ate of local recurrence was observed to be nearly 60% lower in the postimplementation group (hazard ratio [95% confidence interval] = 0.43 [0.26-0.72]) Total mesorectal excision specimens were complete or nearly complete in 87.7% of cases, and the circumferential and distal margins were clear in 93.2% and 92.6%, respectively CONCLUSION Local recurrence rate was low during the learning phase of the transanal total mesorectal excision in a sample of rectal cancer surgeons with acceptable surgical and oncologic outcomes. Both the prevalence and rate of local recurrence were markedly lower in the postimplementation phase, indicating improvement as experience accumulated.Respiratory disease is one of the major causes of losses to the pig industry worldwide. The pig subsector is the largest component of the livestock sector in the Philippines. Using lung scoring, this study aimed to estimate the prevalence of thoracic lesions in slaughter-age pigs in two provinces in the Philippines (Batangas and Albay) and define classes for respiratory health of pigs characterised by different patterns of thoracic lesions. A total of 260 pigs from Batangas and 300 pigs from Albay from either commercial or backyard farm types were included in this cross-sectional study. Lungs were scored for cranio-ventral pneumonia (0-55) and pleurisy (0-3). Presence or absence of pericarditis as well as focal dorso-caudal pneumonia were recorded. Latent class analyses considering four indicator variables, and province and farm type as covariates were used to explore different patterns of thoracic lesions across the study populations. Using a threshold of ≥7, the prevalence of a high lung score was 51.9% (95as where "multi-lesion pigs" are most common and further research to identify risk factors for particular classes should maximize impact of future control measures. The latent class analysis approach used could be applied more widely and could add value to analysis of multi-morbidity data collected routinely as part of ongoing monitoring schemes. Polydatin has been reported to possess remarkable anti-atherosclerotic activities. However, there are different opinions on its regulatory mechanisms. It remains unclear whether the anti-atherosclerotic mechanism of polydatin is related to its autophagic restoration or not. The aim of this study was to explore the question. Using atherosclerotic model induced by high-fat diet in apolipoprotein E-deficient mice, the investigation was performed with polydatin alone or in combination with autophagic inhibitor or inducer intervention. Selleckchem U0126 Inhibitory sites of polydatin to PI3K were identified by molecular docking. Polydatin can significantly inhibit PI3K/Akt/mTOR pathway proteins expression, improve autophagic dysfunction and reduce atherosclerotic lesions. These effects could be antagonized and reinforced by adding autophagic inhibitor and inducer, respectively. Inhibitory sites of polydatin to PI3K were found to be ASP-810, SER-854, VAL-851, LEU-807, SER-774, LYS-802, ASP-933, SER-919, ASN-920, PHE-930, MEF-922, GLN-859 of PI3Kα. The mechanism of polydatin to alleviate atherosclerotic lesions was achieved by autophagic restoration.The mechanism of polydatin to alleviate atherosclerotic lesions was achieved by autophagic restoration. This multi-institutional retrospective study sought to examine the hematologic effects of craniospinal irradiation (CSI) in pediatric patients with medulloblastoma using proton or photon therapy. Clinical and treatment characteristics were recorded for 97 pediatric patients with medulloblastoma who received CSI without concurrent chemotherapy or with concurrent single-agent vincristine from 2000 to 2017. Groups of 60 and 37 patients underwent treatment with proton-based and photon-based therapy, respectively. Overall survival was determined by Kaplan-Meier curves with log-rank test. Comparisons of blood counts at each timepoint were conducted using multiple t tests with Bonferroni corrections. Univariate and multivariate analyses of time to grade ≥3 hematologic toxicity were performed with Cox regression analyses. Median age of patients receiving proton and photon CSI was 7.5 years (range, 3.5-22.7 years) and 9.9 years (range, 3.6-19.5 years), respectively. Most patients had a diagnosis of standard riskased hematologic toxicity compared with those receiving photon therapy.Patients who receive CSI using proton therapy experience significantly decreased hematologic toxicity compared with those receiving photon therapy.Stress-induced cardiomyopathy, also known by various names such as Tako-Tsubo cardiomyopathy (TTC), is a cardiomyopathy that presents different types of transient left ventricular dysfunction. We present two cases of reverse TTC occurring in two young men after amphetamine use and complicated by cardiogenic shock necessitating venoarterial extra-corporeal membrane oxygenation (VA-ECMO). Levosimendan was used in one case to prevent subsequent aggravation of left ventricular function provoked by the use of catecholamine in this context. In both cases, myocardial function recovered rapidly. Amphetamine use can lead to reverse TTC requiring transient mechanical assistance and inotropic support.Implant-supported fixed prostheses in the edentulous maxilla can be difficult because of anatomic limitations and high esthetic demand. The choice between cement and screw retention depends on factors such as esthetics, occlusion, retrievability, and passivity. The choice is also often governed by the ability to manage technical or biologic complications. In the edentulous maxilla, because of the bone trajectory and resorption pattern, unfavorable implant angulations may be encountered. In such situations, a conventional screw-retained prosthesis is difficult to design. This article describes the restoration of edentulous maxillae for a series of patients with different complete-arch fixed prosthesis designs. The clinical guidelines, including indications, advantages, and limitations of each design, were discussed. Information on the bond strength of milled polymethyl methacrylateinterim restorations when relined with chairside reline materials is lacking. The purpose of this invitro study was to measure the shear bond strength of various combinations of 3 different chairside reline materials bonded to milled polymethyl methacrylate blocks with 3 different types of surface treatments. Uniform blocks (10×10×22 mm) were milled from tooth-colored polymethyl methacrylate disks (Vivid PMMA; Pearson Dental Supply Co). The surface treatments tested were airborne-particle abrasion with 50-μm particle size aluminosilicate, application of acrylic resin monomer (Jet Liquid; Lang Dental Manufacturing Co) for 180 seconds, and airborne-particle abrasion with monomer application. The control groups were blocks with no surface treatment. The chairside reline materials tested were Jet acrylic resin (Jet Powder; Lang Dental Manufacturing Co), bis-acryl resin (Integrity; Dentsply Sirona), and flowable composite resin (Reveal; Bisco).