle sizes of 95–250 nm. CRTO nano-emulsion significantly affected various Colletotrichum species. Notably, this nano-emulsion showed potent inhibition for the mycelial growth of C. gloeosporioides and solidly suppressed the development of anthracnose on litchi fruits. In the in vitro inhibition test, the equivalent half-maximal inhibitory concentration of CRTO in nano-formulation was 0.11 mg·mL−1, which was 3.0× and 6.1× lower than IC50 values of CRTO alone (0.33 mg·mL−1) and a mixture of curcuminoids (0.48 mg·mL−1), respectively. In the field trial, the litchi anthracnose infection was effectively controlled by nano-formulation. These results suggest that CRTO nano-emulsion could be used as an alternative to harmful synthetic fungicides to control anthracnose on litchi fruits.

Due to no penetration depth limitation, low cost, and easy control, magnetic nanoparticles mediated magnetic hyperthermia therapy (MHT) has shown great potential in experimental and clinal treatments of various diseases. However, the low heating conversion efficiencies and short circulation times are major drawback for most existing magnetic-thermal materials. Additionally, single MHT treatment always leads to resistance and recurrence. Herein, a highly efficient magnetic-thermal conversion, ferrimagnetic vortex nanoring Fe3O4 coated with hyaluronic acid (HA) nanoparticles (Fe3O4@HA, FVNH NPs) was firstly constructed. Additionally, the doxorubicin (DOX) was successfully enclosed inside the FVNH and released remotely for synergetic magnetic–thermal/chemo cancer therapy. Due to the ferrimagnetic vortex-domain state, the ring shape Fe3O4 displays a high specific absorption rate (SAR) under an external alternating magnetic field (AMF). Additionally, antitumor drug (DOX) can be encapsulated inside the single large hole of FVNH by the hyaluronic acid (HA) shell and quickly released in response the tumor acidic microenvironments and AMF. What’s more, the non-loaded FVNH NPs show good biocompatibility but high cytotoxicity after loading DOX under AMF. Furthermore, the synthesized FVNH can efficiently reduce the transverse relaxation time and enhance negative magnetic resonance imaging (MRI). The impressive in vivo systemic therapeutic efficacy of FVNH was also proved in this work. Taken together, the results of this study demonstrate that the synthesized FVNH NPs offer the promise of serving as multifunctional theranostic nanoplatforms for medical imaging-guided tumor therapies.

BackgroundThe Chinese government has taken action to prevent cervical cancer by implementing the National Cervical Cancer Screening Programme in Rural Areas (NACCSPRA), which was launched in 2009. Numerous studies have demonstrated that long-term cervical cancer screening alters human papillomavirus (HPV) infection rates and cervical disease detection. Nearly 80 million women have been screened over 10 years, representing

As the first DSM-5 based, multidimensional screening tool of Internet gaming disorder (IGD) designed for Chinese gamers, the Chinese Internet Gaming Disorder Checklist (C-IGDC) has shown satisfactory psychometric properties among Chinese young adults. Given the high vulnerability to IGD among adolescents, the present study aimed to examine the applicability of C-IGDC to Chinese adolescents to address shortfalls in the existing literature regarding the assessment of adolescent IGD screening. Through a two-stage sampling method in a cross-sectional survey, we obtained a sample of 1,253 Chinese past-year adolescent gamers (43.8% female; Mage = 14.49 years, SDage = 1.60 years) from local junior or senior high schools in Macao, China for data analysis. Our results confirmed a good model fit of the original two-level, nine-subfactor structure of the 27-item C-IGDC, and indicated adequate internal consistency and test–retest reliability, as well as good concurrent validity as evidenced by expected associations with IGD functioning impairments, gameplay characteristics, and depressive symptoms. An optimal screening cutoff score (≥20) was proposed to identify probable disordered gamers among Chinese adolescents with past-year gaming experience. The findings support the extended use of C-IGDC to Chinese adolescents as a reliable and valid assessment tool for evaluating IGD severity levels and screening for probable IGD cases. Its use can facilitate a proper screening procedure for probable IGD cases in both school and clinical settings.

Cryptorchidism or undescended testis is one of the most common pediatric disorders of the male endocrine glands and the most typical congenital abnormality identified at birth. Bilateral cryptorchidism is frequently associated with azoospermia and male infertility. The standard therapy is the surgical repositioning of the testes (orchidopexy) within the scrotal sac after the age of six months to eighteen months. Current findings suggest that no sperm is recovered in the ejaculate, for patients with bilateral cryptorchidism, when the mean age at the time of orchidopexy is around 16 years and above. Here we report an unusual case of an adult patient with bilateral cryptorchidism and non-obstructive azoospermia for which orchidopexy resulted in the recovery of sperm in the ejaculate, improving his options for future fertility treatment.

Cyber-slacking interrupts classroom teaching and learning activities and is associated with poor academic performance. Based on the theory of planned behavior (TPB), this study aimed to investigate whether both cognitive (i.e., attitudes, perceived norms, and perceived behavioral control) and affective (i.e., fear of missing out [FoMO]) factors contribute to classroom cyber-slacking intention and behavior among Chinese university students. We recruited a convenience sample of 431 undergraduate students (M = 19.34, SD = 1.08; 66.4% female; 33.6% male) from mainland China who completed an online survey (i.e., items measured cognitive factors of cyber-slacking, cyber-slacking behavior, FoMO, and demographic information). The findings of correlational, hierarchical multiple regression, and path analysis with bootstrapping approach showed that both cognitive and affective factors were positive correlates of cyber-slacking intention and behavior and explained the variance in cyber-slacking intention. Moreover, attitudes, perceived norms, perceived behavioral control, and FoMO had statistically significant indirect effects (via intention) on cyber-slacking behaviors, whereas perceived behavioral control alone has a direct impact on cyber-slacking behaviors. The findings not only lend more credence to TPB, suggesting that cognitive factors are reliable correlates of both classroom cyber-slacking intention and behavior, but also showed affective factors, such as FoMO, can be used to reduce students' cyber-slacking intention and, subsequently, their behavior. Based on these findings, interventions for reducing classroom cyber-slacking are discussed.

COVID-19 vaccines have been shown to provide protection against severe disease and death. However, substantial individual differences in vaccination intentions have hindered achieving optimal vaccination rates across the population. To look for efficient strategies to promote vaccination, this study tested whether the protection motivation theory (PMT), a cognitive model based upon threat and coping appraisals, would account for the differences in vaccination intentions under three scenarios (i.e., in the context of getting vaccinated in general, and in the context of high- and low- efficacy for reducing COVID-19 transmission risk). A phone survey was conducted in early 2021 and obtained a probability community sample (n = 472; 49.2% men) in Macao, China. We found that 54.0% of respondents indicated their relatively strong intention to receive COVID-19 vaccination for high-efficacy vaccines, compared to 29.5% for low-efficacy vaccines and 31.0% for vaccines in general. After adjusting for demographics, self-efficacy (i.e., the perceived capability of receiving COVID-19 vaccines) and maladaptive response reward (i.e., the perceived benefits of not receiving COVID-19 vaccines) were consistently associated with COVID-19 vaccination intentions under all three scenarios. The perceived severity of COVID-19 infection and response cost (i.e., the perceived costs of receiving COVID-19 vaccines) were significantly associated with vaccination intention for high-efficacy vaccines, while the response efficacy of lowering the COVID-19 impact with COVID-19 vaccination was positively associated with vaccination intention for general and low-efficacy vaccines. Given that the relative strength of PMT constructs depends on perceived vaccine efficacy, we recommend taking PMT constructs and vaccine efficacy into account for encouraging vaccination.

The severe acute respiratory syndrome (SARS) outbreak in Vietnam was amplified by nosocomial spread within hospital A, but no transmission was reported in hospital B, the second of two designated SARS hospitals. Our study documents lack of SARS-associated coronavirus transmission to hospital B workers, despite variable infection control measures and the use of personal protective equipment.

Introduction: Altered biomechanical properties, due to intervertebral disc (IVD) degeneration and missing nucleus fibrosus, could be thought as one of the reasons for the back pain many herniation patients experience after surgery. It has been suggested to repair annulus fibrosus (AF) to restore stability and allow nucleus pulposus (NP) replacement and furthermore prevent reherniation. The aim of this study was to evaluate a new method for closing a defect in AF for use in herniation surgery. Methods: Our repair method combines a polycaprolactone (PCL) scaffold plugging herniation and soft anchors to secure the plug. Ex vivo biomechanical testing was carried out in nine porcine lumbar motion segments. Flexion–extension, lateral bending and rotation were repeated three times: first in healthy specimens, second with a full thickness circular defect applied, and third time with the specimens repaired. Finally push out tests were performed to check whether the plug would remain in. Results: Tests showed that applying a defect to the AF increases the range of motion (ROM), neutral zone (NZ) and neutral zone stiffness (NZS). In flexion/extension it was found significant for ROM, NZ, and NZS. For lateral bending and rotation a significant increase in ROM occurred. After AF repair ROM, NZ and NZS were normalized. All plugs remained in the AF during push out test up until 4000 N, but NP was squeezed out through the pores of the scaffold. Discussion: A defect in the AF changes the biomechanical properties in the motion segment, changes that point to instability. Repairing the defect with a PCL plug and soft anchors brought the biomechanical behavior back to native state. This concept is promising and might be a viable way to repair the IVD after surgery.

Introduction: The osteogenic differentiation of bone marrow-derived mesenchymal stromal cells (BMSCs) was compared with that of dental pulp-derived stromal cells (DPSCs) in vitro and in a pig calvaria critical-size bone defect model. Methods: BMSCs and DPSCs were extracted from the tibia bone marrow and the molar teeth of each pig, respectively. BMSCs and DPSCs were cultured in monolayer and on a three-dimensional (3D) polycaprolactone (PCL) – hyaluronic acid – tricalcium phosphate (HT-PCL) scaffold. Population doubling (PD), alkaline phosphatase (ALP) activity, and calcium deposition were measured in monolayer. In the 3D culture ALP activity, DNA content, and calcium deposition were evaluated. Six non-penetrating critical-size defects were made in each calvarium of 14 pigs. Three paired sub-studies were conducted: (1) empty defects vs. HT-PCL scaffolds; (2) PCL scaffolds vs. HT-PCL scaffolds; and (3) autologous BMSCs on HT-PCL scaffolds vs. autologous DPSCs on HT-PCL scaffolds. The observation time was five weeks. Bone volume fractions (BV/TV) were assessed with micro-computed tomography (μCT) and histomorphometry. Results and discussion: The results from the in vitro study revealed a higher ALP activity and calcium deposition of the DPSC cultures compared with BMSC cultures. Significantly more bone was present in the HT-PCL group than in both the pure PCL scaffold group and the empty defect group in vivo. DPSCs generated more bone than BMSCs when seeded on HT-PCL. In conclusion, DPSCs exhibited a higher osteogenic potential compared with BMSCs both in vitro and in vivo, making it a potential cell source for future bone tissue engineering.

Artificial photosynthesis systems are proposed as an efficient alternative route to capture CO2 to produce additional food for growing global demand. Here a two-step CO2 electrolyser system was developed to produce a highly concentrated acetate stream with a 57% carbon selectivity (CO2 to acetate), allowing its direct use for the heterotrophic cultivation of yeast, mushroom-producing fungus and a photosynthetic green alga, in the dark without inputs from biological photosynthesis. An evaluation of nine crop plants found that carbon from exogenously supplied acetate incorporates into biomass through major metabolic pathways. Coupling this approach to existing photovoltaic systems could increase solar-to-food energy conversion efficiency by about fourfold over biological photosynthesis, reducing the solar footprint required. This technology allows for a reimagination of how food can be produced in controlled environments.