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Abstract This contribution reports on the physical properties of the natural Namibian red Ochre used by the Himba Community in a form of a formulation, so called Otjize as a skin protective and beauty cream. The morphological and crystallographic studies of this red ochre validated its nano-scaled dominating phase of rhombohedral α-Fe2O3 nanocrystals with an additional hydrolized oxide component in a form of γ-FeOOH. The optical investigations showed that such a red ochre exhibits an exceptional UV filtration and a significant IR reflectivity substantiating its effectiveness as an effective UV-blocking & solar heat IR reflector in support of the low skin cancer rate within the Namibian Himba community. In addition, such nanocrystals exhibited a non-negligible antibacterial response against E. Coli & S. Aurus. This study seems confirming the effectiveness of the indigenous Otjize as an effective skin UV protection cream with a sound antimicrobial efficacy against e-Coli & S-Aurus.

Osteoarthritis is a major cause of mobility problems in older people and is a particular problem in former sportspeople. The objective of this study was to develop and characterise a new system for the detection, monitoring and analysis of acoustic emissions from knee joints. 15 adult volunteers participated in the study. The participants performed six sets of three sit-stand-sit cycles. Reflective markers were placed at specific body landmarks recorded by 3D cameras. The exercise was performed with one foot on a force platform. A sensitive condenser microphone with a wide frequency response was connected to a dedicated acoustic analysis unit. Preliminary results provide clear acoustic signals showing a distinctive sequence of impulse-decay forms occurring naturally during each sit-stand-sit cycle. There are distinct differences between the acoustic signals emitted from younger healthy knees and those from aged knees. This work demonstrates the potential for this system to be used as an indication of the state of health of a human knee during movement.

Abstract LUX-ZEPLIN (LZ) is a second-generation direct dark matter experiment with spin-independent WIMP-nucleon scattering sensitivity above $${1.4 \times 10^{-48}}\, {\hbox {cm}}^{2}$$ 1.4 × 10 - 48 cm 2 for a WIMP mass of $${40}\, \hbox {GeV}/{\hbox {c}}^{2}$$ 40 GeV / c 2 and a $${1000}\, \hbox {days}$$ 1000 days exposure. LZ achieves this sensitivity through a combination of a large $${5.6}\, \hbox {t}$$ 5.6 t fiducial volume, active inner and outer veto systems, and radio-pure construction using materials with inherently low radioactivity content. The LZ collaboration performed an extensive radioassay campaign over a period of six years to inform material selection for construction and provide an input to the experimental background model against which any possible signal excess may be evaluated. The campaign and its results are described in this paper. We present assays of dust and radon daughters depositing on the surface of components as well as cleanliness controls necessary to maintain background expectations through detector construction and assembly. Finally, examples from the campaign to highlight fixed contaminant radioassays for the LZ photomultiplier tubes, quality control and quality assurance procedures through fabrication, radon emanation measurements of major sub-systems, and bespoke detector systems to assay scintillator are presented.

The EU HIBISCUS project consisted of a series of field campaigns during the intense convective summers in 2001, 2003 and 2004 in the State of São Paulo in Brazil. Its objective was to investigate the impact of deep convection on the Tropical Tropopause Layer (TTL) and the lower stratosphere by providing a new set of observational data on meteorology, tracers of horizontal and vertical transport, water vapour, clouds, and chemistry in the tropical Upper Troposphere/Lower Stratosphere (UT/LS). This was achieved using short duration research balloons to study local phenomena associated with convection over land, and long-duration balloons circumnavigating the globe to study the contrast between land and oceans. Analyses of observations of short-lived tracers, ozone and ice particles show strong episodic local updraughts of cold air across the lapse rate tropopause up to 18 or 19 km (420–440 K) in the lower stratosphere by overshooting towers. The long duration balloon and satellite measurements reveal a contrast between the composition of the lower stratosphere over land and oceanic areas, suggesting significant global impact of such events. The overshoots are shown to be well captured by non-hydrostatic meso-scale Cloud Resolving Models indicating vertical velocities of 50–60 m s−1 at the top of the Neutral Buoyancy Level (NBL) at around 14 km, but, in contrast, are poorly represented by global Chemistry-Transport Models (CTM) forced by Numerical Weather Forecast Models (NWP) underestimating the overshooting process. Finally, the data collected by the HIBISCUS balloons have allowed a thorough evaluation of temperature NWP analyses and reanalyses, as well as satellite ozone, nitrogen oxide, water vapour and bromine oxide measurements in the tropics.

Objectives: We conducted the first Irish national study assessing the value of multidisciplinary team meeting review in pathology practice and its impact on error detection before treatment., Methods: Public and private pathology laboratories across Ireland capture their quality activities using standardized codes and submit their data to a centralized database (National Quality Assurance Intelligence System) overseen by the National Histopathology Quality Improvement (NHQI) program. A total of 1,437,746 histopathology and cytopathology cases submitted to the NHQI program over a 60-month period (January 2017 to December 2021) were included in this study. Cases were analyzed with respect to multidisciplinary team meeting peer review and the presence of a revised report (amended or corrected report), a surrogate marker for error detection before treatment., Results: Across all cases assessed, 13.74% (197,587) underwent multidisciplinary team meeting discussion. Cases discussed at review had a statistically significantly higher rate of revised reports (1.25% [2470]) than cases not discussed at review (0.16% [1959]) (Pearson χ2, 6619.26; P < .0001; odds ratio, 8.00 [95% CI, 7.54-8.49]). Overall, multidisciplinary team meeting review made it 8 times more likely to detect an error before treatment. Cancer resections had the highest rate of review at 55.29% (46,806), reflecting the prioritization of oncology case discussion at review meetings., Conclusions: The multidisciplinary team meeting review process plays a valuable role in pathology error detection. A pathologist's participation in the review process comes with a clinically significant workload that needs to be recognized for future workforce planning. This study highlighted the positive role pathologists play in enhancing patient safety., (© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Within South Africa, many low-income communities lack reliable waste management services. Within these contexts, absorbent hygiene product (AHP) waste, including nappies (diapers), are not recycled, and are often dumped, ending up in watercourses and polluting the local environment. The structural barriers to collection which have been well explored, however the behavioural determinants of safe disposal for AHPs remains poorly understood. The purpose of this study is to determine the psycho-social factors driving AHP disposal behaviour for caregivers, while identifying potential underlying mechanisms (such as mental health), which may be influencing disposal behaviour, with the intention of informing a future, contextually appropriate and sustainable, collection system., Methods: The cross-sectional study was conducted within three low-income communities located within eThekwini Municipality (Durban), South Africa. The study included a pre-study and a quantitative survey of 452 caregivers, utilising the RANAS approach of behaviour change. The quantitative questionnaire was based on the RANAS model to measure psycho-social factors underlying sanitary disposal of AHPs. Mental health was assessed using the Self-Reporting Questionnaire (SRQ-20). Statistical analysis involved regressing psycho-social factors onto disposal behaviour and exploring their interaction with mental health through a moderation model., Results: Our findings suggest that one third of caregivers do not dispose of nappies sanitarily, despite intent (86.9%). Regression analysis revealed ten psycho-social factors which significantly predict the desired behavioural outcome, the sanitary disposal of AHPs. Caregivers with poor mental health were less likely to dispose of AHP sanitarily, which reflects previous research linking poor mental health and the impairment of health-related daily activities, particularly within vulnerable groups. Specifically, several psycho-social factors underlying were moderated by poor mental health, the prevalence of sanitary disposal of AHPs depended on mental condition of caregiver., Conclusions: Our findings confirmed the link between poor mental health and unsanitary AHPs disposal. This is especially relevant because poor mental health is common within South Africa. Addressing mental health problems within these communities is an essential step to providing sustainable waste management services. The findings informed an intervention strategy to implement a future collection system for these communities, and similar low-income or informal contexts within South Africa., (© 2024. The Author(s).)

Appendiceal neuroendocrine tumours (aNETs) are rare neoplasms of the gastrointestinal tract often diagnosed incidentally at the time of appendicectomy. Appendicectomy is considered curative in the majority of cases but guidelines recommend right-sided hemicolectomy (RHC) for those with specific high-risk features despite no data supporting a survival benefit. We performed a retrospective search of multi-disciplinary tumour board and pathology databases from 2012 to 2022 to identify cases of aNET treated at our centre. Follow-up data were obtained from the electronic healthcare records. A total of 142 cases of aNET were included for analysis. Mean age at presentation was 34, of which 76% were female and 92% of aNETs were located in the tip/middle of the appendix; 90% were grade 1, and 93% had R0 resection. Tumour size was <1 cm in 54%, 1-2 cm in 36%, >2 cm in 9%. A total of 43 patients (30%) underwent RHC with lymph node metastases identified in 16 (37%). Lymph node metastases were associated with tumour size >2 cm (p = .008) and higher tumour grade (p = .041) on multivariate analysis. For aNET 1-2 cm, lymph node metastases were identified in 7/22 who had RHC (32%) with tumour grade the only significant risk factor (p = .046). Distant metastases were identified in 2 cases (1%), diagnosed synchronously and associated with grade 2 tumours. Overall survival for those with lymph node metastases was 100% after a median 4 years. Progression-free survival was 93%, with a single case of disease progression associated with synchronous distant metastases at initial diagnosis. Lymph node metastases in aNET are associated with higher tumour grade and tumour size >2 cm. Disease progression in the setting of lymph node metastases is rare. The significance of lymph node metastases and need for completion RHC remains uncertain., (© 2023 British Society for Neuroendocrinology.)

Herein, we describe the global comparison of miRNAs in human pancreatic cancer tumors, adjacent normal tissue, and matched patient-derived xenograft models using microarray screening. RNA was extracted from seven tumor, five adjacent normal, and eight FI PDX tumor samples and analyzed by Affymetrix GeneChip miRNA 4.0 array. A transcriptome analysis console (TAC) was used to generate comparative lists of up- and downregulated miRNAs for the comparisons, tumor vs. normal and F1 PDX vs. tumor. Particular attention was paid to miRNAs that were changed in the same direction in both comparisons. We identified the involvement in pancreatic tumor tissue of several miRNAs, including miR4534, miR3154, and miR4742, not previously highlighted as being involved in this type of cancer. Investigation in the parallel mRNA and protein lists from the same samples allowed the elimination of proteins where altered expression correlated with corresponding mRNA levels and was thus less likely to be miRNA regulated. Using the remaining differential expression protein lists for proteins predicted to be targeted for differentially expressed miRNA on our list, we were able to tentatively ascribe specific protein changes to individual miRNA. Particularly interesting target proteins for miRs 615-3p, 2467-3p, 4742-5p, 509-5p, and 605-3p were identified. Prominent among the protein targets are enzymes involved in aldehyde metabolism and membrane transport and trafficking. These results may help to uncover vulnerabilities that could enable novel approaches to treating pancreatic cancer.

Jung used creative methods such as picture-making and active imagination to work with complexes and in particular trauma and dissociation. A clinical example of a 60-year-old woman demonstrates the benefits of using creative methods to work with issues linked to early life, such as somatic intrusions of early childhood trauma. Significant inner figures were delineated, including the original figure associated with the infantile dissociative split. The figures illustrated Jung's complex theory by making visible the nonverbal inner states that were initially feared and experienced as Other. Within an analytic relationship that included a working through, an innate creative process unfolded that permitted inner figures to become agents of change within her psyche. This paper highlights the value of Jung's complex theory and the use of creative methods when working with dissociation, regression and unformulated infantile states, even when the analysand is in the later stages of adulthood., (© 2022 The Society of Analytical Psychology.)

Background and Aims: Mucinous colorectal cancer has traditionally been associated with high rates of recurrence and poor long-term survival. There is limited published data on outcomes for patients undergoing liver resection for metastatic mucinous colorectal cancer. The aim of this study was to compare the clinicopathological outcomes for patients with mucinous colorectal cancer liver metastases (CRCLM) undergoing liver resection to a matched group of patients with adenocarcinoma not otherwise specified (NOS) and to evaluate the accurary of preoperative magnetic resonance imaging (MRI) at detecting the presence of mucin in liver metastases., Materials and Methods: Patients with mucinous CRCLM undergoing liver resection were matched 1:3 to patients with adenocarcinoma NOS CRCLM. Clinicopathological data from the primary tumour and metastatic lesion were collected and compared between the groups. Hepatic recurrence-free, disease-free and overall survival were compared between the groups. The ability of preoperative MRI to detect mucin in CRCLM was also evaluated., Results: A total of 25 patients with mucinous CRCLM underwent surgery over the 12-year period and were matched to 75 patients with adenocarcinoma NOS. Clinicopathological findings were similar between the groups. Resection of mucinous CRCLM was feasible and safe with similar levels of morbidity to adenocarcinoma NOS. There were no differences identified in hepatic recurrence-free (p=0.85), disease-free (p=0.25) and overall survival (p=0.98) between the groups. MRI had a sensitivity of 31.3% in detecting the presence of mucin in CRCLM., Conclusion: Patients with mucinous CRCLM in this study had similar outcomes to patients with adenocarcinoma NOS. Based on our findings, histological subtype should not be taken into account when deciding on resectability of CRCLM., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Reynolds, Cromwell, Ryan, McGrath, Kennelly, Ryan, Swan, Sheahan, Winter and Hoti.)

Background and Aims: The learning curve for robotic-assisted radical prostatectomy (RARP) is estimated to be about 50-200 cases. This study will evaluate the benefit of a mentorship programme after completing a mini-fellowship in RARP by an experienced surgeon who previously trained in open and laparoscopic surgery., Methods: Our study was a retrospective comparative analysis of RARP performed by a single consultant urologist. A retrospective chart review of the first 120 cases was performed. The 120 patients were divided into three groups of 40 cases. For the first 40 cases, an appropriately qualified mentor was present. The peri-operative and oncological outcomes were compared between the three groups., Results: Operative times significantly decreased with experience (250 min vs 234 min vs 225 min, p < 0.05). Complication rates, estimated blood loss, and length of stay were similar between all groups. There was a higher rate of positive margins in the final group (20% vs 17.5% vs 32.5%, p < 0.5). There was a greater number of pT3 tumours in group 3 (42%, n = 17) compared to groups 1 and 2 (20%, n = 8, and 22.5%, n = 9) which may account for the higher rate of positive margins in this group., Conclusion: In the transition of an experienced laparoscopic surgeon to robotic surgery, we showed that there is a benefit of a mentorship programme after a mini-fellowship in reducing the impact of the learning curve on patient outcomes. Ongoing mentorship may be of benefit in cases where a high volume of tumour is suspected and should be avoided in the early part of the learning curve to maximise oncological outcomes., (© 2021. Royal Academy of Medicine in Ireland.)

Background & Objective: Liver resection for breast cancer liver metastases is becoming a more widely accepted therapeutic option for selected groups of patients. The aim of this study was to describe the outcomes of patients undergoing liver resection for breast cancer-related liver metastases and identify any variables associated with recurrence or survival., Methods: A retrospective review of a prospectively maintained database was undertaken for the 12 year period between 2009 and 2021. Clinicopathological, treatment, intraoperative, recurrence, survival and follow-up data were collected on all patients. Kaplan-Meier methods, the log-rank test and Cox proportional hazards regression analysis were used to identify variables that were associated with recurrence and survival., Results: A total of 20 patients underwent 21 liver resections over the 12-year period. There were no deaths within 30 days of surgery and an operative morbidity occurred in 23.8% of cases. The median local recurrence free survival and disease free survival times were both 50 months, while the 5 year overall survival rate was 65%. The presence of extrahepatic metastases were associated with a decreased time to local recurrence (p < 0.01) and worse overall survival (p = 0.02)., Conclusions: This study has demonstrated that liver resection for breast cancer-related liver metastases is feasible, safe and associated with prolonged disease free and overall survival in selected patients. It is likely that this option will be offered to more patients going forward, however, the difficulty lies in selecting out those who will benefit from liver resection particularly given the increasing number of systemic treatments and local ablative methods available that offer good long-term results.

Introduction: The use of multiparametric magnetic resonance imaging (MRI) with targeted biopsies of the prostate improves the diagnosis of clinically significant prostate cancer. Recent studies have shown that targeted prostate biopsies also more accurately predict final histopathology after radical prostatectomy (RP). There are three broad techniques for performing MRI-targeted prostate biopsy: cognitive MRI/ultrasound (US) fusion, software MRI/US fusion, and in-bore MRI-guided. Current practices recommend that a standard systematic 12-core prostate biopsy be performed, as well as targeted biopsies in patients with positive MRI findings. This study aimed to evaluate the accuracy of histological grading of cognitive MRI/US fusion prostate biopsy by comparing the histology from the targeted biopsy specimens (TB), standard systematic specimens (SB), and the combination of both (CB) specimens with the final histological grade from subsequent prostatectomy., Methods: A retrospective, single-center review of 115 patients who underwent standard systematic and cognitive MRI/US-targeted biopsy of the prostate before undergoing a RP between 2016 and 2019 was performed. MRI findings, biopsy, final histology International Society of Urological Pathology (ISUP) grades, and patient demographics were collected. Cochran's Q test and McNemar test were used to compare the differences in upgrading, downgrading, and concordance between each biopsy group., Results: The concordance between SB, TB, and CB biopsy were 28.7%, 49.6%, and 50.4%, respectively. There was no significant difference in concordance between TB and CB. Patients were more likely to be downgraded on the final histology when comparing CB with TB alone (26.1% vs. 16.5%, p<0.05). In cases where an ISUP grade 1 cancer was diagnosed on TB (n=24), there was a 62.5% chance that the final histology would be upgraded. In the same sample, when combined with a SB, the risk of upgrading on final histology was reduced to 37.5%., Conclusions: Although grading concordance between TB and CB were similar, the concomitant use of a SB significantly reduced the rate of upgrading in the final RP histopathology. CB may result in better decision-making regarding treatment options and also have implications for intraoperative planning.

Objective: To investigate the perceived value of handrails and how they are used in Australian aged care facilities (ACFs). Such information aims to contribute to the body of knowledge available about handrails, their design features and application., Methods: This study adopted a descriptive cross-sectional research design. Online surveys were distributed to members of Australian professional networks, collecting information about handrail use, mobility supports and handrail design in ACFs., Results: There were 112 participants (80% female), aged 18-55 years or older. Many identified that handrails in ACF corridors are used by a residents, staff and visitors, and that circular-shaped handrails should be installed in ACF corridors to assist with mobility and safety., Conclusion: Handrails in ACF corridors offer an alternate support to those who experience an unexpected loss of balance and those without or unable to use a mobility aid, ultimately enabling users' mobility and assisting staff to carry out work duties., (© 2020 AJA Inc.)

Background: Current guidance for type 1 gastric neuroendocrine neoplasms (gNENs) recommends either resection of all visible lesions or selective resection of gNENs >10 mm. We adopt a selective strategy targeting lesions approaching 10 mm for endoscopic mucosal resection (EMR) and provide surveillance for smaller lesions., Objectives: This study aimed to describe the incidence of type 1 gNENs requiring endoscopic/surgical resection and the risk of disease progression (both considered significant disease) on endoscopic surveillance. The secondary objective was to assess the risk factors for disease progression during surveillance and the incidence of gastric dysplasia/adenoma/adenocarcinoma., Methods: We collected consecutive patients with type 1 gNENs and obtained demographic and clinical data through the electronic patient record., Results: In our cohort of 57 patients, 12 patients had EMR at index gastroscopy; 7 patients had surgery (4: large/multiple gNENs and 3: nodal metastases) (5.2% [3/57] risk of nodal metastases); and a patient with nodal and liver metastases (1.8% [1/57] risk of distant metastases). The prevalence of gastric adenocarcinoma in our study was 3.5% with an incidence rate of 9.59 per 1,000 persons per year. For patients undergoing surveillance, 29.5% (13/44) of patients progressed requiring resection. Serum gastrin was significantly higher in patients who progressed to resection (p value = 0.023)., Conclusion: We concluded that up to a third of patients with type 1 gNENs have significant disease requiring resection. Hence, endoscopic surveillance and resect strategy would benefit patients., (© 2020 S. Karger AG, Basel.)

Background: Pancreatic cancer is a devastating disease; its lethality is related to rapid growth and tendency to invade adjacent organs and metastasize at an early stage., Objective: The aim of this study was to identify miRNAs and their gene targets involved in the invasive phenotype in pancreatic cancer to better understand the biological behaviour and the rapid progression of this disease., Methods: miRNA profiling was performed in isogenic matched high invasive and low-invasive subclones derived from the MiaPaCa-2 cell line and validated in a panel of pancreatic cancer cell lines, tumour, and normal pancreas. Online miRNA target prediction algorithms and gene expression arrays were used to predict the target genes of the differentially expressed miRNAs. miRNAs and potential target genes were subjected to overexpression and knockdown approaches and downstream functional assays to determine their pathological role in pancreatic cancer., Results: Differential expression analysis revealed 10 significantly dysregulated miRNAs associated with invasive capacity (Student's t -tests; P value <0.05; fold change = ±2). The expression of top upregulated miR-135b and downregulated let-7c miRNAs correlated with the invasive abilities of eight pancreatic cancer cell lines and displayed differential expression in pancreatic cancer and adjacent normal tissue specimens. Ectopic overexpression of let-7c decreased proliferation, invasion, and colony formation. Integrated analysis of miRNA-mRNA using in silico algorithms and experimental validation databases identified four putative gene targets of let-7c. One of these targets, SOX13 , was found to be upregulated in PDAC tumour compared with normal tissue in TCGA and an independent data set by qPCR and immunohistochemistry. RNAi knockdown of SOX13 reduced the invasion and colony formation ability of pancreatic cancer cells., Conclusion: The identification of key miRNA-mRNA gene interactions and networks provide potential diagnostic and therapeutic strategies for better treatment options for pancreatic cancer patients., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Shannon R. Nelson et al.)