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Cannabidiol alleviates neuroinflammation and attenuates neuropathic pain via targeting FKBP5.

Microglia is a heterogeneous population that mediates neuroinflammation in the central nervous system (CNS) and plays a crucial role in developing neuropathic pain. FKBP5 facilitates the assembly of the IκB kinase (IKK) complex for the activation of NF-κB, which arises as a novel target for treating neuropathic pain. In this study, cannabidiol (CBD), a main active component of Cannabis, was identified as an antagonist of FKBP5. In vitro protein intrinsic fluorescence titration showed that CBD directly bound to FKBP5. Cellular thermal shift assay (CETSA) indicated that CBD binding increased the FKBP5 stability, which implies that FKBP5 is the endogenous target of CBD. CBD was found to inhibit the assembly of the IKK complex and the activation of NF-κB, therefore blocking LPS-induced NF-κB downstream pro-inflammatory factors NO, IL-1β, IL-6 and TNF-α. Stern-Volmer analysis and protein thermal shift assay revealed that tyrosine 113 (Y113) of FKBP5 was critical for FKBP5 interacting with CBD, which is consistent with in silico molecular docking simulation. FKBP5 Y113 mutation (Y113A) alleviated the effect of CBD inhibiting LPS-induced pro-inflammatory factors overproduction. Furthermore, systemic administration of CBD inhibited chronic constriction injury (CCI)-induced microglia activation and FKBP5 overexpression in lumbar spinal cord dorsal horn. These data imply that FKBP5 is an endogenous target of CBD.

Strategy for cost-effective BMPs of non-point source pollution in the small agricultural watershed of Poyang Lake: A case study of the Zhuxi River.

In recent years, Poyang Lake has been affected by severe agricultural non-point source (NPS) pollution, a global water pollution problem. The most recognized and effective control measure for agricultural NPS pollution is the strategic selection and placement of best management practices (BMPs) for critical source areas (CSAs). The present study employed the Soil and Water Assessment Tool (SWAT) model to identify CSAs and evaluate the effectiveness of different BMPs in reducing agricultural NPS pollutants in the typical sub-watersheds of the Poyang Lake watershed. The model performed well and satisfactorily in simulating the streamflow and sediment yield at the outlet of the Zhuxi River watershed. The results indicated that urbanization-oriented development strategies and the Grain for Green program (returning the grain plots to forestry) had certain effects on the land-use structure. The proportion of cropland in the study area decreased from 61.45% (2010) to 7.48% (2018) in response to the Grain for Green program, which was mainly converted to forest land (58.7%) and settlements (36.8%). Land-use type changes alter the occurrence of runoff and sediment, which further affect the nitrogen (N) and phosphorus (P) loads since sediment load intensity is a key factor affecting the P load intensity. Vegetation buffer strips (VBSs) proved the most effective BMPs for NPS pollutant reduction, and the cost of 5-m VBSs proved the lowest. The effectiveness of each BMP in reducing N/P load ranked as follows: VBS > grassed river channels (GRC) > 20% fertilizer reduction (FR20) > no-tillage (NT) > 10% fertilizer reduction (FR10). All combined BMPs had higher N and P removal efficiencies than the individual measures. We recommend combining FR20 and VBS-5m or NT and VBS-5m, which could achieve nearly 60% pollutant removal. Depending on the site conditions, the choice between FR20+VBS and NT + VBS is flexible for targeted implementation. Our findings may contribute to the effective implementation of BMPs in the Poyang Lake watershed and provide theoretical support and practical guidance for agricultural authorities to perform and direct agricultural NPS pollution prevention and control.

Responses of earthworms exposed to low-density polyethylene microplastic fragments.

The interest in the effect of microplastics (MPs) on the terrestrial environment has been increasing recently. Different species of earthworms have been used to study the effects of MPs on different aspects of earthworm health. However, there is still a need for more studies because different studies report different effects on earthworms depending on the properties (e.g., types, shapes, sizes) of MPs in the environment and exposure conditions (e.g., exposure period). This study used Eisenia fetida as a test earthworm species to investigate the effect of different concentrations of low-density polyethylene (LDPE) MPs (≤125 μm) in soil on the growth and reproduction of earthworms. The exposure of the earthworms to the different concentrations of LDPE MPs (0-3% w/w) for 14 d and 28 d neither caused death of the earthworms nor showed significant effects on the earthworm weights in this study. The number of cocoons produced by the exposed earthworms were also similar to that of the controls (i.e., no exposure to MPs). Some previous studies reported similar results to what have been observed in this study, while some studies reported different results. On the other hand, the number of ingested MPs by the earthworms increased with increasing MPs concentrations in soil, suggesting a potential for damage to digestive tract. Also, the earthworm skin surface was damaged after exposure to MPs. The ingested MPs and the skin surface damage suggest that there is a potential for adverse effects on the earthworm growth after a longer-term exposure. Overall, the results of this study show that the effects of MPs on earthworms need to be studied using various endpoints including growth, reproduction, ingestion, and skin damage and such effects can be different depending on the exposure conditions such as MPs concentration and exposure period.

Apposition of Fibroblasts With Metaplastic Gastric Cells Promotes Dysplastic Transition.

Elements of field cancerization, including atrophic gastritis, metaplasia, and dysplasia, promote gastric cancer development in association with chronic inflammation. However, it remains unclear how stroma changes during carcinogenesis and how the stroma contributes to progression of gastric preneoplasia. Here we investigated heterogeneity of fibroblasts, one of the most important elements in the stroma, and their roles in neoplastic transformation of metaplasia.

Association between the relationship of bystander and neurologic recovery in pediatric out-of-hospital cardiac arrest.

This study aimed to evaluate whether the relationship between bystanders and victims is associated with neurological outcomes in paediatric out-of-hospital cardiac arrest (OHCA).

Intestines-erythrocytes-mediated bio-disposition deciphers the hypolipidemic effect of berberine from Rhizoma Coptidis: A neglected insight.

Rhizoma Coptidis (RC), the dried rhizome of Coptis Chinensis Franch., can dispel dampness and heat within the body and has been traditionally used for the treatment of cardiovascular disease (CVD)-associated problems including hyperlipidemia in China. Berberine (BBR) is the main active component of RC, which has been shown to possess significant therapeutic potential. However, only 0.14% of BBR is metabolized in the liver, and the extremely low bioavailability (<1%) and blood concentration of BBR in experimental and clinical settings is insufficient to achieve the effects as observed under in vitro conditions, which imposes challenges to explain its excellent pharmacological actions. Intense efforts are currently being devoted to defining its specific pharmacological molecular targets, while the exploration from the perspective of its pharmacokinetic disposition has rarely been reported to date, which could hardly make a comprehensive understanding of its hypolipidemic enigma.

Mongolian medicine formulae Ruda-6 alleviates indomethacin-induced gastric ulcer by regulating gut microbiome and serum metabolomics in rats.

Ruda-6 (RD-6), a typical traditional Mongolian medicine formulae consisting of 6 herbs, has been traditionally used in treating gastric disorders. Even though it has been shown to protect against gastric ulcers (GU) in animal models, the gut microbiome and serum metabololite-related mechanisms that prevent GU are not well understood.

Double-Barrel Nitinol Stent Placement for Iliocaval Reconstruction: The Effect of Deployment Sequence and Direction on Final Configuration.

Double-barrel stent placement across the iliocaval confluence is commonly used for the treatment of chronic bilateral iliocaval occlusion. The difference in the deployment outcomes of synchronous parallel stent deployment versus asynchronous or antiparallel deployment and the underlying stent interactions are poorly understood. In this study, 3 strategies of double-barrel nitinol self-expanding stent deployment across the iliocaval confluence (synchronous parallel, asynchronous parallel, and synchronous antiparallel) were contrasted in vivo in 3 swine followed by assessment of the explanted stent construct. Synchronous parallel stent deployment achieved a desired double-barrel configuration. The asynchronous parallel and antiparallel deployment strategies both resulted in a crushed stent despite subsequent simultaneous balloon angioplasty. These animal model results suggested that in patients who undergo double-barrel iliocaval reconstruction, synchronous parallel stent deployment may provide the desired stent conformation and increase the chance for clinical success.

Age-dependent dysfunction of the cerebrovascular system in the zebrafish telencephalon.

The brain is an essential organ that controls various biological activities via the nervous system. The cerebral blood vessels supply oxygen and nutrients to neuronal cells and carry away waste products, which is essential in maintaining brain functions. Aging affects cerebral vascular function and decreases brain function. However, the physiological process of age-dependent cerebral vascular dysfunction is not fully understood. In this study, we examined aging effects on cerebral vascular patterning, vascular function, and learning ability in adult zebrafish. We found that the tortuosity of the blood vessels was increased, and the blood flow rate was reduced with aging in the zebrafish dorsal telencephalon. Moreover, we found cerebral blood flow positively correlated with learning ability in middle-old-aged zebrafish, as in aged humans. In addition, we also found that the elastin fiber decreased in the middle-old-aged fish brain vessel, suggesting a possible molecular mechanism underlying vessel dysfunction. Therefore, adult zebrafish may serve as a useful model for studying the aging-dependent decline in vascular function and human diseases such as vascular dementia.

Dual orexin/hypocretin receptor antagonism attenuates NMDA receptor hypofunction-induced attentional impairments in a rat model of schizophrenia.

Schizophrenia is a neuropsychiatric condition that is associated with impaired attentional processing and performance. Failure to support increasing attentional load may result, in part, from inhibitory failure in attention-relevant cortical regions, and available antipsychotics often fail to address this issue. Orexin/hypocretin receptors are found throughout the brain and are expressed on neurons relevant to both attention and schizophrenia, highlighting them as a potential target to treat schizophrenia-associated attentional dysfunction. In the present experiment, rats (N = 14) trained in a visual sustained attention task that required discrimination of trials which presented a visual signal from trials during which no signal was presented. Once trained, rats were then co-administered the psychotomimetic N-methyl-D-aspartate (NMDA) receptor antagonist dizocilpine (MK-801: 0 or 0.1 mg/kg, intraperitoneal injections) and the dual orexin receptor antagonist filorexant (MK-6096: 0, 0.1, or 1 mM, intracerebroventricular infusions) prior to task performance across six sessions. Dizocilpine impaired overall accuracy during signal trials, slowed reaction times for correctly-responded trials, and increased the number of omitted trials throughout the task. Dizocilpine-induced increases in signal trial deficits, correct response latencies, and errors of omission were reduced following infusions of the 0.1 mM, but not 1 mM, dose of filorexant. As such, orexin receptor blockade may improve attentional deficits in a state of NMDA receptor hypofunction.

Dissecting sources of variability in patient response to targeted therapy: anti-HER2 therapies as a case study.

Despite their use to treat cancers with specific genetic aberrations, targeted therapies elicit heterogeneous responses. Sources of variability are critical to targeted therapy drug development, yet there exists no method to discern their relative contribution to response heterogeneity.

Emission factors for a biofuel impacted fleet in South America's largest metropolitan area.

The Metropolitan Area of São Paulo (MASP) is among the largest urban areas in the Southern Hemisphere. Vehicular emissions are of great concern in metropolitan areas and MASP is unique due to the use of biofuels on a large scale (sugarcane ethanol and biodiesel). In this work, tunnel measurements were employed to assess vehicle emissions and to calculate emission factors (EFs) for heavy-duty and light-duty vehicles (HDVs and LDVs). The EFs were determined for particulate matter (PM) and its chemical compounds. The EFs obtained for 2018 were compared with previous tunnel experiments performed in the same area. An overall trend of reduction of fine and coarse PM, organic carbon (OC), and elemental carbon (EC) EFs for both LDVs and HDVs was observed if compared to those observed in past years, suggesting the effectiveness of vehicular emissions control policies implemented in Brazil. A predominance of Fe, Cu, Al, and Ba emissions was observed for the LDV fleet in the fine fraction. Cu presented higher emissions than two decades ago, which was associated with the increased use of ethanol fuel in the region. For HDVs, Zn and Pb were mostly emitted in the fine mode and were linked with lubricating oil emissions from diesel vehicles. A predominance in the emission of three- and four-ring polycyclic aromatic hydrocarbons (PAHs) for HDVs and five-ring PAHs for LDVs agreed with what was observed in previous studies. The use of biofuels may explain the lower PAH emissions for LDVs (including carcinogenic benzo[a]pyrene) compared to those observed in other countries. The tendency observed was that LDVs emitted higher amounts of carcinogenic species. The use of these real EFs in air quality modeling resulted in more accurate simulations of PM concentrations, showing the importance of updating data with real-world measurements.

Inactivation of Foodborne Pathogen Biofilm Cells Using a Combination Treatment with Gaseous Chlorine Dioxide and Aerosolized Sanitizers.

A biofilm is a three-dimensional microbial community, which is difficult to completely control with a typical sanitizer owing to its complex structure. The aim of this study was to establish a system for the combined treatment of biofilms with 10 ppmv gaseous chlorine dioxide (ClO

Ex vivo exposure to calcitonin or raloxifene improves mechanical properties of diseased bone through non-cell mediated mechanisms.

Raloxifene (RAL) reduces clinical fracture risk despite modest effects on bone mass and density. This reduction in fracture risk may be due to improved material level-mechanical properties through a non-cell mediated increase in bone hydration. Synthetic salmon calcitonin (CAL) has also demonstrated efficacy in reducing fracture risk with only modest bone mass and density improvements. This study aimed to determine if CAL could modify healthy and diseased bone through cell-independent mechanisms that alter hydration similar to RAL. 26-week-old male C57BL/6 mice induced with chronic kidney disease (CKD) beginning at 16 weeks of age via 0.2 % adenine-laced casein-based (0.9 % P, 0.6 % C) chow, and their non-CKD control littermates (Con), were utilized. Upon sacrifice, right femora were randomly assigned to the following ex vivo experimental groups: RAL (2 μM, n = 10 CKD, n = 10 Con), CAL (100 nM, n = 10 CKD, n = 10 Con), or Vehicle (VEH; n = 9 CKD, n = 9 Con). Bones were incubated in PBS + drug solution at 37 °C for 14 days using an established ex vivo soaking methodology. Cortical geometry (μCT) was used to confirm a CKD bone phenotype, including porosity and cortical thinning, at sacrifice. Femora were assessed for mechanical properties (3-point bending) and bone hydration (via solid state nuclear magnetic resonance spectroscopy with magic angle spinning (ssNMR)). Data were analyzed by two-tailed t-tests (μCT) or 2-way ANOVA for main effects of disease, treatment, and their interaction. Tukey's post hoc analyses followed a significant main effect of treatment to determine the source of the effect. Imaging confirmed a cortical phenotype reflective of CKD, including lower cortical thickness (p < 0.0001) and increased cortical porosity (p = 0.02) compared to Con. In addition, CKD resulted in weaker, less deformable bones. In CKD bones, ex vivo exposure to RAL or CAL improved total work (+120 % and +107 %, respectively; p < 0.05), post-yield work (+143 % and +133 %), total displacement (+197 % and +229 %), total strain (+225 % and +243 %), and toughness (+158 % and +119 %) vs. CKD VEH soaked bones. Ex vivo exposure to RAL or CAL did not impact any mechanical properties in Con bone. Matrix-bound water by ssNMR showed CAL treated bones had significantly higher bound water compared to VEH treated bones in both CKD and Con cohorts (p = 0.001 and p = 0.01, respectively). RAL positively modulated bound water in CKD bone compared to VEH (p = 0.002) but not in Con bone. There were no significant differences between bones soaked with CAL vs. RAL for any outcomes measured. RAL and CAL improve important post-yield properties and toughness in a non-cell mediated manner in CKD bone but not in Con bones. While RAL treated CKD bones had higher matrix-bound water content in line with previous reports, both Con and CKD bones exposed to CAL had higher matrix-bound water. Therapeutic modulation of water, specifically the bound water fraction, represents a novel approach to improving mechanical properties and potentially reducing fracture risk.

Paraquat is toxic to the soil-dwelling arthropod, Folsomia candida (Collembola: Isotomidae), and has potential effects on its Wolbachia endosymbiont.

The springtail, Folsomia candida, is a soil arthropod commonly used to evaluate environmental toxins. Conflicting data on the toxicity of the herbicide paraquat prompted re-evaluation of its effects on F. candida survival and reproduction. Paraquat has an LC

Extracorporeal photopheresis in the treatment of cardiac allograft rejection: A single-centre experience.

Despite novel immunosuppressive (IS) protocols, adverse effects of IS drugs continue to have notable negative impact on patient and cardiac allograft survival after heart transplantation (HTx). Therefore, IS regimens with less toxic side effects are sorely needed. We aimed to evaluate the efficacy of extracorporeal photopheresis (ECP) in combination with tacrolimus-based maintenance IS therapy in the treatment of allograft rejection in adult HTx recipients. Indications for ECP included acute moderate-to-severe or persistent mild cellular rejection, or mixed rejection. Twenty-two patients underwent a median of 22(2-44) ECP treatments after HTx. Median duration of ECP course was 173.5(2-466) days. No relevant adverse effects of ECP were noted. Reduction of methylprednisolone doses was safe throughout the ECP course. ECP, used in conjunction with pharmacological anti-rejection therapy, had a successful reversal of cardiac allograft rejection, decreased the rates of subsequential rejection episodes and normalized the allograft function in patients completing the ECP course. Short- and long-term survivals were excellent (91% at 1 and 5 years post-ECP) and comparable to International Society for Heart and Lung Transplantation registry data on HTx recipient overall survival. In conclusion, ECP can be safely used for the treatment and prevention of cardiac allograft rejection in conjunction with traditional IS regimen.

Improved synthesis and anticancer activity of a potent neuronal nitric oxide synthase inhibitor.

An improved synthesis of 4-methyl-7-(3-((methylamino)methyl)phenethyl)quinolin-2-amine (1) is reported. A scalable, rapid, and efficient methodology was developed to access this compound with an overall yield of 35%, which is 5.9-fold higher than the previous report. The key differences in the improved synthesis are a high yielding quinoline synthesis by a Knorr reaction, a copper-mediated Sonogashira coupling to the internal alkyne in excellent yield, and a crucial deprotection of the N-acetyl and N-Boc groups achieved under acidic conditions in a single step rather than a poor yielding quinoline N-oxide strategy, basic deprotection conditions, and low yielding copper-free conditions that were reported in the previous report. Compound 1, which previously was shown to inhibit IFN-γ-induced tumor growth in a human melanoma xenograft mouse model, was found to inhibit the growth of metastatic melanoma, glioblastoma, and hepatocellular carcinoma in vitro.

High energy ball milling vs. nano spray drying in the development of supersaturated systems loaded with bosentan.

In this study, high energy ball milling and nano spray drying were used to prepare amorphous solid dispersions of bosentan in copovidone for the first time. In particular, the impact of this polymer on the bosentan amorphization kinetics was investigated. Copovidone was shown to facilitate the amorphization of bosentan upon ball milling. As a result, bosentan was dispersed in copovidone at the molecular level, forming amorphous solid dispersions, regardless of the ratio of the compounds. The similarity between the values of the adjustment parameter that describes the goodness of fit of the Gordon-Taylor equation to the experimental data (K = 1.16) and that theoretically calculated for an ideal mixture (K = 1.13) supported these findings. The kind of coprocessing method determined the powder microstructure and the release rate. The opportunity to prepare submicrometer-sized spherical particles using nano spray drying was an important advantage of this technology. Both coprocessing methods allowed the formation of long-lasting supersaturated bosentan solutions in the gastric environment with maximum concentrations reached ranging from four (11.20 μg/mL) to more than ten times higher (31.17 μg/mL) than those recorded when the drug was vitrified alone (2.76 μg/mL). Moreover, this supersaturation lasted for a period of time at least twice as long as that of the amorphous bosentan processed without copovidone (15 min vs. 30-60 min). Finally, these binary amorphous solid dispersions were XRD-amorphous for a year of storage under ambient conditions.

Whey Protein Supplementation with or without Vitamin D on Sarcopenia-Related Measures: A Systematic Review and Meta-Analysis.

The effects of supplementation with whey protein alone or with vitamin D on sarcopenia-related outcomes in older adults are unclear. We aimed to assess the effect of whey protein supplementation alone or with vitamin D on lean mass (LM), strength, and function in older adults with or without sarcopenia or frailty. We searched PubMed, Web of Science, and SCOPUS databases. Randomized controlled trials (RCT) that investigated the effect of whey protein supplementation with or without vitamin D on sarcopenia outcomes in healthy and sarcopenic or frail older adults were included. Standardized mean differences (SMDs) were calculated for LM, muscle strength, and physical function data. The analysis showed that whey protein supplementation had no effect on LM and muscle strength; nevertheless, a significant improvement was found in physical function (SMD = 0.561; 95% confidence interval [CIs]: 0.256, 0.865, n = 33), particularly gait speed (GS). On the contrary, whey protein supplementation significantly improved LM (SMD = 0.982; 95% CI: 0.228, 1.736; n = 11), appendicular lean mass and physical function (SMD = 1.211; 95% CI: 0.588, 1.834; n = 16), and GS in sarcopenic/frail older adults. By contrast, co-supplementation with vitamin D enhanced LM gains (SMD =0.993; 95% CI: 0.112, 1.874; n = 11), muscle strength (SMD =2.005; 95% CI: 0.975, 3.035; n = 11), and physical function (SMD = 3.038; 95% CI: 2.196, 3.879; n = 18) significantly. Muscle strength and physical function improvements after whey protein supplementation plus vitamin D were observed without resistance exercise (RE) and short study duration subgroups. Moreover, the combination of whey protein and vitamin D with RE did not enhance the effect of RE. Whey protein supplementation improved LM and function in sarcopenic/frail older adults but had no positive effect in healthy older persons. By contrast, our meta-analysis showed that co-supplementation with whey protein and vitamin D is effective, particularly in healthy older adults, which is likely owing, we propose, to the correction of vitamin D insufficiency or deficiency. The trial was registered at https://inplasy.com as INPLASY202240167.

Comparison of scale-up strategies in twin-screw wet granulation.

The aim of this study was to compare different scale-up strategies in twin-screw wet granulation and investigate the impact of the selected strategy on granule and tablet properties for a defined formulation. For the scale-up, a granulation process was transferred from a QbCon® 1 with a screw diameter of 16 mm to a QbCon® 25 line with a screw diameter of 25 mm. Three different scale-up strategies were introduced based on differences in process parameters and their resulting effects on various aspects. such as the powder feed number as a surrogate for the barrel fill level or the circumferential speed. Both are highly dependent on screw diameter and screw speed (SS), while the barrel fill level also depends on the overall throughput. Granules produced on the larger scale were significantly larger due to the larger gap size in the granulator, however, these differences were eliminated after milling. Despite major differences in powder feed number, circumferential speed, overall throughput and SS, product properties for both tablets and granules were strikingly similar after milling on both scales and with all applied strategies. For the selected formulation the effect of varying liquid to solid ratio at the same scale was much higher than the differences between scale-up strategies. The results of this study are promising for future process scale-up from lab scale to production scale in twin-screw wet granulation, as they are indicating towards a robust granulation process leading to similar tablet properties afterwards.

Health Characteristics and Aspirin Use in Participants at the Baseline of the ASPirin in Reducing Events in the Elderly - eXTension (ASPREE-XT) Observational Study.

Aspirin as a primary preventative in healthy older adults did not prolong disability-free survival in the ASPREE randomized trial. Observational studies following randomized trials allow assessment of benefits and harms which may not appear during the trial. We describe health characteristics, physical function, and aspirin use in the ASPREE-eXTension (ASPREE-XT) observational study cohort.

Circular mixed sets.

In this article, we introduce the new mathematical concept of circular mixed sets of words over an arbitrary finite alphabet. These circular mixed sets may not be codes in the classical sense and hence allow a higher amount of information to be encoded. After describing their basic properties, we generalize a recent graph theoretical approach for circularity and apply it to distinguish codes from sets (i.e. non-codes). Moreover, several methods are given to construct circular mixed sets. Finally, this approach allows us to propose a new evolution model of the present genetic code that could have evolved from a dinucleotide world to a trinucleotide world via circular mixed sets of dinucleotides and trinucleotides.

Employing single valency polyphenol to prepare metal-phenolic network antitumor reagents through FeOOH assistance.

Metal-phenolic networks (MPNs) have been conventionally formed by the coordination of metal ions and polyphenols, which can responsively release metal ions and polyphenols under the trigger of tumor microenvironment (TME), showing high potential in the field of antitumor. However, MPNs are mainly limited to multi-valency polyphenols, and the unavailability of single valency polyphenols greatly hinders their applications even though they have excellent antitumor activity. Herein, we demonstrate a FeOOH assisted preparation method for MPNs antitumor reagent by introducing the complexes of Fe

Targeted long-term noninvasive treatment of choroidal neovascularization by biodegradable nanoparticles.

Choroidal neovascularization (CNV) is the main cause of vision loss in patients with wet age-related macular degeneration (AMD). Currently, treatment of these conditions requires repeated intravitreal injections, which may lead to complications such as infection and hemorrhage. So, we have developed a noninvasive method for treating CNV with nanoparticles, namely, Angiopoietin1-anti CD105-PLGA nanoparticles (AAP NPs), which targets the CNV to enhance drug accumulation at the site. These nanoparticles, with PLGA as a carrier, can slowly release encapsulated Angiopoietin 1 (Ang 1) and target the choroidal neovascularization marker CD105 to enhance drug accumulation, increases vascular endothelial cadherin (VE-cadherin) expression between vascular endothelial cells, effectively reduce neovascularization leakage and inhibit Angiopoietin 2(Ang 2) secretion by endothelial cells. In a rat model of laser-induced CNV, intravenous injection of AAP NPs exerted a good therapeutic effect in reducing CNV leakage and area. In short, these synthetic AAP NPs provide an effective alternative treatment for AMD and meet the urgent need for noninvasive treatment in neovascular ophthalmopathy. STATEMENT OF SIGNIFICANCE: This work describes the synthesis, injection-mediated delivery, in vitro and in vivo efficacy of targeted nanoparticles with encapsulated Ang1; via these nanoparticles, the drug can be targeted to choroidal neovascularization lesions for continuous treatment. The release of Ang1 can effectively reduce neovascularization leakage, maintain vascular stability, and inhibit Ang2 secretion and inflammation. This study provides a new approach for the treatment of wet age-related macular degeneration.

ATP synthase affects lipid metabolism in the kissing bug Rhodnius prolixus beyond its role in energy metabolism.

ATP synthase plays an essential role in mitochondrial metabolism, being responsible for the production of ATP in oxidative phosphorylation. However, recent results have shown that it may also be present in the cell membrane, involved in lipophorin binding to its receptors. Here, we used a functional genetics approach to investigate the roles of ATP synthase in lipid metabolism in the kissing bug Rhodnius prolixus. The genome of R. prolixus encodes five nucleotide-binding domain genes of the ATP synthase α and β family, including the α and β subunits of ATP synthase (RpATPSynα and RpATPSynβ), and the catalytic and non-catalytic subunits of the vacuolar ATPase (RpVha68 and RpVha55). These genes were expressed in all analyzed organsn highest in the ovaries, fat body and flight muscle. Feeding did not regulate the expression of ATP synthases in the posterior midgut or fat body. Furthermore, ATP synthase is present in the fat body's mitochondrial and membrane fractions. RpATPSynβ knockdown by RNAi impaired ovarian development and reduced egg-laying by approximately 85%. Furthermore, the lack of RpATPSynβ increased the amount of triacylglycerol in the fat body due to increased de novo fatty acid synthesis and reduced transfer of lipids to lipophorin. RpATPSynα knockdown had similar effects, with altered ovarian development, reduced oviposition, and triacylglycerol accumulation in the fat body. However, ATP synthases knockdown had only a slight effect on the amount of ATP in the fat body. These results support the hypothesis that ATP synthase has a direct role in lipid metabolism and lipophorin physiology, which are not directly due to changes in energy metabolism.

Acute angle-closure in juvenile X-linked retinoschisis.

Juvenile X-linked retinoschisis (JXR), the most common inherited retinal disorder in young males, presents with a wide range of phenotypic variations. Acute angle closure in children with JXR has been reported in the literature only once before. We present a case of acute-angle closure, temporally associated with pharmacologic dilation, in a 12-year-old boy with JXR.

The effect of wound electrical stimulation in venous leg ulcer healing-a systematic review.

The benefit of using electric stimulation therapy (EST) to heal venous leg ulcers (VLUs) is not well established. The main aim of this systematic review was to evaluate the effects of ulcer EST in VLU healing.

Parents' physiological reactivity to child distress and associations with parenting behaviour: A systematic review.

This systematic review and narrative synthesis characterized parents' physiological stress responses to child distress and how parents' physiological and behavioural responses relate. The review was pre-registered with PROSPERO (#CRD42021252852). In total, 3607 unique records were identified through Medline, Embase, PsycINFO, and CINAHL. Fifty-five studies reported on parents' physiological stress responses during their young child's (0-3 years) distress and were included in the review. Results were synthesized based on the biological outcome and distress context used and risk of bias was evaluated. Most studies examined cortisol or heart rate variability (HRV). Small to moderate decreases in parents' cortisol levels from baseline to post-stressor were reported across studies. Studies of salivary alpha amylase, electrodermal activity, HRV, and other cardiac outcomes reflected weak or inconsistent physiological responses or a paucity of relevant studies. Among the studies that examined associations between parents' physiological and behavioural responses, stronger associations emerged for insensitive parenting behaviours and during dyadic frustration tasks. Risk of bias was a significant limitation across studies and recommendations for future research are discussed.

Development and characterization of an ETV1 rabbit monoclonal antibody for the immunohistochemical detection of ETV1 expression in cancer tissue specimens.

Aberrant ETV1 overexpression arising from gene rearrangements or mutations occur frequently in prostate cancer, round cell sarcomas, gastrointestinal stromal tumors, gliomas, and other malignancies. The absence of specific monoclonal antibodies (mAb) has limited its detection and our understanding of its oncogenic function.

Kind of blue - An evaluation of etiologies for prenatal versus postnatal depression symptoms.

Prenatal and postnatal depression potentially have severe consequences, but we do not know to what extent they have the same etiological factors. Genetically informative designs yield insight into common etiology between pre- and postnatal depression and inform on potential prevention and intervention efforts. This study evaluates the overlap in genetic and environmental factors in pre- and postnatal depression symptoms.

Improving ultrafiltration of algae-laden water with chitosan quaternary ammonium salt enhanced by sodium percarbonate.

Ultrafiltration (UF) is extensively used for algae removal because of its ability to retain algal cells with high efficiency, but it still faces the problem of membrane fouling and low retention capacity of dissolved organics. Hence, a strategy of coagulation with chitosan quaternary ammonium salt (HTCC) enhanced by sodium percarbonate (SPC) pre-oxidation was proposed to improve the UF performance. The fouling resistances were calculated by a resistance-in-series model based on Darcy's formula, and the membrane fouling mechanism was evaluated using a pore plugging-cake filtration model. The effect of SPC-HTCC treatment on the properties of algal foulants was explored, and the result showed that the water quality was improved with the maximum removal rates of 78.8 %, 52.4 % and 79.5 % for algal cells, dissolved organic carbon and turbidity, respectively. The SPC could achieve a mild oxidation effect that degraded the electronegative organics attached to algal cells without destroying the cell integrity, making the algal pollutants easier to agglomerate through subsequent HTCC coagulation by forming larger flocs. In terms of membrane filtration, the terminal normalized flux was increased from 0.25 to 0.71, with the reversible and irreversible resistances reduced by 90.8 % and 40.2 %, individually. The synergistic treatment reduced the accumulation of algal cells and algae-derived organics on the membrane surface as inferred from the interface fouling characteristics. The interfacial free energy analysis showed that the synergistic treatment reduced the adhesion of contaminants to the membrane surface, as well as the attraction among pollutants. Overall, the proposed process has high application prospects for algae-laden water purification.

Comparative reductions of norovirus, echovirus, adenovirus, Campylobacter jejuni and process indicator organisms during water filtration in alluvial sand.

Sand filtration is a cost-effective means of reducing microbial pathogens in drinking-water treatment. Our understanding of pathogen removal by sand filtration relies largely on studies of process microbial indicators, and comparative data from pathogens are sparse. In this study, we examined the reductions of norovirus, echovirus, adenovirus, bacteriophage MS2 and PRD1, Campylobacter jejuni, and Escherichia coli during water filtration through alluvial sand. Duplicate experiments were conducted using 2 sand columns (50 cm long, 10 cm diameter) and municipal tap water sourced from chlorine-free untreated groundwater (pH 8.0, 1.47 mM) at filtration rates of 1.1-1.3 m/day. The results were analysed using colloid filtration theory and the HYDRUS-1D 2-site attachment-detachment model. The average log

Pandemic COVID-19 ends but soil pollution increases: Impacts and a new approach for risk assessment.

For three years, a large amount of manufactured pollutants such as plastics, antibiotics and disinfectants has been released into the environment due to COVID-19. The accumulation of these pollutants in the environment has exacerbated the damage to the soil system. However, since the epidemic outbreak, the focus of researchers and public attention has consistently been on human health. It is noteworthy that studies conducted in conjunction with soil pollution and COVID-19 represent only 4 % of all COVID-19 studies. In order to enhance researchers' and the public awareness of the seriousness on the COVID-19 derived soil pollution, we propose the viewpoint that "pandemic COVID-19 ends but soil pollution increases" and recommend a whole-cell biosensor based new method to assess the environmental risk of COVID-19 derived pollutants. This approach is expected to provide a new way for environmental risk assessment of soils affected by contaminants produced from the pandemic.

Temporal hormetic response of soil microbes to cadmium: A metagenomic perspective.

The hormetic response of microbes to cadmium (Cd) is often observed in soil, but the mechanisms are unclear. In this study, we proposed a novel perspective of hormesis that successfully explained the temporal hermetic response of soil enzymes and microbes, and the variation of soil physicochemical properties. Several soil enzymatic and microbial activities were stimulated by 0.5 mg·kg

Impacts of land-use change on carbon dynamics in China's coastal wetlands.

The impact of land-use and land-cover change (LULCC) on ecosystem carbon (C) dynamics has been previously documented at local and global scales, but uncertainty persists for coastal wetlands due to geographical variability and field data limitations. Field-based assessments of plant and soil C contents and stocks of various LULCC types were conducted in nine regions along the coastline of China (21°-40°N). These regions cover natural coastal wetlands (NWs, including salt marshes and mangroves) and former wetlands converted to different LULCC types, including reclaimed wetlands (RWs), dry farmlands (DFs), paddy fields (PFs) and aquaculture ponds (APs). The results showed that LULCC generally decreased the C contents and stocks of the plant-soil system by 29.6 % ± 2.5 % and 40.4 % ± 9.2 %, respectively, while it slightly increased the soil inorganic C contents and stocks. Wetlands converted to APs and RWs lost greater ecosystem organic C stocks (EOC, sum of plants and top 30 cm of soil organic C stocks) than other LULCC types. The annual potential CO

Response mechanism of lettuce (Lactuca sativa L.) under combined stress of Cd and DBDPE: An integrated physiological and metabolomics analysis.

DBDPE and Cd are representative contaminants commonly found in electronic waste (e-waste), which tend to be gradually discharged and accumulated in the environment during e-waste dismantling, resulting in frequent outbreaks and detection of these pollutants. The toxicity of both chemicals to vegetables after combined exposure has not been determined. The accumulation and mechanisms of phytotoxicity of the two compounds, alone and in combination, were studied using lettuce. The results showed that the enrichment ability of Cd and DBDPE in root was significantly higher than that in aerial part. Exposure to 1 mg/L Cd + DBDPE reduced the toxicity of Cd to lettuce, while exposure to 5 mg/L Cd + DBDPE increased the toxicity of Cd to lettuce. The absorption of Cd in the underground part of lettuce of 5 mg/L Cd + DBDPE was significantly increased by 108.75 % compared to 5 mg/L Cd. The significant enhancement of antioxidant system activity in lettuce under 5 mg/L Cd + DBDPE exposure, and the root activity and total chlorophyll content were decreased by 19.62 % and 33.13 %, respectively, compared to the control. At the same time, the organelles and cell membranes of lettuce root and leaf were significantly damaged, which was significantly worse than that of single Cd and DBDPE treatment. Combined exposure significantly affected the pathways related to amino acid metabolism, carbon metabolism and ABC transport in lettuce. This study filled the safety gap of DBDPE and Cd combined exposure on vegetables and would provide a theoretical basis for the environmental behavior and toxicological study of DBDPE and Cd.

Defining the in vivo mechanism of air pollutant toxicity using murine stress response biomarkers.

Air pollution can cause a wide range of serious human diseases. For the informed instigation of interventions which prevent these outcomes there is an urgent need to develop robust in vivo biomarkers which provide insights into mechanisms of toxicity and relate pollutants to specific adverse outcomes. We exemplify for a first time the application of in vivo stress response reporters in establishing mechanisms of air pollution toxicity and the application of this knowledge in epidemiological studies. We first demonstrated the utility of reporter mice to understand toxicity mechanisms of air pollutants using diesel exhaust particles compounds. We observed that nitro-PAHs induced Hmox1 and CYP1a1 reporters in a time- and dose-dependent, cell- and tissue-specific manner. Using in vivo genetic and pharmacological approaches we confirmed that the NRF2 pathway mediated this Hmox1-reporter induction stress reporter activity. We then correlated the activation of stress-reporter models (oxidative stress/inflammation, DNA damage and Ah receptor -AhR- activity) with responses in primary human nasal cells exposed to chemicals present in particulate matter (PM; PM

Assessing the impact of recreational water use on carriage of antimicrobial resistant organisms.

Understanding the role of exposure to natural recreational waters in the acquisition and transmission of antimicrobial resistance (AMR) is an area of increasing interest. A point prevalence study was carried out in the island of Ireland to determine the prevalence of colonisation with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) and carbapenem-resistant Enterobacterales (CRE) in recreational water users (WU) and matched controls. A total of 411 adult participants (199 WU, 212 controls) submitted at least one faecal sample between September 2020 - October 2021. In total, 80 Enterobacterales were isolated from 73 participants. ESBL-PE were detected in 29 (7.1 %) participants (7 WU, 22 controls), and CRE were detected in nine (2.2 %) participants (4 WU, 5 controls). No carbapenemase-producing Enterobacterales (CPE) were detected. WU were significantly less likely to harbour ESBL-PE than controls (risk ratio = 0.34, 95 % CI 0.148 to 0.776, χ

Intergenerational consequences of adolescent morphine exposure on learning and memory.

Drug addiction is a worldwide social and medical disorder. More than 50 percent of drug abusers start their substance abuse in adolescence between the ages of 15-19. Adolescence is a sensitive and crucial period for the development and maturity of the brain. Chronic exposure to morphine, particularly during this period, lead to long-lasting effects, including effects that extend to the next generation. The current study examined the intergenerational effects of paternal morphine exposure during adolescence on learning and memory. In this study, male Wistar rats were exposed to increasing doses of morphine (5-25 mg/kg, s.c.) or saline for 10 days at postnatal days (PND) 30-39 during adolescence. Following a 20-day drug-free period, the treated male rats were mated with naïve females. Adult male offspring (PND 60-80) were tested for working memory, novel object recognition memory, spatial memory, and passive avoidance memory using the Y-Maze, novel object recognition, Morris water maze, and shuttle box tests, respectively. The spontaneous alternation (as measured in the Y-Maze test) was significantly less in the morphine-sired group compared to the saline-sired one. The offspring showed significantly less discrimination index in the novel object recognition test when compared to the control group. Morphine-sired offspring tended to spend significantly more time in the target quadrant and less escape latency in the Morris water maze on probe day when compared to the saline-sired ones. The offspring showed significantly less step-through latency to enter the dark compartment compared to the control group when measured in the shuttle box test. Paternal exposure to morphine during adolescence impaired working, novel object recognition, and passive avoidance memory in male offspring. Spatial memory changed in the morphine-sired group compared to the saline-sired one.

Barriers to High-quality Postoperative Glycemic Management by Surgical Teams: A Theory-informed Qualitative Analysis.

Our aim in this study was to identify the barriers to following recommendations for postoperative glycemic management among surgical team members.

Computational modelling in disorders of consciousness: Closing the gap towards personalised models for restoring consciousness.

Disorders of consciousness are complex conditions characterised by persistent loss of responsiveness due to brain injury. They present diagnostic challenges and limited options for treatment, and highlight the urgent need for a more thorough understanding of how human consciousness arises from coordinated neural activity. The increasing availability of multimodal neuroimaging data has given rise to a wide range of clinically- and scientifically-motivated modelling efforts, seeking to improve data-driven stratification of patients, to identify causal mechanisms for patient pathophysiology and loss of consciousness more broadly, and to develop simulations as a means of testing in silico potential treatment avenues to restore consciousness. As a dedicated Working Group of clinicians and neuroscientists of the international Curing Coma Campaign, here we provide our framework and vision to understand the diverse statistical and generative computational modelling approaches that are being employed in this fast-growing field. We identify the gaps that exist between the current state-of-the-art in statistical and biophysical computational modelling in human neuroscience, and the aspirational goal of a mature field of modelling disorders of consciousness; which might drive improved treatments and outcomes in the clinic. Finally, we make several recommendations for how the field as a whole can work together to address these challenges.

Treated chronic hepatitis B is a good prognostic factor of diffuse large B-cell lymphoma.

Chronic hepatitis B (CHB) is a risk factor for non-Hodgkin lymphoma (NHL). Our recent study suggested that antiviral treatment may reduce the incidence of NHL in CHB patients. This study compared the prognoses of hepatitis B virus (HBV)-associated diffuse large B-cell lymphoma (DLBCL) patients receiving antiviral treatment and HBV-unassociated DLBCL patients.

An Insight into the lynch Syndrome: Retrospective Study of the Pattern of Presentation and Management of Lynch Syndrome in Pakistan.

The primary objective of this study was to evaluate the baseline characteristics of Lynch syndrome (LS). Furthermore, the study aimed to evaluate overall survival (OS) among patients with LS.

Indoleamine 2,3-Dioxygenase: A Novel Immunotherapeutic Target for Osteosarcoma.

Tumour-emitted molecules induce immunosuppression in the tumour microenvironment. An immunosuppressive enzyme, indoleamine 2,3-dioxygenase (IDO/IDO1), facilitates immune escape in several malignant tumours, including osteosarcoma. Upregulation of IDO establishes a tolerogenic environment in the tumour and the tumour-draining lymph nodes. IDO-induced downregulation of effector T-cells and upregulation of local regulatory T-cells creates immunosuppression and promotes metastasis.

Profile of Nivolumab in the Treatment of Resected Esophageal Squamous Cell Carcinoma: A Review of the Clinical Data.

Esophageal cancer (EC) is the seventh most common malignancy globally. There are two main histological subtypes: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma. ESCC is the predominant histological type of esophageal cancer worldwide and has worse prognosis than esophageal adenocarcinoma. However, effective treatment for patients with ESCC remains limited. Moreover, the risk of recurrence remains high in patients with resectable ESCC even with perioperative multidisciplinary treatment, such as chemoradiotherapy or chemotherapy. Nivolumab, a human monoclonal immunoglobulin G4 antibody that inhibits programmed cell death protein 1, has recently been identified as a potential treatment for patients with metastatic esophageal cancer based on the results of the ATTRACTION-3 and CheckMate 648 trials. The CheckMate 577 trial showed survival benefits of postoperative nivolumab monotherapy compared with placebo in patients with resectable locally advanced esophageal cancer who did not achieve a pathological complete response after preoperative chemoradiotherapy. In this review, we discuss the data on the efficacy and safety of postoperative nivolumab and share future perspectives on immune checkpoint inhibitors as perioperative therapy for patients with locally advanced ESCC.

Surgical Approaches to Orbital Fractures: A Practical and Systematic Review.

Orbital fractures constitute a significant percentage of all midface injuries. Here, we present a contemporary evidence-based review of the major surgical approaches for orbital wall fractures and analyze the literature to compare all major surgical procedures and their complication rates.

Complex, Crusty Calculi: A Case Study Report of Renal Transplant Lithiasis and Encrustation.

Ureteric encrustation and lithiasis after renal transplantation are rare but not without risk of obstruction and graft loss. Patients are usually asymptomatic, and a majority present with graft dysfunction with imaging demonstrating hydronephrosis and rarely with acute graft pyelonephritis. We compare a case of transplant lithiasis with encrusted pyelitis and highlight key differences in their presentation and workup. A key focus for transplant physicians is to recognize when dealing with transplant hydronephrosis that the presence of a high urine pH and pyuria should be a key indicator to suspect ureteric encrustation to look for a urease-producing organism, recognizing that such organisms require prolonged incubation with urine culturing for up to 72 h.

Toward a New Definition of "Healthy" Food: Issues and Challenges.

Dietary Guidelines for Americans (DGA) have become increasingly food-based guidelines. The Healthy United States-Style Eating Pattern features fruits, vegetables, whole grains, and low-fat dairy, with limits placed on added sugar, sodium, and saturated fat. Recent measures of nutrient density have followed suit, incorporating both nutrients and food groups. Most recently, the United States Food and Drug Administration (FDA) has proposed to redefine the concept of a "healthy" food for regulatory purposes. To qualify as healthy, foods will need to contain specific minimum amounts of fruits, vegetables, dairy, and whole grains, with limits placed on added sugar, sodium, and saturated fat. The present concern was that the proposed criteria, formulated by the FDA per Reference Amount Customarily Consumed, were so stringent that few foods would pass. We applied the proposed FDA criteria to foods in the USDA Food and Nutrient Database for Dietary Studies (FNDDS 2017-2018). The criteria were met by 58% of fruits, 35% of vegetables, 8% of milk and dairy products, and 4% of grain products. Many foods commonly considered to be healthy by consumers and the USDA alike did not pass the proposed FDA criteria. Federal agencies seem to define healthy in different ways. Our findings have implications for the formulation of regulatory and public health policies. We recommend that nutrition scientists be involved in the development of federal regulations and policies that affect American consumers and the food industry.

Flux Sampling in Genome-scale Metabolic Modeling of Microbial Communities.

Microbial communities play a crucial role in ecosystem function through metabolic interactions. Genome-scale modeling is a promising method to understand these interactions. Flux balance analysis (FBA) is most often used to predict the flux through all reactions in a genome-scale model. However, the fluxes predicted by FBA depend on a user-defined cellular objective. Flux sampling is an alternative to FBA, as it provides the range of fluxes possible within a microbial community. Furthermore, flux sampling may capture additional heterogeneity across cells, especially when cells exhibit sub-maximal growth rates. In this study, we simulate the metabolism of microbial communities and compare the metabolic characteristics found with FBA and flux sampling. We find significant differences in the predicted metabolism with sampling, including increased cooperative interactions and pathway-specific changes in predicted flux. Our results suggest the importance of sampling-based and objective function-independent approaches to evaluate metabolic interactions and emphasize their utility in quantitatively studying interactions between cells and organisms.

Primary Squamous Cell Carcinoma of the Pancreas From a Large Cyst: A Case Report.

Pancreatic squamous cell cancer (PSCC) is a rare and aggressive form of pancreatic cancer that has a poor prognosis. The 5-year survival rate for PSCC is estimated to be approximately 10%, and the median overall survival time is 6 to 12 months. Treatment options for PSCC include surgery, chemotherapy, and radiation therapy, but the outcomes are usually not very favorable. The outcomes depend on the stage of the cancer and the patient's overall health and response to treatment. The optimal management remains early diagnosis and surgical resection. We present a rare case of PSCC with spleen invasion, which arises from a large cyst with eggshell calcification, the patient was treated by surgical resection of the tumor and adjuvant chemotherapy. This case report emphasizes the necessity of regular follow for pancreatic cyst.

Key Thresholds and Relative Contributions of Knee Geometry, Anteroposterior Laxity, and Body Weight as Risk Factors for Noncontact ACL Injury.

Limited data exist regarding the association of tibiofemoral bony and soft tissue geometry and knee laxity with risk of first-time noncontact anterior cruciate ligament (ACL) rupture.

Multiple Kidney Infarctions Due to COVID-19 Infection in a Patient with Repeatedly Negative RT-PCR Tests-A Case Report.

Since the outbreak of novel coronavirus in 2019, SARS-CoV-2 has spread worldwide at an unexpected rate, becoming a major global health concern. Although respiratory tract infections represent typical clinical presentation, recently, numerous cases of acute arterial thrombosis and thromboembolic disease have been reported due to COVID-19 infection. Renal artery embolism is a condition that is easily missed due to its infrequent and nonspecific presentation. In this paper, we reported a case of a 63-year-old, previously healthy, male patient who has developed multiple right kidney infarctions due to COVID-19 infection without any respiratory or other typical clinical manifestations. Consecutive RT-PCR tests were negative and the diagnosis was set finally by serological screening. Our presentation has emphasized the necessity of clinical, laboratory, microbiological, and radiological integration in diagnostic approach to this novel and challenging disease with often unusual clinical presentations to avoid false negative discrimination.

Social Media and Organ Donation: Pros and Cons.

Shortage of organ donors is the most important obstacle standing in the way of lifesaving organ transplantation in a myriad of patients suffering from end-stage organ failure. It is vital that the transplant societies and associated appropriate authorities develop strategies to overcome the unmet needs for organ donation. The power of prominent social media (SoMe) platforms such as Facebook, Twitter, and Instagram, which reach millions of people, can increase awareness, provide education, and may ameliorate the pessimism toward organ donation among the general population. Additionally, public solicitation of organs may be helpful for waitlisted candidates for organ transplantation, who cannot find a suitable donor among near relations. However, the use of SoMe for organ donation has several ethical issues. This review attempts to highlight the advantages and limitations of using social media in the context of organ donation for transplantation. Some suggestions on the best utilization of social media platforms for organ donation while balancing ethical considerations have been highlighted here.

Geographic dispersion and corporate resilience during the COVID-19 pandemic.

This study demonstrates the positive role of geographic dispersion in corporate resilience to the COVID-19 pandemic in the context of China. This association is more pronounced when firms are highly dependent on the domestic market, less likely to obtain enough financing, highly apply digital technology, and have low customer concentration. This association is attributable to the following three channels: a diversified portfolio, the maintenance of business relationships, and access to non-local resources. Overall, our findings provide a more nuanced picture of the potential impacts of corporate diversification on corporate resilience.

Hemoglobin Casts in Kidney Biopsies: Etiological Spectrum.

Intravascular hemolysis, which is the destruction of red blood cells in circulation, can cause acute kidney injury as the hemoglobin released by the lysed cells is toxic to the tubular epithelial cells. We performed a retrospective analysis of 56 cases of hemoglobin cast nephropathy reported at our institution to analyze the etiological spectrum causing this rare disease. The mean patient age was 41.7 (range: 2-72 years), and the male-to-female ratio was 1.8:1. All patients presented with acute kidney injury. The etiologies include rifampicin-induced, snake bite, autoimmune hemolytic anemia, falciparum malarial infection, leptospiral infection, autoimmune hemolytic anemia, sepsis, non-steroidal anti-inflammatory drugs, ingestion of termite oil, heavy metal poisoning, wasp sting, and valvular heart disease with severe mitral regurgitation. We demonstrate a wide spectrum of conditions associated with hemoglobin casts in the kidney biopsy. Hemoglobin immunostain is required to establish the diagnosis.

Cutaneous Leishmaniasis Lesion on the Ear from Kashan, Central Iran: A Case Report.

Cutaneous leishmaniasis (CL) frequently occurs in many rural and urban areas of Iran.

Synthesis and Clinical Examination of Novel Formulations of Ivermectin, Albendazole and Niclosamide for the Treatment of Equine Gastrointestinal Helminthoses.

This study aimed to develop new complex preparations of ivermectin, niclosamide and albendazole based on solid-phase mechanochemical technology, and to evaluate their efficacy against equine nematodosis and cestodosis.

NUCB2/nesfatin-1 suppresses the acrosome reaction in sperm within the mouse epididymis.

Nesfatin-1, a polypeptide hormone derived from the nucleobindin 2 (NUCB2) precursor protein, is known to regulate appetite and energy metabolism. Recent studies have also shown that NUCB2/nesfatin-1 is expressed in the reproductive organs of mice. However, the expression and potential role of NUCB2/nesfatin-1 in the mouse epididymis remain unclear. Therefore, we investigated the expression of NUCB2/nesfatin-1 in the mouse epididymis and its potential function. NUCB2/nesfatin-1 was detected in the epididymis by qRT-PCR and western blotting, and high expression levels were observed in epididymal epithelial cells by immunohistochemical staining. Pregnant mare's serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) injections significantly increased NUCB2/nesfatin-1 expression in the epididymis. After castration, NUCB2/nesfatin-1 expression in the epididymis decreased, but was significantly increased by testosterone injection. Nesfatin-1-binding sites were found in the middle piece of testicular sperm, but were scarcely detected in the sperm head. By contrast, nesfatin-1 binding sites were identified on the sperm head within the epididymis. Furthermore, nesfatin-1 treatment inhibited the acrosome reaction in epididymal sperm. These results suggest that the nesfatin-1 protein produced in the epididymis binds to nesfatin-1 binding sites on the sperm head and plays a role in suppressing the acrosome reaction before ejaculation.

Provider confidence in counseling preconception, pregnant, and postpartum patients regarding COVID-19 vaccination: A cross-sectional survey study.

Healthcare provider counseling surrounding COVID-19 vaccine in pregnancy and lactation is essential to vaccination uptake in this population; however, provider knowledge and confidence are not well characterized. We aimed to assess knowledge and confidence in COVID-19 vaccine counseling among practitioners who provide care to pregnant persons and to describe factors associated with confidence in counseling.

Radio Immune Assay (RIA) Enabled Total Triiodothyronine (TT3) and Total Thyroxine (TT4) in Canine Trypanosomiasis: First Case Report from Maharashtra (India).

Radio Immune Assay (RIA) is an extremely sensitive in vitro assay technique to measure concentrations of antigen viz. hormones in biological fluids using antibodies. The present study reports the status of total triiodothyronine (TT

Pointless pondering on predatory publications.

It is a pointless pondering (thinking) on predatory (meaning greedy) publications (meaning journals) while practicing publishing through freedom of expression and or the Press where applicable. It should be noted that a weak publication will vanish (disappear) itself in an open access publishing model where contents are made available for free on the WWW. The fundamental question in this context is the definition of host (congregation) and predator (intruder). The second question is the type (data and or commercial) and subsequent measure of effect of the predator on the host. Detailed discussion on this issue or any other related issue is welcomed under the freedom of the Press yet conclusion on it will be often biased and is clearly unwarranted. The parties aware of such concerns should write to the publisher (with address for communication) to take such action within such time to stand corrected. Please be informed that ISSN is unique for each publication and portals for ISSN is distributed throughout the world in each country. This is well monitored and clearly streamlined. Therefore, NO two publication titles will be identical. Awareness from authors on misleading or misinformed or misrepresented ISSN is important and such information should be petitioned to ISSN and portals for ISSN that is distributed throughout the world with state mechanisms to monitor such activities. Academia should be self-aware on these issues and have discussions on the quality and quantity of data taken to the context. Caveat Emptor is applicable to a considerable extend among the literate community as in this case. The only problem could arise because of compromised (unregistered or mirrored) ISSN number published on the WWW which is already well regulated through DNS lookup. Therefore, parties concerned about ethical issues on scientific publishing should write to concerned publishers with known address to stand corrected or to ISSN and portals for ISSN or to DNS lookup where address is not available to correct such issues through available state mechanisms. Hence, biased advisory notes from government representations, society sponsored mass campaign through news/TV media and academic miss representation based on data collected by an individual without physical address for communication is clearly unwarranted in this regard.

A Rare Case of Postoperative Encephalopathy in Twin.

The clinical picture of encephalopathy invites a broad differential with multiple etiologies. It is with judicious history, hospital course, lab testing, and imaging that the ultimate cause is identified. We present a unique case of identical twins who share a similar clinical presentation of postoperative encephalopathy. The striking similarities in both twins suggest a genetic component requiring further research to identify patients who are genetically predisposed.

Suturing Dermatotraction Techniques in Closing Fasciotomy Wounds: A Systematic Review.

A surgical patient post-fasciotomy presents a challenge to restore the cover of the muscle groups, and the use of the suturing dermatotraction techniques presents a cheap and easy means of native cover. This systematic review of case series and case-control study explored the trend of this technique, including duration of delayed primary wound closure, complications, and failure rates. A literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted on Medline, Embase, and Cumulative Index of Nursing and Allied Health Literature (CINAHL), yielding a combined total of 820 articles between 1946 and June 18, 2022. Human studies with suturing dermatotraction techniques were included. Sixteen (16) studies reviewed met the criteria. The basic anatomy of the dermatotraction technique involves an anchor point on the skin, a material for traction, and a suture pattern. The shoelace technique was the predominant suture pattern, with staples as skin anchor material/method and silastic vessel loops as traction sling used by 11 studies. Modifications of this method included the use of intradermal Prolene sutures and pediatric catheters. The shortest duration for skin apposition was two days, and the longest was 113 days. Complications were comparable to that of surgical wounds and thus may not be attributable to the technique itself. Studies reviewed showed that superficial and early complications were more likely than deep or delayed complications. Negative pressure wound therapy (NPWT) and skin graft salvaged a few failed closures in two studies. There are varying practices of tightening rates with reports ranging from daily to every 72 hours. The rate of tightening and disease burden may account for the wide range of reported delayed primary closure. Most of the studies reviewed closed fasciotomy wounds with this technique within an average of <10 days. It is relatively cheaper, carries a low morbidity burden, and has multiple reported success in the closure of fasciotomy wounds in this review and thus should have an increased adoption as a first approach in managing fasciotomy wounds, especially in low-income countries.

Fatal Hemorrhage Due to Aorto-Enteric Fistula: A Case Report.

The abdominal aortic aneurysm (AAA) is a vascular condition that commonly affects individuals over the age of 65, leading to complications such as rupture, thrombosis, and embolization that can result in significant morbidity and mortality. Aorto-enteric fistula (AEF), a rare but life-threatening complication of abdominal aortic aneurysms, occurs when there is communication between the aneurysm and adjacent bowel loops. A 63-year-old man presented to the emergency department (ED) with severe abdominal pain, nausea, vomiting, and dark, tarry stools. Prior to his current presentation, the patient sought medical care from several primary care centers for vague abdominal pain that was diagnosed as dyspepsia, and he was prescribed omeprazole. During the current presentation, the patient had hemodynamic instability and a diffusely tender abdomen. Subsequently, a computed tomography (CT) scan revealed an abdominal aortic aneurysm with AEF. Although the patient underwent exploratory laparotomy, he suffered cardiac arrest and ultimately died in the operating room. This case underscores the importance of early recognition and management of AEF, which is crucial for improving patient outcomes.

Inherited Hairlessness: A Case Study of Familial Congenital Atrichia.

An uncommon disorder known as atrichia congenita with ectodermal defects (isolated type) can present with the complete absence of hair at birth or can cause the scalp hair to fall out between the ages of one to six months, after that no new hair growth occurs. Patients don't develop pubic and axillary hairs in addition to lacking or having scant brow, eyelash, and body hair. It could develop independently or in tandem with other problems. Isolated congenital alopecia has been reported to occur in both sporadic and familial forms. Although dominant or unevenly dominant inheritance has been found in rare families, the isolated family form often inherits in an autosomal recessive manner. In this case report, we present a rare case of familial congenital atrichia in a 16-year-old girl. There can be a genetic component to her illness because both her mother and father also show some of the clinical features.

Blood Culture-Negative Endocarditis Secondary to Skin Popping.

Infectious endocarditis (IE) is a diagnosis in which thorough evaluation must be performed and certain diagnostic criteria must be met. Thorough history and detailed physical examination can affect and guide the management of a patient from the very beginning. One of the main causes of endocarditis that physicians deal with in the hospital is intravenous drug abuse. This case report is of a 29-year-old male presenting to a rural emergency department with a two-week history of altered mental status after being struck on the head with a metal pipe. The patient also endorsed using intravenous drugs along with subcutaneous injections (skin popping). The patient was initially treated as a traumatic intracranial hemorrhage, but it was later found to be secondary to septic emboli from blood culture-negative endocarditis. Throughout this case report, we will approach the difficulties of diagnosing IE in a patient who represented many of the less common findings including dermatologic manifestations of diseases such as Osler nodes and Janeway lesions.

Shifting the Spotlight From the Mandibular Condyle to the Coronoid Process: A Report of a Unique Case of Trifid Mandibular Coronoid Process.

The trifid mandibular coronoid process is an uncommon finding characterized by three projections arising from the mandibular ramus instead of a single triangular coronoid process. Previous authors reported cases of the bifid coronoid process. The authors referred to them as the bifid/second/double coronoid process. This article aims to report a unique case of a trifid coronoid process incidentally detected during radiographic evaluation for implant planning. This article also emphasizes the effectiveness of cone beam computed tomography (CBCT) volume rendering as a valuable tool in demonstrating morphological variations such as the trifid coronoid process. In addition, we discussed possible etiologies for the trifid coronoid process. To the best of our knowledge, this is the first case of the trifid coronoid process.

Factors Associated With Emergency Department Visits or Readmission of Late Preterm Infants at the Neonatal Intensive Care Department, National Guard Health Affairs, Riyadh.

Background Infants who are born between 34 0/7 and 36 6/7 weeks of pregnancy as a result of maternal or fetal factors are defined as "late preterm infants". Compared to term infants, late preterm infants are more predisposed to pregnancy complications because they are less mature physiologically and metabolically. In addition, health practitioners still face difficulties in differentiating between term and late preterm infants due to similar general appearance. The aim of this study is to explore the epidemiology of readmission among late preterm infants at the National Guard Health Affairs. The objectives of the study were to calculate the rate of readmission among late preterm infants in the first month after discharge and to identify the associated risk factors for readmission. Methods A retrospective cross-sectional study was carried out at the neonatal intensive care unit (NICU at King Abdulaziz Medical City in Riyadh). We identified preterm infants born in 2018 and the risk factors for readmission within the first month of life. Data on risk factors were collected using the electronic medical file. Results A total of 249 late preterm infants with a mean gestational age of 36 weeks were included in the study. Of them, 64 infants (25.7%) suffered from at least a subsequent admission and stayed overnight in either the inpatient department or pediatric emergency room. Maternal diabetes was a significant risk factor for readmission; on the other hand, a positive maternal Rh factor was a protective factor against readmission. Among readmitted infants (n=64), 51 infants were admitted to the emergency room (79.69%), eight infants were readmitted to the pediatric ward (12.5%), and five infants were readmitted to both (7.8%). The most common cause for pediatric ER visits was gastrointestinal (GIT) problems (27%), followed by upper respiratory tract infection (URTI) (18%) and jaundice (14%). The most common cause for direct ward readmission was jaundice (n= 5; 62%). Conclusion Gastrointestinal (GIT) issues and upper respiratory tract infections (URTIs) were the leading causes of pediatric emergency room admissions. In contrast, jaundice, congenital diaphragmatic hernia (CDH), airway problems, and regurgitation were the most frequent causes of admission to the ward, with jaundice being the primary cause. Although studies suggest that the late preterm population is at a higher risk for long-term health issues, further research is necessary to investigate this topic thoroughly.

The Effect of Prognostic Nutritional Index in Postoperative Infection Following Lobectomy in Non-Small Cell Lung Cancer Patients.

Background The prognostic nutritional index (PNI) is a valuable marker for evaluating the nutritional status associated with postoperative complications and the prognosis of patients with cancer. However, the role and clinical value of PNI in infection after lung cancer surgery remains unclear. This study examined the association between PNI and infection after lobectomy for lung cancer, focusing on the predictive value of PNI. Methods We conducted this retrospective cohort study on 139 patients with non-small cell lung cancer (NSCLC) who underwent surgery between September 2013 and December 2018. Two groups were composed according to their PNI values (≥ 50 or <50 ), and the relationship was assessed with infection after lobectomy. Results Only PNI values, atelectasis, and prolonged air leaks were significantly associated with the development of infection. The median preoperative PNI was 52.97±5.69. Postoperative infection was seen in patients (15.5%) with PNI≥ 50 and 38.1% in patients with PNI <50. The mean PNI in patients with postoperative infection, empyema, and prolonged air leakage was lower than in patients without these conditions. Conclusions Malnutrition is commonly seen in patients with malignancy. The overall malnutrition rate is 45% in lung cancer patients. Patients with metastatic diseases are malnourished in a 73% ratio compared to 5% for localized diseases. Furthermore, malnutrition increases the tendency of postoperative infection and reduces wound healing. We aim to determine whether PNI can be a predictive index marker for postoperative infection in patients with NSCLC who underwent lobectomy. Postoperative infection was seen in 15.5% of patients with PNI>50 and 38.1% in patients with PNI <50.

A Study of Cutaneous Adverse Drug Reactions at a Tertiary Care Center in Andhra Pradesh, India.

Practically all physicians encounter a diverse range of suspected cutaneous adverse drug reactions (CADRs) in their daily clinical practice. The skin and mucosa are the most often encountered areas for the early presentation of numerous adverse drug reactions. Cutaneous adverse drug reactions are classified as benign or severe. The clinical manifestations of drug eruptions can range from mild maculopapular exanthema to severe cutaneous adverse drug reactions (SCARs).

Tele-Oral Oncology: Reinvigorating Telemedicine in Oral Cancer Care.

In recent years, we have witnessed significant growth in the employment of technological advancements in health-care practices. These advancements have increased the practicality and utility of telemedicine applications. The aim of this focused review is to provide in-depth insights into the current state of telemedicine in oral oncology.

Imaging Characteristics of Breast Lymphoma; a Case Series.

Breast involvement by lymphoma is rare. It can occur as a primary breast tumour or as an extranodal manifestation of the systemic disease. The imaging features of breast lymphoma (BL) are not characteristic. Biopsy is necessary for diagnosis due to non-specific imaging features.

Factors that impacted mobile-payment adoption in China during the COVID-19 pandemic.

The Unified Theory of Acceptance and Use of Technology (UTAUT) is a potential paradigm for explaining technology adoption and can be applied to a wide range of scenarios. During the COVID-19 (C-19) outbreak in China, mobile-payment platforms (Mpayment) were used extensively in everyday life because they allowed people to avoid direct and indirect connections during transactions, adhere to social-distancing guidelines, and support social-economic stabilization. By exploring the technological and psychological variables that influenced user Mpayment-adoption intentions during the C-19 pandemic, this study broadens the literature on technology adoption in emergency circumstances and expands the UTAUT. A total of 593 complete samples were collected online, with SPSS used for data analysis. The empirical findings reveal that performance expectancy, trust, perceived security, and social influence all had a significant influence on Mpayment acceptance during the C-19 outbreak, with social distancing having the greatest impact, followed by fear of C-19. Interestingly, perceived-effort expectancy had a negative influence on payment acceptance. These findings suggest that future studies should apply the expanded model to different countries and areas to investigate the impact of the C-19 pandemic on Mpayment acceptance.

Critical Care Nurses' Adherence to Ethical Codes and Its Association with Spiritual Well-Being and Moral Sensitivity.

Adherence to ethical codes is a major pillar of nursing care that is affected by various factors. Identifying these factors can lead to better ethical performance. The present study was conducted to determine critical care nurses' adherence to ethical codes and its association with spiritual well-being (SWB) and moral sensitivity (MS).

Use of the endoscopic powered resection device for the management of scarred polyps.

The endoscopic powered resection (EPR) device (EndoRotor, Interscope Inc, Northbridge, Mass, USA) is a novel nonthermal device that can be used for polyp and tissue removal in the GI tract. Here, we review the EPR device and illustrate its use for resection of scarred or fibrotic lesions in the GI tract.

"Loop-10" line-assisted clip closure method: closure of perforation in re-do peroral endoscopic myotomy.

Video 1Demonstration of the Loop-10 closure technique for unintentional mucosal perforation during re-do esophageal peroral endoscopic myotomy.

Timing and Magnitude of the Second Wave of the COVID-19 Omicron Variant - 189 Countries and Territories, November 2021 to February 2023.

The first nationwide wave of coronavirus disease 2019 (COVID-19), driven by the Omicron variant, has largely subsided. However, subsequent epidemic waves are inevitable due to waning immunity and the ongoing evolution of the severe acute respiratory syndrome coronavirus 2.

Preparation and properties of composite manganese/fluorine coatings on metallic titanium.

Titanium is widely used in implants because of its good mechanical properties and biocompatibility. However, titanium has no biological activity and is prone to causing implant failure after implantation. In this study, we prepared a manganese- and fluorine-doped titanium dioxide coating on a titanium surface by microarc oxidation technology. The surface characteristics of the coating were evaluated by field emission scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy, and atomic force microscopy and profiler, and the corrosion resistance and wear resistance of the coating were also evaluated. The bioactivity of the coating on bone marrow mesenchymal stem cells was evaluated by

Synthesis, characterization and study of electrochemical applicability of novel asymmetrically substituted 1,3-dialkyl-1,2,3-benzotriazolium salts for supercapacitor fabrication.

Here we report the successful synthesis, fabrication, and testing of novel asymmetrically substituted 1,3-dialkyl-1,2,3-benzotriazolium-based ionic liquids. Their applicability in energy storage is tested as gel polymer electrolytes (ILGPE) immobilized in poly(vinylidene fluoride-

Real-World Experience on the Use of Mepolizumab from the Severe Asthma Registry of the German Asthma Net (MepoGAN-Study).

The German Asthma Net (GAN) operates a Severe Asthma Registry that provides an overview of the clinical presentation and management of patients with severe asthma. Based upon data from the GAN registry, the MepoGAN study aimed to describe clinical profiles and treatment outcomes of patients who were treated with the anti-IL-5 monoclonal antibody mepolizumab (Nucala

COVID 19 prevention practice of patients with known chronic illness in Ethiopia: A systemic review and meta-analysis.

There were different studies done and found a highly variable level of COVID 19 prevention practice; however, there was no summarized evidence on the prevention practice of chronic disease patients in Ethiopia. This systematic review and meta-analysis aims to assess the pooled prevalence of COVID 19 prevention practice and associated factors among chronic disease patients in Ethiopia.

HBV reactivation and its effect on survival in HBV-related hepatocarcinoma patients undergoing transarterial chemoembolization combined with tyrosine kinase inhibitors plus immune checkpoint inhibitors.

This study aimed to access hepatitis B virus (HBV) reactivation and its effect on survival in HBV-related hepatocarcinoma (HCC) patients who underwent transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) plus immune checkpoint inhibitors (ICIs).

Extraskeletal Mesenchymal Chondrosarcoma, a Rare Entity with Unusual Metastases: A Case Report.

Extraskeletal mesenchymal chondrosarcoma (ESMC) is rare, aggressive, and high grade malignant tumors originating from soft tissues. It carries a poor prognosis with a tendency for local recurrence and distant metastasis, necessitating long-term follow-up. The most common sites for metastasis are the lungs, bones, and lymph nodes. Meanwhile, pancreatic metastases are extremely rare.

Extramedullary Plasmacytomas of the Oral Cavity: A Case Report and Review of the Literature.

Multiple myeloma is a haematologic malignancy characterised by the proliferation of plasma cells and typically presents with lesions in bone, known as plasmacytomas. Through haematogenous spread, extramedullary plasmacytomas can develop in soft tissue in any location of the body. This case report describes a patient with multiple myeloma who presented with an extramedullary plasmacytoma on his maxillary gingiva and provides an updated review on the classification and characterisation of extramedullary plasmacytomas of the oral cavity. A 53-year-old male with a known diagnosis of multiple myeloma was referred to our clinic for evaluation of a gingival nodule, which was tender to palpation and had been present for a month. Clinical examination revealed a 1.5 cm violaceous, red nodule of the maxillary buccal attached gingiva, which did not blanch on palpation. He had a similar 1 cm, smooth, red nodule of his cutaneous skin on his left arm. Radiographic examination was within normal limits without evidence of dental or bony pathology. An incisional biopsy revealed the diagnosis of plasmacytoma, indicating relapse and progression of the patient's multiple myeloma. Multiple myeloma can present in the oral cavity either as intrabony plasmacytomas, paraskeletal plasmacytomas or extramedullary plasmacytomas in the soft tissue. Extramedullary disease representative of haematogenous spread is concerning for high-risk disease with a poor risk prognosis.

Associations of psychological inflexibility with posttraumatic stress disorder and adherence to COVID-19 control measures among refugees in Uganda: The moderating role of coping strategies.

Refugees are vulnerable to developing mental health problems. The unprecedented appearance and rapid spread of COVID-19 exacerbated this vulnerability, especially in low-income countries where refugees survive on humanitarian aid and live in congested settlements. These appalling living conditions are a stressor, making adherence to COVID-19 control measures impractical and an additional psychological strain for refugees. The present study examined how psychological inflexibility is associated with adherence to COVID-19 control measures. A sample of 352 refugees from Kampala City and Bidibidi settlements were recruited. Refugees with high levels of psychological inflexibility reported higher PTSD symptom severity and low adherence to COVID-19 control measures. Moreover, PTSD severity mediated the association between psychological inflexibility and adherence, while avoidance coping moderated both direct and indirect effects. Interventions for reducing psychological inflexibility and avoidance coping may be essential in boosting adherence to measures relevant to the current and future status of the pandemic, along with other crises that refugees face.

Imbalance of Microbacterial Diversity Is Associated with Functional Prognosis of Stroke.

There is mounting evidence to suggest that the pathophysiology of stroke is greatly influenced by the microbiota of the gut and its metabolites, in particular short-chain fatty acids (SCFAs). The primary purpose of the study was to evaluate whether the levels of SCFAs and the gut microbiota are altered in poststroke patients and to examine the relationship between these alterations and the physical condition, intestinal health, pain, or nutritional status of patients.

Infantile Tubercular Endobronchial Polypoid Obstructive Lesion.

Endobronchial tuberculosis is reported in 18% of adults and 30%-60% of children with primary pulmonary tuberculosis. We are reporting two infants who presented with nonspecific respiratory symptoms due to an obstructive tubercular polypoid mass which was detected on computed tomography. Bronchoscopy showed a pale friable polypoid lesion in the bronchus causing a luminal obstruction. The biopsy of the lesion was suggestive of tuberculosis. On treatment with antitubercular medications, both the babies improved and remained asymptomatic on long-term follow-up.

Case Report of Primary Synovial Sarcoma of the Thyroid Gland: An Unusual Histology at Atypical Location.

Primary synovial sarcoma of the thyroid gland is extremely rare, aggressive, and has a dismal prognosis. We report the case of a 15-year-old male who presented with a progressively increasing neck mass, which was excised and the histopathological and immunohistochemical study suggested biphasic synovial sarcoma of the thyroid gland which was confirmed by synovial sarcoma translocation. There are 14 cases of primary synovial sarcoma of the thyroid reported in the literature so far. This study aimed to document the occurrence of synovial sarcoma histology at an unusual anatomical location with a review of the literature on this rare entity.

Assessing the Feasibility of Predicting Intermediate Outcomes of Esophageal Atresia Using Okamoto Classification: A Prospective Study.

Several risk classifications based on various preoperative factors have been proposed to prognosticate the immediate survival of children operated for esophageal atresia. A major drawback of these classifications is that they only focus on immediate survival while ignoring the long-term morbidity and mortality in these children. Our study aims to bridge this gap in knowledge by studying the impact of one such classification (Okamoto's classification) on mortality and morbidity during a period of 1 year after discharge from the hospital in operated cases of esophageal atresia.

Role of Procalcitonin as a Biomarker in Early Identification of Adverse Events Following Esophageal Atresia Surgery.

Surgical complication following esophageal atresia repair is one of the several factors known to influence the final outcomes. Early identification of such complications may help in timely institution of therapeutic measures and translate into improved prognosis.

Clinical outcomes: endoscopic resection of duodenal ampullary lesions.

Ampullary adenomas are lesions at the duodenum's major papilla commonly associated with familial adenomatous polyposis (FAP) but may also occur sporadically. Historically, ampullary adenomas were removed surgically, however endoscopic resection has become the preferred method of resection. Most of the literature on management of ampullary adenomas are small single-center retrospective reviews. The objective of this study is to describe endoscopic papillectomy outcomes to further refine management guidelines.

History of colonoscopy and technological advances: a narrative review.

Colonoscopy is an ever-growing procedure, being the primary diagnostic and therapeutic modality to manage lower gastrointestinal pathologies. It has a decades-old history with significant successive endoscopic innovations that eventually led to the development of the current colonoscope, as we know it today.

An investigation of factors affecting the utilization of antenatal care services among women in post-natal wards in two Namibian hospitals in the Khomas region.

Antenatal care (ANC) services are the care provided by skilled healthcare professionals to pregnant women to ensure the best health for both mother and baby during pregnancy and after delivery. In Namibia, utilization of antenatal care services has been reported to be dropping from 97% in 2013 to 91% in 2016.

The psychological impact of COVID-19 lockdown on the wellbeing, learning efficacy and sleeping behaviors of Romanian medical students.

The COVID-19 lockdowns are reported to have negatively influenced the wellbeing and learning efficacy of students. In this context, we analyzed the psychological impact of the COVID-19 quarantine on healthcare students, a subpopulation experiencing high stress levels.

Lipstick influence on teeth color appearance.

A beautiful smile with white and shiny teeth is nowadays a must, according to aesthetics norms. The color of the lips, with or without lipstick, may influence the appearance of the teeth color. The objective of the study was to evaluate the influence of the lipstick on the tooth color appearance.

Environmentally friendly behavior in dentistry.

Sustainability is the sensitive and responsible way of using the natural resources, its goal being to prevent their depletion and preserving the ecological balance. An essential requirement to achieve this is to practice environmentally conscious behavior. The main objective of the present study was to carry out a survey among dentists about the importance of sustainability, feasibility of an environmentally friendly dental practice and the steps in favor of it.

Catastrophic Propeller Brain Injury with Large Scalp Defect Treated with Omental Flap.

In this study, we report a case of catastrophic propeller brain injury with large scalp defect treated with omental flap reconstruction. A 62-year-old man was accidentally caught in a powered paraglider propeller during maintenance. The rotor blades impacted the left part of his head. On arrival at the hospital, he presented with a Glasgow Coma Scale score of E4V1M4. On some areas on his head, skin was noticeably cut off, and the brain tissue out-slipped through an open skull fracture. Continuous bleeding from the superior sagittal sinus (SSS) and the brain surface was observed during emergency surgery. Massive bleeding from the SSS was controlled using a number of tenting sutures and hemostatic agents. We evacuated the crushed brain tissue and coagulated the severed middle cerebral arteries. Dural plasty using the deep fascia of the thigh was performed. The skin defect was closed using an artificial dermis. The administration of high-dose antibiotics has failed to prevent meningitis. Moreover, the severed skin edges and fasciae were necrotic. Plastic surgeons performed debridement and vacuum-assisted closure therapy to promote wound healing. Follow-up head computed tomography revealed hydrocephalus. Lumbar drainage was performed; however, sinking skin flap syndrome was observed. After removing the lumbar drainage, cerebrospinal fluid leakage occurred. We then performed cranioplasty with a titanium mesh and omental flap on day 31. After the surgery, perfect wound healing and infection control were achieved; however, severe disturbance of consciousness remained. The patient was transferred to a nursing home. Primary hemostasis and infection control are mandatory. An omental flap has been determined to be effective in controlling infection by covering the exposed brain tissue.

A Presenile Patient with Filar Lipoma Who Developed Tethered Spinal Cord Syndrome Triggered by Lumbar Canal Stenosis.

Lumbar canal stenosis (LCS) has been reported as a precipitating factor by which a tethered spinal cord, which is asymptomatic during childhood, develops into tethered cord syndrome (TCS) in adulthood. However, only a few reports on surgical strategies for such cases are available. A 64-year-old woman presented with unbearable pain in the left buttock and dorsal aspect of the thigh approximately 1 year ago. Magnetic resonance imaging showed cord tethering with a filar-type spinal lipoma and LCS due to the thickening of the ligamentum flavum at the L4-5 vertebral level. Five months after the decompressive laminectomy for the treatment of LCS, an untethering surgery was performed at the dural cul-de-sac at the S4 level. The severed end of the filum was elevated rostrally by 7 mm, and the pain subsided postoperatively. This case study shows that surgeries for both lesions should be indicated for adult-onset TCS triggered by LCS.

Survivorship of Allologous Structural Bone Graft at a Minimum of 2 Years When Used to Address Significant Glenoid Bone Loss in Revision Shoulder Arthroplasty: A Computed Tomographic and Clinical Review.

This study assesses outcomes in revision shoulder replacements where the glenoid bone loss was managed using a structural allograft (donated femoral head) in combination with a trabecular titanium (TT) implant.

A new federated learning-based wireless communication and client scheduling solution for combating COVID-19.

Federated learning is a machine learning method that can break the data island. Its inherent privacy-preserving property has an important role in training medical image models. However, federated learning requires frequent communication, which incur high communication costs. Moreover, the data is heterogeneous due to different users' preferences, which may degrade the performance of models. To address the problem of statistical heterogeneity, we propose FedUC, an algorithm to control the uploaded updates for federated learning, where a client scheduling method is made on the basis of weight divergence, update increment, and loss. We also balance the local data of the clients by image augmentation to mitigate the impact of the non-independently identically distribution. The server assigns compression thresholds to the clients based on the weight divergence and update increment of the models for gradient compression to reduce the wireless communication costs. Finally, based on the weight divergence, update increment and accuracy, the server dynamically assigns weights to the model parameters for the aggregation. Simulation and analysis utilizing a publicly available chest disease dataset containing COVID-19 are compared with existing federated learning methods. Experimental results show that our proposed strategy has better training performance in improving model accuracy and reducing wireless communication costs.