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Purpose. The purpose of this study was to determine the incidence and predictors of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic therapy (ET) in the elective treatment of recurrent variceal hemorrhage. Methods. Seventy patients were treated with elective TIPS and fifty-six patients with ET. Median observation time was 46.28 months in the TIPS group and 42.31 months in the ET group. Results. 30 patients (42.8%) developed clinically evident portosystemic encephalopathy in TIPS group and 20 patients (35.6%) in ET group. The difference between the groups was not statistically significant (P=0.542; χ2 test). The incidence of new or worsening portosystemic encephalopathy was 24.3% in TIPS group and 10.7% in ET group. Multivariate analysis showed that ET treatment (P=0.031), age of >65 years (P=0.022), pre-existing HE (P=0.045), and Child's class C (P=0.051) values were independent predictors for the occurrence of HE. Conclusions. Procedure-related HE is a complication in a minority of patients treated with TIPS or ET. Patients with increased age, preexisting HE, and higher Child-Pugh score should be carefully observed after TIPS procedure because the risk of post-TIPS HE in these patients is higher.

BackgroundSex differences in obesity and related diseases are well established. Gonadal hormones are a major determinant of these sex differences. However, sex differences in body size and composition are evident prior to exposure to gonadal hormones, providing evidence for gonadal-independent contributions attributable to the XX or XY sex chromosome complement. Large-scale genetic studies have revealed male/female differences in the genetic architecture of adipose tissue amount and anatomical distribution. However, these studies have typically neglected the X and Y chromosomes.Scope of the reviewHere we discuss how the sex chromosome complement may influence obesity, lipid levels, and inflammation. Human sex chromosome anomalies such as Klinefelter syndrome (XXY), as well as mouse models with engineered alterations in sex chromosome complement, support an important role for sex chromosomes in obesity and metabolism. In particular, the Four Core Genotypes mouse model-consisting of XX mice with either ovaries or testes, and XY mice with either ovaries or testes-has revealed an effect of X chromosome dosage on adiposity, hyperlipidemia, and inflammation irrespective of male or female gonads. Mechanisms may include enhanced expression of genes that escape X chromosome inactivation.Major conclusionsAlthough less well studied than effects of gonadal hormones, sex chromosomes exert independent and interactive effects on adiposity, lipid metabolism, and inflammation. In particular, the presence of two X chromosomes has been associated with increased adiposity and dyslipidemia in mouse models and in XXY men. The enhanced expression of genes that escape X chromosome inactivation may contribute, but more work is required.

Prispevek predstavi nekatere segmente dveh izrazov sorodnega načina filozofskega mišljenja, tj. skepticizma v zgodnji filozofski misli Indije s posebnim poudarkom na budizmu in starogrškega skepticizma, predstavnik katerega je Piron iz Elide, ki je svojo držo osnoval prek srečevanj z nauki asketov v Indiji, kamor je potoval v času osvajalskih pohodov Aleksandra Velikega v 4. stol. pr. n. št. Posebno pozornost namenja metodi Buddhovega in Pironovega skepticizma, ki temelji na pretresu uveljavljenih dogem in poleg prikaza njihove nekonsistentnosti problematizira tudi samo navezanost na stališča, kar v obeh tokovih predstavlja ne zgolj stranpot od resnice, ampak tudi glavni vir človekovega trpljenja. Njun poziv k opuščanju slehernih stališč, ki se odslikava v metodi zadržanja sodbe, ne razveljavlja možnosti spoznanja sploh, ampak zgolj konvencionalne načine spoznavanja, in vodi do resničnega, nepojmovnega doumetja, s tem pa do sprostitve slehernih navezanosti in spokojnega bivanja. Tako se v luči tovrstnega načina filozofiranja glede na predhodne miselne tokove prevrednoti tudi sama vloga filozofije kot veščine izpiljene argumentacije – le-ta namreč postane dejavnost, ki se z območja diskurzivnega pomakne v izkustvo, k praksi avtonomnega mišljenja, nezamejenega z dogmami, ki samo filozofijo preobraža v način življenja.

Introduction: In recent years, environmental issues and their destructive effects on human health have become important concerns. These concerns about the environment have led to the emergence of a new type of consumers who express the concerns in their purchasing decisions. The pace of change in the world in terms of population and technology has changed the consumption patterns, which has led to unsustainable consumption and environmental problems. This issue has increased the attention of people to the preservation and sustainability of the environment, which has ultimately caused changes in consumer behavior. Studies show that consumers who are aware of environmental issues play an important role in reducing environmental problems. So, marketers around the world seek to educate people and develop green consumerism. Much research has been done to identify the determinants of consumer behavior, which shows that demand for green products is growing at a remarkable rate. Therefore, it can be safely concluded that green marketers should focus on consumers because of their positive attitude towards the environment. In order to fully understand the complexities of sustainable marketing, consumers are considered as decision makers. Highly educated consumers are at the forefront of innovation and transformation in the economy, and they are a potential force for environmental protection because they have a significant awareness of the environment. In addition, such consumers can act as a positive influence on others. Therefore, this study was conducted to identify the main factors affecting the environmental approaches which affect the green shopping behavior of consumers. Methodology: This research is applied in terms of purpose and descriptive-survey in terms of data collection method. The statistical population consists of the students of Yazd University who were selected by the convenience sampling method. To determine the sample size, the structural equation modeling sampling formula (5q≤n≤15q) was used. According to the 16 questions in the questionnaire, a sample size of at least 80 and a maximum of 240 people were selected, and finally 233 questionnaires were collected. The data collection to gain environmental knowledge was based on the questionnaire devised by Ellen et al. (1991) and Suki (2013), the measurement of interpersonal impacts was based on the views of Bearden et al. (1989), and the measurements of the variables of green shopping behavior and environmental attitudes were based on the questionnaire of Lee (2009). Also, the questionnaire by Schwartz (1977) was used to measure altruistic variables. Structural equation modeling was done with the SPSS and Amos software programs to analyze the data and test the research hypotheses. Results and Discussion: The findings show that interpersonal relationships and altruism affect environmental attitudes but do not affect green shopping behavior. Also, interpersonal relationships do not affect green shopping behavior through the mediation of environmental attitudes, but altruism mediates environmental attitudes. It directly affects green buying behavior. The effect of environmental knowledge on environmental attitudes has been ruled out, but it has a partial effect on green purchasing behavior through the mediation of environmental attitudes. According to the research results, marketers and policymakers should seriously disseminate information on environmental issues, which can persuade buyers to purchase green products. Any advertising message to attract consumers should be based on idealism, altruism and values and help to reduce doubts about the consumption of green products. Conclusion: The results of the present study showed that consumers became environmentally aware and showed an altruistic and compassionate understanding of green shopping behavior. It is, however, difficult to implement knowledge transfer strategies among consumers. The present study provides key management implications and informs marketing professionals, managers and policy makers about the predictions made on green consumerism among consumers so that they can better understand the barriers to green buying behavior. This understanding may enable them to tailor their products and use marketing strategies that encourage green buying behavior. Government marketers and policymakers need to seriously disseminate information on environmental problems to drive buyers towards green products. Most importantly, it should be noted that the consumption of green products should be reasonable, cost-effective and appropriate so that consumers can have a positive attitude towards them and be encouraged to consume them. By enhancing the sense of altruism, various measures, such as holding cultural programs for people in the community, can be taken to develop green shopping behavior. By using the influence of the intellectual leaders of the society, people can be encouraged to engage in green shopping behavior. Marketing managers can also use different marketing methods such as promotions to influence different groups of buyers and create positive environmental attitude toward green consumption.

Simple Summary: The pharyngocutaneous fistula (PCF) is a pathologic canal connecting the pharyngeal lumen with the skin of the neck occurring after a total laryngectomy (TLE), the removal of the entire larynx. The incidence of PCF ranges from 0% to 80%. Our study aimed to identify the temporal changes in PCF incidence over an extended period and determine the risk factors for increases in the PCF rate. By reviewing patient data from 2004 to 2022, we discovered a total incidence of 26.7%. This study revealed four high-incidence periods, averaging 37.61%, each followed by lower-incidence periods of 19.38%. The surgical wound infection and a history of head and neck cancer along with its related treatments were identified as independent risk factors during most of the high-incidence periods. The continuous monitoring of patients following TLE can assist providers in the better prediction and, consequently, timely management of PCF, ultimately improving patient outcomes after TLE. Background: This study aimed to analyse the variability in the incidence of the pharyngocutaneous fistula (PCF), the most common complication following a total laryngectomy (TLE), and to identify the underlying causes for fluctuations in incidence rates. Methods: In the retrospective study, the annual PCF incidence data and comprehensive clinicopathologic data from 540 patients who underwent TLE between January 2004 and December 2022 were reviewed. Distinct peri ods of both high and low PCF incidence were identified. Within these periods, patients were categorized into groups with PCF (study groups) and without it (control groups). These groups were statistically compared based on potential risk factors for PCF development. The high-incidence periods were specially analysed for recurring risk factors and the corresponding corrective measures were reviewed. Results: The analysis revealed four high-incidence periods with an overall PCF incidence of 37.61%, along with three low-incidence periods in between with an overall incidence of 19.38%. Surgical wound infection (SWI) and a history of head and neck cancer alongside their related treatments were repeatedly identified as independent risk factors during high-incidence periods, with SWI being the most consistent predictor of PCF development. Conclusions: Continuous monitoring of PCF incidence is crucial, as it allows for the identification of emerging risk factors and the immediate implementation of corrective measures to mitigate these newly identified risk factors. [ABSTRACT FROM AUTHOR]

New classes of antibiotics are urgently needed in the fight against multidrug-resistant bacteria. Drug repurposing has emerged as an alternative approach to accelerate antimicrobial research and development. In this study, we screened a library of sphingosine-1-phosphate receptor (S1PR) modulators against Staphylococcus aureus and identified five active compounds. Among them, etrasimod (APD334), an investigational drug for the treatment of ulcerative colitis, displayed the best inhibitory activity against S. aureus when growing as free-floating planktonic cells and within biofilms. In follow-up studies, etrasimod showed bactericidal activity and drastic reduction of viable bacteria within 1 h of exposure. It also displayed a potent activity against other Gram-positive bacteria, including penicillin- and methicillin-resistant S. aureus strains, S. epidermidis, and Enterococcus faecalis, with a minimum inhibitory concentration (MIC) ranging from 5 to 10 μM (2.3–4.6 μg/mL). However, no inhibition of viability was observed against Gram-negative bacteria Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa, showing that etrasimod preferably acts against Gram-positive bacteria. On the other hand, etrasimod was shown to inhibit quorum sensing (QS) signaling in Chromobacterium violaceum, suggesting that it may block the biofilm formation by targeting QS in certain Gram-negative bacteria. Furthermore, etrasimod displayed a synergistic effect with gentamicin against S. aureus, thus showing potential to be used in antibiotic combination therapy. Finally, no in vitro toxicity toward mammalian cells was observed. In conclusion, our study reports for the first time the potential of etrasimod as a repurposed antibacterial compound against Gram-positive bacteria.

In May 2015, the southeastern coastal states of India encountered one of the deadliest heatwaves in Indian history. Researchers have extensively studied the event to understand the underlying mechanisms and concluded that horizontal warm‐air advection from northwestern parts of India and adiabatic heating were the main attributing factors for the event. However, the large‐scale atmospheric processes that led to these conditions have not been thoroughly explored. In the present study, we show that this event was largely associated with the boreal summer intraseasonal oscillation (BSISO) that is prominent during this season. Our analysis shows that the BSISO dry phase lead to a persistent high‐pressure system, with anomalous subsidence favoring adiabatic heating and anticyclonic circulation anomalies increasing the northwesterly warm‐air advection. It is shown that a 55% to 75% contribution to the maximum surface air temperature (SAT) anomalies during the heatwave period can be attributed to BSISO‐related temperature anomalies. Furthermore, the results show that, in the absence of BSISO, the heat event would have dissipated with 1–2 hot days with much less intensity and the presence of the BSISO dry phase extended the heatwave duration by six days. The impact of BSISO on this heatwave was further substantiated by sensitivity experiments using the Weather Research and Forecasting (WRF) model. This analysis emphasizes that improving the forecasting skills of BSISO may facilitate the subseasonal forecast of local heatwave events. [ABSTRACT FROM AUTHOR]