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Agentic Health, Inc. 3

https://www.semanticscholar.org/paper/954f85c9690f53a9ea57caf3503ee631b492c5ce

Association between localized retinal nerve fiber layer defects in nonglaucomatous eyes and metabolic syndrome: a propensity score-matched analysis

Annals of Translational Medicine

15a12adf-61c6-4c5f-9edc-675b2ee2f6e2

Association between localized retinal nerve fiber layer defects in nonglaucomatous eyes and metabolic syndrome: a propensity score-matched analysis Background We investigated the association between metabolic syndrome and localized retinal nerve fiber layer (RNFL) defects in nonglaucomatous subjects. Methods We examined 20,385 adults who visited the Health Promotion Center of Seoul St. Mary’s Hospital between May 2015 and April 2016. After excluding those with known glaucoma or glaucomatous optic discs, subjects with and without localized RNFL defects were 1:5 propensity score matched. Metabolic syndrome components, including central obesity, elevated triglyceride, reduced high-density lipoprotein (HDL) cholesterol, elevated blood pressure (BP), and elevated fasting glucose, were compared between two groups. We performed logistic regression to investigate the association between RNFL defects and each component of metabolic syndrome and the number of metabolic syndrome components. Results Subjects with RNFL defects showed higher waist-to-hip ratios, systolic BP (SBP) and diastolic BP (DBP), fasting blood glucose, and hemoglobin A1c (HbA1c) levels than did those without RNFL defects both before and after propensity score matching. The number of metabolic syndrome components was significantly greater in those with RNFL defects (1.66±1.35) than in those without (1.27±1.32, P<0.01). In multivariate logistic regression, the odds ratio (OR) of RNFL defects was significantly increased in subjects with central obesity , elevated BP (OR =1.50, 95% CI: 1.09–2.05), and an elevated fasting glucose level (OR =1.42, 95% CI: 1.03–1.97). An increased number of metabolic syndrome components was associated with a higher risk of RNFL defects. Conclusions Localized RNFL defects in nonglaucomatous subjects are associated with metabolic syndrome components, including central obesity, elevated BP, and an elevated fasting glucose level, suggesting that comorbid metabolic syndrome should be considered when evaluating subjects with RNFL defects.

https://www.semanticscholar.org/paper/f61bedb3a2921231f9d68293c6c5761af8341193

Screening for Lyme Disease with C6 Peptide at a Veterans Hospital in Long Island, NY

Open Forum Infectious Diseases

f20432ac-3c14-4779-bc66-2f24e1b2715e

Screening for Lyme Disease with C6 Peptide at a Veterans Hospital in Long Island, NY Abstract Background Lyme Disease (LD) is an endemic disease in Long Island, NY caused by Borrelia burgdorferi. The CDC recommends a two tier system for diagnosis of LD, a screening immunoassay followed by confirmatory Western Blot (WB). The C6 peptide (C6P) is a very sensitive screening test for LD and is currently used as the standard method of screening for LD at the Northport Veteran Affairs Hospital. Methods A retrospective review of all C6P testing was conducted during the periods of 1/1/2010 to 12/31/2016. A total of 2558 C6P tests were performed at the Northport VA Medical Center. Patients with either positive or equivocal assays were then divided into Lyme Positive (LP) or Lyme Negative (LN) groups. Lyme positive was defined as either having an erythema migrans rash, 2 or more IgM bands or 5 or more IgG bands. Results Out of the 409 C6P tests which were evaluated with a follow up western blot, 181 patients were considered LP and 228 were LN. These two groups are similar in age, gender and race. Results summarized in Table 1 and frequency of Western Blot bands were plotted in figure 1. Six of the LP patients were coinfected with babesia and 1 patient coinfected with anaplasma. Conclusion A positive tick bite history, headaches, and joint swelling /aches (P 30d 29 16.0 18 7.9 Tick Bite history 63 34.8 28.00 12.3 0.00001 Signs andSymptoms EM rash 32 17.7 0 0.0 Headaches/neck ache 27 14.9 19 8.3 0.036 Joint Ache/Swelling 58 32.0 47 20.6 0.0086 Bell’s Palsy 5 2.8 4 1.8 0.49 Myalgias 34 18.8 17 7.5 0.00057 Palpitations 2 1.1 0 0.0 Disclosures All authors: No reported disclosures.

https://www.semanticscholar.org/paper/b7e44c372efab90be03ac96dd55bd7863cdb621c

Mastering Emergency Medicine: A Practical Guide. 1st Edition

Ulster medical journal

aa6d27d0-f046-4ee6-af2c-460c46a888d0

Mastering Emergency Medicine: A Practical Guide. 1st Edition the place of PGD in late-onset disorders is highlighted. Its controversial role is explored with reference to parents of children needing haematopoietic stem cell transplants who are trying to ensure that their next child is free of disease or indeed are trying to provide a good tissue match for an existing sick child. Excellent up-to-date accounts are given of clinical practice in endometriosis, recurrent miscarriage and post-menopausal bleeding. Moreover, the historical practice of ovarian surgery for polycystic ovarian syndrome is reexamined with the benefits of laparoscopy. Two thirds of women can ovulate after ovarian surgery with half conceiving within twelve months. However, women with raised BMI or infertility lasting greater than three years appear to be resistant to surgery. The role of insulin resistance in polycystic ovarian syndrome is afforded a further detailed chapter for those with an academic interest. Of particular note is the concise but highly relevant chapter on Risk Management. This chapter gives a synopsis of all the buzzwords commonly used in this topic. It provides a useful framework for a subject which encompasses an extensive array of theories, thus enabling the reader to form a basis upon which to question preventable errors in medicine. In conclusion, the eighteen chapters are presented in an accessible and easy to read format, which are all well referenced. Each topic incorporates a comprehensive overview, which emphasises the salient points of interest and, just as importantly, highlights areas that remain ambiguous, making this a very user-friendly aid for both busy clinicians and those sitting RCOG membership examinations. In all, this is a bookcase essential for all grades within the speciality. dr david glenn gEt through first frcr: mcQs for thE physics moduLE. This book is part of the Royal Society of Medicine Press " Get Through … " series aimed at doctors in training. It's a pocket size book of multiple choice questions with answers and a mock examination at the end to test yourself. The First Part FRCR exam has gone through some renovation recently so this book is timely and comprehensive. It is written by three specialist registrars in Radiology (all passed their exam first time) and edited by Jerry Williams, Head of Radiological Physics Training for South East Scotland. The book will appeal to trainee radiologists who are sitting their FRCR part 1 exam, lecturers in Physics for Radiologists and also Radiology tutors. After a contents page and …

https://www.semanticscholar.org/paper/eb9918b746faf2c42c2e7d47801f190dd2e7dc8c

Endocarditis

The Hospital

965d752e-3d99-47a6-bf0f-de96ba26b1f3

Endocarditis on the temperature in this disease. In the diagnosis of endocarditis the thermometer is of as much use, or even of more use than the stethoscope. But it is not enough to take the temperature at long intervals, and especially it is not enough to take it at one fixed time every day. "What happens in endocarditis is that the temperature runs up occasionally for short periods, so that the curve may be very apparent in a four-hour chart, but may not show at all on an ordinai'j daily chart. Endocarditis may occur from various causes, and

https://www.semanticscholar.org/paper/1bd861b9f7097d2d954903d8650bd2081ea41934

The Stomach, Intestines and Pancreas

The Indian medical gazette

7bc8c601-4efa-400f-972e-164343190429

The Stomach, Intestines and Pancreas This book is intended for both physicians and surgeons. It bears out the general idea of the Editor that "the dividing line between their respective provinces is every where purely arbitrary, and in no department is their ready cooperation more necessary than in that of diseases of the digestive tract." It is printed in a clear large type and the book is not a large one. The various diseases are briefly discussed and the views on them are dogmatic?the size of the

https://www.semanticscholar.org/paper/4d644a1ad110a05320dfce9e851de56a11962d5d

Madness Or—What? III.—The Kings of Spain

The Hospital

965d752e-3d99-47a6-bf0f-de96ba26b1f3

Madness Or—What? III.—The Kings of Spain i'OND parents shed tears when the spoiled and petted son of their hopes marries, as they say, beneath him. Cautious and avaricious parents wish him to marry the heiress cousin, " keep the money in the family." Even the most complaisant and amiable parents wonder at his marrying a girl " with not a single taste in common with him." Hardly any father, one might say not a single mother, can see anything but misery in the choice the boy makes of a girl whose characteristics, physical and mental, are the very opposite of his own. But nature is wiser than the wisest parents, and guides the hearts of men and maidens to such union as will preserve a wholesome balance of

https://www.semanticscholar.org/paper/360573e52f3e4940ddc701420cd599e49daffb37

Air Pollution and Neonatal Blood Pressure: Examining Earlier Exposures

Environmental Health Perspectives

74dbb751-54d9-4be5-baa6-52a5e58ea8dd

Air Pollution and Neonatal Blood Pressure: Examining Earlier Exposures Ambient air pollution has been associated in some studies (but not all) with increased blood pressure in adults1 and children.2,3 A study in this issue of EHP examines even earlier exposures during gestation, an important period of cardiovascular growth and development.4 The results show a small but significant increase in newborn systolic blood pressure associated with exposure in the third trimester to black carbon (BC) and, to a lesser extent, fine particulate matter (PM2.5).

https://www.semanticscholar.org/paper/759c902a32d9350419d1542e663e4c5fb8e34c81

Characterization analysis of Rongchang pig population based on the Zhongxin-1 Porcine Breeding Array PLUS

Animal bioscience

22eee258-d7eb-4d09-94b2-3049bca00b3b

Characterization analysis of Rongchang pig population based on the Zhongxin-1 Porcine Breeding Array PLUS Objective To carry out a comprehensive production planning of the existing Rongchang pig population from both environmental and genetic aspects, and to establish a closed population with stable genetic diversity and strict pathogen control, it is necessary to fully understand the genetic background of the population. Methods We genotyped 54 specific pathogen free (SPF) Rongchang pigs using the Zhongxin-1 Porcine Breeding Array PLUS, calculated their genetic diversity parameters and constructed their families. In addition, we also counted the runs of homozygosity (ROH) of each individual and calculated the value of inbreeding coefficient based on ROH for each individual. Results Firstly, the results of genetic diversity analysis showed that the effective population size (Ne) of this population was 3.2, proportion of polymorphic markers (PN) was 0.515, desired heterozygosity (He) and observed heterozygosity (Ho) were 0.315 and 0.335. Ho was higher than He, indicating that the heterozygosity of all the selected loci was high. Secondly, combining the results of genomic relatedness analysis and cluster analysis, it was found that the existing Rongchang pig population could be divided into four families. Finally, we also counted the ROH of each individual and calculated the inbreeding coefficient value accordingly, whose mean value was 0.09. Conclusion Due to the limitation of population size and other factors, the genetic diversity of this Rongchang pig population is low. The results of this study can provide basic data to support the development of Rongchang pig breeding program, the establishment of SPF Rongchang pig closed herd and its experimental utilization.

https://www.semanticscholar.org/paper/3286e1dda990f9cdccc0cfea11b7e5f804dadd89

Protecting Science from Abuse Requires a Broader Form of Outreach

PLoS Biology

83ff973b-8a0e-4e00-a06a-2cfd9e222de9

Protecting Science from Abuse Requires a Broader Form of Outreach Students and postdocs at Stanford University have formed an organization dedicated to promoting the use of sound science in policymaking: scienceinpolicy.org.

https://www.semanticscholar.org/paper/aa377eaa2f4a538dd77bd2a8712e2aaa8d5bbf92

Use and validation of mirrorless digital single light reflex camera for recording of vitreoretinal surgeries in high definition

Indian Journal of Ophthalmology

2bbc1e45-4074-471d-b003-2c8f5a99cdb0

Use and validation of mirrorless digital single light reflex camera for recording of vitreoretinal surgeries in high definition Purpose: The purpose of this study is to describe the use of commercial digital single light reflex (DSLR) for vitreoretinal surgery recording and compare it to standard 3-chip charged coupling device (CCD) camera. Methods: Simultaneous recording was done using Sony A7s2 camera and Sony high-definition 3-chip camera attached to each side of the microscope. The videos recorded from both the camera systems were edited and sequences of similar time frames were selected. Three sequences that selected for evaluation were (a) anterior segment surgery, (b) surgery under direct viewing system, and (c) surgery under indirect wide-angle viewing system. The videos of each sequence were evaluated and rated on a scale of 0-10 for color, contrast, and overall quality Results: Most results were rated either 8/10 or 9/10 for both the cameras. A noninferiority analysis by comparing mean scores of DSLR camera versus CCD camera was performed and P values were obtained. The mean scores of the two cameras were comparable for each other on all parameters assessed in the different videos except of color and contrast in posterior pole view and color on wide-angle view, which were rated significantly higher (better) in DSLR camera. Conclusion: Commercial DSLRs are an affordable low-cost alternative for vitreoretinal surgery recording and may be used for documentation and teaching.

https://www.semanticscholar.org/paper/31c2c087618d7483ca50a2d1ad70b0cac5ec240b

Correction: Jessri, M.; et al. Assessing the Nutritional Quality of Diets of Canadian Adults Using the 2014 Health Canada Surveillance Tool Tier System. Nutrients 2015, 7, 5543

Nutrients

3416dd37-f45d-40ed-b04e-875fcff8fa2f

Correction: Jessri, M.; et al. Assessing the Nutritional Quality of Diets of Canadian Adults Using the 2014 Health Canada Surveillance Tool Tier System. Nutrients 2015, 7, 5543 Due to a mistake in the publication process, "NS" symbols are missing from Figure 3 from this article ..

https://www.semanticscholar.org/paper/8c4f296ff4556e957a12245023910edc9c1d6320

Dr. J. Patterson Cassells

Glasgow medical journal

cd716251-f81d-4522-b18d-326a397023cd

Dr. J. Patterson Cassells contributed frequently on subjects connected with diseases of the ear. His latest work, the translation of Politzer's work on this subject, was favourably noticed in these pages. Dr. Cassells was a hard working and careful practitioner of the specialty to which he devoted himself; and he did much to bring this specialty before the profession in Glasgow. We believe that he was induced to adopt this department of surgery from the peculiar infirmity from which he suffered for many years, and which finally compelled him to give up practice. This he did about a year ago, and he has since then lived in retirement. Dying at a comparatively early age, he has left a record of much careful and useful

https://www.semanticscholar.org/paper/586b0a237655944838653977647fa392dbba70ed

Carbon reduction and water saving potentials for growing corrugated boxes for express delivery services in China

Proceedings of the National Academy of Sciences of the United States of America

bb95bf2e-8383-4748-bf9d-d6906d091085

Carbon reduction and water saving potentials for growing corrugated boxes for express delivery services in China Significance Courier over-packaging and disposal are causing serious environmental issues. Eighty percent of global express delivery growth happened in China, where the corrugated packaging demand increased 90-fold during the past decade. However, the existing knowledge on environmental impacts of producing and consuming corrugated boxes is confined to only life-cycle carbon emissions at 1-y snapshot. Facing the changing global supply chains of water-intensive raw materials and increasing rate of packaging recycling, here we estimate the inter-annual trends and drivers in cradle-to-grave life-cycle carbon emissions, water quantity and quality appropriation of corrugated boxes used in China over 2007-2021, as well as mitigation potentials for 2035. The results provide key information towards green express delivery industries in both China and the globe.

https://www.semanticscholar.org/paper/0999a0150e04d12879c4441914b3f14ed9225368

SAT-321 Bilateral Cortical Sparing Adrenalectomy For Treatment Of Pheochromocytoma In A MEN2-a Mutation Carrier: 19 Year Follow-up

Journal of the Endocrine Society

ccbeb193-d73e-4c27-9e78-65553fb9c08a

SAT-321 Bilateral Cortical Sparing Adrenalectomy For Treatment Of Pheochromocytoma In A MEN2-a Mutation Carrier: 19 Year Follow-up Abstract Background: cortical sparing adrenalectomy is rarely proposed for the treatment of bilateral pheochromocytomas. We describe the longest reported follow-up of this approach in a MEN2-A mutation carrier woman. Clinical case: a 27-year-old woman was referred with a 2-year history of hypertensive crisis, headache, tachycardia, diaphoresis, hot flushes, dyspnea, chest pain, weight loss, and polyuria. Pheochromocytoma was suspected and abdominal CT scan showed a 6 x 5 cm heterogeneous expansive lesion with a central hypodense area in the right adrenal and the left adrenal was lobulated and slightly increased in size, showing a heterogeneous contrast enhancement. 24h-urinary fractionated catecholamines were: norepinephrine 1920 ng/min (n<50 ng/min), epinephrine 386.7 ng/min (n<10 ng/min) and dopamine 1740 ng/min (n<400 ng/min), and the diagnosis of pheocromocytoma was confirmed. She had also medullary thyroid carcinoma, primary hyperparathyroidism and cutaneous lichen amyloidosis and genetic testing for MEN2A has found a C634R mutation in exon 11 of RET proto-oncogene. A bilateral cortical sparing adrenalectomy was proposed aiming to preserve cortical adrenal function. The patient was successfully operated on October/1999 by an open anterior approach. On the first postoperative day her serum cortisol levels were normal. During the post-operative period she developed a surgical site infection and an extensive nosocomial pneumonia that were treated with antibiotics, with no need for gluco- or mineralocorticoid replacement.  Subsequently, the patient was regularly followed-up, was asymptomatic, but with sustained hypertension, successfully treated with enalapril monotherapy. For eleven years she had normal urinary metanephrines and abdominal CT scans without signs of pheocromocytoma recurrence and had a successful pregnancy in 2005. In 2010, urinary normetanephrines increased (1.2-1.5 times the upper limit of normal), and the abdominal CT revealed bilateral nodules in the residual adrenals. After discussing therapeutic options with the patient, a decision to maintain clinical follow-up was made. From 2010 until 2015 urinary metanephrines were back to normal range. In 2016, urinary normetanephrines increased again (1.99 times the upper limit of normal), results that were confirmed thereafter, ranging from 2.94 – 4.31 times the normal range. The patient had a transient ischemic attack due to right vertebral artery dissection in 2014. Current abdominal CT reveals bilateral enlargement of the previously described nodules, which has made our team to propose a new bilateral adrenalectomy. Conclusion: this case illustrates the feasibility of cortical sparing surgery in the long-term preservation of adrenocortical function, avoiding the potential risks associated with adrenal insufficiency, and could be considered as a first-line treatment approach.

https://www.semanticscholar.org/paper/1808effcd5ec3076ab6d91f62bf0b625c7c8e5d6

Activation of CGRP receptor–mediated signaling promotes tendon-bone healing

Science Advances

cb30f0c9-2980-4b7d-bbcb-68fc5472b97c

Activation of CGRP receptor–mediated signaling promotes tendon-bone healing Calcitonin gene-related peptide (CGRP), an osteopromotive neurotransmitter with a short half-life, shows increase while calcitonin receptor-like (CALCRL) level is decreased at the early stage in bone fractures. Therefore, the activation of CALCRL-mediated signaling may be more critical to promote the tendon-bone healing. We found CGRP enhanced osteogenic differentiation of BMSCs through PKA/CREB/JUNB pathway, contributing to improved sonic hedgehog (SHH) expression, which was verified at the tendon-bone interface (TBI) in the mice with Calcrl overexpression. The osteoblast-derived SHH and slit guidance ligand 3 were reported to favor nerve regeneration and type H (CD31hiEMCNhi) vessel formation, respectively. Encouragingly, the activation or inactivation of CALCRL-mediated signaling significantly increased or decreased intensity of type H vessel and nerve fiber at the TBI, respectively. Simultaneously, improved gait characteristics and biomechanical performance were observed in the Calcrl overexpression group. Together, the gene therapy targeting CGRP receptor may be a therapeutic strategy in sports medicine.

https://www.semanticscholar.org/paper/9ee4968748c2cc0c1d0281cdb1452493e92fc5f8

HOME-DELIVERED MEAL DELIVERIES AND FEELINGS OF SAFETY FOR OLDER AMERICANS ACT PARTICIPANTS

Innovation in aging

6d6a372b-cc95-4ba3-85d8-165d6d96da48

HOME-DELIVERED MEAL DELIVERIES AND FEELINGS OF SAFETY FOR OLDER AMERICANS ACT PARTICIPANTS Abstract Home-delivered meals supported by the Older Americans Act (OAA) serve a dual purpose of improving nutritional intake and providing regular social contact for older adults. This regular contact can increase feelings of safety experienced by meal recipients. The benefits of home-delivered meal services may vary between meal recipients based on sociodemographic characteristics. Variation in home-delivered meal clients’ reports of feeling safer at home because of regular meal delivery visits was examined to support ongoing efforts to increase social engagement and equity through the delivery of OAA services. Using data from the 2019 National Survey of Older Americans Act Participants (NSOAAP) home-delivered meal module, descriptive statistics and logistic regression were conducted to identify the characteristics associated with feeling safer at home because of meal delivery visits. The majority (85%) of meal recipients report feeling safer because of meal delivery visits, and rates were especially high for rural recipients (92%), those with a high school education or less (89%),racial/ethnic minorities (94%), and those with three or more ADL limitations (90%). Logistic regression found that rural residence (OR=3.3), lower educational attainment (OR=2.0), racial/ethnic minority status (OR=4.7), living alone (OR=1.6), and having 3+ ADLs (OR=1.9) were significantly associated with higher odds of feeling safer at home because of meal delivery visits; however, age, gender, and suburban residence were not significant. Findings suggest that benefits of home-delivered meal programs are supporting the needs of traditionally disadvantaged groups and broadly increasing meal recipients’ sense of safety in their homes.

https://www.semanticscholar.org/paper/a98cb12031a3a63827a1e4495be48a51ce0d242e

Corrigendum to “Topical Colchicine Gel versus Diclofenac Sodium Gel for the Treatment of Actinic Keratoses: A Randomized, Double-Blind Study”

Advances in Medicine

34d6f8f9-190d-4cdb-b783-d1ced58e5e51

Corrigendum to “Topical Colchicine Gel versus Diclofenac Sodium Gel for the Treatment of Actinic Keratoses: A Randomized, Double-Blind Study” .

https://www.semanticscholar.org/paper/fd77d883e7ea0a543f7bb39982485979481066b6

Structure‐Function Relationships of Microcystins, Liver Tumor Promoters, in Interaction with Protein Phosphatase

Japanese journal of cancer research : Gann

Structure‐Function Relationships of Microcystins, Liver Tumor Promoters, in Interaction with Protein Phosphatase Microcystins, isolated from toxic blue‐green algae, are potent inhibitors of protein phosphatases 1 and 2A. Recently, we have reported that mierocystin LR has a potent tumor‐promoting activity on rat liver initiated with diethylnitrosamine. The structure of microcystins is unique in having an unusual ammo acid, 3‐amino‐9‐methoxy‐10‐phenyl‐2,6,8‐trimethyl‐deca‐4(E),6(E)‐dienoic acid (Adda), which is thought to be significant for the activity. Geometrical isomers at C‐7 in the Adda portion of microcystins, 6(Z)‐Adda microcystins LR and RR, have been isolated from cyanohacteria. To estimate their tumor‐promoting activities and to understand the importance of the Adda portion for activity, the maternal microcystins LR and RR and their isomers were subjected to examination of their interaction with protein phosphatases 1 and 2A and the release of glutamic pyruvic transaminase from rat liver. 6(Z)‐Adda microcystins LR and RR bound to protein phosphatases 1 and 2A, inhibited their activities and released glutamic pyruvic transaminase from rat liver into serum, ten to one hundred times more weakly than the maternal microcystins LR and RR. These results indicated that the conjugated diene with 4(E),6(E) geometry in the Adda portion is important in the interaction with protein phosphatases.

https://www.semanticscholar.org/paper/546b0fbfabc2617c77a237fdce4b20506b78e73d

Museum of Morbid Anatomy at Fort Pitt

Edinburgh medical journal

befe79e7-4edb-4281-9c6b-d16dbe123330

Museum of Morbid Anatomy at Fort Pitt , +n tlio 56th number ot the Edinburgh Medical Journal Sir,?My attention lias been . , on tjie authority of Dr Williamson, that Sir James for February 18G0, 111 which 1 ilosnitals at Portsmouth?originated and promoted Macgregor, in 1810 then Inspe , anat0my for the use of the medical officers of the the idea of forming a collection o , in ^810, when Director-General of the Army royal army ; and that, although ne _c, promote this invaluable object, yet little Medical Department, and made van conclusion of the war, when the infant was done to augment the collection unt nhelsea, to Chatham. transferred from York Hospital, at museum was it you will talie the trouDie to reier to mo -j .

https://www.semanticscholar.org/paper/d857575ccbcd9569c3e1f61912a4ee185b274a01

Handbook on Leprosy

The Indian medical gazette

7bc8c601-4efa-400f-972e-164343190429

Handbook on Leprosy The book deals' only with the practical aspects of the disease; the first part consists of an account of the diagnosis, the second describes the modern methods of treatment, and the third gives some excellent suggestions for the prevention of leprosy. By strictly limiting the scope of the book Dr.. Muir has managed to condense into a small and inexpensive volume all that the medical man needs to know about leprosy. The treatment recommended is on the well-

https://www.semanticscholar.org/paper/2c9a3a9cbc0120e9e76be59808f326b24c3702af

Polymer Semiconductors: Phthalimide‐Based High Mobility Polymer Semiconductors for Efficient Nonfullerene Solar Cells with Power Conversion Efficiencies over 13% (Adv. Sci. 2/2019)

Advancement of science

28927fa0-8dca-4082-a7d0-abd989c8ef12

Polymer Semiconductors: Phthalimide‐Based High Mobility Polymer Semiconductors for Efficient Nonfullerene Solar Cells with Power Conversion Efficiencies over 13% (Adv. Sci. 2/2019) In article number 1801743, Xugang Guo and co‐workers develop two phthalimide‐based polymers featuring a D‐A1‐D‐A2 backbone motif. Eliminating benzodithiophene leads to polymers with substantial mobility. Nonfullerene polymer solar cells utilizing these high‐mobility polymers achieve a remarkable power conversion efficiency >13%. The results demonstrate that phthalimides are excellent building blocks for enabling polymer semiconductors with outstanding solar cell performances and benzodithiophenes are not necessary for constructing such polymers.

https://www.semanticscholar.org/paper/425fd11b1cd0146d9adb0887c7dfdaafe4c4495d

AIDS TO GYNÆCOLOGY

Ulster medical journal

aa6d27d0-f046-4ee6-af2c-460c46a888d0

AIDS TO GYNÆCOLOGY THIS is a crusading novel by a former U.S. Army engineer and is concerned with a problem perhaps not so important here as in the United States, but one which the reviewer has encountered once. Laid in a technical college in Pasadena in 1930, it is concerned with a description of what happens when a self-appointed minister counsels against medical attention for the daughter of one of his followers, practises faith-healing and the girl dies from appendicitis. The legal anomaly against which the author protests is that the parent who denies the child medical aid can be punished, yet the pastor who counsels that denial goes free. In general, when an author writes a crusading novel, it is poorer literature than when he is less concerned to right the wrongs of mankind. Mr. Cawley's novel is not great literature, the characters do not come to life and the book, apart from a rapidly developing love affair between the narrator and the victim, a girl of 17 years, is concerned mainly with the illness of the girl and her brother, the stubborn faith of the widowed mother and the advice of her pastor. There can be no doubt that the book poses a problem. When those legally responsible for their own actions refuse medical treatment their conduct is sometimes most vexatious and that of their spiritual advisers may seem to be even more so. The children of persons so misguided excite our sympathy and sometimes our passions. Much discussion on this subject might, however, broaden the ethical problems concerned very considerably and emphasise the conflict between much accepted medical practice and the faith of millions. It is perhaps fortunate that here faith-healers are numerically few, and that, in serious illness, the resolution of their adherents is more liable to be shaken by the common sense and prejudice of their friends and neighbours than sustained by the ministrations of their pastors. 'IHIS book is written for pupil midwives and midwives, and the author, as chairman of the Central Midwives' Board and for many years as associate of the late Sir Comyns Berkeley, is the logical successor to carry on this popular handbook. Like most obstetric books for midwives, it errs in being too long and too detailed, and a valuable opportunity to prune the text and to bring into prominence the essentials of the subject has been lost. I'he midwife has a …

https://www.semanticscholar.org/paper/58e1867680b6dba155d24c066f964d0825cd2c8c

Serious Illness Communication in Cancer Care in Africa: A Scoping Review of Empirical Research

JCO Global Oncology

91b3b96d-ebfc-4fdb-b8fe-42cf87956da2

Serious Illness Communication in Cancer Care in Africa: A Scoping Review of Empirical Research PURPOSE Serious illness communication (SIC) in cancer care describes conversations between clinicians, patients, and families about prognosis and treatment decisions. Cultural context influences SIC. Researchers have studied SIC across diverse settings in Africa. We aimed to describe and synthesize the heterogeneous body of research on SIC practices, preferences, and needs in Africa to identify research and training priorities. METHODS Our search strategy identified studies that focused on SIC within cancer or palliative care in Africa. Following PRISMA guidelines, a systematic literature search was performed using PubMed, Embase, Web of Science, CINAHL, African Index Medicus, and PsycINFO, yielding 1811 unique titles. After sequential review of abstracts, full text, and cited references, 42 articles met inclusion criteria. Quantitative and qualitative data describing study characteristics, aims, methods, and findings were abstracted and analyzed using descriptive statistics and thematic analysis. Critical appraisal was performed using the Mixed Methods Appraisal Tool. RESULTS The 42 included articles were published from 1997-2021, half since 2017, representing 16 countries and all African Union regions: West (33%), East (29%), South (21%), North (12%), and Central (5%). Most study designs were qualitative (45%) or quantitative surveys (50%). Study participants included patients (35%), family caregivers (18%), doctors (18%), nurses (12%), and/or other (11%). Study aims focused on disclosure of diagnosis (27%) or prognosis (20%), breaking bad news (15%), general patient-clinician communication (12%), truth-telling (8%), shared decision-making (7%), information needs/preferences (5%), and/or advance care planning (5%). Despite diverse contexts, common themes emerged. Study authors frequently recommended communication skills training. Critical appraisal demonstrated high quality of studies overall. CONCLUSION Research on SIC in Africa has increased in recent years. Most studies have focused on information delivery by clinicians; fewer on eliciting information from patients (eg, shared decision-making, advanced care planning). Significant opportunities exist for further study and for communication skills training.

https://www.semanticscholar.org/paper/33a2851c0d8231f65b25fcf1c43077e0c482be32

390. Eravacycline combination therapy for severe, recurrent, or fulminant Clostridioides difficile infection

Open Forum Infectious Diseases

f20432ac-3c14-4779-bc66-2f24e1b2715e

390. Eravacycline combination therapy for severe, recurrent, or fulminant Clostridioides difficile infection Abstract Background Eravacycline (ERV) is a fluorocycline with in vitro activity against Clostridioides difficile infection (CDI). The purpose of this study was to evaluate the usage of ERV in the management of CDI. Methods IRB-approved, retrospective case series in a health system that added ERV to formulary in 9/2019. All patients between 9/2019 and 2/2020 treated with adjunctive ERV for > 24 hours for severe, recurrent, or fulminant CDI were included. Exclusion criteria: pregnant, age < 18 years. Primary outcome: all-cause mortality at 30 days (d) from start of ERV. Secondary outcomes: clinical cure, colectomy, and recurrence within 30 d. Data was reported using descriptive statistics and measures of central tendency. Results 14 patients included: severe (4, 29%), recurrent (4, 29%), and fulminant CDI (6, 43%) (table 1). Infectious diseases consult: 14/14, median time to consult 1 (1, 2) d. Surgery consult: 1 severe and 5 fulminant CDI cases, median time to consult 1 (1, 3) d. Prior to ERV initiation, 10 patients were on oral vancomycin (PO VAN) and intravenous metronidazole (IV MTZ), one was on PO VAN, two were on IV MTZ, and one was on no CDI therapy. After ERV was initiated, six patients were on ERV, PO VAN, and IV MTZ combination and eight patients were on ERV and PO VAN concurrently. The reason for using ERV was fulminant CDI (6, 42.8%), severe CDI (4, 29%), unable to tolerate other CDI medications (3, 21%), refractory CDI (3, 21%), and recurrent CDI (1, 7%). Time to eravacycline initiation 1.5 d (1, 3.75) with median duration of 6 d (4.5, 7.75). 30-day all-cause mortality 2 (14%), all were in-hospital; 1 (7%) hospice. Clinical cure occurred in 12 (86%). Two (14%) required colectomy; one received surgery on the same day of CDI diagnosis and ERV initiation and the other had surgery 4 days before ERV initiation. Two patients with recurrent CDI received fecal microbiota transplant outpatient, one of which also received bezlotoxumab. Zero recurrences and one readmission within 30 d. Table 1. Patient demographics, severity, and clinical outcomes Conclusion ERV appears to be a potential adjunctive therapy for severe, recurrent, or fulminant CDI. Prospective studies are needed to further investigate the safety and efficacy of ERV in serious CDI. Disclosures All Authors: No reported disclosures.

https://www.semanticscholar.org/paper/5b2623cdb78a7e35190d5ab60bd5bf7035c1c134

First case of human ehrlichiosis in Mexico.

Emerging Infectious Diseases

59a1832b-4bac-4b66-a0fc-1c8d201d95aa

First case of human ehrlichiosis in Mexico. To the Editor: Ehrlichiosis is a zoonotic disease transmitted to humans through the bite of infected ticks (1). The first recognized human ehrlichial infection, Sennetsu fever, was described in Japan in 1954 (2). The first case of human ehrlichiosis in the United States was recognized in 1986 and was reported in 1987 (3). The disease is caused by intracellular gram-negative bacteria of the Ehrlichia genus. The bacteria can be found in the monocytes and granulocytes of peripheral blood. Human monocytic ehrlichiosis is caused by E. chafeensis, and human granulocytic ehrlichiosis is caused by E. equi or E. phagocytophilia, which was first recognized in 1994 (4). Most cases occur between April and September, and the reservoirs are field animals such as rodents, deer, and dogs. The clinical spectrum of the disease is similar to that of other febrile illnesses; without adequate and timely treatment, approximately 5% of the patients die (5). In the United States, more than 400 cases of serologically confirmed E. chaffensis infection have been documented since 1996 (6). No cases have been reported in Mexico. In February 1997, we evaluated a 41-year-old male patient from Merida. The patient had been exposed to ticks during activity in a rural area 1 week before the onset of illness. Clinical manifestations included frequent hyperthermia, rash, myalgia, headache, anorexia, fatigue, and cough. Physical examination showed bilateral cervical lymphadenopathy, and a chest radio-graph showed an interstitial bilateral infiltrate. Hematic cytometry showed thrombocytopenia of 134 x 10 3 /µL and 3200 leukocytes (1440 neutrophils/µL). Hepatic transaminases were elevated, with an aspartate aminotransferase: 92 U/L (normal: 22 U/L), alanine aminotrans-ferase: 48 U/L (normal: 18 U/L), gamma-glutamyltranspeptidase: 278 U/L (normal: 28 U/L); and globulins: 4.8 g/dL with a polyclonal pattern. No antibodies against rickettsia, dengue virus, B-19 parvovirus, or HIV were detected. A serum sample gave a positive reaction by indirect immunofluorescence assay against E. chaffeensis at titers of 1:64 on week 2 and 1:128 on week 3. No infected monocytes or granulocytes were observed in peripheral blood. Remission of the clinical manifestations began on week 4 and was completed on week 6. This case indicates the existence of human ehrlichiosis in Yucatan, Mexico. Reactivity to E. chaffeensis suggests human monocytic ehrlichiosis; however, as antibody testing was not performed with E. phagocytophila or E. equi, the possibility of human granulocytic ehrlichiosis cannot be excluded. In any event, case reports indicate the need for deliberate search for …

https://www.semanticscholar.org/paper/00a67bfc4914dc4037bd169ab62ba7ca8b7311ad

Analysis of delayed initial radioactive iodine therapy and clinical outcomes in papillary thyroid cancer: a two-center retrospective study.

Nuclear medicine communications

749bf016-4efa-4f5c-ae87-0d5acacf27fb

Analysis of delayed initial radioactive iodine therapy and clinical outcomes in papillary thyroid cancer: a two-center retrospective study. Background It remains unclear whether the time interval between total thyroidectomy and radioactive iodine (RAI) therapy influences clinical outcomes in papillary thyroid carcinoma (PTC). This study aims to evaluate the impact of the timing to initiate RAI therapy on the response in PTC patients. Methods We retrospectively included 405 patients who underwent total thyroidectomy and subsequent RAI therapy at two tertiary hospitals in southwest China. Patients were categorized into two groups based on the interval between thyroidectomy and initial RAI therapy, that is, an early group (interval ≤90 days, n = 317) and a delayed group (interval >90 days, n = 88). Responses to RAI therapy were classified as excellent, indeterminate, biochemical incomplete, or structural incomplete. Univariate and multivariate analyses were conducted to identify factors associated with a nonexcellent response. Results Excellent responses were observed in 77.3% of the early group and 83.0% of the delayed group (P = 0.252). No significant impact of RAI therapy timing was also observed across all American Thyroid Association risk classification categories. These findings persisted when patients were analyzed separately according to RAI dose (intermediate-dose group: 3.7 GBq ; high-activity group: ≥5.5 GBq ), further subdivided by the timing of RAI therapy. Multivariate analysis identified lymph node dissection, RAI dose, and stimulated thyroglobulin as independent risk factors for excellent response (P < 0.05). Conclusion The timing of initial RAI therapy following surgery did not significantly affect outcomes in patients with PTC.

https://www.semanticscholar.org/paper/89df56959e942bfbfdbbc86c7ba851698d8e5518

UEG Week 2014 Oral Presentations

United European Gastroenterology journal

a18bc17b-a45d-4087-a9cf-9a56dd12d92c

UEG Week 2014 Oral Presentations INTRODUCTION:Helicobater pylori (Hp) is a bacterial pathogen that colonizes the human stomach, and is the main risk factor for gastro-duodenal ulcers and gastric cancer. Hp are found in close proximity to the surface of the stomach epithelium either as a free-swimming population in the gastric mucus or adhered to epithelial cells. The attached bacteria are known to alter cell signalling and behavior though different virulence factors. AIMS & METHODS: While the effects of attachment have been studied extensively in vitro, we aimed to study the localization and pathological relevance of the direct interaction of bacteria with the gastric epithelum, and in particular with gastric stem cells, in vivo. We utilized a murine model ofHp infection using a mouse adapted Hp strain PMSS1. We developed a novel technique to visualize Hp in mouse stomachs using 3D confocal microscopy. In addition, full thickness stomach surgical specimens were used to visualize bacteria in human stomachs. Lgr5eGFP mice were used to study the interaction of Hp with stem cells. Lgr5eGFPCreER RosadtTomato compound heterozygous mice were used for lineage tracing experiments. RESULTS: We discovered that Hp colonize the epithelial surface deep in the gastric glands where they grow as distinct microcolonies associated with the epithelial junctions. In addition, using EdU or mitosis labeling, we find that the gland-associated H. pylori directly colonize the surface of progenitor cells. In addition to the data obtained in our murine model, we document glandassociated Hp microcolonies deep in the human gastric glands in association with the epithelial junctions and with dividing precursor cells. We hypothesized that direct colonization of precursor/stem cells may drive pathological responses. Using quantitative microscopy we mapped the distribution of bacteria in the glands of the antrum vs the corpus. We found that the location of bacteria in the glands correlates with hyperplastic and metaplastic lesions. Using Lgr5eGFP mice, we observerd a direct interaction of Hp with gastric Lgr5 expressing stem cells. Infection induced an expansion of the stem cell number. In addition, lineage tracing experiments revelaed a significantly higher number of cells being generated from Lgr5 expressing stem cell in infected animals compared to uninfected controls. The acclerated tracing tightly correlated with the bacteria in the gastric glands. CONCLUSION: Taken together our data reveals that bacteria directly interact with progenitor and stem cells in the stomach, induce hyper-proliferation and alter the stem cell homeostasis of the colonized glands. Disclosure of Interest: None declared

https://www.semanticscholar.org/paper/82c7d88b2153e7bec4568222f2fcda3aad21f5b6

Erratum to “Fat Embolism Syndrome: A Case Report and Review Literature”

Case Reports in Medicine

d910901d-9043-449b-8b02-575a29b88f1f

Erratum to “Fat Embolism Syndrome: A Case Report and Review Literature” .

https://www.semanticscholar.org/paper/7770272731c88c684ae0494b60507296eee1283a

Effect of Azadirachta indica Crude Bark Extracts Concentrations against Gram-Positive and Gram-Negative Bacterial Pathogens

Journal of Pharmacy and Bioallied Sciences

78f0693c-2254-425e-9816-0af30e467821

Effect of Azadirachta indica Crude Bark Extracts Concentrations against Gram-Positive and Gram-Negative Bacterial Pathogens Background: Today’s pharmaceutical markets are crowded with antibacterial agents, yet their toxicities and resistance are always contentious. Azadirachta indica is used in India as an age-old treatment for diverse medical conditions. This study was put forth to analyze the antibacterial action of A. indica bark extract on different bacterial pathogens. Materials and Methods: A. indica bark extract was prepared using Soxhlet extraction method. The bark extract of A. indica was screened for antibacterial activity by agar well diffusion assay technique against Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, and Proteus mirabilis. Ciprofloxacin (5 µg per disc) was used as positive control. All assays were carried out under strict aseptic precautions. All the concentrations included were duplicated, and the results obtained were the average of two independent experiments. Broth microdilution method was used to study the minimum inhibitory concentration of the bark extract of A. indica. Results: A. indica bark extract has shown antibacterial activity against all concentrations of bark extract, whereas antibacterial activity against S. aureus was observed at higher concentration of >500 µg/mL. The bark extract of A. indica showed zone of clearance against E. faecalis, P. aeruginosa, and P. mirabilis at all concentrations. Zone of inhibition was observed in higher concentrations against S. aureus. Conclusion: This study has shown that A. indica bark extract has a potent antibacterial property against S. aureus, E. faecalis, P. aeruginosa, and P. mirabilis. Further isolation of bioactive compounds may lead to a new scope in the treatment of bacterial infections.

https://www.semanticscholar.org/paper/13ce8ed1d807694bb12b0711d58e84e7f1f645c9

War and Disease: Biomedical Research on Malaria in the Twentieth Century

Emerging Infectious Diseases

59a1832b-4bac-4b66-a0fc-1c8d201d95aa

War and Disease: Biomedical Research on Malaria in the Twentieth Century War and Disease is a fascinating historical account of the discovery of drugs effective against malaria, one of the great scourges of humankind. The author, Leo B. Slater, makes good use of his expertise as a historian of biomedical science and technology. He provides a meticulous reconstruction of the manner in which the scientific community, in the midst of World War II, established an antimalarial program, which was to biomedical research what the Manhattan Project was to the physical sciences. At a time when industrialized nations are involved in the effort to find solutions to the ongoing global health catastrophe that malaria is today, this volume is a timely and valuable contribution.

https://www.semanticscholar.org/paper/8ea53f29baeedb44113a13db3a6c3df884ae373d

Many Handicaps and a Lot of Good Luck. A Scientific Autobiography

ACS Central Science

df882f0f-d88c-4139-8462-219dcb05d97c

Many Handicaps and a Lot of Good Luck. A Scientific Autobiography ■ INTRODUCTION I never thought that I would write an autobiography, as I thought, in my opinion, that my personal history was of no interest to anyone except my close family. However, Professor Ilan Marek very kindly invited me to consider writing down the development of several scientific ideas in which I participated. At first I hesitated, but then I thought perhaps there was something special in how I became a scientist. I still feel that in my story the unusual thing is the combination of terrible handicaps on the one hand and a measure of extraordinarily good luck on the other. In order to understand this I have to tell you my personal story from the beginning and then I can show the scientific steps taken and try to illustrate in each case how I found the problem and how I arrived at the solution.

https://www.semanticscholar.org/paper/9363e30de275dda3042d11057334c2b11ca42db6

The Institutional Worker

The Hospital

965d752e-3d99-47a6-bf0f-de96ba26b1f3

The Institutional Worker In a Stateor municipal-supported institution the life of the Inquiry Officer may be an easy one; but in the large number of struggling voluntary hospitals he is engaged in the Hercutask of penetrating a veritable stronghold of apathy?a voice crying the wilderness of ignorance of the real facts of hospital finances. His i Primary duty is to ascertain the social status of all patients seeking admission j *o his institution to keep a register of and out-patients, and to record information regarding the length of time !n hospital, date of discharge, etc. He 18 also called upon to bring home to each person admitted the obligations ^'hieh are incurred in the way of maintenance, housing, and nursing. How Widespread, alas, is the idea that hospitals receive more than sufficient supPort from some mysterious source, and ar? in such a fortunate position financia% that no efforts are required on the P^rt of patients themselves to assist in he costly work of carrying on. The ?ecent enviable experience of certain London hospitals in receiving anonymous donations of ?500 from a Mysterious and unknown stranger seems ^ lend colour to such a desirable cirCl1 instance. , The Inquiry Officer, then, is a man

https://www.semanticscholar.org/paper/d09b4a75ec07b2369281492d99c716bc3e0eba5e

Preparedness for Zika virus testing in the World Health Organization Western Pacific Region

Western Pacific surveillance and response journal : WPSAR

Preparedness for Zika virus testing in the World Health Organization Western Pacific Region On 1 February 2016, the World Health Organization (WHO) declared that clusters of microcephaly cases and other neurological disorders occurring in Zika virus (ZIKV)-affected areas constituted a public health emergency of international concern. Increased surveillance of the virus, including the requirement for laboratory confirmation of infection, was recommended. The WHO Regional Office for the Western Pacific therefore initiated a rapid survey among national-level public health laboratories in 19 countries and areas to determine regional capacity for ZIKV detection. The survey indicated that 16/19 (84%) countries had capacity for molecular detection of ZIKV while others facilitated testing through referral. These results suggest that robust laboratory capacity is in place to support ZIKV surveillance in the Western Pacific Region.

https://www.semanticscholar.org/paper/088a9f4324fad5ca54aa2975358ecd695bc8888d

Using Virtual Emergency Medicine Clinicians as a Health System Entry Point (Virtual First): Cross-Sectional Survey Study

Journal of Medical Internet Research

2baad992-2268-4c38-9120-e453622f2eeb

Using Virtual Emergency Medicine Clinicians as a Health System Entry Point (Virtual First): Cross-Sectional Survey Study Background The COVID-19 pandemic accelerated the use and acceptance of telemedicine. Simultaneously, emergency departments (EDs) have experienced increased ED boarding. With this acceptance of telemedicine and the weighty increase in patient boarding, we proposed the innovative Virtual First (VF) program to leverage emergency medicine clinicians’ (EMCs) ability to triage patients. VF seeks to reduce unnecessary ED visits by connecting patients with EMCs prior to seeking in-person care rather than using traditional ED referral systems. Objective The goal of this study is to investigate how patients’ access to EMCs from home via the establishment of VF changed how patients sought care for acute care needs. Methods VF is a synchronous virtual video visit at a tertiary care academic hospital. VF was staffed by EMCs and enabled full management of patient complaints or, if necessary, referral to the appropriate level of care. Patients self-selected this service as an alternative to seeking in-person care at a primary care provider, urgent care center, or ED. A postvisit convenience sample survey was collected through a phone SMS text message or email to VF users. This is a cross-sectional survey study. The primary outcome measure is based on responses to the question “How would you have sought care if a VF visit was not available to you?” Secondary outcome measures describe valued aspects and criticisms. Results were analyzed using descriptive statistics. Results There were 3097 patients seen via VF from July 2021 through May 2022. A total of 176 (5.7%) patients completed the survey. Of these, 87 (49.4%) would have sought care at urgent care centers if VF had not been available. There were 28 (15.9%) patients, 26 (14.8%) patients, and 1 (0.6%) patient that would have sought care at primary care providers, EDs, or other locations, respectively. Interestingly, 34 (19.3%) patients would not have sought care. The most valued aspect of VF was receiving care in the comfort of the home (n=137, 77.8%). For suggested improvements, 58 (33%) patients most commonly included “Nothing” as free text. Conclusions VF has the potential to restructure how patients seek medical care by connecting EMCs with patients prior to ED arrival. Without the option of VF, 64.2% (113/177) of patients would have sought care at an acute care facility. VF’s innovative employment of EMCs allows for acute care needs to be treated virtually if feasible. If not, EMCs understand the local resources to better direct patients to the appropriate site. This has the potential to substantially decrease patient costs because patients are given the appropriate destination for in-person care, reducing the likelihood of the need for transfer and multiple ED visits.

https://www.semanticscholar.org/paper/001a50d25b40f7eda5b38664ed825af8679a0fa4

Exogenous pulmonary surfactant replacement therapy in a neonate with pulmonary hypoplasia accompanying congenital diaphragmatic hernia--a case report.

Journal of Korean medical science

234eed58-91c0-4682-ac5e-2a86d6d3acdc

Exogenous pulmonary surfactant replacement therapy in a neonate with pulmonary hypoplasia accompanying congenital diaphragmatic hernia--a case report. Pulmonary hypoplasia(PH) commonly occurs in association with oligohydramnios and other congenital anomalies, especially congenital diaphragmatic hernia (CDH). Pulmonary hypoplasia is an important factor, as persistent pulmonary hypertension, in the prognosis of CDH. In some reports, there is a decrement of pulmonary surfactant in PH accompanying CDH. Recently, there are some reports that exogenous pulmonary surfactant therapy is effective in experimental animal model and neonatal respiratory distress with PH. We report a case of a 5 day-old male neonate, who had shown dyspnea and diagnosed as left pulmonary hypoplasia accompanying CDH. The CDH was surgically treated and the ipsilateral PH, with intratracheal administration of exogenous pulmonary surfactant postoperatively. After exogenous pulmonary surfactant application, the left lung volume was increased on chest roentgenogram and lung perfusion scan findings, and there was an improvement in oxygenation and clinical manifestations. We suggest that postoperative exogenous pulmonary surfactant replacement therapy is effective in the case of PH and further trials are needed to clarify the optimal dose and timing of supplementation of surfactant for treatment of infants with PH accompanying CDH.

https://www.semanticscholar.org/paper/a8cf090bfabd8c40b7b04ccdb3e5c3f4e44782ad

Epidemiology of syphilis-related hospitalisations in Spain between 1997 and 2006: a retrospective study

BMJ Open

e6216b43-2428-4aaf-8101-b40e1dfd2810

Epidemiology of syphilis-related hospitalisations in Spain between 1997 and 2006: a retrospective study Objective In order to illustrate the important public health impact of syphilis, which is a preventable infection, the epidemiology of syphilis-related hospitalisations in Spain was studied over a 10-year period. Methods A retrospective study was conducted using the National Epidemiological Surveillance System for Hospital Data (Minimum Data Set). All hospitalisations due to syphilis infection in any diagnostic position (ICD-9-CM 090–097) between 1997 and 2006 were analysed, according to the Spanish version of the International Classification of Diseases, ninth revision (ICD-9-CM). Results There were 9556 hospitalisations associated with syphilis in Spain. The hospitalisation rate was 2.33 per 100 000 population, the mortality rate was 0.07 per 100 000 population and the lethality was 3.17%. The hospitalisation rate increased significantly after 2000 and was higher in men. Conclusion Syphilis remains a major public health problem because of both potential complications and its close association with HIV infection. It is necessary to promote early diagnosis, ensure treatment in patients with syphilis and emphasise health promotion and prevention programmes.

https://www.semanticscholar.org/paper/91065c618bdae7238f024fe51d6e07332c6158e4

Dihydroartemisinin inhibits liver cancer cell migration and invasion by reducing ATP synthase production through CaMKK2/NCLX

Oncology Letters

32d29099-0305-4734-b3ec-534d630e10ff

Dihydroartemisinin inhibits liver cancer cell migration and invasion by reducing ATP synthase production through CaMKK2/NCLX Calcium/calmodulin-dependent protein kinase kinase 2 (CaMKK2) and mitochondrial sodium/calcium exchanger protein (NCLX) are key regulatory factors in calcium homeostasis. Finding natural drugs that target regulators of calcium homeostasis is critical. Dihydroartemisinin (DHA) is considered to have anticancer effects. The present study aimed to investigate the mechanism of DHA in regulating liver cancer migration and invasion. The present study used HepG2 and HuH-7 cells and overexpressed CaMKK2 and knocked down CaMKK2 and NCLX. The antiproliferative activity of DHA on liver cancer cells was assessed through colony formation and EdU assays. Cell apoptosis was detected through YO-PRO-1/PI staining. The levels of reactive oxygen species (ROS) were measured using a ROS detection kit (DCFH-DA fluorescent probe). Cell migratory and invasive abilities were examined using wound healing and Transwell assays. The ATP production of liver cancer cells was detected using ATP fluorescent probes. Cell microfilaments were monitored for changes using Actin-Tracker Green-488. The effects of DHA on the expression of CaMKK2, NCLX, sodium/potassium-transporting ATPase subunit α-1 (ATP1A1) and ATP synthase subunit d, mitochondrial (ATP5H) were determined by western blotting and reverse transcription-quantitative PCR. The results revealed that DHA significantly inhibited proliferation, reduced ROS levels and promoted apoptosis in liver cancer cells. CaMKK2 overexpression significantly enhanced the invasive and migratory ability of liver cancer cells, whereas DHA inhibited the pro-migratory effects of CaMKK2 overexpression. DHA significantly reduced the mitochondrial ATP production and altered the arrangement of microfilaments in liver cancer cells. In addition, DHA significantly decreased the expression of CaMKK2, NCLX, ATP1A1 and ATP5H. Furthermore, by knockdown experiments of NCLX the results demonstrated that CaMKK2 downregulated the expression of ATP1A1 and ATP5H in liver cancer cells through NCLX. In conclusion, DHA may reduce ATP synthase production via the CaMKK2/NCLX signaling pathway to inhibit the invasive phenotype of liver cancer cells. It is essential to further investigate the effectiveness of DHA in the anticancer mechanism of liver cancer cells.

https://www.semanticscholar.org/paper/148c3232518ca6432ca877ea66157d8aa1c50cb9

Toys for Sick Children

Mental Health

Toys for Sick Children for children kept in bed during an illness, together with a list of appropriate toys at different ages, will be welcomed by mothers and nurses and should help to solve at least one of their problems which arise at such times. It can be obtained (price 3d. post free) from the N.A.M.H. Publications Department, 39 Queen Anne Street, W.l, or direct from Children's Play Activities, 94 Wimpole Street, W.l.

https://www.semanticscholar.org/paper/a486d972cfc5b7d9afcfb8d4fe8b1b1181143d28

Autologous Fat Grafting in Total Temporomandibular Joint Replacement Surgery

Annals of Maxillofacial Surgery

1820b43c-9da0-4721-8fbf-b23cc432fd9c

Autologous Fat Grafting in Total Temporomandibular Joint Replacement Surgery Context: Alloplastic temporomandibular joint replacement. Aims: To search for evidence for the use of periprosthetic autologous fat transplantation. Setting and Design: Systematic review. Materials and Methods: We searched in PubMed Central, Elsevier ScienceDirect Complete, Wiley Online Library Journals, Ovid Lippincott Williams and Wilkins, and Cochrane Library plus Results. Six studies reported improved results with the use of autologous fat graft (AFG) in patients treated with a total joint replacement, mainly about increased mobility. Three studies involved patients from the same surgeon with increased inclusions and increased follow-up period. A 1997 study by Wolford showed a significant difference in heterotopic bone formation between patients treated with AFG, compared to those who were not, indicating the potential and usefulness of AFG. Conclusion: A prospective multicenter randomized controlled trial of this promising concept is warranted before justifying common application because of the added morbidity and the questionable advantage.

https://www.semanticscholar.org/paper/afaf32467cc23acd4db92d988bdce889c409404c

Notice of Retraction

The Korean journal of thoracic and cardiovascular surgery

9267bc2b-198f-4c25-a916-8459c7ecf19f

Notice of Retraction .

https://www.semanticscholar.org/paper/9a29553d9f552a3ff570bc231a309724c3e06a05

Pressure Ulcer-Related Pelvic Osteomyelitis: Evaluation of a Two-Stage Surgical Strategy (Debridement, Negative Pressure Therapy and Flap Coverage) with Prolonged Antimicrobial Therapy

Open Forum Infectious Diseases

f20432ac-3c14-4779-bc66-2f24e1b2715e

Pressure Ulcer-Related Pelvic Osteomyelitis: Evaluation of a Two-Stage Surgical Strategy (Debridement, Negative Pressure Therapy and Flap Coverage) with Prolonged Antimicrobial Therapy Abstract Background A two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitis but has not been widely evaluated. Methods Adult patients with pressure ulcer-related pelvic osteomyelitis treated by a two-stage surgical strategy were included in a retrospective cohort study. Determinants of superinfection (i.e.,, additional microbiological findings at reconstruction) and treatment failure were assessed using binary logistic regression and Kaplan–Meier curve analysis. Results Sixty-four pressure ulcer-related pelvic osteomyelitis in 61 patients (age, 47 ) were included. Osteomyelitis was mostly plurimicrobial (73%), with a predominance of S. aureus (47%), Enterobacteriaceae (44%), and anaerobes (44%). Flap coverage was performed after 7 (IQR 5–10) weeks of NPT, with 43 (68%) positive bone samples among which 39 (91%) were superinfections, associated with a high ASA score (OR, 5.8; P = 0.022). An increased prevalence of coagulase negative Staphylococci (P = 0.017) and Candida (P = 0.003) was observed at time of flap coverage. An ESBL Enterobacteriaceae was found in one (12%) patients, associated with fluoroquinolone consumption (OR, 32.4; P = 0.005). Treatment duration was as 20 (IQR 14–27) weeks, including 11 (IQR 8–15) after reconstruction. After a follow-up of 54 (IQR 27–102) weeks, 15 (23%) failures were observed, associated with previous pressure ulcer (OR, 5.7; P = 0.025) and Actinomyces infection (OR, 9.5; P = 0.027). Conclusion Pressure ulcer-related pelvic osteomyelitis is a difficult-to-treat clinical condition, generating an important consumption of broad-spectrum antibiotics. Carbapenem should be reserved for ESBL at-risk patients only, including those with previous fluoroquinolone use. The uncorrelation between outcome and the debridement-to-reconstruction interval argue for a short sequence to limit the total duration of treatment. Disclosures T. Ferry, HERAEUS: Consultant, Speaker honorarium

https://www.semanticscholar.org/paper/d90b6f452f7739ebd5d827cfbf012896c4fe569f

Dealing with the Pandemic and After for Children and Adolescents, and their Families

European psychiatry

7041a439-ab15-46e5-a720-6a33dc405e12

Dealing with the Pandemic and After for Children and Adolescents, and their Families France has been severely impacted by the pandemic. The first wave imposed a major lockdown, never seen before. The second and third wave lockdown responses were somewhat less dramatic. People were allowed to travel to work. Nursery and elementary schools were left open while high schools had part-time attendance. Spring 2021, still presented with a terrible death toll of 300/day, for a 67million population country. For many months the spotlights were focused on the high levels of mortality and morbidity of the elderly. This somehow obliterated the younger generation’s mental health issues. It now appears that children and adolescents have had to pay a steep price to Covid 19. In France, during the first lockdown, child and adolescent morbidity and mortality due to abuse heightened considerably compared to 2019 during the same period. And during the second and mostly the third lockdown, pediatric emergency wards have been underwater with youth mental health issues ranging form suicidal ideation to acute dissociation. Different hypotheses have emerged on how the pandemic has so dramatically impacted the mental health of children and adolescents, specifically the most vulnerable ones. The consequences this might have for child development and mental health during the years to come will be debated. Disclosure No significant relationships.

https://www.semanticscholar.org/paper/2a635e68477f43d9efc9c7a7511c40cc539175ad

Performance of ChatGPT Across Different Versions in Medical Licensing Examinations Worldwide: Systematic Review and Meta-Analysis.

Journal of Medical Internet Research

2baad992-2268-4c38-9120-e453622f2eeb

Performance of ChatGPT Across Different Versions in Medical Licensing Examinations Worldwide: Systematic Review and Meta-Analysis. Background Over the past 2 years, researchers have used various medical licensing examinations to test whether ChatGPT (OpenAI) possesses accurate medical knowledge. The performance of each version of ChatGPT on the medical licensing examination in multiple environments showed remarkable differences. At this stage, there is still a lack of a comprehensive understanding of the variability in ChatGPT’s performance on different medical licensing examinations. Objective In this study, we reviewed all studies on ChatGPT performance in medical licensing examinations up to March 2024. This review aims to contribute to the evolving discourse on artificial intelligence (AI) in medical education by providing a comprehensive analysis of the performance of ChatGPT in various environments. The insights gained from this systematic review will guide educators, policymakers, and technical experts to effectively and judiciously use AI in medical education. Methods We searched the literature published between January 1, 2022, and March 29, 2024, by searching query strings in Web of Science, PubMed, and Scopus. Two authors screened the literature according to the inclusion and exclusion criteria, extracted data, and independently assessed the quality of the literature concerning Quality Assessment of Diagnostic Accuracy Studies-2. We conducted both qualitative and quantitative analyses. Results A total of 45 studies on the performance of different versions of ChatGPT in medical licensing examinations were included in this study. GPT-4 achieved an overall accuracy rate of 81% (95% CI 78-84; P<.01), significantly surpassing the 58% (95% CI 53-63; P<.01) accuracy rate of GPT-3.5. GPT-4 passed the medical examinations in 26 of 29 cases, outperforming the average scores of medical students in 13 of 17 cases. Translating the examination questions into English improved GPT-3.5’s performance but did not affect GPT-4. GPT-3.5 showed no difference in performance between examinations from English-speaking and non–English-speaking countries (P=.72), but GPT-4 performed better on examinations from English-speaking countries significantly (P=.02). Any type of prompt could significantly improve GPT-3.5’s (P=.03) and GPT-4’s (P<.01) performance. GPT-3.5 performed better on short-text questions than on long-text questions. The difficulty of the questions affected the performance of GPT-3.5 and GPT-4. In image-based multiple-choice questions (MCQs), ChatGPT’s accuracy rate ranges from 13.1% to 100%. ChatGPT performed significantly worse on open-ended questions than on MCQs. Conclusions GPT-4 demonstrates considerable potential for future use in medical education. However, due to its insufficient accuracy, inconsistent performance, and the challenges posed by differing medical policies and knowledge across countries, GPT-4 is not yet suitable for use in medical education. Trial Registration PROSPERO CRD42024506687;

https://www.semanticscholar.org/paper/8903d8ab660b63fa2e6fbd65e74e3de939c50004

Institutional Notes and News

The Hospital

965d752e-3d99-47a6-bf0f-de96ba26b1f3

Institutional Notes and News Norfolk and Norwich Hospital. His Majesty was received by the Earl of Leicester (President), and the Bishop of Thetford. The following gentlemen had the honour of being presented to the King : Mr. Walter E. Hansell, the Chairman of the Board of Management (the Rev. Harvey W. G. Thursby), the Vice-Chairman of the Board (the Veil. Archdeacon Sidney Pelham), the Consulting Physician (Sir Peter Eade, M.D.), the Consulting Surgeons (Dr. Michael Beverley and Mr. H. S. Robinson), the Senior Physician (Dr. Samuel J. Barton), the Senior Surgeon (Mr. Samuel H. Burton), the Chairman of the Building Committee (Mr. Eustace Gurney), the Architect (Mr. E. T. Boardman), and the Lady Superintendent (Miss Florence A. Cann). The King having taken his place on the platform erected for the occasion, the Bishop of Norwich offered prayer, after which Lord Leicester presented an address, to which His Majesty in reply said :? I thank you for your loyal address of welcome, which your lordship has presented to me from the governing body and friends of the Norfolk and Norwich Hospital. I well remember my visits to you in 1872 and 1884. The hospital is, and always will be,' associated in my mind with the personality of the late Lord Leicester, a man whom, as you know, I held in the highest esteem and regard during the many years of my residence in your county. It was of great interest to me to hear the account of the good work performed by the hospital since its opening. I am glad to cay that a want long felt by the hospital authorities, and one which has in many cases hampered their efforts, has now been supplied, and it is a source of gratification to me to open to-day the extension of the hospital designed as an isolation block for the reception of such cases as cannot without risk of infection be

https://www.semanticscholar.org/paper/2e7a9d3e128e9323041179f7946ba77381d82a3d

Correction: Nickel-catalyzed γ-alkylation of cyclopropyl ketones with unactivated primary alkyl chlorides: balancing reactivity and selectivity via halide exchange

RSC Advances

0650c289-97b1-4db5-a39d-247ed29f04e3

Correction: Nickel-catalyzed γ-alkylation of cyclopropyl ketones with unactivated primary alkyl chlorides: balancing reactivity and selectivity via halide exchange Correction for ‘Nickel-catalyzed γ-alkylation of cyclopropyl ketones with unactivated primary alkyl chlorides: balancing reactivity and selectivity via halide exchange’ by Zhen-Ying Wang et al., RSC Adv., 2024, 14, 12883–12887, .

https://www.semanticscholar.org/paper/594d682ca5037928de970d987a6dae0e3b87f8b5

A DNA methylation haplotype block landscape in human tissues and preimplantation embryos reveals regulatory elements defined by comethylation patterns

Genome Research

0a96e67f-c1f1-491d-ab41-4c2c50b523a2

A DNA methylation haplotype block landscape in human tissues and preimplantation embryos reveals regulatory elements defined by comethylation patterns DNA methylation and associated regulatory elements play a crucial role in gene expression regulation. Previous studies have focused primarily on the distribution of mean methylation levels. Advances in whole-genome bisulfite sequencing (WGBS) have enabled the characterization of DNA methylation haplotypes (MHAPs), representing CpG sites from the same read fragment on a single chromosome, and the subsequent identification of methylation haplotype blocks (MHBs), in which adjacent CpGs on the same fragment are comethylated. Using our expert-curated WGBS data sets, we report comprehensive landscapes of MHBs in 17 representative normal somatic human tissues and during early human embryonic development. Integrative analysis reveals MHBs as a distinctive type of regulatory element characterized by comethylation patterns rather than mean methylation levels. We show the enrichment of MHBs in open chromatin regions, tissue-specific histone marks, and enhancers, including super-enhancers. Moreover, we find that MHBs tend to localize near tissue-specific genes and show an association with differential gene expression that is independent of mean methylation. Similar findings are observed in the context of human embryonic development, highlighting the dynamic nature of MHBs during early development. Collectively, our comprehensive MHB landscapes provide valuable insights into the tissue specificity and developmental dynamics of DNA methylation.

https://www.semanticscholar.org/paper/443d6e37a0f5b4f1997a4f5b200fa6c71222a612

Correction: Interventions facilitating access to perinatal care for migrant women without medical insurance: A scoping review protocol

PLoS ONE

0aed7a40-85f3-4c66-9e1b-c1556c57001b

Correction: Interventions facilitating access to perinatal care for migrant women without medical insurance: A scoping review protocol .

https://www.semanticscholar.org/paper/7fa7a6790510c148862ec98a6f2dc73477c2c3a1

Letter to the Editor

Journal of Veterinary Internal Medicine

d9f5053c-a9db-4874-9131-2d2e304206cc

Letter to the Editor Thank you for the opportunity to respond to the letter from Dr. Strain regarding our recent publication “Seizure disorders in goats and sheep”. We thank Dr. Strain for his insightful comments regarding our article. In his letter, Dr. Strain correctly pointed out the following statement in the abstract: “Currently, no reports describing seizures in goats and sheep are available.” Dr. Strain provided a reference of a case report of partial epilepsy in a goat. We thank Dr. Strain for providing the reference, and we agree with him that we overlooked the reference he provided. Dr. Strain also was concerned with another statement we included in the abstract: “Goats and sheep are more likely to be presented for examination for seizures than are cattle.” He also provided a reference of a case report of primary generalized epilepsy in a cow. However, the statement Dr. Strain provided in his letter is only part of the full statement. We would like to respectfully refer Dr. Strain to the full statement in the abstract which states that: “Goats and sheep are more likely to be presented for examination for seizures than are cattle, possibly as a consequence of their relatively smaller body size”. The last part of the statement emphasizes that in clinical practice, owners are more likely to transport goats and sheep for clinical examination by veterinarians because they can be safely restrained during or after seizuring compared to cattle, due to their relatively smaller size. We respectfully argue that this statement should remain as it is, due to its important practical clinical relevance. It is also important to note that a recent retrospective study describing seizures in cattle has been published.

https://www.semanticscholar.org/paper/e888f6e3e7f4a4bde83909f5bdc2335dae7fcd13

Nosocomial Urinary Tract Aspergilloma in an Immunocompetent Host: An Unusual Occurrence

Indian Journal of Dermatology

9dfbd503-d104-4952-88dc-462e8ce2e5c2

Nosocomial Urinary Tract Aspergilloma in an Immunocompetent Host: An Unusual Occurrence Fungal infections of the urinary tract are usually encountered following prolonged antibiotic use, instrumentation and indwelling urinary catheters. Candida is the most frequent causative fungus. However, infections with Aspergillus flavus have been reported previously in immune-compromised hosts. We, hereby, report a 32-year-old immunocompetent man diagnosed to have urinary tract infection caused by Aspergillus flavus following instrumentation for the removal of a ureteric stone. The infection was symptomatic, associated with abdominal pain and subsequent passage of fungal masses per urethra. Patient was treated successfully with a prolonged course of broad spectrum antifungal agent itraconazole.

https://www.semanticscholar.org/paper/1774b9c771071369d0414592fac86f3179671e8e

An appropriately performed conventional blood culture can facilitate choice of therapy in resource-constrained settings-comparison with BACTEC 9050

Journal of Postgraduate Medicine

f75b40af-e778-47da-a56a-9a74cc6b13e0

An appropriately performed conventional blood culture can facilitate choice of therapy in resource-constrained settings-comparison with BACTEC 9050 Aims: Comparison of conventional blood culture with BACTEC 9050 for rate and time to detection of microorganisms. Settings and Design: A prospective study was carried out in a multispecialty tertiary care teaching hospital. Subjects and Methods: A total of 835 paired specimens (797 blood and 38 nonblood specimens) were collected and processed according to standard microbiological procedures by both conventional method as well as by BACTEC 9050 automated culture system. Clinical details of patients were recorded. Data were analyzed for time to detection and isolation rate by the two systems and compared. Results: Overall culture positivity for BACTEC 9050 and the conventional system was 32% and 19.88%, respectively. Eighty-five demonstrated concordant growth, 136 specimens were culture positive by BACTEC only, and 38 specimens were culture positive by conventional only. Twelve contaminants in BACTEC and nine contaminants in conventional system were detected. Using BACTEC 9050, higher isolation was observed for Acinetobacter spp., coagulase negative Staphylococcus spp., Streptococcus spp., and Candida spp. A total of 410 patients were on antimicrobial treatment and culture positivity was significantly higher with BACTEC 9050 (P < 0.0001). There was a significant difference in the mean time to detection with BACTEC 9050 recovering 86.8% of isolates within 48 h (P < 0.0001). Conclusions: Although BACTEC 9050 demonstrated a significantly higher recovery of microorganisms from blood, an appropriately performed conventional blood culture can facilitate the choice of therapy.

https://www.semanticscholar.org/paper/ddd60ed1f8784e594cd28e3544b410e1e2f6afc1

Pattern of Preoperative Uroflowmetry in Hypospadias Patients and Age-matched Control Patients

Journal of Indian Association of Pediatric Surgeons

b68cbbfd-7c8f-41de-8509-f91781aef19b

Pattern of Preoperative Uroflowmetry in Hypospadias Patients and Age-matched Control Patients Aim: Patients with hypospadias often present with voiding difficulties after successful repairs. We sought to analyze the degree of uroflowmetric anomalies that may be present in children with hypospadias before a surgical repair. We, thus, undertook this study to compare the pattern of preoperative uroflowmetry study in hypospadias patients and a comparable age-matched control group. Materials and Methods: A total of 90 children underwent preoperative uroflowmetry in the Department of Pediatric Surgery at All India Institute of Medical Sciences (AIIMS), Jodhpur, India, between January 2019 and December 2020. Thirty patients with hypospadias and sixty age-matched controls who presented to the outpatient department without any associated urological or neurological anomalies were included in the study. Uroflowmetry parameters such as maximum urine flow rate (Qmax), average urine flow rate (Qavg), voided volume (VV), urination duration, duration of reaching maximum speed, and urine flow curves of the cases and the control group were measured and compared. Results: The median age of patients at the time of uroflowmetry in the hypospadias group was 7 years, while the same for the control group was 7.5 years. Median maximum urinary flow rates (Qmax) (10.7 vs. 14.45 mL/s, P = 0.01278), average urinary flow rates (Qavg) (6.5 vs. 8.5 mL/s, P = 0.0124), the ratio of maximum urinary flow rates with VV (Qmax/VV) (0.043 vs. 0.053, P = 0.0264) was found to be significant (P < 0.05). These values were significantly lower in the hypospadias group (P < 0.05). The voiding time (43.5 vs. 30 s, P = 0.0285) was significantly higher in the hypospadias group. However, there was no difference in the VV per micturition (219.5 vs. 270.0 mL, P = 0.40) and time to maximum flow rate (10 vs. 10, P = 0.43). Flow curve pattern analysis revealed plateau-shaped curves in 60% of the hypospadias group compared to 27% in the control group, while bell-shaped curve was seen in 37% of the hypospadias group as compared to 65% in the control group which were statistically significant (P = 0.003415). No statistically significant association was found between meatal localization and the uroflowmetry parameters. Conclusion: Children with hypospadias have abnormal uroflowmetry even before surgical correction and have a significantly low maximum urine flow rate. These uroflow anomalies may be due to meatal stenosis or hypoplastic proximal urethra. We postulate that these preoperative abnormal uroflow patterns in patients with hypospadias may contribute to voiding difficulties in repaired hypospadias cases. A greater understanding of the factors behind these uroflowmetric anomalies may allow surgeons to proactively tackle these intraoperatively, leading to better outcomes for patients with hypospadias.

https://www.semanticscholar.org/paper/fea1abf4d4bda0924b20f986cffc3d96ec5fdf58

Community-Engaged Use of Low-Cost Sensors to Assess the Spatial Distribution of PM2.5 Concentrations across Disadvantaged Communities: Results from a Pilot Study in Santa Ana, CA

Atmosphere

0a6835b2-217d-4708-8735-f574a583a7d7

Community-Engaged Use of Low-Cost Sensors to Assess the Spatial Distribution of PM2.5 Concentrations across Disadvantaged Communities: Results from a Pilot Study in Santa Ana, CA PM2.5 is an air pollutant that is widely associated with adverse health effects, and which tends to be disproportionately located near low-income communities and communities of color. We applied a community-engaged research approach to assess the distribution of PM2.5 concentrations in the context of community concerns and urban features within and around the city of Santa Ana, CA. Approximately 183 h of one-minute average PM2.5 measurements, along with high-resolution geographic coordinate measurements, were collected by volunteer community participants using roughly two dozen low-cost AtmoTube Pro air pollution sensors paired with real-time GPS tracking devices. PM2.5 varied by region, time of day, and month. In general, concentrations were higher near the city’s industrial corridor, which is an area of concern to local community members. While the freeway systems were shown to correlate with some degree of elevated air pollution, two of four sampling days demonstrated little to no visible association with freeway traffic. Concentrations tended to be higher within socioeconomically disadvantaged communities compared to other areas. This pilot study demonstrates the utility of using low-cost air pollution sensors for the application of community-engaged study designs that leverage community knowledge, enable high-density air monitoring, and facilitate greater health-related awareness, education, and empowerment among communities. The mobile air-monitoring approach used in this study, and its application to characterize the ambient air quality within a defined geographic region, is in contrast to other community-engaged studies, which employ fixed-site monitoring and/or focus on personal exposure. The findings from this study underscore the existence of environmental health inequities that persist in urban areas today, which can help to inform policy decisions related to health equity, future urban planning, and community access to resources.

https://www.semanticscholar.org/paper/2431500e9c2c7c60f7f2b321c91bf2cf7784b066

Comparison of intrathecal bupivacaine-fentanyl and bupivacaine-butorphanol mixtures for lower limb orthopedic procedures

Anesthesia Essays and Researches

3adfe47a-7cf7-43a7-9deb-546e0b53fda2

Comparison of intrathecal bupivacaine-fentanyl and bupivacaine-butorphanol mixtures for lower limb orthopedic procedures Context: Intrathecal use of butorphanol is less explored in human subjects. Aims: To compare the safety and efficacy of anesthesia and analgesia of intrathecal bupivacaine-butorphanol mixture with intrathecal bupivacaine-fentanyl mixture. Settings and Design: Tertiary level, teaching hospital. Prospective, randomized, double-blind study Materials and Methods: Eighty patients aged above 18 years, of ASA physical status 1 or 2, undergoing lower limb orthopedic surgeries were randomly allocated to two groups of 40 patients each. Patients in group A and group B received intrathecal 2.5 ml of hyperbaric bupivacaine (0.5%), with 25 μg of fentanyl and 25 μg of butorphanol, respectively. Statistical Analysis Used: Fisher's exact test and Chi square tests Results: The times required for onset of sensory and motor blockade were comparable among the two groups. Significantly slower block regression to S2 level was observed in the group receiving intrathecal butorphanol as compared to intrathecal fentanyl (P=0.0230). A higher number of patients in group A requested for rescue analgesia during the postoperative period than in group B (9 versus 2; P=0.0238). The average times to first request for rescue analgesia were 308.6±14.9 minutes and 365.9±12.3 minutes in group A and B, respectively (P=0.0254). Conclusions: Both 25 μg fentanyl and 25 μg butorphanol given intrathecally along with 12.5 mg of hyperbaric bupivacaine provide effective anesthesia for lower limb surgeries. Intrathecal bupivacaine-butorphanol mixture provides longer duration of sensory blockade and superior analgesia than intrathecal fentanyl-bupivacaine mixture.

https://www.semanticscholar.org/paper/d61609afea5067223de2e2f5be2ada1fefee603f

Clinical Laboratory Utility of a Humanized Antibody in Commercially Available Enzyme Immunoassays for Coccidioidomycosis

Microbiology spectrum

8c502236-f3b9-40c1-a98f-9929d4f709ae

Clinical Laboratory Utility of a Humanized Antibody in Commercially Available Enzyme Immunoassays for Coccidioidomycosis In southwestern and western regions of the United States, at least half a million diagnostic tests for coccidioidomycosis (valley fever) are run annually. Enzyme immunoassays (EIAs) are blood tests which require precise dilution of patient serum prior to testing. ABSTRACT Coccidioidomycosis, also called valley fever (VF), is a fungal infection with endemicity in desert regions of the western United States as well as certain arid regions of Central and South America. Laboratory-based diagnosis of VF often relies on the composite results from three serologic-based diagnostics, complement fixation, immunodiffusion, and enzyme immunoassay (EIA). EIA is commonly performed in clinical laboratories because results can be obtained in a few hours. Two commercially available EIAs, IMMY clarus Coccidioides antibody and Meridian Premier Coccidioides, look for the presence of anticoccidioidal IgG and IgM in patient sera that are diluted 1:441. Per regulatory requirements, this dilution step must be verified with a dilution step control despite not being provided as a reagent in either FDA-approved EIA kit. Therefore, clinical laboratories collect and reuse patient sera in subsequent tests that had a positive result in a previous test. This is a nonstandard process, reinforcing the need for a consistent and reliable dilution control. Here, we evaluate the performance of a humanized IgG and IgM antibody as a dilution control in both EIA kits. Both humanized IgG and IgM work well in each EIA and meet the appropriate threshold for positivity. IMPORTANCE In southwestern and western regions of the United States, at least half a million diagnostic tests for coccidioidomycosis (valley fever) are run annually. Enzyme immunoassays (EIAs) are blood tests which require precise dilution of patient serum prior to testing. To ensure patient serum is properly diluted, there is a regulatory requirement to ensure the dilution step is accurate. Two FDA-approved EIAs used to aid in the diagnosis of coccidioidomycosis do not contain controls for this dilution step, leaving clinical laboratories with the only option of using previously positive patient sera, which may not react in a reliable or predictable manner. Here, we evaluate a humanized monoclonal antibody against a coccidioidal antigen and its utility as a dilution control in both available commercial EIAs. The use of a humanized monoclonal antibody provides a standardized and well-characterized dilution control for use in serological assays that aid in diagnosis of coccidioidomycosis.

https://www.semanticscholar.org/paper/e264167cbf714cce2c1645728fb9a3046bb01951

A Case Report of Klinefelter Syndrome with Schizophrenia-Like Psychosis and Seizure Disorder

Indian Journal of Psychological Medicine

7abf4f02-0f64-4ff9-a789-3b7fbe1388e7

A Case Report of Klinefelter Syndrome with Schizophrenia-Like Psychosis and Seizure Disorder Klinefelter syndrome is a disorder of variation of sex chromosome, the most common karyotype being 47XXY. Multiple case reports and articles have been published linking the increased prevalence of psychiatric disorders like Schizophrenia, Schizophreniform psychosis, Attention deficit hyperkinetic disorder, Learning disorder, etc. and seizure disorder in Klinefelter syndrome than in general population, attributing to the extra X chromosome. Here is a case of a 45-year-old gentleman with Klinefelter syndrome with schizophrenia-like psychosis and seizure disorder. He was diagnosed as Klinefelter syndrome 15 years back by genetic testing (47XXY) when he was investigated for infertility. His luteinizing hormone (LH) (32.04 mIU/ml) and follicle-stimulating hormone (FSH) (50.70 mIU/ml) levels were high and his testosterone level was low (1.76 ng/ml). He had four episodes of seizures in 2004 for which he was started on phenytoin and sodium valproate, and was seizure-free for past 10 years. He was brought to our hospital in July 2014 with complaints of talking and laughing to self, suspicion, hearing voices and aggressive behaviour, which were persistent mildly for past 15 years and aggravated for past 6 months. He was not going for work for past 15 years, does not mingle with relatives or friends.

https://www.semanticscholar.org/paper/a57df1781256cc5f8c68597d9a4b1365a802c518

One Health surveillance of West Nile and Usutu viruses: a repeated cross-sectional study exploring seroprevalence and endemicity in Southern France, 2016 to 2020

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

One Health surveillance of West Nile and Usutu viruses: a repeated cross-sectional study exploring seroprevalence and endemicity in Southern France, 2016 to 2020 Background West Nile virus (WNV) and Usutu virus (USUV), two closely related flaviviruses, mainly follow an enzootic cycle involving mosquitoes and birds, but also infect humans and other mammals. Since 2010, their epidemiological situation may have shifted from irregular epidemics to endemicity in several European regions; this requires confirmation, as it could have implications for risk assessment and surveillance strategies. Aim To explore the seroprevalence in animals and humans and potential endemicity of WNV and USUV in Southern France, given a long history of WNV outbreaks and the only severe human USUV case in France in this region. Methods We evaluated the prevalence of WNV and USUV in a repeated cross-sectional study by serological and molecular analyses of human, dog, horse, bird and mosquito samples in the Camargue area, including the city of Montpellier, between 2016 and 2020. Results We observed the active transmission of both viruses and higher USUV prevalence in humans, dogs, birds and mosquitoes, while WNV prevalence was higher in horses. In 500 human samples, 15 were positive for USUV and 6 for WNV. Genetic data showed that the same lineages, WNV lineage 1a and USUV lineage Africa 3, were found in mosquitoes in 2015, 2018 and 2020. Conclusion These findings support existing literature suggesting endemisation in the study region and contribute to a better understanding of USUV and WNV circulation in Southern France. Our study underlines the importance of a One Health approach for the surveillance of these viruses.

https://www.semanticscholar.org/paper/3ee27c0e2dd2e6c04bd2505d0fd0c1b5060d01ca

CDK4/6 inhibitor abemaciclib combined with low-dose radiotherapy enhances the anti-tumor immune response to PD-1 blockade by inflaming the tumor microenvironment in Rb-deficient small cell lung cancer

Translational Lung Cancer Research

e26ac614-70cd-46ac-b2c3-2b4d5b9ca6a4

CDK4/6 inhibitor abemaciclib combined with low-dose radiotherapy enhances the anti-tumor immune response to PD-1 blockade by inflaming the tumor microenvironment in Rb-deficient small cell lung cancer Background Cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors have shown significant activity against several solid tumors by reducing the phosphorylation of the canonical CDK4/6 substrate retinoblastoma (Rb) protein, while the anti-tumor effect of CDK4/6 inhibitors on Rb-deficient tumors is not clear. Most small cell lung cancers (SCLCs) are Rb-deficient and show very modest response to immune checkpoint blockade (ICB) despite recent advances in the use of immunotherapy. Here, we aimed to investigate the direct effect of CDK4/6 inhibition on SCLC cells and determine its efficacy in combination therapy for SCLC. Methods The immediate impact of CDK4/6 inhibitor abemaciclib on cell cycle, cell viability and apoptosis in four SCLC cell lines was initially checked. To explore the effect of abemaciclib on double-strand DNA (ds-DNA) damage induction and the combination impact of abemaciclib coupled with radiotherapy (RT), western blot, immunofluorescence (IF) and quantitative real-time polymerase chain reaction (qRT-PCR) were performed. An Rb-deficient immunocompetent murine SCLC model was established to evaluate efficacy of abemaciclib in combination therapy. Histological staining, flow cytometry analysis and RNA sequencing were performed to analyze alteration of infiltrating immune cells in tumor microenvironment (TME). Results Here, we demonstrated that abemaciclib induced increased ds-DNA damage in Rb-deficient SCLC cells. Combination of abemaciclib and RT induced more cytosolic ds-DNA, and activated the STING pathway synergistically. We further showed that combining low doses of abemaciclib with low-dose RT (LDRT) plus anti-programmed cell death protein-1 (anti-PD-1) antibody substantially potentiated CD8+ T cell infiltration and significantly inhibited tumor growth and prolonged survival in an Rb-deficient immunocompetent murine SCLC model. Conclusions Our results define previously uncertain DNA damage-inducing properties of CDK4/6 inhibitor abemaciclib in Rb-deficient SCLCs, and demonstrate that low doses of abemaciclib combined with LDRT inflame the TME and enhance the efficacy of anti-PD-1 immunotherapy in SCLC model, which represents a potential novel therapeutic strategy for SCLC.

https://www.semanticscholar.org/paper/24e10a28500ba4a72e924bb4cf187bb5c3cd6cbf

Important miRs of Pathways in Different Tumor Types

PLoS Comput. Biol.

Important miRs of Pathways in Different Tumor Types We computationally determined miRs that are significantly connected to molecular pathways by utilizing gene expression profiles in different cancer types such as glioblastomas, ovarian and breast cancers. Specifically, we assumed that the knowledge of physical interactions between miRs and genes indicated subsets of important miRs (IM) that significantly contributed to the regression of pathway-specific enrichment scores. Despite the different nature of the considered cancer types, we found strongly overlapping sets of IMs. Furthermore, IMs that were important for many pathways were enriched with literature-curated cancer and differentially expressed miRs. Such sets of IMs also coincided well with clusters of miRs that were experimentally indicated in numerous other cancer types. In particular, we focused on an overlapping set of 99 overall important miRs (OIM) that were found in glioblastomas, ovarian and breast cancers simultaneously. Notably, we observed that interactions between OIMs and leading edge genes of differentially expressed pathways were characterized by considerable changes in their expression correlations. Such gains/losses of miR and gene expression correlation indicated miR/gene pairs that may play a causal role in the underlying cancers.

https://www.semanticscholar.org/paper/9a79c702e62ab3224d01e5fc3b2641958abcee7a

1H-Detected Biomolecular NMR under Fast Magic-Angle Spinning

Chemical Reviews

f458795b-af97-4b7c-ba4e-d57bbb57f90a

1H-Detected Biomolecular NMR under Fast Magic-Angle Spinning Since the first pioneering studies on small deuterated peptides dating more than 20 years ago, 1H detection has evolved into the most efficient approach for investigation of biomolecular structure, dynamics, and interactions by solid-state NMR. The development of faster and faster magic-angle spinning (MAS) rates (up to 150 kHz today) at ultrahigh magnetic fields has triggered a real revolution in the field. This new spinning regime reduces the 1H–1H dipolar couplings, so that a direct detection of 1H signals, for long impossible without proton dilution, has become possible at high resolution. The switch from the traditional MAS NMR approaches with 13C and 15N detection to 1H boosts the signal by more than an order of magnitude, accelerating the site-specific analysis and opening the way to more complex immobilized biological systems of higher molecular weight and available in limited amounts. This paper reviews the concepts underlying this recent leap forward in sensitivity and resolution, presents a detailed description of the experimental aspects of acquisition of multidimensional correlation spectra with fast MAS, and summarizes the most successful strategies for the assignment of the resonances and for the elucidation of protein structure and conformational dynamics. It finally outlines the many examples where 1H-detected MAS NMR has contributed to the detailed characterization of a variety of crystalline and noncrystalline biomolecular targets involved in biological processes ranging from catalysis through drug binding, viral infectivity, amyloid fibril formation, to transport across lipid membranes.

https://www.semanticscholar.org/paper/0183c04dd4625d1dd09befd39ea2a2146357dd86

Guy's Hospital and the Southwark Guardians

The Hospital

965d752e-3d99-47a6-bf0f-de96ba26b1f3

Guy's Hospital and the Southwark Guardians We take the following statement from the Times of 5th inst: Recently the Southwark guardians complained of the action of the authorities of Guy's Hospital in sending to their workhouse a man named Reid, who was suffering from stricture. Sent by his private doctor to the hospital to be operated upon, Reid, it was alleged, was rendered worse by an unsuccessful operation, and, instead of the joung house surgeon's calling upon his superiors to remedy the case, he packed the man off to St. George's Workhouse, where there is no convenience for carrying out operations. Here Reid was received at 2 o'clock in the morning unconscious, and, although relieved by the medical officer of the institution t

https://www.semanticscholar.org/paper/f07abdba125774d309e2b6598cfe8c16ff211932

Round the Hospitals

The Hospital

965d752e-3d99-47a6-bf0f-de96ba26b1f3

Round the Hospitals recognition and registration of nurses would protect the members of the profession and the public. At present any woman who> likes can call herself a trained nurse, and dress as though she were one. The Bill will provide for the State recognition of uniform or of some kind of badge. Anyone wearing this without the right to do so will be penalised. Expert advice has been sought and given free of charge in the preparation of the Bill for the State Begistration of Nurses, which has been moulded in the form most likely to pass through Parliament. Mr. Stanley said he hoped that very shortly either he or Major Chappie would present the new mieasure to the House of Commons. Mr. Stanley in his Brighton speech emphasised the desirability of going to Parliament with 10,000 names on the Begister, and reminded his hearers that Begistration Offices had been opened at the

https://www.semanticscholar.org/paper/9504cdd0ce381952c8f6b4b7e1a8e0dfef98467f

Synergism of Environmental Carcinogens and Promoters on Bladder Cancer Development Initiated by N‐Butyl‐N‐(4‐hydroxybutyl)nitrosamine in F344 Rats

Japanese journal of cancer research : Gann

Synergism of Environmental Carcinogens and Promoters on Bladder Cancer Development Initiated by N‐Butyl‐N‐(4‐hydroxybutyl)nitrosamine in F344 Rats Synergistic or additive effects of combined treatments with carcinogens or promoters on N‐butyl‐N‐(4‐hydroxybutyl)nitrosamine (BBN)‐initiated rat bladder carcinogenesis were examined. Male F344 rats were given BBN as an initiator followed by low doses of 3 sodium salts (sodium bicarbonate, sodium L‐ascorbate and sodium citrate) and/or 3 antioxidants (butylated hydroxyanisole, butylated hydroxytoluene and tertiary butylhydroxyquinone). Combined treatments with 3 sodium salts or 3 antioxidants, and especially all 6 chemicals together promoted bladder carcinogenesis. In addition, these combined treatments were associated with increased DNA synthesis of the bladder epithelium. Combined administration of the carcinogens, o‐anisidine, p‐cresidine, and 4‐chloro‐o‐phenylenedi‐amine at low doses also enhanced BBN‐initiated bladder carcinogenesis. These results indicate that environmental carcinogens or promoters can exert synergistic or additive actions on bladder cancer induction.

https://www.semanticscholar.org/paper/dde191abd2e5990074bdb325d3c4f32a0018680f

Robotic re-exploration for post-operative in house complications following robotic pelvic uro-oncologic surgery: Initial experience, tips and tricks

Journal of Minimal Access Surgery

810ce2f6-8686-44e4-9825-209870d60a0d

Robotic re-exploration for post-operative in house complications following robotic pelvic uro-oncologic surgery: Initial experience, tips and tricks Purpose: Despite widespread acceptance of robotics in urology, literature on using the minimally invasive approach for management of post robotic surgical complications is limited. Here we describe our experience with tips and tricks for robotic re-exploration of post-operative in house complications following robotic pelvic uro-oncologic surgery. Methods: A retrospective query of prospectively maintained database was done for all patients who underwent robotic - radical cystoprostatectomy (RCP, 437 patients) and radical prostatectomy (RP, 649 patients), from Jan 2015 or March 2021. Clinical details were collected for all who underwent a second robotic procedure during the same hospital admission for any complication related to the primary surgery. Results: Following RCP, 5 patients were re-explored for intestinal obstruction. Surgery was successfully completed in all with a median console time of 80 minutes. Median time to the passage of flatus and discharge from hospital following relook surgery was 3 and 6 days, respectively. Following RP, 3 patients underwent robotic re-exploration (two for reactionary hemorrhage, one for rectal injury). All three cases were managed with a median console time of 75 minutes. Robotic re-exploration was accomplished without extending the skin incision of the index surgery and we did not find an increased incidence of infectious or wound related complications. Conclusion: Robotic re-exploration for select post robotic urologic pelvic oncology surgery complications in the immediate and early post-operative period is feasible in the hands of experienced surgeons. Our experience can help others adopt robotics in such scenarios.

https://www.semanticscholar.org/paper/cbe90b84f9f54071a03d6f16b7f5dca8b708f4ec

A comparative evaluation of the effectiveness of subpedicle acellular dermal matrix allograft with subepithelial connective tissue graft in the treatment of isolated marginal tissue recession: A clinical study

Journal of Indian Society of Periodontology

8c7575fd-6f5a-484f-a247-3cbd44f72c79

A comparative evaluation of the effectiveness of subpedicle acellular dermal matrix allograft with subepithelial connective tissue graft in the treatment of isolated marginal tissue recession: A clinical study Introduction: The most common problem encountered in our day to day practice is exposed root surface or a tooth getting long. The main indication for root coverage procedures are esthetics and/or cosmetic demands followed by the management of root hypersensitivity, root caries or when it hampers proper plaque removal. Over the years, various techniques have been used to achieve root coverage. Aim and Objectives: The aim of this study was to compare the effectiveness of subpedicle acellular dermal matrix allograft (ADMA) with subepithelial connective tissue graft (SCTG) in the treatment of isolated marginal tissue recession. Materials and Methods: Twenty systemically healthy patients aged between 18 to 50 years (mean age29.7±4.35 years) with a recession defect on the labial and the buccal surfaces of any teeth were selected for the study. Ten patients received the test treatment (ADMA), ten patients received the control treatment (SCTG). Clinical recordings assessed at baseline, three months and six months post surgery, included Plaque index (PI), Papillary bleeding index (PBI), Gingival recession (REC), Probing pocket depth (PPD), Clinical attachment level (CAL) and Width of keratinized gingival (WKG). Results: Test group (ADMA) showed 86.93% mean root coverage while control group (SCTG) showed 84.72% at six months post surgery. Mean increase in the width of keratinized gingiva was significantly greater in the SCTG group (3.3±0.48mm) compared to ADMA group (2.4±0.51mm). Conclusion: Both the treatment produced a significant reduction in gingival recession and probing pocket depth and significant gain in clinical attachment level and width of keratinised gingiva.

https://www.semanticscholar.org/paper/7102da470f074e3bcb7886fdc4f148e4f02e5cac

Comprehensive Analysis of Tumor Microenvironment Reveals Prognostic ceRNA Network Related to Immune Infiltration in Sarcoma

Clinical Cancer Research

a360cd20-21d0-42cf-a0af-2f14e10514f0

Comprehensive Analysis of Tumor Microenvironment Reveals Prognostic ceRNA Network Related to Immune Infiltration in Sarcoma Abstract Purpose: Sarcoma is the second most common solid tumor type in children and adolescents. The high level of tumor heterogeneity as well as aggressive behavior of sarcomas brings serious difficulties to developing effective therapeutic strategies for clinical application. Therefore, it is of great importance to identify accurate biomarkers for early detection and prognostic prediction of sarcomas. Experimental Design: In this study, we characterized three subtypes of sarcomas based on tumor immune infiltration levels (TIIL), and constructed a prognosis-related competing endogenous RNA (ceRNA) network to investigate molecular regulations in the sarcoma tumor microenvironment (TME). We further built a subnetwork consisting of mRNAs and lncRNAs that are targets of key miRNAs and strongly correlated with each other in the ceRNA network. After validation using public data and experiments in vivo and in vitro, we deeply dug the biological role of the miRNAs and lncRNAs in a subnetwork and their impact on TME. Results: Altogether, 5 miRNAs (hsa-mir-125b-2, hsa-mir-135a-1, hsa-mir92a-2, hsa-mir-181a-2, and hsa-mir-214), 3 lncRNAs (LINC00641, LINC01146, and LINC00892), and 10 mRNAs (AGO2, CXCL10, CD86, CASP1, IKZF1, CD27, CD247, CD69, CCR2, and CSF2RB) in the subnetwork were identified as vital regulators to shape the TME. On the basis of the systematic network, we identified that trichostatin A, a pan-HDAC inhibitor, could potentially regulate the TME of sarcoma, thereby inhibiting the tumor growth. Conclusions: Our study identifies a ceRNA network as a promising biomarker for sarcoma. This system provides a more comprehensive understanding and a novel perspective of how ceRNAs are involved in shaping sarcoma TME.

https://www.semanticscholar.org/paper/f40bf03f308f28cd36f517bc0519fdb3366d0f24

Evaluation of Amphetamine-Related Hospitalizations and Associated Clinical Outcomes and Costs in the United States

JAMA Network Open

b9444cdd-c1d0-45a8-9db6-f8a53936292e

Evaluation of Amphetamine-Related Hospitalizations and Associated Clinical Outcomes and Costs in the United States Key Points Question What are the current trends in frequency and costs of amphetamine-related hospitalizations in the United States? Findings In this cross-sectional study of approximately 1.3 million amphetamine-related US hospitalizations between 2003 and 2015, hospitalizations increased substantially by 2015, with the highest frequency being in the western United States and the predominant payer being Medicaid. Meaning Amphetamine use may be an emerging public health issue; pharmacologic and nonpharmacologic therapies that effectively treat amphetamine use disorder are needed.

https://www.semanticscholar.org/paper/2ab732f99d10caf2043e1db3dbd17b1ad3b6f21e

Notes

The Classical Review

6afbd88d-f493-4d85-bc06-3358c00b2a1b

Notes The other contributors old and new have combined to raise the standard of the work to a higher pitch of excellence than before, and many pieces of great merit have been rejected to make room for better. One piece by W.G.C. has been retained from the ' Lotus Eaters' (page 355) which should have been sacrificed. In Greek verse Mr Archer-Hind fully maintains the old character of his school; and is equally strong in Elegiacs and Iambics. In a fine passage (page 387), a translation of Tennyson's 'The Revenge,' are two' false prints—ireppov for arepnov' and ?IIUV for ^ifuv. While on this subject it may be as well to note accents misprinted for breathings (pages 115 and 261) and avrbs for avrbs (page 159) ' caram' for ' earam' (page 305) and ' florens' for ' floreus ' (page 389). Is it lawful to disregard ' synaphea' in anapaests, except after the paroemiac verse ? If not TTJS troKv&oiXov iv Se yepdvruv will be incorrect at page 87. The first part concludes, as it began, with ' Sabrina fair' translated beautifully into Alcaics, and is followed by Carolina Sacra, most of them written by Dr. Kennedy and Canon Evans, but containing a fine elegiac copy by Mr Bum. In conclusion the advice to be given to possessors and non-possessors of the old volume may be briefly expressed thus :—

https://www.semanticscholar.org/paper/9a4d89311df9923e8dcc1d5a6c92b0ae92eb7da7

Joint statement for the diagnosis, management, and prevention of chronic obstructive pulmonary disease for Gulf Cooperation Council countries and Middle East-North Africa region, 2017 [Corrigendum]

International Journal of COPD

2ba74a01-f435-4518-8351-d7879cf45ced

Joint statement for the diagnosis, management, and prevention of chronic obstructive pulmonary disease for Gulf Cooperation Council countries and Middle East-North Africa region, 2017 .

https://www.semanticscholar.org/paper/678e7bf129e29028d1415273792ae38080eb7069

An Ishmaelite

The Hospital

965d752e-3d99-47a6-bf0f-de96ba26b1f3

An Ishmaelite numerous sisters and cousins in the season, and was rather peremptory in insisting that she should keep up friendly relations with them all, while, if he did not absolutely discourage visits to her own kindred, he showed plainly enough that he took scant interest in hearing of them. Poor little Nellie ! The old feeling of being in disgrace frequently haunted her still. Her husband was generous enough to her. She had a smart little victoria in which to drive

https://www.semanticscholar.org/paper/8faf3debb541f7dbc764a8e5f5bdadfee73f7f1b

Calcium lights up cell cycle

Journal of Cell Biology

bf59074e-18fd-4f9a-a1b0-a9bafc16f518

Calcium lights up cell cycle Calcium biologists have long suggested that there was a fundamental role for the cation in the cell cycle, but the supporting data have been largely circumstantial. Now, See et al. (page 661) have direct evidence for a transient Ca2+ trigger in the initiation of the cell cycle upon serum stimulation. They also find that the transcription factor NF-κB links the ion flux to a well-known cell cycle control gene, cyclin D1.

https://www.semanticscholar.org/paper/3935312e2e13a967c3b2f794b3c23254558d3036

Erratum: Investigation of two suspected diarrhoeal-illness outbreaks in Northern Cape and KwaZulu-Natal provinces, South Africa, April–July 2013: The role of rotavirus

Southern African Journal of Infectious Diseases

94f4c4cb-7b79-4a80-87e5-2fe38eff354a

Erratum: Investigation of two suspected diarrhoeal-illness outbreaks in Northern Cape and KwaZulu-Natal provinces, South Africa, April–July 2013: The role of rotavirus .

https://www.semanticscholar.org/paper/ab71e6b9035e48b1771a97c228f58fe369463cbc

Erratum: Associations between Ambient Fine Particulate Oxidative Potential and Cardiorespiratory Emergency Department Visits

Environmental Health Perspectives

74dbb751-54d9-4be5-baa6-52a5e58ea8dd

Erratum: Associations between Ambient Fine Particulate Oxidative Potential and Cardiorespiratory Emergency Department Visits .

https://www.semanticscholar.org/paper/46800195c8973bd46549f624e835af10bab0d85b

PHL9/455: DIKS - The National Diabetes Information and Communication Server

Journal of Medical Internet Research

2baad992-2268-4c38-9120-e453622f2eeb

PHL9/455: DIKS - The National Diabetes Information and Communication Server Introduction Diabetes mellitus has developed to a wide-spread disease. It is known that information about the risks of diabetes could lead to a change in personal behaviour, which lowers the risks of diabetes and diseases caused by it. Esp. early diagnosis could help avoiding diabetes-caused diseases. The National Diabetes Information and Communication Server DIKS shall lead to better information of the public. The Diabetes Research Institute Düsseldorf has started with its development in a project financed by the German Ministry of Health. Methods DIKS will cover a wide range of services. As means of presentation are planned: print media, multimedia CDs, touch screen terminals (located in pharmacies, but also in many public places) and of course the Internet. The presentation will be actualized regularly, and attractive enough to guarantee public interest. It is planned to make special presentations for all ages (e.g. children, seniors) and foreign citizens as well (multi-lingual).The Internet offers the possibility for feedback, and profiles of users will be generated. The citizen will have the opportunity to ask questions via Internet. A second level will be the communication between experts. Diabetologist will have a platform for information interchange, publications, and they are asked to participate in the whole project. The DIKS project has just begun. All information will be stored in databases, from where all presentations will be generated dynamically, so that a unique layout will lead to a corporate identity. It is planned to go "online" in about a year. Discussion We hope that the DIKS will reach a great part of the public. I should not be just one new web site, which loses its attractiveness over the time.

https://www.semanticscholar.org/paper/b0ed2de0645d6ddd0bbbc89a8ff881f7b29747db

The American Hospital in Moscow: A Lesson in International Cooperation, 1917–23

Medicina e historia

01e1b869-8faa-4deb-8cd9-48453c0c239e

The American Hospital in Moscow: A Lesson in International Cooperation, 1917–23 In its examination of American Medical Aid to Russia, this article shows how the best of intentions can have the potential to go horribly awry. It argues that the competing binary forces of international collaboration and goodwill versus political tensions and uncertainty combined to create an environment wherein actors and agents inhabited an ever changing and unpredictable international stage. Could American philanthropic organisations and individuals overcome political volatility, financial restrictions and ideological barriers? Just what would it take to establish an American hospital in Moscow, the Bolshevik seat of power? The attempt to establish the hospital proved to be an exercise in patience, persistence and prudence (although not always in equal measure). This article shows that international cooperation, while undoubtedly complicated, was certainly possible. The flow of information, materiel and personnel between the United States, Germany and Russia proved that good intentions, trust and a will to help others were valued. The history of American Medical Aid to Russia also demonstrates that the Quaker role of facilitator and interlocutor was vital in establishing a relationship of trust between Soviet Russia and the United States. This article discusses the difficulties that philanthropic organisations faced when navigating the choppy international waters of the early 1920s and highlights the rewards of successfully doing this. It argues that basic human relationships and trust were just as, if not sometimes more, important than ideology in determining the tenor of early US–Soviet relations.

https://www.semanticscholar.org/paper/ed6ba539e244fbdebc3bbcc1d0affb781aa7949f

Inverse Takotsubo Syndrome Resulting from a Fall, Malleolar Fracture, Anesthesia, Surgery, or Complicating Pulmonary Embolism?

Korean Circulation Journal

06f9f224-e5e4-4f7e-81e0-dd9a5edfdf5d

Inverse Takotsubo Syndrome Resulting from a Fall, Malleolar Fracture, Anesthesia, Surgery, or Complicating Pulmonary Embolism? To the Editor: The interesting case report of Lee et al.1) published in the December 2013 issue of the Journal, of a 43-year-old woman who suffered inverted takotsubo syndrome (TTS) (left ventricular apical hyperkinesis with midventricular and basal hypokinesis/akinesis) in the setting of complicating pulmonary embolism (PE), following surgery for a malleolar fracture, managed surgically under spinal anesthesia, spurs one to delve in the real cause of TTS in this patient; accordingly one wonders whether the emotional upheaval (with consequent adrenerergic sympathetic surge) from falling from a ladder, physical stress of pain from suffering a malleolar fracture, spinal anesthesia, surgical management of the fracture, or PE, all, or one or more of the above, in any combination, was the actual trigger of TTS in this otherwise healthy woman. More and more cases of TTS following PE are being reported in the literature, but TTS is also common in association with accidents, pain, fractures, anesthesia, various invasive procedures, and surgery, as can be shown by browsing the large research output on TTS.2) The present case reminds one about the ambivalence in attributing a case of TTS to a urological instrumentation, or the resultant sepsis, in a recently published report.3) The electrocardiogram (ECG) included in this case report is not of much help to ascertain the onset of TTS (ST-segment elevation and attenuation of the voltage of the QRS complexes, early in the illness,4),5) with deep T-wave inversions with QTc prolongation in subsequent evolution. Indeed the prevalence of the T-wave inversions have been found to be lower in patients with the inverse TTS, as compared with the typical apical TTS variant.6) Careful scrutiny of history, with timing of the suspected triggers, and frequent assessment of biomarkers, recording of ECGs, and performing echocardiograms, will improve our abilities in detecting the real trigger of TTS in reported cases.

https://www.semanticscholar.org/paper/4ed6f8c9fe35b4ce2b7a359c92df0f6e2be55260

Impact of diabetes mellitus on the respiratory function of amyotrophic lateral sclerosis patients

European Journal of Neurology

051af27b-63c1-4210-a397-2fa053a410cc

Impact of diabetes mellitus on the respiratory function of amyotrophic lateral sclerosis patients Respiratory insufficiency and its complications are the main cause of death in amyotrophic lateral sclerosis (ALS). The impact of diabetes mellitus (DM) on respiratory function of ALS patients is uncertain.

https://www.semanticscholar.org/paper/891f2d0f216bf3378b33ca658d854e2c03c6bec5

Grading the Impact of a Standardized Β Lactam Antibiotic Allergy Assessment Protocol for Treatment Decisions: An Antimicrobial Stewardship Target

Open Forum Infectious Diseases

f20432ac-3c14-4779-bc66-2f24e1b2715e

Grading the Impact of a Standardized Β Lactam Antibiotic Allergy Assessment Protocol for Treatment Decisions: An Antimicrobial Stewardship Target Abstract Background Approximately 30% of patients at our institution have β-lactam (BL) antibiotic allergies documented in their medical record. This translates to high use of non-β-lactams (NBL) or other structurally dissimilar agents. Patients treated with NBL are three times as likely to experience an adverse effect or be readmitted for infection. BL allergy assessment, re-challenge and de-labeling remain an important target for antimicrobial stewardship (AST). Published protocols have been validated at large teaching institutions with improvements in documentation and the care of patients with labeled allergies, including drug challenge protocols and desensitization for true allergies. At BIDMC, a multidisciplinary committee developed a guidance document to include a series of standard questions, medical record review and appropriate clarifications for the medical record. The guideline also includes recommendations an algorithm for the approach to drug challenge or desensitization. Methods The guideline was launched in September 2016 and this study examined the first 4 months of use. The primary endpoint compared the number of full desensitizations requiring ICU admission, and number of graded/full challenges pre- and post-implementation. Aztreonam, which is structurally dissimilar to other BL, was used as a surrogate marker of avoidance of BL. Results Pre-implementation rates of graded challenges and full desensitizations were equivalent. This was bifurcated by 1,000% within 4 months such that the use of graded challenge was 10 times the desensitization rate (Figure 1). Aztreonam use decreased from a 2.33 patient days of therapy (pDOT) per 1,000 days in September to 1.74 in January (Figure 2). The decrease in utilization was most pronounced on the General Medicine units. Utilization was driven most heavily by patients being treated by the Hematology Oncology Service. No adverse reactions were documented during any post guideline β lactam challenges. Conclusion Introduction of a multidisciplinary guideline by AST and Allergy led to preferred utilization of graded challenge over full ICU desensitization and an overall decrease in aztreonam use.Figure 1Figure 2 Disclosures All authors: No reported disclosures.

https://www.semanticscholar.org/paper/0e4abf3a036b2fabdc20e78e10cce2ee0460ef77

Does hyperthermic povidone-iodine lavage increase the apoptotic rate of residual cancer cell in patients with malignant pleural mesothelioma?—a prospective pilot study

Translational Lung Cancer Research

e26ac614-70cd-46ac-b2c3-2b4d5b9ca6a4

Does hyperthermic povidone-iodine lavage increase the apoptotic rate of residual cancer cell in patients with malignant pleural mesothelioma?—a prospective pilot study Background Malignant pleural mesothelioma (MPM) is an incurable, late presenting primary cancer, conferring a survival of 8–14 months. Different intrapleural treatments have been tested as part of a multimodality approach to treat a select group of patients with limited disease, increasing survival. Recently, povidone-iodine has been shown to induce apoptosis in microscopic tumour cells in vitro, with no reported complications. This is the first in vivo study assessing the apoptotic rate caused by intraoperative hyperthermic betadine lavage using routine immunohistochemistry combined with transmission electron microscopy (TEM). Methods We included surgically fit patients aged >18, undergoing minimally invasive video-assisted thoracoscopic surgery (VATS) pleural biopsy between December 2016 and February 2018, for confirmed or presumed pleural malignancy. Parietal pleural biopsies were obtained at 7.5, 15 and 30 minutes after hyperthermic betadine lavage, and compared to pre-lavage biopsy samples, for apoptotic changes. Viable tumour samples underwent histological, immunohistochemical and ultrastructural analysis as well as TEM for features of apoptosis. Results N=6. Median age was 76 years. Median overall survival was 26.7 months. There was no statistical impact on survival of side of disease (left vs. right). There was no significant difference in expressions of markers of apoptotic index pre and post betadine treatment upon immunohistochemical analysis. There was no discernible effect on morphological features of apoptosis seen with betadine treatment, on TEM analysis. No side effects were identified post betadine lavage. Conclusions Although hyperthermic betadine lavage is a safe antiseptic solution with no toxicity when performed intraoperatively, it confers no effect on apoptotic rate or necrosis. It is therefore unlikely that hyperthermic betadine lavage will have an impact on reducing the microscopic residual disease after pleurectomy decortication and enhancing survival.

https://www.semanticscholar.org/paper/67203530db30d498957336a867b30db13ba1eda7

Computer Based Assessment (CBA): Perception of residents at Dow University of Health Sciences

Pakistan Journal of Medical Sciences

bb28e951-d445-482f-a892-f62ee52d3221

Computer Based Assessment (CBA): Perception of residents at Dow University of Health Sciences Background and objective : During the past few years, Computer-based assessment (CBA) has gained popularkity as a testing modality. This assessment offers several advantages over paper based assessment (PBA) testing. The objective of this study was to find out residents’ perception of this method of assessment. Methods : The post graduate residents of Dow University of Health Sciences in the field of Surgery, Medicine, Gynecology and Obstetrics experienced their first formative Computer-based assessment (CBA) in year 2013.Immediately after formative CBA, an anonymous paper based questionnaire was distributed amongst the residents and response was sought for their self-perceived computer usage competence before starting residency, perceptions regarding CBA method and to determine their preference for PBA or CBA in future assessment preferences. Results: Total 173 residents completed the questionnaire. More than half of residents, 56.1% had no prior experience of CBA. Three fourth, 76.4% of the residents were less than confident before sitting in CBA, while after completing CBA, 64.8% were either confident or extremely confident for CBA. Most common problem encountered by students was logging in 28.9%. More students (53.2%) believed that paper assessment took longer to complete than CBA. Majority of the students (61.8%) rated CBA as better than PBA despite experiencing it for the first time. Conclusion: Resident’s perception for CBA is good and they recommend its use in future assessment as well. However, to take maximal advantage of this technology, faculty should be trained to develop questions not only with text and pictures but with audio and video support.

https://www.semanticscholar.org/paper/dd6bcc914e51e9e372f064087364e39c322b2238

Clinical Study in 11 Cases of Endobronchial Foreign Body

Diagnostic and Therapeutic Endoscopy

88f9fa26-240b-429b-b395-2468ab8d3b79

Clinical Study in 11 Cases of Endobronchial Foreign Body We report 11 cases of endobronchial foreign body. From January 1982 through December 1994, a total of 11 cases were diagnosed roentogenographically and bronchoscopically at our hospital. These patients consisted of 10 men and 1 woman with a mean age of 58.5 years (range 33 to 77 years). Symptoms on presenting were usually cough, sputum, or chest pain. The foreign bodies were inorganic in 10 cases and of organic origin in 1 case. Three patients were not aware that they had aspirated a foreign body. In 9 patients, the endobronchial foreign bodies were successfully removed endoscopically. One patient spontaneously expectorated the foreign body before bronchoscopy. One patient underwent thoracotomy because the foreign body could not be removed bronchoscopically. There were no severe complications during or after the endoscopic removal of the foreign bodies, but in one patient extraction of the foreign body caused pneumonia after bronchoscopy. In conclusion, flexible bronchoscopy is useful for the diagnosis and treatment of endobronchial foreign bodies.

https://www.semanticscholar.org/paper/75024e7f42ae2c91b0443e7bb63cd9717e57bcaf

Giant honeybees (Apis dorsata) trade off defensiveness against periodic mass flight activity

PLoS ONE

0aed7a40-85f3-4c66-9e1b-c1556c57001b

Giant honeybees (Apis dorsata) trade off defensiveness against periodic mass flight activity The giant honeybee Apis dorsata (Fabricius, 1793) is an evolutionarily ancient species that builds its nests in the open. The nest consists of a single honeycomb covered with the bee curtain which are several layers of worker bees that remain almost motionless with their heads up and abdomens down on the nest surface, except for the mouth area, the hub between inner- and outer-nest activities. A colony may change this semi-quiescence several times a day, depending on its reproductive state and ambient temperature, to enter the state of mass flight activity (MFA), in which nest organisation is restructured and defense ability is likely to be suppressed (predicted by the mass-flight-suspend-defensiveness hypothesis). For this study, three episode of MFA (mfa1-3) of a selected experimental nest were analysed in a case study with sequences of >60 000 images at 50 Hz, each comprise a short pre-MFA session, the MFA and the post-MFA phase of further 10 min. To test colony defensiveness under normative conditions, a dummy wasp was cyclically presented with a standardised motion programme (Pd) with intervening sessions without such a presentation (nPd). Motion activity at five selected surveillance zones (sz1-5) on the nest were analysed. In contrast to mfa1,2, in mfa3 the experimental regime started with the cyclic presentation of the dummy wasp only after the MFA had subsided. As a result, the MFA intensity in mfa3 was significantly lower than in mfa1-2, suggesting that a colony is able to perceive external threats during the MFA. Characteristic ripples appear in the motion profiles, which can be interpreted as a start signal for the transition to MFA. Because they are strongest in the mouth zone and shift to higher frequencies on their way to the nest periphery, it can be concluded that MFA starts earlier in the mouth zone than in the peripheral zones, also suggesting that the mouth zone is a control centre for the scheduling of MFA. In Pd phases of pre- and postMFA, the histogram-based motion spectra are biphasic, suggesting two cohorts in the process, one remaining at quiescence and the other involved in shimmering. Under MFA, nPd and Pd spectra were typically Gaussian, suggesting that the nest mates with a uniform workload shifted to higher motion activity. At the end of the MFA, the spectra shift back to the lower motion activities and the Pd spectra form a biphasic again. This happens a few minutes earlier in the peripheral zones than in the mouth zone. Using time profiles of the skewness of the Pd motion spectra, the mass-flight-suspend-defensiveness hypothesis is confirmed, whereby the inhibition of defense ability was found to increase progressively during the MFA. These sawtooth-like time profiles of skewness during MFA show that defense capability is recovered again quite quickly at the end of MFA. Finally, with the help of the Pd motion spectra, clear indications can be obtained that the giant honeybees engage in a decision in the sense of a tradeoff between MFA and collective defensiveness, especially in the regions in the periphery to the mouth zone.

https://www.semanticscholar.org/paper/c732745b9bda920176d5e8b9ded0e52b1479021b

Traditional medicine consumption in postpartum for HBV-infected women enrolled in the ANRS 12345 TA PROHM study in Cambodia

PLoS ONE

0aed7a40-85f3-4c66-9e1b-c1556c57001b

Traditional medicine consumption in postpartum for HBV-infected women enrolled in the ANRS 12345 TA PROHM study in Cambodia In Cambodia, traditional medicine was commonly described as being used by pregnant women at two time points: one month before birth and during early postpartum. The present study aims to describe traditional medicine consumption during postpartum phase for women enrolled in the TA PROHM study and to investigate the possible association between traditional medicine consumption and acute liver toxicity. An ethnobotanical survey was conducted in 2 groups of HBV-infected pregnant women (with and without postpartum hepatocellular injury) enrolled in the study. Hepatocellular injury was defined by having Alanine Aminotransferase (ALT) > 2.5 times the Upper Limit of Normal (ULN = 40 U/L) at the 6th week postpartum visit. Interviews were done using a standardized questionnaire. Plant samples were collected and later identified by two traditional healers. Chi-square test was used to find the association between hepatocellular injury and traditional medicine consumption or a specific plant species. In total, 75 women were enrolled and 52 (69.3%) used at least one traditional remedy composed of 123 different plants and 12 alcoholic macerations of porcupine stomach. Orally consuming at least one remedy with alcohol was significantly associated with hepatocellular injury (33% vs 13%, p = 0.034). Among the 123 plants species identified, four were found to be associated with hepatocellular injury, namely Amphineurion marginatum (Roxb.) D.J.Middleton (p = 0.022), Selaginella tamariscina (P.Beauv.) Spring (p = 0.048), Mitragyna speciosa Korth. (p = 0.099) and Tetracera indica (Christm. & Panz.) Merr. (p = 0.079). Consumption of traditional medicine in postpartum is a common practice for women enrolled in the TA PROHM study. Alcohol-based remedies may exacerbate the risk of acute hepatocellular injury in HBV-infected women already exposed to immune restoration. The complex mixtures of herbs need to be further evaluated by in vitro and in vivo studies.

https://www.semanticscholar.org/paper/1a461961532e49f29ae170e223e44292cf786378

Increased levels of immature and activated low density granulocytes and altered degradation of neutrophil extracellular traps in granulomatosis with polyangiitis

PLoS ONE

0aed7a40-85f3-4c66-9e1b-c1556c57001b

Increased levels of immature and activated low density granulocytes and altered degradation of neutrophil extracellular traps in granulomatosis with polyangiitis Granulomatosis with Polyangiitis (GPA) is a small vessel vasculitis typically associated with release of neutrophil extracellular traps (NETs) by activated neutrophils. In this study, we further aimed to investigate the contributions of neutrophils and NETs to the complex disease pathogenesis. We characterized the phenotype of neutrophils and their capacity to induce NETs. In addition, the level of circulating NETs, determined by neutrophil elastase/DNA complexes, and the capacity of patient sera to degrade NETs were investigated from blood samples of 12 GPA patients, 21 patients with systemic lupus erythematosus (SLE) and 21 healthy donors (HD). We found that GPA patients had significantly increased levels of low-density granulocytes (LDGs) compared to HD, which displayed an activated and more immature phenotype. While the propensity of normal-density granulocytes to release NETs and the levels of circulating NETs were not significantly different from HD, patient sera from GPA patients degraded NETs less effectively, which weakly correlated with markers of disease activity. In conclusion, increased levels of immature and activated LDGs and altered degradation of circulating NETs may contribute to pathogenesis of GPA, potentially by providing a source of autoantigens that trigger or further enhance autoimmune responses.

https://www.semanticscholar.org/paper/288ae61678bb79ff84b712eac1586f3607c4a0bc

Labor curves based on cervical dilatation over time and their accuracy and effectiveness: A systematic scoping review

PLoS ONE

0aed7a40-85f3-4c66-9e1b-c1556c57001b

Labor curves based on cervical dilatation over time and their accuracy and effectiveness: A systematic scoping review Objectives This systematic scoping review was conducted to 1) identify and describe labor curves that illustrate cervical dilatation over time; 2) map any evidence for, as well as outcomes used to evaluate the accuracy and effectiveness of the curves; and 3) identify areas in research that require further investigation. Methods A three-step systematic literature search was conducted for publications up to May 2023. We searched the Medline, Maternity & Infant Care, Embase, Cochrane Library, Epistemonikos, CINAHL, Scopus, and African Index Medicus databases for studies describing labor curves, assessing their effectiveness in improving birth outcomes, or assessing their accuracy as screening or diagnostic tools. Original research articles and systematic reviews were included. We excluded studies investigating adverse birth outcomes retrospectively, and those investigating the effect of analgesia-related interventions on labor progression. Study eligibility was assessed, and data were extracted from included studies using a piloted charting form. The findings are presented according to descriptive summaries created for the included studies. Results and implications for research Of 26,073 potentially eligible studies, 108 studies were included. Seventy-three studies described labor curves, of which ten of the thirteen largest were based mainly on the United States Consortium on Safe Labor cohort. Labor curve endpoints were 10 cm cervical dilatation in 69 studies and vaginal birth in 4 studies. Labor curve accuracy was assessed in 26 studies, of which all 15 published after 1986 were from low- and middle–income countries. Recent studies of labor curve accuracy in high-income countries are lacking. The effectiveness of labor curves was assessed in 13 studies, which failed to prove the superiority of any curve. Patient-reported health and well-being is an underrepresented outcome in evaluations of labor curves. The usefulness of labor curves is still a matter of debate, as studies have failed to prove their accuracy or effectiveness.

https://www.semanticscholar.org/paper/82b95d8f95ab9c49348ee945203ec421a9da698d

The absence of core piRNA biogenesis factors does not impact efficient transposon silencing in Drosophila

PLoS Biology

83ff973b-8a0e-4e00-a06a-2cfd9e222de9

The absence of core piRNA biogenesis factors does not impact efficient transposon silencing in Drosophila Organisms require mechanisms to distinguish self and non-self-RNA. This distinction is crucial to initiate the biogenesis of Piwi-interacting RNAs (piRNAs). In Drosophila ovaries, PIWI-guided slicing and the recognition of piRNA precursor transcripts by the DEAD-box RNA helicase Yb are the 2 known mechanisms to licence an RNA for piRNA biogenesis in the germline and the soma, respectively. Both the PIWI proteins and Yb are highly conserved across most Drosophila species and are thought to be essential to the piRNA pathway and for silencing transposons. However, we find that species closely related to Drosophila melanogaster have lost the yb gene, as well as the PIWI gene Ago3. We show that the precursor RNA is still selected in the absence of Yb to abundantly generate transposon antisense piRNAs in the soma. We further demonstrate that Drosophila eugracilis, which lacks Ago3, is completely devoid of ping-pong piRNAs and exclusively produces phased piRNAs in the absence of slicing. Thus, core piRNA pathway genes can be lost in evolution while still maintaining efficient transposon silencing.

https://www.semanticscholar.org/paper/8ea316abec53cfa267f0600c03bc5f4f43317974

The prognostic significance of tumor-immune microenvironment in ascites of patients with high-grade serous carcinoma

Radiology and Oncology

20a0bd6c-5966-491e-a768-06986b9348f1

The prognostic significance of tumor-immune microenvironment in ascites of patients with high-grade serous carcinoma Abstract Background High-grade serous carcinoma (HGSC) is often associated with ascites at presentation. Our objective was to quantify immune cells (ICs) in ascites prior to any treatment was given and evaluate their impact on progression-free survival (PFS) and overall survival (OS). Patients and methods Forty-seven patients with primary HGSC and ascites were included. Flow-cytometric analysis was performed to detect percentages of CD3+ T cells (CD4+, CD8+, Tregs, and NKT cells), B cells, NK cells (CD56brightCD16− and CD56dimCD16+ subsets), macrophages and dendritic cells (DCs). Furthermore, CD103 expression was analyzed on T cells and their subsets, while PD-1 and PD-L1 expression on all ICs. Cut-off of low and high percentages of ICs was determined by the median of variables, and correlation with PFS and OS was calculated. Results CD3+ cells were the predominant ICs (median 51%), while the presence of other ICs was much lower (median ≤10%). CD103+ expression was mostly present on CD8+, and not CD4+ cells. PD-1 was mainly expressed on CD3+ T cells (median 20%), lower expression was observed on other ICs (median ≤10%). PD-L1 expression was not detected. High percentages of CD103+CD3+ T cells, PD-1+ Tregs, CD56brightCD16− NK cells, and DCs correlated with prolonged PFS and OS, while high percentages of CD8+ cells, macrophages, and PD-1+CD56brightCD16− NK cells, along with low percentages of CD4+ cells, correlated with better OS only. DCs were the only independent prognostic marker among all ICs. Conclusions Our results highlight the potential of ascites tumor-immune microenvironment to provide additional prognostic information for HGSC patients. However, a larger patient cohort and longer follow-up are needed to confirm our findings.

https://www.semanticscholar.org/paper/24ba0e2dd781deef3d252f11ceefa8794e0d341e

Retracted: Effect of the Kanghuier Transparent Hydrocolloid Dressing in Preventing Central Venous Catheter Infection and Phlebitis after Cardiac Surgery

Computational and Mathematical Methods in Medicine

2ca1e2ac-8c3b-4251-94ed-24846d391d3b

Retracted: Effect of the Kanghuier Transparent Hydrocolloid Dressing in Preventing Central Venous Catheter Infection and Phlebitis after Cardiac Surgery .

https://www.semanticscholar.org/paper/14f4c511872b6f5fca8dc19262b2f02c2e7123da

Urinary Neurotransmitter Testing: Considerations of Spot Baseline Norepinephrine and Epinephrine [Retraction]

Research and Reports in Urology

3384a182-b216-4c75-9e98-1e52f0d92dcb

Urinary Neurotransmitter Testing: Considerations of Spot Baseline Norepinephrine and Epinephrine .

https://www.semanticscholar.org/paper/49b4cdc4bcc54c1fdc41015ee1ce9b7a58563bd5

Causally Investigating Cortical Dynamics and Signal Processing by Targeting Natural System Attractors With Precisely Timed (Electrical) Stimulation

Frontiers in Computational Neuroscience

8c456f98-9892-42ac-9b16-418755f01550

Causally Investigating Cortical Dynamics and Signal Processing by Targeting Natural System Attractors With Precisely Timed (Electrical) Stimulation Electrical stimulation is a promising tool for interacting with neuronal dynamics to identify neural mechanisms that underlie cognitive function. Since effects of a single short stimulation pulse typically vary greatly and depend on the current network state, many experimental paradigms have rather resorted to continuous or periodic stimulation in order to establish and maintain a desired effect. However, such an approach explicitly leads to forced and “unnatural” brain activity. Further, continuous stimulation can make it hard to parse the recorded activity and separate neural signal from stimulation artifacts. In this study we propose an alternate strategy: by monitoring a system in realtime, we use the existing preferred states or attractors of the network and apply short and precise pulses in order to switch between those states. When pushed into one of its attractors, one can use the natural tendency of the system to remain in such a state to prolong the effect of a stimulation pulse, opening a larger window of opportunity to observe the consequences on cognitive processing. To elaborate on this idea, we consider flexible information routing in the visual cortex as a prototypical example. When processing a stimulus, neural populations in the visual cortex have been found to engage in synchronized gamma activity. In this context, selective signal routing is achieved by changing the relative phase between oscillatory activity in sending and receiving populations (communication through coherence, CTC). In order to explore how perturbations interact with CTC, we investigate a network of interneuronal gamma (ING) oscillators composed of integrate-and-fire neurons exhibiting similar synchronization and signal routing phenomena. We develop a closed-loop stimulation paradigm based on the phase-response characteristics of the network and demonstrate its ability to establish desired synchronization states. By measuring information content throughout the model, we evaluate the effect of signal contamination caused by the stimulation in relation to the magnitude of the injected pulses and intrinsic noise in the system. Finally, we demonstrate that, up to a critical noise level, precisely timed perturbations can be used to artificially induce the effect of attention by selectively routing visual signals to higher cortical areas.

https://www.semanticscholar.org/paper/8c3fe31139f674cbd390c0fcf4fe415e317d1b2b

Chondroblastoma patella presenting as a pathological fracture

Indian Journal of Orthopaedics

078d2ad5-d81d-4e98-be04-8749abc94247

Chondroblastoma patella presenting as a pathological fracture A 24-year-old male presented with an inability to walk after a trivial fall. He had pain and mild swelling anterior to the right knee for the past one year. X-ray showed a transverse fracture of patella with a lytic lesion occupying most of the two halves of the patella. Fine needle aspiration cytology (FNAC) of the lytic lesion revealed a few osteoclastic giant cells and occasional osteoblasts against a hemorrhagic background. Patellectomy was performed. Histology revealed trabecular bone admixed with proliferating chondroid tissue at places admixed with myxoid and fibrous tissue with focal areas of calcification suggestive of chondroblastoma. Focal areas showed osteoclastic giant cells with areas of hemorrhage. The purpose is to present a rare tumor occurring at an unusual site which presented as pathological fracture.

https://www.semanticscholar.org/paper/ae1781c36d94b6e3b0e612ae912564e281c1e48a

Quantitative Proteomic and Transcriptomic Analyses of Metabolic Regulation of Adult Reproductive Diapause in Drosophila suzukii (Diptera: Drosophilidae) Females

Frontiers in Physiology

e28a224b-8ddb-49a6-82d2-17f23c68b30c

Quantitative Proteomic and Transcriptomic Analyses of Metabolic Regulation of Adult Reproductive Diapause in Drosophila suzukii (Diptera: Drosophilidae) Females Diapause is a form of dormancy used by many insects to survive adverse environmental conditions, which can occur in specific developmental stages in different species. Drosophila suzukii is a serious economic pest and we determined the conditions for adult reproductive diapause by the females in our previous studies. In this study, we combined RNA-Seq transcriptomic and quantitative proteomic analyses to identify adult reproductive diapause-related genes and proteins. According to the transcriptomic analysis, among 242 annotated differentially expressed genes in non-diapause and diapause females, 129 and 113 genes were up- and down-regulated, respectively. In addition, among the 2,375 proteins quantified, 39 and 23 proteins were up- and down-regulated, respectively. The gene expression patterns in diapause- and non-diapause were confirmed by qRT-PCR or western blot analysis. The overall analysis of robustly regulated genes at the protein and mRNA levels found four genes that overlapped in the up-regulated group and six genes in the down-regulated group, and thus these proteins/genes may regulate adult reproductive diapause. These differentially expressed proteins/genes act in the citrate cycle, insulin signaling pathway, PI3K-Akt signaling pathway, and amino acid biosynthesis pathways. These results provide the basis for further studies of the molecular regulation of reproductive diapause in this species.

https://www.semanticscholar.org/paper/6c54a34b721f8f8d63e0ab63471f0a16821ad566

Black market blood transfusions for Ebola: potential for increases in other infections

Global Health Action

a694c512-e591-4fa9-8959-ac0b91207792

Black market blood transfusions for Ebola: potential for increases in other infections No abstract available. (Published: 17 November 2014) Citation : Glob Health Action 2014,  7 : 26356 - 

https://www.semanticscholar.org/paper/81299fa123c9b5699ee1d161e025257a7d9eef33

Urinary Catheterization in Medical Wards

Journal of Global Infectious Diseases

9efb0f18-6540-419e-883b-810a791ae217

Urinary Catheterization in Medical Wards Aims: The study aims to determine the: 1. frequency of inappropriate catheterization in medical wards and the reasons for doing it. 2. various risk factors associated with inappropriate catheterization, catheter associated urinary tract infections (CAUTI) and bacterial colonization on Foley's catheters (BCFC). Settings and Design: Hospital-based prospective study. Materials and Methods: One hundred and twenty five patients admitted consecutively in the medical wards of a tertiary care hospital, who underwent catheterization with a Foley's catheter, at admission, have been included in the study. Patient profiles were evaluated using the following parameters: age, sex, diagnosis, functional status, mental status, indication, duration and place of catheterization, development of BCFC and CAUTI. Statistical tests used: Chi-square test. Results: Thirty-six out of 125 (28.8%) patients included were inappropriately catheterized. BCFC developed in 52.8% and 22.4% were diagnosed with a CAUTI. The most frequent indication for inappropriate catheterization was urinary incontinence without significant skin breakdown (27.8%). The risk factors for inappropriate catheterization were female sex (RR=1.29, 95% CI=0.99, 1.69, P60 years (RR=0.65, 95% CI=0.48, 0.89, P3 days (RR=0.62, 95% CI=0.43, 0.89, P60 years (RR=0.47, 95% CI=0.25, 0.90, P3 days (RR=0.24, 95% CI=0.10, 0.58, P<0.01). Conclusions: Inappropriate catheterization is highly prevalent in medical wards, especially in patients with urinary incontinence. The patients catheterized in the medical emergency and female patients in particular are at high risk. Careful attention to these factors can reduce the frequency of inappropriate catheterization and unnecessary morbidity.

https://www.semanticscholar.org/paper/70d0d7ccdf3a990d23411d910130a3ad9cc76fea

A Therapeutic Arrangement and Syllabus of Materia Medica

The Medical Quarterly Review

A Therapeutic Arrangement and Syllabus of Materia Medica This lucid and succinct manual is intended more particularly for the students at the Birmingham School of Medicine, but may prove useful to others ; and may even be consulted with advantage by some of the lecturers at the new schools now springing up in all directions. The following is Dr. Johnstone's general arrangement of medicinal substances : " Class 1. Medicines which act upon the alimentary canal. " Class 2. Medicines which act upon the glandular system, and upon the secretory and excretory vessels. " Class 3. Medicines which act upon the heart and arteries. " Class 4. Medicines which act upon the brain and nervous system. " Class 5. Medicines which act upon the muscular fibre. " Class 6. Medicines which act upon the skin and external parts, by application to the surface of the body." (P. 3.) The following are his arterial stimulants: " Cantharis. Mastiche.

https://www.semanticscholar.org/paper/829aeeb258439e6ef773f4c7012721d6173f53f4

Sexual network drivers of HIV and herpes simplex virus type 2 transmission

AIDS (London)

e8ca7ac1-3bc1-4292-8d39-69c321ae0e74

Sexual network drivers of HIV and herpes simplex virus type 2 transmission Objectives: HIV and herpes simplex virus type 2 (HSV-2) infections are sexually transmitted and propagate in sexual networks. Using mathematical modeling, we aimed to quantify effects of key network statistics on infection transmission, and extent to which HSV-2 prevalence can be a proxy of HIV prevalence. Design/methods: An individual-based simulation model was constructed to describe sex partnering and infection transmission, and was parameterized with representative natural history, transmission, and sexual behavior data. Correlations were assessed on model outcomes (HIV/HSV-2 prevalences) and multiple linear regressions were conducted to estimate adjusted associations and effect sizes. Results: HIV prevalence was one-third or less of HSV-2 prevalence. HIV and HSV-2 prevalences were associated with a Spearman's rank correlation coefficient of 0.64 (95% confidence interval: 0.58–0.69). Collinearities among network statistics were detected, most notably between concurrency versus mean and variance of number of partners. Controlling for confounding, unmarried mean/variance of number of partners (or alternatively concurrency) were the strongest predictors of HIV prevalence. Meanwhile, unmarried/married mean/variance of number of partners (or alternatively concurrency), and clustering coefficient were the strongest predictors of HSV-2 prevalence. HSV-2 prevalence was a strong predictor of HIV prevalence by proxying effects of network statistics. Conclusion: Network statistics produced similar and differential effects on HIV/HSV-2 transmission, and explained most of the variation in HIV and HSV-2 prevalences. HIV prevalence reflected primarily mean and variance of number of partners, but HSV-2 prevalence was affected by a range of network statistics. HSV-2 prevalence (as a proxy) can forecast a population's HIV epidemic potential, thereby informing interventions.

https://www.semanticscholar.org/paper/1b22b74d2b92095c949236e0035023e97646a78d

Molecular analyses reveal the occurrence of three new sympatric lineages of velvet worms (Onychophora: Peripatidae) in the eastern Amazon basin

Genetics and Molecular Biology

a4442b50-7b98-4eb3-b453-c104bd1e74c1

Molecular analyses reveal the occurrence of three new sympatric lineages of velvet worms (Onychophora: Peripatidae) in the eastern Amazon basin Abstract In the present study, we investigated the possible existence of new lineages of peripatids through comparisons between known Neotropical species and specimens obtained from two locations in Pará, a state in eastern Brazilian Amazonia using a molecular approach based on sequences of the mtDNA genes COI, 16Sr RNA, and 18S RNA. The analyses included also sequences of Asian and African taxa for a more systematic understanding of the phylogenetic relationships within the group. The analysis of the COI, 16S rRNA and 18S RNA sequences permitted the identification of three distinct lineages (A, B and C) based on two different phylogenetic approaches (Bayesian methods and ML). The three lineages presented here are completely distinct from all other peripatid taxa so far defined by molecular data. The presence of specimens of three independent onychophoran lineages occurring in sympatry in the Amazon basin was confirmed in all the analyses, providing consistent support for the phylogenies presented in this study. These findings reinforce the importance of the Amazon region in the diversification of Neotropical peripatids, and indicate that onychophoran diversity is much greater than previously thought, given that the number of taxa found at a single site was equivalent to the total number of allopatric species described for the entire region.

https://www.semanticscholar.org/paper/54d869d5e95534eae67aa6510bec5a432c3e8f75

Optimizing the JEM

Journal of Experimental Medicine

7d071626-1aa2-4dad-a259-bcccedccf44d

Optimizing the JEM Published since 1896, the Journal of Experimental Medicine was long ago established as a reliable source of high-impact findings relevant to human disease. Five months ago, I joined the JEM as Executive Editor, with the aim of making this strong journal even stronger. This editorial describes recent

https://www.semanticscholar.org/paper/f6636b0c59b9a792519507e83d7961d63e9b320b

Corrigendum

Ecology and Evolution

e940bdf3-601c-415d-95ed-9c0197737d03

Corrigendum .

https://www.semanticscholar.org/paper/8e613c95f2c981261bab22551e8f8bfedbd63684

Retracted: Emotional Intervention and Education System Construction for Rural Children Based on Semantic Analysis

Occupational Therapy International

5a6bfc5a-e695-48df-a089-da329e985d87

Retracted: Emotional Intervention and Education System Construction for Rural Children Based on Semantic Analysis .

https://www.semanticscholar.org/paper/50b40b8e2fe98e0cd3e4e3faa01c96a890898321

Observable Atrial and Ventricular Fibrillation Episode Durations Are Conformant With a Power Law Based on System Size and Spatial Synchronization

Circulation: Arrhythmia and Electrophysiology

Observable Atrial and Ventricular Fibrillation Episode Durations Are Conformant With a Power Law Based on System Size and Spatial Synchronization BACKGROUND: Atrial fibrillation (AF) and ventricular fibrillation (VF) episodes exhibit varying durations, with some spontaneously ending quickly while others persist. A quantitative framework to explain episode durations remains elusive. We hypothesized that observable self-terminating AF and VF episode lengths, whereby durations are known, would conform with a power law based on the ratio of system size and correlation length (L/ξ). METHODS: Using data from computer simulations (2-dimensional sheet and 3-dimensional left-atrial), human ischemic VF recordings (256-electrode sock, n=12 patients), and human AF recordings (64-electrode basket-catheter, n=9 patients; 16-electrode high definition-grid catheter, n=42 patients), conformance with a power law was assessed using the Akaike information criterion, Bayesian information criterion, coefficient of determination (R2, significance=P0.05). CONCLUSIONS: Observable fibrillation episode durations are conformant with a power law based on system size and correlation length.