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Biliary atresia, a destructive inflammatory cholangiopathy, leads to liver cirrhosis and subsequent death by the age of 2 years if left untreated. Biliary atresia splenic malformation (BASM) syndrome makes up 10% of all cases of biliary atresia. Kasai hepatoportoenterostomy (KPE) may establish continuity of bile flow and slow down progression to cirrhosis if the procedure is performed early in infancy. We describe an 8.5-year-old boy with known BASM syndrome (polysplenia, intestinal malrotation, interrupted inferior vena cava, shortened pancreas, centralised liver and left atrial isomerism) who underwent a successful KPE at the age of 3 months. He presented with features suggestive of a late onset ascending cholangitis (AC) complicated by cholangitic liver abscesses. Resolution of the abscesses with prolonged antibiotic therapy avoided the need for percutaneous drainage. Once the abscesses resolved, the child underwent a successful cadaveric liver transplantation.

Channel is the primary building block of wireless communication system between the transmitter and receivers. Measuring, characterizing, and modeling channels are of significant importance for network modeling, system deployment, and theoretical analysis of communication systems. Next-generation networks such as sixth-generation (6G) will bring new enabling technologies (THz), multiple mobilities (high-speed train (HST), UAV trajectory), and architectures (3D network, integrated terrestrial-non terrestrial network) which ought to cater to channel propagation characteristics. Accurate channel models that combine different technologies and disciplines can capture these channel characteristics play a critical role in designing and testing the future 6G system. In this article, we overview the characteristics, measurement, and modeling of 6G wireless channels. Also, we provide a summary of recent advances in channel research of 6G. Finally, we outline the research challenges, open issues, and future direction of channel models and characteristics in 6G wireless communications.

Influenza is associated with an increased risk for serious illness, hospitalization and/or death in pregnant women and young infants. We prospectively studied the effectiveness of a quadrivalent inactivated influenza vaccine (QIV) in pregnant women and their infants during the 2018–2019 influenza season. A QIV was offered to pregnant women cared in a maternity hospital in Athens. Women were contacted weekly by telephone during the influenza season and PCR test was offered to women or infants who developed influenza-like illness (ILI). We studied 423 pregnant women and 446 infants. Unvaccinated pregnant women had a 7.5% probability to develop laboratory-confirmed influenza compared to 2.1% among vaccinated women (Odds ratio: 3.6; confidence intervals: 1.14–11.34, p-value = 0.029). Infants whose mothers were not vaccinated had a 7.9% probability to develop laboratory-confirmed influenza compared to 2.8% among infants of vaccinated mothers (Odds ratio = 2.849, confidence intervals: 0.892–9.102, p-value = 0.053). Cox regression analyses showed that QIV vaccination was significantly associated with a decreased probability for laboratory-confirmed influenza, ILI, healthcare seeking and hospitalization among pregnant women and a decreased probability for laboratory-confirmed influenza, healthcare seeking and prescription of antibiotics among infants. The effectiveness of QIV against laboratory-confirmed influenza was 72% among pregnant women and 64.5% among infants during the 2018–2019 influenza season. Vaccination of pregnant women with the QIV was associated with a lower risk for laboratory-confirmed influenza for them and their infants during the influenza season. Our findings strongly support the World Health Organization recommendations for vaccinating pregnant women against influenza. © 2020 Elsevier Ltd

Objective: to evaluate the effect of the addition of low dose human chorionic gonadotropin (hCG) to human menopausal gonadotropin (HMG) throughout the early follicular phase in controlled ovarian stimulation (COS) conducted with two difference regimens. Gonadotropin-releasing hormone (GnRH) antagonist and short GnRH-agonist protocol were applied in two in vitro fertilization (IVF) clinics. Methods: Clinical study conducted during the period 2014–2016 in two IVF clinics in a cohort of 240 women. In the first group 1 (124 women), a GnRH antagonist protocol with HMG and addition of low dose (100IU/day) h CG was applied. The other group 2 consisted of 116 women who underwent a short GnRH- agonist protocol with HMG and addition of low dose (100 IU/day) h CG. Results: Multiple logistic regression analysis was performed. The group 2 found to be associated with greater number of follicles and oocytes. The pregnancy rates were 12.1% and 26.7% in group 1 and group 2, respectively (p = 0.004). For patients over 40 years, the number of follicles and oocytes retrieved were significant higher in group 2.The pregnancy rate in group 2 was higher than in group 1 (21, 6% vs 5%, p = 0.017). Conclusions: Advanced age women are likely to achievepregnancy using the GnRH Short than GnRH antagonist, when HMG/hCG is used, while HMG–hCG gonadotropins have the same potentialas Recombinant follicle stimulating hormone (rFSH)–hCG used in GnRH short protocol. © 2019 Elsevier Masson SAS

Tripartite motif (TRIM) proteins belong to a large family with many roles in host biology, including restricting virus infection. Here, we found that TRIM2, which has been implicated in cases of Charcot–Marie–Tooth disease (CMTD) in humans, acts by blocking hemorrhagic fever New World arenavirus (NWA) entry into cells. We show that Trim2-knockout mice, as well as primary fibroblasts from a CMTD patient with mutations in TRIM2, are more highly infected by the NWAs Junín and Tacaribe virus than wild-type mice or cells are. Using mice with different Trim2 gene deletions and TRIM2 mutant constructs, we demonstrate that its antiviral activity is uniquely independent of the RING domain encoding ubiquitin ligase activity. Finally, we show that one member of the TRIM2 interactome, signal regulatory protein α (SIRPA), a known inhibitor of phagocytosis, also restricts NWA infection and conversely that TRIM2 limits phagocytosis of apoptotic cells. In addition to demonstrating a novel antiviral mechanism for TRIM proteins, these studies suggest that the NWA entry and phagocytosis pathways overlap., TRIM2, one of the proteins mutated in Charcot Marie Tooth Disease, blocks the entry of new world arenaviruses into cells, a novel mechanism for antiviral TRIM proteins, which generally restrict viruses at other stages of infection., Author summary New World arenaviruses (NWAs) are rodent-transmitted viruses that cause high mortality when they evolve the ability to infect humans. Although these clade B pathogenic viruses are known to bind to transferrin receptor 1 and other receptors on the cell surface, the steps leading to their entry into the cell are not well determined. We show that a host factor identified in a previous small interfering RNA (siRNA) screen, tripartite motif 2 (TRIM2), limits NWA endocytosis into cells. Moreover, we show that a member of the TRIM2 interactome, signal regulatory protein α (SIRPA), which is well-known for inhibiting phagocytosis by macrophages, interacts with TRIM2 and also blocks NWA infection. This finding suggests that there are common mechanisms that regulate virus endocytosis and phagocytosis.

Introduction: BRCA1 inherited mutation carriers face a lifetime risk of 72% to develop breast cancer and a percentage of 44% risk for ovarian cancer. Presentation of case: We present a case of a 35-year old Caucasian woman who, after the excision of a possible malignant finding on the right breast, was diagnosed with ductal breast carcinoma. The patient treatment included first chemotherapy and radiotherapy and then prophylactic bilateral mastectomy with plastic reconstructive surgery. At the age of 37, she underwent prophylactic laparoscopic bilateral salpingoophorectomy. The histological diagnosis of the surgical specimens was suggestive of a unilateral invasive high grade salpingeal cancer and the patient underwent an abdominal hysterectomy by laparotomy, omentectomy and bilateral pelvic lymphadenectomy. Discussion: Women with known BRCA mutations are strongly recommended to consider a risk reducing prophylactic salpingoophorectomy (RRSO) from their early 40 s to gain maximum benefit in cancer risk reduction from the procedure. The prevalence of occult carcinomas in BRCA1 carriers is almost 1, 5% if the prophylactic bilateral salpingoophorectomy is performed before the age of 40, while this percentage may be increased to 3, 8% for women who undergo the surgery between 40 and 49 years. Conclusion: We present an interesting case, of an accidentally revealed salpingeal carcinoma via RRSO in an asymptomatic young premenopausal woman. © 2018

Introduction Ovarian vein thrombosis is a rare but potentially serious complication after surgical and gynecologic procedures such as oophorectomy and hysterectomy. The association of this event with laparoscopic hysterectomy in particular, is very rare. Only two cases have been described so far. Presentation of case We present a case of ovarian vein thrombosis after laparoscopic hysterectomy in a 40-year-old with deep endometriosis and multiple intramural uterine myomas. Laparoscopic hysterectomy, left oophorectomy, right salpingectomy, and suspension (ovariopexy) of the right ovary on the ipsilateral round ligament of the uterus were performed, using bipolar electrocautery as a hemostatic tool. Discussion The 7th postoperative day the patient presented to our hospital complaining of abdominal pain and fever. An abdominal CT scan demonstrated a filling defect and enlargement of the right ovarian vein, a finding compatible with ovarian vein thrombosis. She was treated with low molecular weight heparin (LMWH). On the 19th postoperative day, an MRI scan was performed and did not reveal any pathological findings of the right ovarian vein. The patient was discharged on LMWH for three months. Post treatment evaluation for thrombophilia was negative for pathological findings. Conclusion Our case is a very rare condition. Only two 'similar’ cases have been described in the literature so far. Bipolar electrocautery and ovariopexy on the ipsilateral round ligament during laparoscopic hysterectomy should be evaluated further as possible contributing mechanisms for the thrombus formation. © 2017 The Authors

Background: Stress is defined as a state of threatened or perceived as threatened homeostasis. A broad spectrum of extrinsic or intrinsic, real or perceived stressful stimuli, called ‘stressors’, activates a highly conserved system, the ‘stress system’, which adjusts homeostasis through central and peripheral neuroendocrine responses. Inadequate, excessive or prolonged adaptive responses to stress may underlie the pathogenesis of several disease states prevalent in modern societies. The development and severity of these conditions primarily depend on the genetic vulnerability of the individual, the exposure to adverse environmental factors and the timing of the stressful event(s), given that prenatal life, infancy, childhood and adolescence are critical periods characterized by increased vulnerability to stressors. Materials and methods: We conducted a systematic review of original articles and reviews published in MEDLINE from 1975 through June 2016. The search terms were ‘childhood stress’, ‘pediatric stress’, ‘stress and disorders’ and ‘stress management’. Results: In this review, we discuss the historical and neuroendocrine aspects of stress, and we present representative examples of paediatric stress system disorders, such as early-life adversity, obesity and bullying. We also discuss the adverse impact of a socio-economic crisis on childhood health. The tremendous progress of epigenetics has enabled us to have a deeper understanding of the molecular mechanisms underlying paediatric stress-related disorders. Conclusions: The need for early successful stress management techniques to decrease the incidence of paediatric stress-related diseases, as well as to prevent the development of several pathologic conditions in adolescence and adulthood, is imperative. © 2017 Stichting European Society for Clinical Investigation Journal Foundation

Introduction Giant juvenile fibroadenomas represent only the 0.5% of all fibroadenomas, constituting a rare condition in adolescence. In prepuberty, the presence of this condition is extremely rare. Presentation of case We describe a rare case of a 12- year-old Caucasian girl who presented to our Hospital complaining of a palpable mass with rapid enlargement in her right breast that she had first noticed 3 months ago. Her menarche hadn't occurred yet. Discussion Physical examination showed a giant mass of 15 × 13 cm in the right breast. The patient was further evaluated via ultrasonography showing a sole large lesion of 13 × 12 cm in the right breast. A surgical procedure under general anesthesia was performed. Histopathological findings after the surgical excision were suggestive of giant juvenile fibroadenoma. The patient has a normal breast development over a period of 9 month follow up. Conclusion Giant juvenile fibroadenomas should be included in differential diagnosis of a breast mass in prepubertal girls despite the fact that they are very rare in prepuberty, tend to appear later during adolescence and their prevalence is lower in Caucasians. The remarkable size and the rapid growth of the lesion should not be ruled out in the diagnostic process of an adolescent breast. © 2017

This study proposes a unifying framework for m-Health video communication systems that provides for the joint optimization of video quality, bitrate demands, and encoding time. The framework is video modality and infrastructure independent and facilitates adaptation to the best available encoding mode that satisfies underlying technology and application imposed constraints. The scalability of the proposed algorithm is demonstrated using different HEVC encoding configurations and realistic modelling of 802.11× wireless infrastructure for emergency scenery and response videos. Extensive experimentation shows that a jointly optimal solution in the encoding time, bitrate, and video quality space is feasible. © 2015 IEEE. 2015-November 173 176 Sponsors: Conference code: 116805 Cited By :4

This study proposes a unifying framework for m-Health video communication systems that provides for the joint optimization of video quality, bitrate demands, and encoding time. The framework is video modality and infrastructure independent and facilitates adaptation to the best available encoding mode that satisfies underlying technology and application imposed constraints. The scalability of the proposed algorithm is demonstrated using different HEVC encoding configurations and realistic modelling of 802.11× wireless infrastructure for emergency scenery and response videos. Extensive experimentation shows that a jointly optimal solution in the encoding time, bitrate, and video quality space is feasible.

The apolipoprotein B editing complex 3 (A3) cytidine deaminases are among the most highly evolutionarily selected retroviral restriction factors, both in terms of gene copy number and sequence diversity. Primate genomes encode seven A3 genes, and while A3F and 3G are widely recognized as important in the restriction of HIV, the role of the other genes, particularly A3A, is not as clear. Indeed, since human cells can express multiple A3 genes, and because of the lack of an experimentally tractable model, it is difficult to dissect the individual contribution of each gene to virus restriction in vivo. To overcome this problem, we generated human A3A and A3G transgenic mice on a mouse A3 knockout background. Using these mice, we demonstrate that both A3A and A3G restrict infection by murine retroviruses but by different mechanisms: A3G was packaged into virions and caused extensive deamination of the retrovirus genomes while A3A was not packaged and instead restricted infection when expressed in target cells. Additionally, we show that a murine leukemia virus engineered to express HIV Vif overcame the A3G-mediated restriction, thereby creating a novel model for studying the interaction between these proteins. We have thus developed an in vivo system for understanding how human A3 proteins use different modes of restriction, as well as a means for testing therapies that disrupt HIV Vif-A3G interactions.

This work proposes the use of 3D Ray Tracing (RT) to construct radiomaps for WLAN Received Signal Strength (RSS) fingerprint-based positioning, in conjunction with calibration techniques to tackle with the problem using different devices. In addition to the fact that RSS data collection might be a tedious and time-consuming process, the measured radiomap accuracy and applicability is subject to potential changes in the wireless environment. Therefore, RT becomes a very suitable and efficient solution to tackle this problem. Moreover, in traditional fingerprint-based methods, the underlying radiomap is restricted to the mobile device for which the radiomap has been created. To overcome this limitation, we propose the use of linear data transformation to match the characteristics of various devices. We address both challenges by using 3D RT-generated radiomaps and highlight the efficiency of this approach in terms of the time spent to create the radiomap, the amount of data required to calibrate the radiomap for different devices and the positioning error which is compared against the case of using dedicated radiomaps collected with each device.

We study the use of 3D Ray Tracing (RT) to construct radiomaps for WLAN Received Signal Strength (RSS) fingerprint-based positioning, in conjunction with calibration techniques to make the overall process device-independent. RSS data collection might be a tedious and time-consuming process and also the measured radiomap accuracy and applicability is subject to potential changes in the wireless environment. Therefore, RT becomes a more attractive and efficient way to generate radiomaps. Moreover, traditional fingerprint-based methods lead to radiomaps which are restricted to the device used to generate the radiomap and fail to provide acceptable performance when different devices are considered. We address both challenges by exploiting 3D RT-generated radiomaps and using linear data transformation to match the characteristics of various devices. We evaluate the efficiency of this approach in terms of the time spent to create the radiomap, the amount of data required to calibrate the radiomap for different devices and the positioning error which is compared against the case of using dedicated radiomaps collected with each device.

Quantification of distortion effects on UWB system performances in terms of positioning error is analysed in this research. UWB multipath distorted channels are simulated in each frequency subband, over 2-11 GHz. Its characteristics are modelled corresponding to multipath clusters along the propagation paths. The classification of clusters and physics. based distortion mechanisms are generalized to be included into the simulation algorithm. Finally, distortion impacts on system performances regarding to frequency dependent characteristics and positioning errors are investigated.