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36896250

Pediatric tele-coaching fidelity evaluation: Feasibility, perceived satisfaction and usefulness of a new measure.

To promote and ensure coaches' fidelity in delivering an online health coaching program to parents of children with suspected developmental delay, we developed and implemented a novel coaching fidelity rating tool, CO-FIDEL (COaches Fidelity in Intervention DELivery). We aimed to (1) Demonstrate CO-FIDEL's feasibility in evaluating coaches' fidelity and its change over time; and (2) Explore coaches' satisfaction with and usefulness of the tool.

36896251

Mapping frameworks and approaches to measuring the quality of transition support services for young people with intellectual and developmental disabilities.

Transition to adulthood for young people with intellectual disabilities and developmental disabilities (IDD) has been given significant attention in research, policy development and practice. The aim of this paper was to explore how a recently developed theoretical es-based framework for measuring the quality of services for people with disabilities could potentially be useful in conceptualizing and supporting successful transition to adulthood. The theoretical discussion draws on both the scoping review and template analysis that was used to develop the Service Quality Framework and on a separate study synthesizing pleted country templates and literature review which included models of and research on successful transition to adulthood. Synthesis identified that using a quality of life es focused framework of Service Quality could be mapped onto and extend current thinking on what is seen as successful transition to adulthood by putting the focus on successful transition as people with IDD moving towards having similar opportunities and quality of life as other adults without disabilities living in the munity/society. Implications of a more wide-ranging definition and holistic view for both practice and future research are discussed.

36896252

Experiences with COVID-19 case investigation and contact tracing: A qualitative analysis.

Case investigation and contact tracing (CI/CT) is a critical part of the public health response to COVID-19. Individuals' experiences with CI/CT for COVID-19 varied based on geographic location, changes in knowledge and guidelines, access to testing and vaccination, as well as demographic characteristics including age, race, ethnicity, e, and political ideology. In this paper, we explore the experiences and behaviors of adults with positive SARS-CoV-2 test results, or who were exposed to a person with COVID-19, to understand their knowledge, motivations, and facilitators and barriers to their actions. We conducted focus groups and one-on-one interviews with 94 cases and 90 contacts from across the United States. We found that participants were concerned about infecting or exposing others, which motivated them to isolate or quarantine, notify contacts, and get tested. Although most cases and contacts were not contacted by CI/CT professionals, those who were reported a positive experience and received helpful information. Many cases and contacts reported seeking information from family, friends, health care providers, as well as television news and Internet sources. Although participants reported similar perspectives and experiences across demographic characteristics, some highlighted inequities in receiving COVID-19 information and resources.

36896254

Thyroid Hormone Abuse Among Elite Athletes.

Thyroid hormone (TH) abuse for performance enhancement in sport remains controversial and it is not prohibited in sports under the World Anti-Doping Code. However, the prevalence of TH usage in athletes is not known.

36896255

Bundle branch block in cardiac arrest survivors without ischemic heart disease.

Cardiac arrest (CA) survivors with left/right bundle branch block (LBBB/RBBB) and no ischemic heart disease (IHD) have not been previously characterized. The aim of this study was to describe heart failure, implantable cardioverter defibrillator (ICD) therapy and mortality in this population.

36896256

Translation ambiguity in and out of context.

pare translations of single words, made by bilingual speakers in a laboratory setting, with contextualized translation choices of the same items, made by professional translators and extracted from parallel language corpora. The translation choices in both cases show moderate convergence, demonstrating that decontextualized translation probabilities partially reflect bilinguals' life experience regarding the conditional distributions of alternative translations. Lexical attributes of the target word differ in their ability to predict translation probability: form similarity is a stronger predictor in decontextualized translation choice, whereas word frequency and semantic salience are stronger predictors for context-embedded translation choice. These findings establish the utility of parallel language corpora as important tools in psycholinguistic investigations of bilingual language processing.

36896257

Ultrasound-guided endoscopic endonasal resection of sellar and suprasellar craniopharyngiomas.

Optimal planning and minimally invasive surgical approach are essential plete craniopharyngiomas (CP) resection with limited postoperative morbidity. Given the nature of craniopharyngioma plete resection of the neoplasm is crucial. Since CP arise from the pituitary stalk and may grow anteriorly or laterally, some cases require an extended endonasal craniotomy. The extension of the craniotomy is crucial to expose the whole tumor and to make its dissection from the surrounding structures feasible. In order to guide the extension of the approach, the intraoperative use of ultrasound is helpful for the surgeons. The objective of this paper is to describe and to demonstrate the applicability of the utilization of intraoperative ultrasound (US) guidance for planning and confirmation of craniopharyngioma resection in EES.

36896258

Tranexamic acid is associated with improved hemostasis in elderly patients undergoing coronary-artery surgeries in a retrospective cohort study.

More elderly patients undergo coronary artery bypass surgery (CABG) than younger patients. Whether tranexamic acid (TA) is still effective and safe in elderly patients undergoing CABG surgeries is still unclear.

36896259

Case report: Hilar metastasis of breast cancer: A single-center retrospective case-control study.

The lungs are mon metastatic organ in breast cancer, mainly due to blood metastasis. On imaging, most metastatic lesions show a peripheral round mass in the lung, occasionally with a hilar mass as the primary manifestation, showing burr and lobulation signs. This study aimed to investigate breast cancer patient's clinical characteristics and prognosis with two different metastatic sites in the lung.

36896260

Case Report: Wernicke's encephalopathy after gastric surgery presenting as lactic acidosis and refractory thrombocytopenia.

Wernicke's encephalopathy (WE) is a severe neuropsychiatric disorder, mainly resulting from a nutritional deficiency of thiamine. WE is hard to detect at an early stage. Less than 20% of WE can be diagnosed during a patient's lifetime, and WE tends to occur in patients with chronic alcoholism. Therefore, a large proportion of non-alcoholic WE patients are misdiagnosed. Lactate is an important by-product of anaerobic metabolism when the aerobic metabolism is blocked without thiamine, which can potentially serve as an alerting index for WE. Here, we report a case of a patient with WE who suffered gastric outlet obstruction following postoperative fasting, panied by lactic acidosis and refractory thrombocytopenia. A 67-year-old non-alcoholic woman who suffered hyperemesis for 2 months was diagnosed with gastric outlet obstruction (GOO). Gastric biopsies with endoscopy revealed gastric cancer, and total gastrectomy, together with D2 nodal dissection, was performed. She developed a with refractory thrombocytopenia rapidly after the surgical procedures were performed. The above conditions were treated not by the administration of antibiotics but by that of thiamine. We also found before the start of the procedures that she had a high level of blood lactate for a long period of time. Early diagnosis of WE is important because permanent injury can be caused to the central nervous system. Even today, the diagnosis of WE mainly depends on clinical symptoms, but occasionally, a typical triad occurs among WE patients. Therefore, a sensitive index for early diagnosis is critical for WE. Rising levels of blood lactate as a result of thiamine deficiency can serve as a warning for WE. In addition, we noted that this patient had a non-typical thiamine-sensitive refractory thrombocytopenia.

36896261

Case report: Intra-abdominal aggressive fibromatosis: A rare cause of hyperemesis.

Aggressive fibromatosis is a rare and locally infiltrative monoclonal fibroblastic proliferation with lack of metastatic potential. We describe a rare case of intra-abdominal aggressive fibromatosis on young female with hyperemesis.

36896262

Comparison of discover cervical disc arthroplasty and anterior cervical discectomy and fusion for the treatment of cervical degenerative disc diseases: A meta-analysis of prospective, randomized controlled trials.

This study aims to evaluate the clinical efficacy and safety between Discover cervical disc arthroplasty (DCDA) and anterior cervical discectomy and fusion (ACDF) in Cervical degenerative disc diseases.

36896263

Bone marrow stimulation in arthroscopic rotator cuff repair is a cost-effective and straightforward technique to reduce retear rates: A systematic review and meta-analysis.

Bone marrow stimulation (BMS) has been considered a well-established method for treating knee and ankle osteochondral lesions. Some studies have also shown that BMS can promote healing of the repaired tendon and enhance biomechanical properties during rotator cuff repair. Our purpose was pare the clinical es of arthroscopic repair rotator cuff (ARCR) with and without BMS.

36896264

Failure to rescue following anatomical lung resection. Analysis of a prospective nationwide database.

Rescue failure has been described as an important factor that conditions postoperative mortality after surgical interventions. The objective of this study is to determine the incidence and main determinants of failure to rescue after anatomical lung resections.

36896265

Diagnosis and surgical management strategy for pediatric small bowel obstruction: Experience from a single medical center.

Identifying Bowel strangulation and the approach and timing of surgical intervention for pediatric SBO are still uncertain. In this study, 75 consecutive pediatric patients with surgically confirmed SBO were retrospectively reviewed. The patients were divided into group 1 (

36896266

Identifying predictors of on-table adaptation for pancreas stereotactic body radiotherapy (SBRT).

To identify any clinical or dosimetric parameters that predict which individuals may benefit from on-table adaptation during pancreas stereotactic body radiotherapy (SBRT) with MRI-guided radiotherapy.

36896268

Factors Affecting Patient Adherence to Inhalation Therapy: An Application of SEIPS Model 2.0.

This study aims to explore factors that affect patient adherence to inhalation therapy by applying a patient-centered approach.

36896269

The Effect of Patients' Psychological Contract with Pharmacists on Medication Adherence: A Qualitative Study.

To investigate the effect of psychological contract of outpatients with hospital pharmacists on medication adherence, providing reference for improving the management of patients' medication adherence from the perspective of pharmacist-patient relationship and psychological contract.

36896270

Point of Care Ultrasound (POCUS) in Bedside Diagnosis of Pyomyositis.

A 43 year old man with a history of IV drug use, and presenting with three days of painful and swollen left calf, was referred to exclude deep vein thrombosis (DVT). Ultrasound showed no evidence of DVT. An area of localised warm, erythematous, which was disproportionately tender, prompted a point of care ultrasound (POCUS) assessment. POCUS confirmed a hypoechoic area in the underlying tissue, likely representing a collection because of no recent trauma. It led to prompt antibiotic therapy for the treatment of his pyomyositis. The patient surgical team reviewed the patient and mended a conservative approach with a satisfactory clinical e that led to a safe discharge. Overall, this case demonstrates the versatility of POCUS as an efficient diagnostic tool in the acute setting, and it also helped to differentiate cellulitis from pyomyositis.

36896271

Avulsion Fracture of the Anterior Superior Iliac Spine in a Young Athlete Detected by Point-Of-Care Ultrasound.

Pelvic avulsion fractures (PAFs) mon in adolescents. X-ray monly used to diagnose PAF, but the use of point-of-care ultrasound (POCUS) for this purpose in pediatric emergency departments has yet to be published. We reported herein a pediatric case of anterior superior iliac spine (ASIS) avulsion fracture detected by POCUS. A 14-year-old male patient visited our emergency department for groin pain he experienced during a game of baseball. POCUS of the right ilium demonstrated a hyperechoic structure anterolaterally displaced towards the ASIS, suggesting an ASIS avulsion fracture. X-ray of the pelvis confirmed the findings and led to the diagnosis of ASIS avulsion fracture.

36896275

A Brisk and Life-Saving Diagnosis of Pericardial Effusion as the Cause for Recurrent Dyspnea.

Point of care ultrasound (POCUS) is a reliable diagnostic tool for the evaluation of a patient with dyspnea. This case provides an example of an acutely dyspneic patient in which standard evaluation failed to elucidate the true etiology of the patient's dyspnea. The patient was initially diagnosed with pneumonia but returned to the emergency department with acute worsening of his symptoms despite empiric antibiotics leading to the presumption of antibiotic failure. POCUS revealed a large pericardial effusion requiring pericardiocentesis ultimately leading to the accurate diagnosis. This case highlights the importance of POCUS in evaluating patients with shortness of breath.

36896276

Hickam's Dictum Incarnate: A Case of Simultaneous Left-Sided Urolithiasis and Ruptured Iliac Artery Aneurysm.

A 51-year-old man with a history of nephrolithiasis presented to the Emergency Department after a sudden onset of left-sided groin pain and syncope. At presentation, he described his pain as similar to prior renal colic episodes. At his initial assessment, point of care ultrasound (POCUS) was used, which revealed findings consistent with obstructive renal stones, as well as a substantially enlarged left iliac artery. Computed tomography (CT) imaging confirmed orbid diagnoses of left-sided urolithiasis and a ruptured isolated left iliac artery aneurysm. POCUS facilitated expedited definitive imaging and operative management. This case highlights the importance of performing related POCUS studies in reducing anchoring and premature closure bias.

36896279

Diagnosing Paget-Schroetter Syndrome Using Point of Care Ultrasound (POCUS).

Paget-Schroetter Syndrome, or effort thrombosis, is a relatively rare disorder. It refers to axillary-subclavian vein thrombosis (ASVT) that is associated with strenuous and repetitive activity of the upper extremities 1. Anatomical abnormalities at the thoracic outlet and repetitive trauma to the endothelium of the subclavian vein are key factors in its initiation and progression. Doppler ultrasonography is the preferred initial test, but contrast venography is the gold standard for diagnosis 1, 2. Early diagnosis coupled with a multimodal treatment strategy is crucial for optimal es. We present a case of a 21-year-old male in which point of care ultrasound (POCUS) expedited the diagnosis and subsequent early treatment of right subclavian vein thrombosis. He presented to our Emergency Department with acute swelling, pain and erythema of his right upper limb. He was promptly diagnosed to have thrombotic occlusion of the right subclavian vein using POCUS in our Emergency Department.

36896281

Impact of Point-of-Care Ultrasound in Medical Decision Making: Informing the Development of an Internal Medicine Global Health POCUS Curriculum.

Point-of-care Ultrasound (POCUS) is particularly useful in low-middle e countries (LMICs) where advanced imaging modalities and diagnostics are often unavailable. However, its use among Internal Medicine (IM) practitioners is limited and without standard curricula. This study describes POCUS scans performed by U.S. IM residents rotating in LMICs to provide mendations for curriculum development.

36896282

The Takotsubo Syndrome: Clinical Diagnosis Using POCUS.

Takotsubo syndrome is a cardiomyopathy that can mimic an acute heart attack, in terms of clinical presentation, electrocardiographic changes, and findings on echocardiogram. Point-of-care-ultrasound (POCUS) can be used to detect this condition, even though the definitive diagnosis is made angiographically. We present the case of an 84-year-old woman with a subacute coronary syndrome and high levels of myocardial ischemia markers. The POCUS performed on admission showed characteristic left ventricular dysfunction involving the apex but sparing the base. The coronary angiography ruled out significant arteriosclerotic in the coronary arteries. The wall motion abnormalities were partially corrected in the 48 hours after admission. POCUS might be a useful tool to establish an early diagnosis of Takotsubo syndrome at time of admission.

36896288

Predictive equations for dietary energy are improved when independently developed for dry and wet food which could benefit both the pet and the environment.

Measuring energy availability through metabolizable energy feeding studies is the "gold standard" for establishing metabolizable energy concentration. However, predictive equations are often used to estimate metabolizable energy in dog and cat pet foods. The goal of this work was to evaluate the prediction of energy density pare those predictions to each other and the energy needs of the individual pets.

36896289

Life expectancy tables for dogs and cats derived from clinical data.

There are few recent and methodologically robust life expectancy (LE) tables for dogs or cats. This study aimed to generate LE tables for these species with clinical records from >1,000 Banfield Pet hospitals in the USA. Using Sullivan's method, LE tables were generated across survey years 2013-2019, by survey year, and for subpopulations defined by sex, adult body size group (purebred dogs only: toy, small, medium, large and giant), and median body condition score (BCS) over life. The deceased population for each survey prised animals with a recorded date of death in that year; survivors had no death date in that year and were confirmed living by a veterinary visit in a subsequent year. The dataset totaled 13,292,929 unique dogs and 2,390,078 unique cats. LE at birth (LE

36896290

Evaluations of the Disease Surveillance Centre network in Scotland: What parts has it reached?

Regular evaluation is a prerequisite for systems that provide surveillance of animal populations. Scotland's Rural College Veterinary Services' Disease Surveillance Centre (DSC) network plays an integral part in surveillance to detect new and re-emerging threats within animal populations, predominantly livestock. In response to surveillance reviews and proposed changes to the network, an initial evaluation of diagnostic submissions data in 2010 to mid-2012 established a baseline “footprint,” while highlighting challenges with the data. In this recent evaluation for the period 2013–2018, we developed a new denominator using bination of agricultural census and movement data, to identify relevant holdings more accurately. Iterative discussions between those processing submissions data and those involved in collection at source took place to understand the intricacies of the data, establish the most appropriate dataset, and develop the processes required to optimise the data extraction and cleansing. The subsequent descriptive analysis identifies the number of diagnostic submissions, the number of unique holdings making submissions to the network and shows that both the surrounding geographic region of, and maximum distance to the closest DSC vary greatly between centres. Analysis of those submissions classed as farm animal post-mortems also highlights the effect of distance to the closest DSC. Whether specific differences between the time periods are due to changes in the behavior of the submitting holdings or the data extraction and cleaning processes was difficult to disentangle. However, with the improved techniques producing better data to work with, a new baseline footprint for the network has been created. This provides information that can help policy makers and surveillance providers make decisions about service provision and evaluate the impact of future changes. Additionally, the outputs of these analyses can provide feedback to those employed in the service, providing evidence of what they are achieving and why changes to data collection processes and ways of working are being made. In a different setting, other data will be available and different challenges may arise. However, the fundamental principles highlighted in these evaluations and the solutions developed should be of interest to any surveillance providers generating similar diagnostic data.

36896291

Benchmark study for evaluating the quality of reference genomes and gene annotations in 114 species.

For reference genomes and gene annotations are key materials that can determine the limits of the molecular biology research of a species; however, systematic research on their quality assessment remains insufficient.

36896292

A 10-year retrospective analysis (2012-2021) of hospitalizations resulting from dog bites in Southern Italy.

This study aimed to describe the incidence and characteristics of dog-bite injury hospitalizations (DBIH) in the largest administrative region of Italy (Sicily) over the 10-year period: 2012-2021. Four hundred and forty-nine cases were analyzed. Patients were divided into seven age groups: preschoolers (0-5 years), school-age children (6-12 years), teenagers (13-19 years), young adults (20-39 years), middle-aged adults (40-59 years), old adults (60-74 years), and the elderly (≥75 years). Association among categorical variables (age, gender, principal injury location) was evaluated using chi-square tests, and mean differences for normally distributed variables were assessed using one-way analysis of variance. Finally, a Poisson regression general linear model (GLM) analysis was used to model incidence data. The results revealed that the incidence of DBIH per 100,000 population increased from 0.648 in 2012 (95%CI 0.565-0.731) to 1.162 in 2021 (95%CI 1.078-1.247,

36896293

Epidemiology of

Leptospirosis is an infectious disease caused by pathogenic

36896294

Effects of adding nano-emulsified plant oil and probiotics to drinking water during different periods besides sex on processing characteristics, physicochemical properties, and meat quality traits of broiler chickens.

High-quality meat is one of the consumer demands. Therefore, several studies have concluded that supplementing broilers with natural additives can improve meat quality. This study was carried out to evaluate the effects of nano-emulsified plant oil (Magic oil

36896295

Using an Internal Joint Stabilizer Through a Single Posterior Approach for Elderly Patients With Terrible Triad Injury.

Treating a terrible triad injury of the elbow remains a challenge for orthopedic surgeons, especially in elderly patients due to the poor quality of the surrounding soft tissue and bony structures. In the present study, we propose a treatment protocol using an internal joint stabilizer through a single posterior approach and analyze the clinical results.

36896296

Hypophosphatemia as a prognostic tool for post-hepatectomy liver failure: A systematic review.

Post-hepatectomy liver failure (PHLF) is one of the main causes of postoperative mortality and is challenging to predict early in patients after liver resection. Some studies suggest that the postoperative serum phosphorus might predict es in these patients.

36896297

Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations.

Different follow-up strategies are available for patients with rectal cancer following curative treatment. bination of biochemical testing and imaging investigation, associated with physical examination monly used. However, there is currently no consensus about the types of tests to perform, the timing of the testing, and even the need for follow-up at all has been questioned. The aim of this study was to review the evidence of the impact of different follow-up tests and programs in patients with non-metastatic disease after definitive treatment of the primary. A literature review was performed of studies published on MEDLINE, EMBASE, the Cochrane Library and Web of Science up to November 2022. Current published guidelines from the most authoritative specialty societies were also reviewed. According to the follow-up strategies available, the office visit is not efficient but represents the only way to maintain direct contact with the patient and is mended by all authoritative specialty societies. In colorectal cancer surveillance, carcinoembryonic antigen represents the only established tumor marker. Abdominal and puted tomography scan is mended considering that the liver and lungs are the mon sites of recurrence. Since local relapse in rectal cancer is higher than in colon cancer, endoscopic surveillance is mandatory. Different follow-up regimens have been published but parisons and meta-analyses do not allow to determine whether intensive or less intensive follow-up had any significant influence on survival and recurrence detection rate. The available data do not allow the drawing of final conclusions on the ideal surveillance methods and the frequency with which they should be applied. It is very useful and urgent for clinicians to identify a cost-effective strategy that allows early identification of recurrence with a special focus for high-risk patients and patients undergoing a "watch and wait" approach.

36896298

Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study.

Hepatobiliary manifestations occur in ulcerative colitis (UC) patients. The effect of laparoscopic restorative proctocolectomy (LRP) with ileal pouch anal anastomosis (IPAA) on hepatobiliary manifestations is debated.

36896299

Causes of epigastric pain and vomiting after laparoscopic-assisted radical right hemicolectomy - superior mesenteric artery syndrome.

Superior mesenteric artery syndrome (SMAS) is a rare condition causing functional obstruction of the third portion of the duodenum. Postoperative SMAS following laparoscopic-assisted radical right hemicolectomy is even less prevalent and can often be unrecognized by radiologists and clinicians.

36896300

Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery.

Remnant gastric cancer (GC) is defined as GC that occurs five years or more after gastrectomy. Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer (RGC) patients are crucial. A simple scoring system bines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.

36896301

Does size matter for resection of giant versus non-giant hepatocellular carcinoma? A meta-analysis.

Research on long-term survival after resection of giant (≥ 10 cm) and non-giant hepatocellular carcinoma (HCC) (< 10 cm) has produced conflicting results.

36896302

Network meta-analysis of the prognosis of curative treatment strategies for recurrent hepatocellular carcinoma after hepatectomy.

Recurrent hepatocellular carcinoma (rHCC) is mon e after curative treatment. Retreatment for rHCC is mended, but no guidelines exist.

36896303

Mesh erosion into the colon following repair of parastomal hernia: A case report.

In recent years, mesh has e a standard repair method for parastomal hernia surgery due to its low recurrence rate and low postoperative pain. However, using mesh to repair parastomal hernias also carries potential dangers. One of these dangers is mesh erosion, a rare but plication following hernia surgery, particularly parastomal hernia surgery, and has attracted the attention of surgeons in recent years.

36896304

Primary malignant melanoma of the esophagus combined with squamous cell carcinoma: A case report.

Primary malignant melanoma of the esophagus is a rare malignant tumor of the esophagus, and bination with squamous cell carcinoma is also rare. Here, we report the diagnosis and treatment of a case of primary esophageal malignant bined with squamous cell carcinoma.

36896307

Analysis of the impact of ERAS-based respiratory function training on older patients' ability to prevent pulmonary complications after abdominal surgery.

In China, as the population grows older, the number of elderly people who have died from respiratory problems has increased.

36896306

Efficacy and safety of preoperative immunotherapy in patients with mismatch repair-deficient or microsatellite instability-high gastrointestinal malignancies.

Programmed death protein (PD)-1 blockade immunotherapy significantly prolongs survival in patients with metastatic mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) gastrointestinal malignancies such gastric and colorectal cancer. However, the data on preoperative immunotherapy are limited.

36896309

Comprehensive multimodal management of borderline resectable pancreatic cancer: Current status and progress.

Borderline resectable pancreatic cancer (BRPC) is plex clinical entity with specific biological features. Criteria for resectability need to be assessed bination with tumor anatomy and oncology. Neoadjuvant therapy (NAT) for BRPC patients is associated with additional survival benefits. Research is currently focused on exploring the optimal NAT regimen and more reliable ways of assessing response to NAT. More attention to management standards during NAT, including biliary drainage and nutritional support, is needed. Surgery remains the cornerstone of BRPC treatment and multidisciplinary teams can help to evaluate whether patients are suitable for surgery and provide individualized management during the perioperative period, including NAT responsiveness and the selection of surgical timing.

36896310

Current management of concomitant cholelithiasis and common bile duct stones.

The management policy of itant cholelithiasis and choledocholithiasis is based on a one- or two-stage procedure. It basically includes either laparoscopic cholecystectomy (LC) with mon bile duct (CBD) exploration (LCBDE) in the same operation or LC with preoperative, postoperative and even intraoperative endoscopic retrograde cholangiopancreatography-endoscopic sphincterotomy (ERCP-ES) for stone clearance. The most frequently used worldwide option is preoperative ERCP-ES and stone removal followed by LC, preferably on the next day. In cases where preoperative ERCP-ES is not feasible, the proposed alternative of intraoperative rendezvous ERCP-ES simultaneously with LC has been advocated. The intraoperative extraction of CBD stones is superior to postoperative rendezvous ERCP-ES. However, there is no consensus on the superiority of laparoendoscopic rendezvous. This is equivalent to a traditional two-stage procedure. Endoscopic papillary large balloon dilation reduces recurrence. LCBDE and intraoperative ERCP have similar good es. The risk of recurrence after ERCP-ES is greater than that after LCBDE. Laparoscopic ultrasonography may delineate the anatomy and detect CBD stones. The majority of surgeons prefer the transcductal instead of the transcystic approach for CBDE with or without T-tube drainage, but the transcystic approach must be used where possible. LCBDE is a safe and effective choice when performed by an experienced surgeon. However, the requirement of specific equipment and advanced training are drawbacks. The percutaneous approach is an alternative when ERCP fails. Surgical or endoscopic reintervention for retained stones may be needed. For asymptomatic CBD stones, ERCP clearance is the first-choice method. Both one-stage and two-stage management are acceptable and can ensure improved quality of life.

36896311

Impact of endoscopic ultrasound-guided radiofrequency ablation in managing pancreatic malignancy.

Pancreatic malignancy is still the most lethal gastrointestinal malignancy. It has a very poor prognosis with low survival rate. Surgery is still the main treatment option for pancreatic malignancy. Most patients already have locally advanced and even late stage disease due to non-specific abdominal symptoms. Even though some cases are still suitable for surgical treatment, due to its aggressiveness adjuvant chemotherapy is ing the standard treatment for controlling the disease. Radiofrequency ablation (RFA) is a thermal therapy that has been used as one of the standard treatments for liver malignancy. It can also be performed intraoperatively. There are several reports on percutaneous RFA treatment for pancreatic malignancy using transabdominal ultrasound and guided puted tomography scan. However, due to its anatomical location and the risk of high radiation exposure, these methods seem to be very limited. Endoscopic ultrasound (EUS) has been widely used for pancreatic abnormality evaluation due to its ability to detect more accurately, especially small pancreatic pared to other imaging modalities. By the EUS approach, it is easier to achieve good visualization of tumor ablation and necrosis as the echoendoscope position is closer to the tumor area. Based on studies and a recent meta-analysis, EUS-guided RFA is a promising treatment approach for most pancreatic malignancy cases, but most studies only collected data from a small sample size. Larger studies are needed before clinical mendations can be made.

36896308

Minimum platelet count threshold before invasive procedures in cirrhosis: Evolution of the guidelines.

Cirrhotic patients with severe thrombocytopenia are at increased risk of bleeding during invasive procedures. The need for preprocedural prophylaxis aimed at reducing the risk of bleeding in cirrhotic patients with thrombocytopenia who undergo scheduled procedures is assessed

36896312

Hot topics in pancreatic cancer management.

Pancreatic ductal adenocarcinoma (PDAC) is a sneaky and lethal disease burdened by poor prognosis. PDAC is often detected too late to be successfully cured, and it has been estimated that it will be a leading cause of cancer-related deaths in the near future. During the last decade, multimodal treatments involving surgery, chemotherapy and radiotherapy have contributed to improving the prognosis of this disease; however, long-term results are still not satisfactory. Postoperative morbidity and mortality rates remain high, and systemic treatments are burdened by toxicity in both neoadjuvant and adjuvant settings. Advancements in technologies, targeted therapies, immunotherapy and PDAC microenvironment modulation strategies may represent useful potential weapons in the future. Nevertheless, in the fight against this dreadful disease, there is an urgent need for new, cheap and user-friendly tools for early detection. In this field, promising results have been found in nanotechnologies and "omics" analyses that search for new biomarkers to be used in primary and secondary prevention. However, there are many issues that need to be solved before considering these tools in daily clinical practice. This editorial reported the state of the art of pancreatic cancer management.

36896313

A methodology to implement a closed-loop feedback-feedforward level control in a laboratory-scale flotation bank using peristaltic pumps.

This paper describes the implementation of a level control strategy in a laboratory-scale flotation system. The laboratory-scale system consists of a bank of three flotation tanks connected in series, which mimics a flotation system found in mineral processing plants. Besides the classical feedback control strategy, we have also included a feedforward strategy to better account for process disturbances. Results revealed that the level control performance significantly improves when a feedforward strategy is considered. This methodology uses peristaltic pumps for level control, which has not been extensively documented even though: (1) peristaltic pumps monly used in laboratory-scale systems, and (2) the control implementation is not as straightforward as those control strategies that use valves. Therefore, we believe that this paper, which describes a proven methodology that has been validated in an experimental system, can be a useful reference for many researchers in the field.•Preparation of reagents to ensure that the froth stability of the froth layer is representative of an industrial flotation froth.•Calibration of instruments - convert the electrical signal from PLCs to engineering units.•Tuning PI parameters using SIMC rules by performing step-changes in each flotation cell.

36896315

Potential Benefits of

The main therapy for head and neck cancer is radiation, and one of the toxic effects of radiation is radiation dermatitis.

36896316

Study of the Effects of Melatonin on Sleep Disorders in Pulmonary Sarcoidosis Patients.

The symptoms of pulmonary sarcoidosis may lead to fatigue, excessive daytime sleepiness, poor sleep quality, and a decrease in quality of life in these patients.

36896314

Overview of myelin, major myelin lipids, and myelin-associated proteins.

Myelin is a modified cell membrane that forms a multilayer sheath around the axon. It retains the main characteristics of biological membranes, such as lipid bilayer, but differs from them in several important respects. In this review, we focus on aspects of position that are peculiar to this structure and differentiate it from the more conventional cell membranes, with special attention to its constituent ponents and several of the mon and important myelin proteins: myelin basic protein, proteolipid protein, and myelin protein zero. We also discuss the many-fold functions of myelin, which include reliable electrical insulation of axons to ensure rapid propagation of nerve impulses, provision of trophic support along the axon and organization of the unmyelinated nodes of Ranvier, as well as the relationship between myelin biology and neurologic disease such as multiple sclerosis. We conclude with a brief history of discovery in the field and outline questions for future research.

36896317

Effects of

As a chronic joint condition, osteoarthritis (OA) is mon problem among older people. Pain, aching, stiffness, swelling, decreased flexibility, reduced function, and disability are the symptoms of arthritis.

36896318

Application of SPRA Technology for Delivery of Erythropoietin: Stability Evaluation of Conjugated Erythropoietin with Adamantane and in SPRA Inclusion Complex.

As a widely used therapeutic protein, binant human erythropoietin (rhEPO) is currently one of the most effective biopharmaceuticals on the market for the treatment of anemia in patients with chronic renal disease. Increasing in vivo rhEPO half-life and its bioactivity is a significant challenge. It was hypothesized that the application of self-assembly PEGylation retaining activity, named supramolecular (SPRA) technology, could prolong the protein half-life without a significant loss of bioactivity.

36896321

Brain Homogenate of a Rat Model of Alzheimer's Disease Modifies the Secretome of 3D Cultured Periodontal Ligament Stem Cells: A Potential Neuroregenerative Therapy.

Alzheimer's disease (AD) is a progressive neurodegenerative disease leading to neuronal cell death and manifested by cognitive disorders and behavioral impairment. Mesenchymal stem cells (MSCs) are one of the most promising candidates to stimulate neuroregeneration and prevent disease progression. Optimization of MSC culturing protocols is a key strategy to increase the therapeutic potential of the secretome.

36896322

Doxorubicin-Loaded Multivesicular Liposomes (DepoFoam) as a Sustained Release Carrier Intended for Locoregional Delivery in Cancer Treatment: Development, Characterization, and Cytotoxicity Evaluation.

Despite the advantages of direct intratumoral (IT) injection, the relatively rapid withdrawal of most anti-cancer drugs from the tumor due to their small molecular size limits the effectiveness of this method of administration. To address these limitations, recently, increasing attention has been directed to using slow-release biodegradable delivery systems for IT injection.

36896320

Evaluation and Comparison of the Effects of Mature Silkworm (

Silkworm products were first used by physicians more than 8500 years ago, in the early Neolithic period. In Persian medicine, silkworm extract has several uses for treating and preventing neurological, cardiac, and liver diseases. Mature silkworms (

36896323

Tumor Suppression by PD-1/PD-L1 Interaction Blockage in Mice Model.

Overexpression of programmed cell death ligand 1 (PD-L1) in tumor cells and subsequent interaction with the programmed cell death protein 1 (PD-1) in tumor-infiltrating T cells cause an immune evasion of the tumor from cytotoxic T-cells. Therefore, inhibiting such interaction by a binant PD-1 can hinder tumor growth and extend the survival rate.

36896324

Amelioratory Effect of Melatonin on Cognition Dysfunction Induced by Sevoflurane Anesthesia in Aged Mice.

Postoperative cognitive dysfunction (POCD) can be described as a clinical phenomenon characterized by cognitive impairment in patients, particularly elderly patients, after anesthesia and surgery. Researchers have focused on the probable effect of general anesthesia drugs on cognitive functioning status in older adults. Melatonin is an indole-type neuroendocrine hormone with broad biological activity and potent anti-inflammatory, anti-apoptotic, and neuroprotective effects. This study investigated the effects of melatonin on cognitive behavior in aged mice anesthetized with sevoflurane. In addition, melatonin's molecular mechanism was determined.

36896325

Researching the Aftermath of Slavery in Mainland East Africa: Methodological, Ethical, and Practical Challenges.

This article examines ethical, practical, and methodological challenges in researching the aftermath of slavery in continental East Africa away from the coastal plantation belt. Interest in post-slavery there is recent and inspired by the apparent contrast with West Africa, where the issue is much more salient. The article explains this silence by highlighting politically-motivated avoidance of the issue in colonial sources and the preference of post-colonial historians for 'useful' pasts. Further, it questions the balance of successful integration and continuing marginalization reflected in the apparent obsolescence of slavery. It argues that tracing the trajectories of ex-slaves requires attention to all forms of social inequality and dependency, to the potential status implications for informants of speaking about slavery, and to the variety of terms and fields of meaning relevant to freedom, unfreedom and dependency. Recent research in this vein shows that slave antecedents remain a matter of

36896326

Emancipation in the Gold Coast: The Abolitionist Views of James Hutton Brew.

This article deals with the abolitionist views of James Hutton Brew who argued against the British emancipation model in the Gold Coast. Brew was the proprietor and editor of the

36896327

Primary thromboprophylaxis in not surgically treated intra-luminal gastrointestinal cancer (ILGC) treated with first-line chemotherapy: A single institution preliminary safety report.

Occurrence of venous thromboembolism in cancer patients (patients) undergoing chemotherapy is a remarkable concern for the oncologist. In addition, careful attention has to be paid to the possible major bleeding when patients carrying gastrointestinal cancer need antithrombotic therapies. To date some Cancer Associated Thrombosis (CAT) risk scores as Khorana and PROTECHT score have been developed to identify the cancer population at high-risk for venous thromboembolism (VTE). Consensus guidelines mend to consider also low molecular weight heparin (LMWH) for primary thromboprophylaxis in high-risk patients. This is a report on a retrospective case series of 15 intra-luminal not surgically treated gastrointestinal cancer patients deemed high risk for VTE. The patients had a Khorana or PROTECHT score of 2 points or more (at least ≥ 2 points). They were undergoing first line chemotherapy in the absence of endoscopic signs of cancer spontaneous bleeding. A prophylactic dose of LMWH was administered just before starting the chemotherapy session and until 48 hours after pletion. The authors mainly aimed to report occurrence of clinically perceptible gastrointestinal bleeding events. Fifteen patients were administered LMWH - median age: 59 (range: 42-79); gender: male 12 (80%); tumor type: stomach - 13 patients (86%); gastro-esophageal junction: 2 patients (14%). Duration of heparin treatment: the total treatment duration was 228 days; mean 15.2 days (range: 5-45); nadroparin: mean 14.7 days (range: 5-45); enoxaparin: mean 10.1 days (range: 5-20); parnaparin: a total of 5 days. None of the patients experienced perceptible gastrointestinal bleeding. Short-term LMWH thromboprophylaxis appeared to be safe for this series of patients.

36896328

A case of vanishing gastroschisis with short bowel syndrome treated by total parenteral nutrition and intestinal lengthening procedures.

The diagnosis of vanishing gastroschisis is made when in the presence of a full-thickness intrauterine abdominal wall defect the eviscerated loops are incarcerated in the fascial interruption. Four types of vanishing gastroschisis are described (A-D). We report on the case of a newborn with a vanishing gastroschisis-D. Gastroschisis was diagnosed at the 19th week of gestation, confirmed at the 30th, when the herniated loops previously visible to the right of the funiculus were no longer visualized. At the 32nd week, delivery was induced. The neonate weighed 1600 g, and the abdomen was distended, free from skin defects. On surgical exploration, the jejunum was 13 cm in length, with a blind ending. The post-atretic intestine measured 22 cm. A jejunostomy and a colostomy were built. The child received total parenteral nutrition for 13 months due to short bowel syndrome and was then subjected to intestinal lengthening procedure when she was 18 months old. Vanishing gastroschisis is a rare entity with a worse prognosis of the "classic" gastroschisis.

36896329

Screening the risk of obstructive sleep apnea by utilizing supervised learning techniques based on anthropometric features and snoring events.

Obstructive sleep apnea (OSA) is typically diagnosed by polysomnography (PSG). However, PSG is time-consuming and has some clinical limitations. This study thus aimed to establish machine learning models to screen for the risk of having moderate-to-severe and severe OSA based on easily acquired features.

36896330

COVID-19 topics and emotional frames in vaccine hesitation: A social media text and sentiment analysis.

Addressing gaps in COVID-19 vaccine-hesitancy research, the current study aimed to add depth and nuance to the exploratory research examining vaccine-hesitant groups. Using a larger, but more focused conversation occurring on social media, the results can be used by municators to frame emotionally resonant messaging to improve COVID-19 vaccine advocacy while also mitigating negative concerns for vaccine-hesitant individuals.

36896334

Synthetic computed tomography generation for abdominal adaptive radiotherapy using low-field magnetic resonance imaging.

Magnetic Resonance guided Radiotherapy (MRgRT) still needs the acquisition of Computed Tomography (CT) images and co-registration between CT and Magnetic Resonance Imaging (MRI). The generation of synthetic CT (sCT) images from the MR data can e this limitation. In this study we aim to propose a Deep Learning (DL) based approach for sCT image generation for abdominal Radiotherapy using low field MR images.

36896332

An artificially intelligent, natural language processing chatbot designed to promote COVID-19 vaccination: A proof-of-concept pilot study.

Our goal is to establish the feasibility of using an artificially intelligent chatbot in diverse healthcare settings to promote COVID-19 vaccination.

36896335

CoviExpert: COVID-19 detection from chest X-ray using CNN.

COVID-19 continues to threaten the world with its impact and severity. This pandemic has created a sense of havoc and shook the world stretching the medical fraternity to an unimaginable extent, who are now facing fatigue and exhaustion. Due to the rapid increase in cases all across the globe demanding extensive medical care, people are hunting for resources like testing facilities, medical drugs and even hospital beds. Even people with mild to moderate infection are panicking and mentally giving up due to anxiety and desperation. bat these issues, it is necessary to find an inexpensive and faster way to save lives and bring about a much-needed change. The most fundamental way through which this can be achieved is with the help of radiology which involves examination of Chest X rays. They are primarily used for the diagnosis of this disease. But due to panic and severity of this disease a recent trend of performing CT scans has been observed. This has been under scrutiny since it exposes patients to a very high level of radiation known to increase the probability of cancer. As quoted by the AIIMS Director, one CT scan is equivalent to around 300-400 Chest X-rays. Also, it is relatively a much costlier testing method. Hence, in this report, we have presented a Deep learning approach which can detect covid 19 positive cases from Chest X ray images. It involves creation of a Deep learning based Convolutional Neural Network (CNN) using Keras (python library) and integrating the model with a front-end user interface for ease of use. This leads up to the creation of a software which we have named as CoviExpert. It uses the sequential Keras model which is built layer by layer. All the layers are trained independently to make independent predictions which are bined to give the final output. 1584 images of Chest X-rays of both COVID-19 positive and negative patients have been used as training data. 177 images have been used as testing data. The proposed approach gives a classification accuracy of 99%. CoviExpert can be used on any device by any medical professional to detect Covid positive patients within a few seconds.

36896336

Lessons Learned From a Prospective Observational Study of U.S. Marine Recruits During a Supervised Quarantine, Spring‒Fall 2020.

Quarantining monly used to mitigate the spread of SARS-CoV-2. However, questions remain regarding what specific interventions are most effective.

36896337

Radiomics model using preoperative computed tomography angiography images to differentiate new from old emboli of acute lower limb arterial embolism.

Our purpose was to devise a radiomics model using puted tomography angiography (CTA) images to differentiate new from old emboli of acute lower limb arterial embolism. 57 patients (95 regions of interest; training set:

36896331

The utility of phonocardiograms in real-time remote cardiac auscultation using an internet-connected electronic stethoscope: Open-label randomized controlled pilot trial.

We have shown classical cardiac auscultation was superior to remote auscultation. We developed a phonocardiogram system to visualize sounds in remote auscultation.

36896333

Alzheimer's Disease is a Disorder of Consciousness.

The diagnostic criteria for Alzheimer's disease (AD) described in DSM-5-TR, require a decline in memory and learning and in at least one other cognitive domain among six cognitive domains, and also interference with the activities of daily living (ADL) because of decline in these cognitive functions; as such, DSM-5-TR positions memory impairment as the core symptom of AD. DSM-5-TR shows the following examples of symptoms or observations regarding impairments in everyday activities in terms of learning and memory involving the six cognitive domains. Mild: Has difficulty recalling recent events, and relies increasingly on list making or calendar. Major: Repeats self in conversation, often within the same conversation. These examples of symptoms/observations demonstrate difficulties in recall, or difficulties in bringing memories into the consciousness. In the article, it is proposed that considering AD as a disorder of consciousness could promote a better understanding of the symptoms experienced by AD patients and contribute to devising methods to provide improved care to these patients.

36896338

WGCNA-based identification of potential targets and pathways in response to treatment in locally advanced breast cancer patients.

Locally advanced breast cancer patients have a poor prognosis; however, the relationship between potential targets and the response to treatment is still unclear. The gene expression profiles of breast cancer patients with stages from IIB to IIIC were downloaded from The Cancer Genome Atlas. We applied weighted gene co-expression network analysis and differentially expressed gene analysis to identify the primary genes involved in treatment response. The disease-free survival between low- and high-expression groups was analyzed using Kaplan-Meier analysis. Gene set enrichment analysis was applied to identify hub genes-related pathways. Additionally, the CIBERSORT algorithm was employed to evaluate the correlation between the hub gene expression and immune cell types. A total of 16 genes were identified to be related to radiotherapy response, and low expression of SVOPL, EDAR, GSTA1, and ABCA13 was associated with poor overall survival and progression-free survival in breast cancer cases. Correlation analysis revealed that the four genes negatively related to some specific immune cell types. The four genes were downregulated in H pared with the L group. Four hub genes associated with the immune cell infiltration of breast cancer were identified; these genes might be used as a promising biomarker to test the treatment in breast cancer patients.

36896339

High Prevalence of Symptomatic Dry Eye Disease Among University Students During the COVID-19 Pandemic in University of West Indies, Trinidad and Tobago.

The Covid-19 pandemic lockdown obligated higher education students to attend online courses, leading to prolonged exposure to digital displays. Excessive time on digital devices could be a risk factor for ocular problems, including symptomatic dry eye. There are limited evidences to show the magnitude of symptomatic dry eye disease and its associated factors during COVID-19 pandemic. This study aimed to fill this gap, among university students in Trinidad and Tobago.

36896340

Validation of the Spanish Version of the Trauma and Loss Spectrum Self-Report (TALS-SR): A Study on Healthcare Workers Facing the COVID-19 Pandemic.

The present study aimed at reporting about the validity and reliability of the Spanish version of the Trauma and Loss Spectrum-Self Report (TALS-SR), an instrument based on a multidimensional approach to Post-Traumatic Stress Disorder (PTSD) and Prolonged Grief Disorder (PGD), including a range of threatening or traumatic experiences and significant losses, besides the spectrum of peri-traumatic stress reactions and post-traumatic stress symptoms that may occur.

36636741

Rapid molecular assays for the detection of the four dengue viruses in infected mosquitoes.

The pantropic emergence of severe dengue disease can partly be attributed to the co-circulation of different dengue viruses (DENVs) in the same geographical location. Effective monitoring for circulation of each of the four DENVs is critical to inform disease mitigation strategies. In low resource settings, this can be effectively achieved by utilizing inexpensive, rapid, sensitive and specific assays to detect viruses in mosquito populations. In this study, we developed four rapid DENV tests with direct applicability for low-resource virus surveillance in mosquitoes. The test protocols utilize a novel sample preparation step, a single-temperature isothermal amplification, and a simple lateral flow detection. Analytical sensitivity testing demonstrated tests could detect down to 1,000 copies/µL of virus-specific DENV RNA, and analytical specificity testing indicated tests were highly specific for their respective virus, and did not detect closely related flaviviruses. All four DENV tests showed excellent diagnostic specificity and sensitivity when used for detection of both individually infected mosquitoes and infected mosquitoes in pools of uninfected mosquitoes. With individually infected mosquitoes, the rapid DENV-1, -2 and -3 tests showed 100% diagnostic sensitivity (95% CI = 69% to 100%, n=8 for DENV-1; n=10 for DENV 2,3) and the DENV-4 test showed 92% diagnostic sensitivity (CI: 62% to 100%, n=12) along with 100% diagnostic specificity (CI: 48-100%) for all four tests. Testing infected mosquito pools, the rapid DENV-2, -3 and -4 tests showed 100% diagnostic sensitivity (95% CI = 69% to 100%, n=10) and the DENV-1 test showed 90% diagnostic sensitivity (55.50% to 99.75%, n=10) together with 100% diagnostic specificity (CI: 48-100%). Our tests reduce the operational time required to perform mosquito infection status surveillance testing from > two hours to only 35 minutes, and have potential to improve accessibility of mosquito screening, improving monitoring and control strategies in e countries most affected by dengue outbreaks.

36896342

Polynitroxylated PEGylated hemoglobin protects pig brain neocortical gray and white matter after traumatic brain injury and hemorrhagic shock.

Polynitroxylated PEGylated hemoglobin (PNPH, aka SanFlow) possesses superoxide dismutase/catalase mimetic activities that may directly protect the brain from oxidative stress. Stabilization of PNPH with bound carbon monoxide prevents methemoglobin formation during storage and permits it to serve as an anti-inflammatory carbon monoxide donor. We determined whether small volume transfusion of hyperoncotic PNPH is neuroprotective in a porcine model of traumatic brain injury (TBI) with and without panying hemorrhagic shock (HS). TBI was produced by controlled cortical impact over the frontal lobe of anesthetized juvenile pigs. Hemorrhagic shock was induced starting 5 min after TBI by 30 ml/kg blood withdrawal. At 120 min after TBI, pigs were resuscitated with 60 ml/kg lactated Ringer's (LR) or 10 or 20 ml/kg PNPH. Mean arterial pressure recovered to approximately 100 mmHg in all groups. A significant amount of PNPH was retained in the plasma over the first day of recovery. At 4 days of recovery in the LR-resuscitated group, the volume of frontal lobe subcortical white matter ipsilateral to the injury was 26.2 ± 7.6% smaller than homotypic contralateral volume, whereas this white matter loss was only 8.6 ± 12.0% with 20-ml/kg PNPH resuscitation. Amyloid precursor protein punctate accumulation, a marker of axonopathy, increased in ipsilateral subcortical white matter by 132 ± 71% after LR resuscitation, whereas the changes after 10 ml/kg (36 ± 41%) and 20 ml/kg (26 ± 15%) PNPH resuscitation were not significantly different from controls. The number of cortical neuron long dendrites enriched in microtubules (length >50 microns) decreased in neocortex by 41 ± 24% after LR resuscitation but was not significantly changed after PNPH resuscitation. The perilesion microglia density increased by 45 ± 24% after LR resuscitation but was unchanged after 20 ml/kg PNPH resuscitation (4 ± 18%). Furthermore, the number with an activated morphology was attenuated by 30 ± 10%. In TBI pigs without HS followed 2 h later by infusion of 10 ml/kg LR or PNPH, PNPH remained neuroprotective. These results in a gyrencephalic brain show that resuscitation from TBI + HS with PNPH protects neocortical gray matter, including dendritic microstructure, and white matter axons and myelin. This neuroprotective effect persists with TBI alone, indicating brain-targeting benefits independent of blood pressure restoration.

36896344

Return on investment from service transformation for young people experiencing mental health problems: Approach to economic evaluations in ACCESS Open Minds (Esprits ouverts), a multi-site pan-Canadian youth mental health project.

Mental health problems mon globally, and typically have their onset in adolescence and early adulthood-making youth (aged 11-25) an optimal target for prevention and early intervention efforts. While increasing numbers of youth mental health (YMH) initiatives are now underway, thus far few have been subject to economic evaluations. Here we describe an approach to determining the return on investment of YMH service transformation

36896345

Illegal drug use is associated with poorer life satisfaction and self-rated health (SRH) in young people.

Illegal drugs can bring negative health and psychological health consequences to people who use them. However, much less is known about illegal drug use and its association with life satisfaction and self-rated health (SRH) in young people in the context of the United Kingdom, which is important because SRH and life satisfaction are associated with important es including morbidity and mortality. By analyzing data from a nationally representative sample with 2,173 people who do not use drugs and 506 people who use illegal drugs aged between 16 and 22 (mean = 18.73 ± 1.61) years old from Understanding Society: the UK Household Longitudinal Study (UKHLS) using a train-and-test approach and one-sample

36896346

Probing the relevance of the accelerated aging mouse line SAMP8 as a model for certain types of neuropsychiatric symptoms in dementia.

People with dementia (PwD) often present with neuropsychiatric symptoms (NPS). NPS are of substantial burden to the patients, and current treatment options are unsatisfactory. Investigators searching for novel medications need animal models that present disease-relevant phenotypes and can be used for drug screening. The Senescence Accelerated Mouse-Prone 8 (SAMP8) strain shows an accelerated aging phenotype associated with neurodegeneration and cognitive decline. Its behavioural phenotype in relation to NPS has not yet been thoroughly investigated. Physical and verbal aggression in reaction to the external environment (e.g., interaction with the caregiver) is one of the most prevalent and debilitating NPS occurring in PwD. Reactive aggression can be studied in male mice using the Resident-Intruder (R-I) test. SAMP8 mice are known to be more aggressive than the Senescence Accelerated Mouse-Resistant 1 (SAMR1) control strain at specific ages, but the development of the aggressive phenotype over time, is still unknown.

36896347

Depression, anxiety, insomnia, stress, and the way of coping emotions as risk factors for ischemic stroke and their influence on stroke severity: A case-control study in Lebanon.

Stroke is a leading cause of disability and death worldwide. There are numerous debates regarding the relationship between depression, anxiety, insomnia, perceived stress, and ischemic stroke. Moreover, no research on the efficacy of emotion regulation, which is critical for ponents of healthy affective and social adaptability, is being conducted. To the best of our knowledge, this is the first study in the MENA region to shed light on the relationship between these conditions and stroke risk, aiming to determine whether depression, anxiety, insomnia, stress, and the way of coping with emotions may be risk factors for ischemic stroke occurrence and to further investigate the ability of two specific types of emotion regulation (cognitive reappraisal and expressive suppression) as possible moderators of the relationship between these psychological diseases and ischemic stroke risk. As a secondary objective, we sought to determine how these pre-existing conditions affect stroke severity levels.

36896348

The involvement of spontaneous brain activity in natural recovery from internet gaming disorder: A resting-state fMRI study.

Internet gaming disorder (IGD) can seriously impair an individual's physical and mental health. However, unlike the majority of those suffering from substance addiction, individuals with IGD may recover without any professional intervention. Understanding the brain mechanisms of natural recovery from IGD may provide new insight into how to prevent addiction and implement more targeted interventions.

36896349

Passive and active suicidal ideation in a population-based sample of older adults: Associations with polygenic risk scores of relevance for suicidal behavior.

There are few studies investigating genetic factors related to suicidal ideation or behavior in older adult populations. Our aim was to test associations between passive and active suicidal ideation and polygenic risk scores (PRSs) for suicidality and other traits of relevance for suicidality in old age (i.e. depression, neuroticism, loneliness, Alzheimer's disease, cognitive performance, educational attainment, and several specified vascular diseases) in a population-based sample aged 70 years and older.

36896350

Acupuncture ameliorates Mobile Phone Addiction with sleep disorders and restores salivary metabolites rhythm.

Mobile Phone Addiction (MPA) is a novel behavioral addiction resulting in circadian rhythm disorders that severely affect mental and physical health. The purpose of this study is to detect rhythmic salivary metabolites in MPA with sleep disorder (MPASD) subjects and investigate the effects of acupuncture.

36896351

Inhibition of matrix metalloproteinases by HIV-1 integrase strand transfer inhibitors.

More than fifteen million women with the human immunodeficiency virus type-1 (HIV-1) infection are of childbearing age world-wide. Due to improved and affordable access to antiretroviral therapy (ART), the number of

36896354

Nanogap traps for passive bacteria concentration and single-point confocal Raman spectroscopy.

A microfluidic device enabling the isolation and concentration of bacteria for analysis by confocal Raman spectroscopy is presented. The glass-on-silicon device employs a tapered chamber surrounded by a 500 nm gap that serves to concentrate cells at the chamber apex during sample perfusion. The sub-micrometer gap retains bacteria by size exclusion while allowing smaller contaminants to pass unimpeded. Concentrating bacteria within the fixed volume enables the use of single-point confocal Raman detection for the rapid acquisition of spectral signatures for bacteria identification. The technology is evaluated for the analysis of

36896352

RUNX2 and ALP expression in osteoblast cells exposed by PMMA-HAp combination: An in vitro study.

To observe the expression of Runt-Related Transcription Factors 2 (RUNX2) and Alkaline Phosphatase (ALP) markers in osteoblast cell cultures exposed to Polymethylmethacrylate bined with hydroxyapatite (HAp) material to improve osteointegration of bone implants.

36896355

On-chip dielectrophoretic device for cancer cell manipulation: A numerical and artificial neural network study.

Breast cancer, as one of the most frequent types of cancer in women, imposes large financial and human losses annually. MCF-7, a well-known cell line isolated from the breast tissue of cancer patients, is usually used in breast cancer research. Microfluidics is a newly established technique that provides many benefits, such as sample volume reduction, high-resolution operations, and multiple parallel analyses for various cell studies. This numerical study presents a novel microfluidic chip for the separation of MCF-7 cells from other blood cells, considering the effect of dielectrophoretic force. An artificial neural network, a novel tool for pattern recognition and data prediction, is implemented in this research. To prevent hyperthermia in cells, the temperature should not exceed 35 °C. In the first part, the effect of flow rate and applied voltage on the separation time, focusing efficiency, and maximum temperature of the field is investigated. The results denote that the separation time is affected by both the input parameters inversely, whereas the two remaining parameters increase with the input voltage and decrease with the sheath flow rate. A maximum focusing efficiency of 81% is achieved with a purity of 100% for a flow rate of

36896353

Comparative evaluation of hemispheric and masticatory laterality in complete dentures with two occlusal schemes - A prospective cohort study.

The lateralization can influence the choice of occlusion scheme, fort and success of the prosthesis. The existence of favored masticatory side plete denture patients and its influence with various occlusal schemes is less analyzed in the literature. The study objective was pare the masticatory and hemispheric laterality plete denture subjects rehabilitated with 2 different occlusal schemes at different time intervals.

36896356

ISCCM Guidelines on Acute Kidney Injury and Renal Replacement Therapy.

Acute kidney injury (AKI) is plex syndrome with a high incidence and considerable morbidity in critically ill patients. Renal replacement therapy (RRT) remains the mainstay of treatment for AKI. There are at present multiple disparities in uniform definition, diagnosis, and prevention of AKI and timing of initiation, mode, optimal dose, and discontinuation of RRT that need to be addressed. The Indian Society of Critical Care Medicine (ISCCM) AKI and RRT guidelines aim to address the clinical issues pertaining to AKI and practices to be followed for RRT, which will aid the clinicians in their day-to-day management of ICU patients with AKI.

36896359

ISCCM Guidelines for Hemodynamic Monitoring in the Critically Ill.

Hemodynamic assessment along with continuous monitoring and appropriate therapy forms an integral part of management of critically ill patients with acute circulatory failure. In India, the infrastructure in ICUs varies from very basic facilities in smaller towns and semi-urban areas, to world-class, cutting-edge technology in corporate hospitals, in metropolitan cities. Surveys and studies from India suggest a wide variation in clinical practices due to possible lack of awareness, expertise, high costs, and lack of availability of advanced hemodynamic monitoring devices. We, therefore, on behalf of the Indian Society of Critical Care Medicine (ISCCM), formulated these evidence-based guidelines for optimal use of various hemodynamic monitoring modalities keeping in mind the resource-limited settings and the specific needs of our patients. When enough evidence was not ing, we have made mendations after achieving consensus amongst members. Careful integration of clinical assessment and critical information obtained from laboratory data and monitoring devices should help in improving es of our patients.

36896361

Recommendations for Evaluation and Selection of Deceased Organ Donor: Position Statement of ISCCM.

There is a wide gap between patients who need transplants and the organs that are available in India. Extending the standard donation criterion is certainly important to address the scarcity of organs for transplantation. Intensivists play a major role in the success of deceased donor organ transplants. mendations for deceased donor organ evaluation are not discussed in most intensive care guidelines. The purpose of this position statement is to establish current evidence-based mendations for multiprofessional critical care staff in the evaluation, assessment, and selection of potential organ donors. These mendations will give "real-world" criteria that are acceptable in the Indian context. The aim of this set of mendations is to both increase the number and enhance the quality of transplantable organs.

36896362

Renal Replacement Therapy in Adult Intensive Care Unit: An ISCCM Expert Panel Practice Recommendation.

Acute kidney injury (AKI) contributes significantly to morbidity and mortality in ICU patients. The cause of AKI may be multifactorial and the management strategies focus primarily on the prevention of AKI along with optimization of hemodynamics. However, those who do not respond to medical management may require renal replacement therapy (RRT). The various options include intermittent and continuous therapies. Continuous therapy is preferred in hemodynamically unstable patients requiring moderate to high dose vasoactive drugs. A multidisciplinary approach is advocated in the management of critically ill patients with multi-organ dysfunction in ICU. However, an intensivist is a primary physician involved in life-saving interventions and key decisions. This RRT practice mendation has been made after appropriate discussion with intensivists and nephrologists representing diversified critical care practices in Indian ICUs. The basic aim of this document is to optimize renal replacement practices (initiation and management) with the help of trained intensivists in the management of AKI patients effectively and promptly. The mendations represent opinions and practice patterns and are not based solely on evidence or a systematic literature review. However, various existing guidelines and literature have been reviewed to support the mendations. A trained intensivist must be involved in the management of AKI patients in ICU at all levels of care, including identifying a patient requiring RRT, writing a prescription and its modification as per the patient's metabolic need, and discontinuation of therapy on renal recovery. Nevertheless, the involvement of the nephrology team in AKI management is paramount. Appropriate documentation is strongly mended not only to ensure quality assurance but also to help future research as well.

36896363

Indian Society of Critical Care Medicine Consensus Statement for Prevention of Venous Thromboembolism in the Critical Care Unit.

Deep vein thrombosis (DVT) is a plication of critical illness, and this guideline aims to convey a pragmatic approach to the problem. Guidelines have multiplied over the last decade, and their utility has e increasingly conflicted as the reader interprets all suggestions or mendations as something that must be followed. The nuances of grade of mendation vs level of evidence are often ignored, and the difference between a "we suggest" vs a "we mend" is overlooked. There is a general unease among clinicians that failure to follow the guidelines translates to poor medical practice and legal culpability. We attempt to e these limitations by highlighting ambiguity when it occurs and refraining from dogmatic mendations in the absence of robust evidence. Readers and practitioners may find the lack of specific mendations unsatisfactory, but we believe that true ambiguity is better than inaccurate certainty. We have attempted ply with the guidelines on how to create guidelines.

36896364

Associations between health problems and athlete burnout: a cohort study in 210 adolescent elite athletes.

We studied associations between the burden of health problems and athlete burnout in a population of athletes from Norwegian Sport Academy High Schools.

36896365

Eating behaviours, menstrual history and the athletic career: a retrospective survey from adolescence to adulthood in female endurance athletes.

To evaluate differences in menstrual and pubertal history and trends in eating behaviours among women with and without petitive sports background. Additionally, we investigated if menstrual history and eating behaviours are associated with sports career-related factors.

36896366

Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial.

To investigate the effects of 4 months of customised, home-based exergaming on physical function and pain after total knee replacement pared with standard exercise protocol.

36896367

Statin-Induced Immune-Mediated Necrotizing Myopathy Resulting in Proximal Muscle Weakness.

Statin-induced immune-mediated necrotizing myopathy (IMNM) is a subtype of IMNM linked to exposure to statins and is characterized by positive anti-hydroxymethylglutaryl (HMG) coenzyme A reductase (HMGCR) antibodies. Although rare, this entity has e increasingly recognized as a cause of proximal muscle weakness, especially with the widespread use of statin therapy. Unlike typical statin-associated muscle symptoms, IMNM myopathy often causes severe muscle injury, and muscle weakness persists or sometimes worsens following the withdrawal of statin therapy. Medical practitioners need to keep a high index of clinical suspicion for statin-induced IMNM in patients taking statins who present with muscle weakness. The disease can be debilitating, and treatment strategies are not well established despite the advances that have been made in the diagnosis. Here we present the clinical characteristics and disease course of two cases of statin-induced IMNM. Both patients presented with progressive proximal muscle weakness and myalgias while on long-term statin therapy without significant improvement in their symptoms following the withdrawal of statin therapy. IMNM was suspected, and both patients were found to have high titers of anti-HMG coenzyme A reductase antibodies and demonstrated microscopic features consistent with a diagnosis of IMNM on muscle biopsy. The patients experienced significant disability due to muscle weakness and required a protracted course of escalated immunosuppressive therapy. Although rare, IMNM should be suspected in patients taking statins who present with muscle weakness that fails to improve or worsens when statins were stopped. Early diagnosis and institution of immunosuppressive therapy are important to prevent the progression of the disease.

36896368

Left Main Coronary Artery Aneurysm With Rare Quadfurcation Anatomy.

Coronary artery aneurysms (CAAs) are found in a small percentage of coronary angiograms, with left main coronary artery (LMCA) aneurysms being the mon. We present a 63-year-old male patient with a history of chest pain and an abnormal nuclear stress test. Cardiac catheterization showed a large LMCA aneurysm with unusual quadfurcation left main (LM) anatomy, but otherwise showed no evidence of obstructive coronary artery disease. The patient remained clinically stable, and a repeat cardiac catheterization 2 years later showed unchanged coronary anatomy. Further medical management with close observation was elected. This case illustrates that in select cases, large LMCA aneurysms can be successfully managed medically without surgical or percutaneous interventions. To our knowledge, this is the first report of LMCA aneurysm with quadfurcation anatomy. In addition to the case description, a review of the literature is provided.