Sediment cores are optimal mediums for investigating the historical presence of offshore microplastics (MPs). In this study, two sediment cores were collected at varying water depths, i.e., XS2 (10 m) and XS3 (20 m), from the Xiangshan offshore (XSO) in Ningbo. We focused on the spatiotemporal distribution characteristics of MPs within two sediment cores and explored the response differences of MPs abundance to natural factors and human activities. The results showed that the MPs abundance in sediments has gradually increased since the late 1960s, but with interannual fluctuations. MPs abundance in XS2 and XS3 were 1133-8700 and 633-11433 items/kg dry weight, respectively. The predominant polymers were PA, PU, PET and ACR, with fragmented particles being the most prevalent shape of MPs. The MPs abundance in XS2 and XS3 had a similar response to natural factors, mainly including (i) MPs abundance significantly correlated with the sediment load of the Qiantang River (p < 0.01), indicating that sediment load might be an important factor affecting the MPs abundance and that MPs transported by rivers had characteristics of near-source sedimentation; (ii) typhoons had the effect of weakening the MPs abundance; and (iii) geological activities might be potential contributing factors to variations in MPs\' abundance in deep sediments. Correlation analyses demonstrated that MPs in XSO was the result of multiple sources, stemming from plastic production, sewage discharge, marine fisheries and shipping activities. Notably, XS3 exhibited higher sensitivity to human activities compared to XS2, owing to differences in sampling locations. This study underscores the significance of employing two sediment cores, rather than a single core, as it provides a more comprehensive insight into the overarching trends and disparities in the historical pollution of MPs. Our findings contribute to a deeper understanding of the history of offshore MPs pollution, shedding new light on this critical environmental issue.

As life expectancy increases, the effectiveness of cervical cancer screening programs needs to be reassessed for the older population. We addressed the effect of test history in and outside organized screening at age 50-64 years on later cervical cancer risk. A case-control study was conducted by deriving 229 cases of 65-79 years old women with invasive cervical cancer in 2010-2019 from the Finnish Cancer Registry. Ten controls were matched for each case by birth year and hospital district. The effect of test uptake and abnormal results in 50-64 year olds on cancer risk was investigated using conditional logistic regression and adjusted for self-selection. Test uptake within the 50-64 years age group showed 75% lower odds of cervical cancer [adjusted OR (aOR) = 0.25; 95% confidence interval (95% CI), 0.18-0.35]. Untested women had 4.9 times higher odds than those tested with normal results (aOR = 4.86; 95% CI, 3.42-6.92). Having at least one abnormal test result increased the odds by 2.5 when compared with only normal results but showed lower odds when compared with untested women. The importance of testing is exhibited by the result showing a reduction of odds of cancer to one-fourth for those tested compared with untested. Similarly, receiving abnormal results was protective of cancer compared with having no tests highlighting the importance of proper follow-up. Therefore, screening history should be considered when further developing cervical cancer screening programs with special interest in non-attenders and those receiving abnormal results at older ages.
To our knowledge, this is the first study from Finnish data describing the effect of test history on later cervical cancer at older ages. Focusing on the cervical tests taken within the Finnish national screening program and outside it highlights the overall importance of having cervical tests and adds this study into the slowly increasing number of studies considering all cervical testing in Finland.

UNASSIGNED: Lymphoscintigraphy is a safe, minimally invasive, and well-established imaging modality for evaluating lymphatic drainage in patients with suspected lymphedema. We report a case of an 8-year-old girl with lymphangioma circumscriptum of the labium majora. She was referred to lymphoscintigraphy for swelling of the lower extremities. Scintigraphy showed widespread dermal backflow at bilateral lower limbs, aberrant uptake in the abdominal lymph nodes, and unexpected uptake in the right axillary lymph nodes.

Construction and Demolition Waste Management (CDWM) includes collecting, transporting, processing, and disposing construction and demolition (C&D) waste, where collection and transportation of bulky and voluminous C&D waste contribute significantly to economic and environmental impacts. Transfer station (TS) being a link between various waste management (WM) facilities plays a significant role in collection and transportation of waste. Thus, locating TS at suitable site can help in reducing the overall impacts. Employment of Geographic Information System (GIS) analysis tools in CDWM is a powerful strategy for site suitability study. A case study in Coimbatore, India, is presented in this study using GIS-based multi-criteria analysis for locating C&D waste TS. The criteria for site suitability analysis are chosen based on literature review, regulations, and experts\' opinions. Weights of the chosen criteria are estimated using analytic hierarchy process (AHP), and the final suitability map is created by weighted overlay analysis (WOA) in GIS environment. Results provide first-hand information for local decision makers to locate C&D waste transfer station in the chosen study region and report that 12% of the entire area is \"highly suitable\" for transfer station location.

This study aims to explore the perspectives of medical trainees on the impartation of digital competencies in Singapore\'s medical school curricula. It also considers how the medical school experience can be strengthened in order to bridge potential gaps in the integration of these competencies in the local curricula. Findings were drawn from individual interviews with 44 junior doctors from Singapore\'s public healthcare institutions including hospitals and national specialty centers. House officers and residents from different medical and surgical specialties were recruited using purposive sampling. Data was interpreted using qualitative thematic analysis. The doctors were in their first to tenth year of post-graduate training. Thirty of them graduated from the three local medical schools whereas 14 others were trained overseas. Overall, they felt insufficiently prepared to utilize digital technologies in view of their limited exposure to such technologies in medical school. Six key reasons were identified: lack of flexibility and dynamism within the curriculum, dated learning style, limited access to electronic health records, gradual uptake of digital technologies in the healthcare sector, lack of an ecosystem that promotes innovation, and lack of guidance from qualified and available mentors. Equipping medical students with skills relevant to the digital age would benefit from a concerted effort from multiple stakeholders: medical schools, medical educators and innovators, as well as the government. This study bears important implications for countries that seek to bridge the \'transformation gap\' brought about by the digital age, which is defined as the sharp divergence between innovations that healthcare providers recognize as important but for which they feel insufficiently prepared.

Secondary anemia in hemoglobinopathies like thalassemia can cause expansion of the bone marrow cavities because of compensatory marrow hyperplasia. This case demonstrates spontaneous osteonecrosis of the distal left femur in a patient with β-thalassemia that may be secondary to ischemic infarction secondary to occlusion of the microvasculature within the expanded cancellous bone. This subject was referred to Hazrat Rasool Akram Hospital because of fever, cough, and bone pain. In the CT scan she had scattered peripheral CGO in both lungs due to COVID-19 with two paravertebral masses due to extramedullary hematopoiesis. The patient had also generalized bone pain so the physician asked for a whole-body bone scan and incidentally, we found a cold lesion with a rim of increased uptake in the distal left femur that with bone biopsy it was consistent with osteonecrosis. This case illustrates the importance of performing a whole-body bone scan in β-thalassemia for the management of patients and diagnosis of occult osteonecrosis.

UNASSIGNED: Vertebral brucellosis is a relatively rare disease that usually emerges in animal husbandry areas. We report a case that brucellosis of lumbar vertebral body showed an intense uptake of FAPI on 18F-FAPI PET/CT, which mimics to malignant lesions or vertebral tuberculosis. It is an interesting finding to realize that vertebral brucellosis is also one of the reasons for intense uptake of FAPI.

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Spatiotemporal cues orchestrate the development of organs and cellular differentiation in multicellular organisms. For instance, in the root apical meristem an auxin gradient patterns the transition from stem cell maintenance to transit amplification and eventual differentiation. Among the proximal tissues generated by this growth apex, the early, so-called protophloem, is the first tissue to differentiate. This observation has been linked to increased auxin activity in the developing protophloem sieve element cell files as compared to the neighboring tissues. Here we review recent progress in the characterization of the unique mechanism by which auxin canalizes its activity in the developing protophloem and fine-tunes its own transport to guide proper timing of protophloem sieve element differentiation.

In the first edition of this book, we presented the basics of explicitly incorporating the lipid biochemistry into a confluent cell monolayer transport model and the novel findings of this model up to 2013, including the use of global optimization to fit the elementary rate constants and the efflux active P-glycoprotein (P-gp) membrane concentrations for the transport of four P-gp substrates across MDCKII-hMDR1-NKI confluent cell monolayers. This chapter is an update on that model, which has been focused primarily on discovering how microvilli morphology regulates the efflux active P-gp and the existence of, as yet, unidentified uptake transporters of P-gp substrates in all of the commonly used P-gp expressing cell lines used in the pharmaceutical industry, thereby adding new players to DDI predictions and IVIVE. The structural mass action kinetic model uses the general mass action reactions for P-gp binding and efflux, with the membrane structural parameters for the confluent cell monolayer to predict drug transport over time. Binding of drug to P-gp occurs within the cytosolic monolayer of the apical membrane, according to (a) the molar partition coefficient of the drug to the cytosolic monolayer and (b) the association rate constant, k1 (M-1 s-1), of the drug from the basolateral or apical outer monolayers into the P-gp binding site. Release of substrate from P-gp back into the cytosolic monolayer occurs with a dissociation rate constant kr (s-1) or, much less frequently, into the apical aqueous chamber with an efflux rate constant k2 (s-1). The model fits the efflux active P-gp concentration, T(0), i.e., the P-gp whose effluxed drug actually reaches the apical aqueous chamber, as opposed to the majority of P-gp whose effluxed drug is reabsorbed back into the same or neighboring microvilli prior to reaching the apical aqueous chamber. Efflux active P-gp largely resides near the tips of the microvilli. We have shown using kinetics and structured illumination microscopy that: (a) efflux active P-gp is controlled by microvilli morphology; (b) there are apical (AT) and basolateral (BT) uptake transporters for P-gp substrates in most, if not all, P-gp expressing cell lines used in the pharmaceutical industry, which exist, but which remain unidentified; (c) the lab-to-lab variability in P-gp IC50 values observed in the P-gp IC50 initiative was due to the conflated inhibition of P-gp and the basolateral digoxin uptake transporters by all 15 P-gp substrates tested in that study; (d) even the IC50 values for P-gp inhibition alone do not obey the Cheng-Prusoff relationship; (e) the fitted elementary rate constants and the molecular dissociation constant Ki for this kinetic model are system independent; and (f) the time dependence of product formation for these confluent cell monolayers is correlated with the P-gp Vmax/Km, when defined by its fitted elementary rate constants and uptake transporter clearances, without any steady-state assumptions.