This study proposed a new ethanol-lactic type fermentation (ELTF) and explored the optimal control strategy. Using batch experiments, the effects of pH, temperature and organic loading (OL) on ELTF were investigated. The sum of ethanol and lactic acid yield was highest at whole-control pH value of 4.0, 35°C temperature and OL of 33 gCOD/L. To improve ELTF, the dynamic pH control in the long-term CSTR was adjusted at 4.0 (1-28 days), 5.0 (29-44 days) and 4.0 (46-62 days) successively. The high concentration of ethanol and lactic acid was 8190.5 mg/L at 16th day of pH 4.0. At pH of 5.0, the average acidogenesis rate and total concentration of fermentation products increased 111.0% and 128.0%, respectively. Organisms of Lactobacillus and Bifidobacterium were the predominant bacteria in reactor. It can achieve the directional regulation of ELTF and provides parameter support for the application of two-phase anaerobic digestion.There is increasing focus on the value of real-world clinical registry data in multiple medical disciplines, including ophthalmology. However, disease-focused clinical registries that engage optometrists are rare. This paper introduces the Optometry Module of the Save Sight Keratoconus Registry (SSKR) and highlights the potential advantages it can offer to optometrists for improving their quality of patient care and for engaging in research. Optometrists are primary eye care providers and have a major role in providing clinical care to people with keratoconus. The SSKR system has been developed to collects high-quality information on essential clinical parameters including patient-reported outcomes (i.e., quality of life data). The real-world data from the Optometry Module of the SSKR can be analysed to obtain insights into contemporary optometry keratoconus practice, and be used to identify opportunities for improving clinical care. Optometrists' engagement with the registry supports reflective clinical practice through real-time benchmarking. Optometrists can use the registry system to track patient outcomes, and it provides a framework for educating patients about their keratoconus journey. The system also captures details relating to patient adverse events, with subsequent data analysis enabling risk factors for such events to be identified. In summary, the Optometry Module of the SSKR captures real-world clinical evidence that has the potential to inform practice improvement, facilitate safety surveillance and enable outcomes research in keratoconus, all with the ultimate intent of enhancing care for people living with keratoconus.The in vitro antitumor activity (e.g., IC50) of anticancer drugs is important for selecting candidate compounds for in vivo drug efficacy study in the early stage of drug discovery. In this study, we investigated the relationship between in vitro IC50 and in vivo EC50 using six heat shock protein 90 (HSP90) inhibitors.IC50 of each compound was calculated from in vitro cell proliferation assays using the NCI-N87 cancer cell line.  https://www.selleckchem.com/products/u18666a.html  Each compound was administered to NCI-N87 xenograft mice, and EC50 and the maximum tumor-killing rate constant were calculated from pharmacokinetics/pharmacodynamics analyses using plasma concentrations and tumor volumes.IC50 obtained in vitro was poorly correlated with EC50 obtained in vivo, while a good correlation (r = 0.856) was observed between them when corrected with the unbound fraction ratio.The results of this study using of HSP90 inhibitors as model compounds suggest importance of the consideration of an unbound fraction to evaluate the relationship between IC50 and EC50. These results will contribute to improvement in the prediction accuracy of in vivo drug efficacy from in vitro activity and the efficiency of drug discovery research.Clinical relevance Given the association of scleral characteristics with many ophthalmological diseases, there is an important need to measure the anterior scleral thickness (AST).Background This study examined the AST by swept-source optical coherence tomography (SS-OCT) in a large healthy population, assessing also the reproducibility of AST measurements and the correlation with different parameters.Methods Cross-sectional study in 605 eyes of 605 subjects. AST measurements were made in the temporal and nasal quadrants at 1 (AST1) and 3 mm (AST3) from the scleral spur using SS-OCT. These dimensions were then assessed for associations in a multivariate model with the factors age, sex, refractive error, conjunctival-Tenon capsule thickness (CTT), anterior chamber angle (ACA), intraocular pressure (IOP), iris thickness (IT), limbus-sulcus distance (LSD), and ciliary muscle thickness (CMT). The reproducibility of the AST measurements was determined in 30 of the participants.Results The mean age was 42.6 ± 17.3 years (range 5 to 86 years). The following means were recorded AST1 was 522.3 ± 65.7 µm (355 to 761) and 558.4 ± 71.5 µm (357 to 889); AST2 was 513.3 ± 67.3 µm (343 to 732) and 574.4 ± 71.6 µm (389 to 789), and AST3 548.8 ± 71.9 µm (356 to 762) and 590.1 ± 76.6 µm (414 to 873) in the temporal and nasal quadrants respectively, being thicker the nasal quadrant (all p less then 0.001). A positive correlation was detected between AST and age, sex, temporal ACA and LSD (all p ≤ 0.043), being negative the correlation with CMT (p ≤ 0.044). No correlation was observed between AST measurements and refractive error, CTT and IT (p ≥ 0.064). The reproducibility of AST measurements was excellent (intraclass correlation coefficient ≥0.951).Conclusions SS-OCT allows for in vivo AST measurements. Our data contained a wide range of measurements, showing an association between AST and age, sex, ACA, LSD and CMT.
  Pagetoid urothelial intraepithelial neoplasia (PUIN) is a form of secondary Extramammary Paget Disease (EMPD). It is a rare malignant condition seen on the female genitalia synchronous or metachronous with bladder cancer (BC).
 
  A 66-year-old female presented with PUIN at the labia minora 2 years after an open anterior pelvic exenteration with ileal conduit urinary diversion for carcinoma 
  (CIS) of the bladder. PUIN of the vulva and vagina was confirmed by a punch biopsy and the patient underwent a radical vaginectomy with urethrectomy and inguinal sentinel node procedure. Immunohistochemically EMPD was identified by the expression tumor protein 63 (p63), cytokeratin 7, and cytokeratin 20 (CK20).
 
  PUIN is a rare but distinct clinical entity as a form of secondary EMPD which can be differentiated from primary EMPD based on medical history, histology, and immunohistochemistry.
 PUIN is a rare but distinct clinical entity as a form of secondary EMPD which can be differentiated from primary EMPD based on medical history, histology, and immunohistochemistry.