Tumor lysis syndrome is a life-threatening condition for humans due to the lack of urate oxidase. In this study, several variants of PASylated uricase from the Aspergillus flavus species were analyzed computationally to find the appropriate fusions to solve short half-life and stability concern. The Ab initio method was performed using Rosetta software to structurally characterize the PAS sequences. The 3D structures of fusions were predicted for fused C-or N-terminally PAS sequences in different length to the uricase. The refinement and energy minimization steps revealed that physicochemical and conformational properties of fusions improved while the structures possessed prolonged PAS sequences. Molecular docking results showed that the highest binding affinity to uric acid belonged to uricase-PAS1-100 by the formation of six hydrogen and four non-hydrogen bonds. Altogether, the results indicated that the PASylation process would be promising upon the production of urate oxidase with improved solubility and stability.

Introduction: Acute appendicitis in children is associated with morbidity and mortality due to late diagnosis. Several scoring systems, such as Alvarado and PAS have been developed to help diagnose acute appendicitis in children to make the most accurate and prompt decision. The purpose of this study was to compare the efficacy and diagnostic value of these scoring systems. Materials and Methods: In this cross-sectional study, 130 children aged 5-14 with suspected acute appendicitis were included. After the collection of demographic data, all patients were scored by Alvarado and PAS systems. The decision for surgery was made by a surgeon, independently of these scores. The diagnosis of acute appendicitis was affirmed by surgical and pathologic findings. Results: Male: Female ratio was 1. 32: 1, and the average age of the patients were 9. 2± 2. 7 years. The mean Alvarado and PAS scores were higher in patients with positive pathologic findings. Neutrophilia >75% and RLQ tenderness had the highest relationship with the diagnosis of the disease. The diagnostic value of Alvarado was higher than PAS concerning the area under the ROC curve. The cutoff point of 7 was associated with a sensitivity of 74. 5% and specificity of 66. 7% for the Alvarado score, and a sensitivity of 58. 5% and specificity of 79. 2% for the PAS score. Conclusions: The results showed the high sensitivity of Alvarado and the high specificity of PAS. However, the sensitivity, specificity, PPV, and NPV of these criteria were not satisfactory for the confirmation of the diagnosis.

Background: This study aimed at evaluating the accuracy of the pediatric appendicitis scoring method in differentiating nonspecific abdominal pain (NSAP) from appendicitis. Methods: This cross‑, sectional study was conducted on 391 children who were hospitalized in the emergency ward due to acute abdominal pain suspected of appendicitis. Pediatric Appendicitis Score (PAS), C-reactive protein (CRP), and appendicitis pathology results of patients undergoing surgery were recorded. Results: The results showed that the no significant difference was found among patients in the three experimental groups (appendicitis, specific abdominal pain except appendicitis, and NSAP) with respect to temperature (p = 0. 212), but the other variables were significantly different. Findings showed that high CRP frequency, pain migration to right lower quadrant (RLQ), tenderness in right iliac fossa (RIF), anorexia, leukocytosis, high neutrophil, and mean tenderness in RLQ in the appendicitis group were higher than those in the other two groups (p = 0. 001). The PAS questionnaire can also be used as a reliable questionnaire with appropriate sensitivity (0. 929) and specificity (0. 993), and this questionnaire along with detailed clinical examinations could reduce the rate of negative appendectomy to less than 1%. Conclusions: This study showed high accuracy of PAS in diagnosing children with appendicitis and differentiating appendicitis from cases of NSAP and specific abdominal pain other than appendicitis. The PAS system could also significantly reduce cases of negative appendicitis. Although high CRP had an excellent ability to diagnose appendicitis, its accuracy was lower than PAS.

Objective: Placenta Accreta Spectrum (PAS) affects approximately one in a thousand deliveries. Very few studies evaluated PAS risk factors based on their location. In this study, we have investigated the effects of placenta location on placental adhesion-related complications, its risk factors, and outcomes. Materials and methods: We performed a retrospective cohort study of pathology-confirmed cases of PAS from patients with peripartum hysterectomy, at a large educational hospital in Qazvin, Iran, from 2009 to 2019. Placenta location was found by ultrasound reports and intraoperative evaluation. We measured demographic features, basic characteristics, maternal and neonatal outcomes based on placental location including anterior, posterior, and lateral in Placenta Accreta Spectrum. Chi-square, t-test, and one-way ANOVA were used to examine the relation of complications, risk factors, and outcomes in PAS. Results: A review of 70 cases showed the distribution of placenta location as follows: 57% anterior, 27% posterior, and 16% lateral. The mean gestational age at delivery was 35 (33-39) weeks. In 78. 6% (n=55) of the patients, an association with placenta previa and in 94/2% (n=66) of cases a history of cesarean section was found, however, it was not significantly correlated with placenta location (p=0. 082). We found that surgery duration was significantly longer in patients with lateral PAS (155±, 38, vs 129. 35±, 33. 8 and 133. 15±, 31. 5 for anterior and posterior placenta respectively, p=0. 09). Patients with lateral PAS also bled more than the remaining two groups (2836 ml for lateral PAS vs 2002 and 1847 for anterior and posterior placenta respectively, p=0. 022). Moreover, women with a history of uterine surgery were more likely to have posterior PAS compared to those with anterior and lateral PAS (p=0. 035). Conclusion: Differences in complications, risk factors, and outcomes of PAS based on placenta location may lead to improved diagnosis and decreased morbidity in women.

Background: Among the birds, chicken was the model used in the majority of studies on germ cells and other birds like quail, turkey and pheasant had some interest but ostrich has been lacking from these researches. Aims: The present study was conducted to confirm the presence of ostrich primordial germ cells (PGCs) in the embryonic blood and to determine the appropriate time for having them in the blood. Methods: Embryos were extracted in embryonic day (E) 6-12, their blood was obtained and the rest of the embryos were processed for histological examinations. Staining by periodic acid-Schiff (PAS) method and immunohistochemistry (IHC) using stage-specific embryonic antigen 1 (SSEA1) and stage-specific embryonic antigen 4 (SSEA4) antibodies (Abs) were used for identification of the PGCs. Results: While the blood circulating ostrich PGCs were SSEA1-negative and SSEA4-positive, in the presumptive gonads PGCs showed negative immunoreactivity for both Abs. Although the ostrich PGCs were PAS-positive in both blood and presumptive gonad, their PAS-positive contents reduced during development from E 10 to E 12. Conclusion: E 9, when the hind limb buds appear, is the best time for detecting PGCs in the ostrich embryonic blood.