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Immunoglobulin G4 (IgG4)-related disease is an immune-mediated, fibroinflammatory condition that causes multisystemic contrast enhancement and is predominantly observed in elderly male patients. The most prominent features of IgG4-related disease are systemic involvement affecting from two to six systems. In the central nervous system, these contrast enhancements are typically found in the meninges and orbit. This case study describes a 78-year-old female patient with persistent headaches and constant diarrhea who underwent treatment for IgG4-related disease. Despite two months of treatment with non-steroidal and opioid analgesics, the patient remained unresponsive and continued to experience diarrhea for 4 months. Brain magnetic resonance imaging revealed contrast enhancement in the leptomeningeal surfaces, and a biopsy of the gastrointestinal mucosa confirmed the diagnosis of IgG4-related disease, showing widespread plasma cell infiltration and IgG4 expression on plasma cells. The patient was initially treated with 1.0 g/day of pulse therapy for 5 days, followed by a maintenance dose of 1.0 mg/kg oral azathioprine. When azathioprine caused significant pancytopenia, rituximab therapy was initiated. The patient’s headaches resolved completely, and the diarrheal attacks were controlled. This case highlights the importance of considering IgG4-related disease as a potential cause of headache or multiorgan symptoms in elderly patients with new-onset headache unresponsive to conventional analgesics. IgG4-related disease can often be effectively treated with steroids and monoclonal antibodies.

Heavy metals are released into the environment due to anthropogenic activities. Cement industries are classified among the main sources of environmental pollutants. This study aims to evaluate the ecological and human health risks of heavy metals in soils and leaves from the CIMTOGO cement factory area in Lomé, Togo. Samples were dried successively in open air and in oven at 105 oC for 24 hours. Samples ground and sieved were used in the analysis using a ZEEnit 700 atomic absorption spectrometer and Ion chromatograph IC 1500 Dionex. The amount of heavy metals in the samples as well as the pollution indices were investigated. High concentration of and Cadmium in the soil, and of chromium and lead in the leaves were found. High potential ecological risk index of 157.26 and 303.73 and the pollution load index of 1.02 and 1.39 were found for the soil and the leaf, respectively confirming the deterioration of the quality of the soil and leaves. The hazard index (0.86) closer to 1 indicates that the cement production activities could have harmful impacts on the health of the surrounding populations and the decision makers have to think about the decontamination of the area.

Abstract Background The risk of developing type 2 diabetes mellitus (T2DM) is up to 50% among women with gestational diabetes mellitus (GDM). However, diabetes education during and after pregnancy is limited. To bridge this gap, our team developed four training modules on GDM for nurses and community health workers. This pilot study assesses changes in knowledge, self-efficacy for providing diabetes education, attitudes, and intentions to recommend diabetes prevention before and after training completion. Methods Interactive online modules were disseminated to clinical staff providing care for women with GDM in the United States. Optional pre- and post-training surveys were conducted to gauge the effectiveness of the modules. GDM knowledge (scoring 0–100) was evaluated with a 23 question assessment with total score and individual module scores reported [(# correct/# total)*100]. Self-efficacy for providing diabetes education (scoring 1–10) was evaluated with a 15-question survey and intention to recommend diabetes prevention (scoring 1–5) was assessed with an 8-item survey. Attitudes were assessed with three subscales of the Diabetes Attitude Scale (scoring 1–5). Changes in scores on each scale before and after training are reported using non-parametric Wilcoxon matched-pair signed rank tests. Results Eighty-two individuals completed baseline evaluation and 20 individuals accessed all modules and completed post-training assessments. Among those completing the training, improvement was noted in GDM knowledge [56.5 (16.0) v. 78.3 (22.0), p

Abstract Background The temperature changes, chemical agents, and brushing activity that resin composite restorations are exposed to in the oral environment can cause changes in surface roughness. In this study, the aim was to investigate in vitro the clinical one-year surface roughness changes of different types of composites (flowable or conventional) from the same companies by subjecting them to immersion in solutions, brushing, and thermal cycling procedures to simulate intraoral conditions. Methods Four different resin composite brands were included in the study using both their conventional (Charisma Smart, 3M Filtek Ultimate Universal, Omnichroma, Beautifil II) and flowable resin composites (Charisma Flow, 3M Filtek Ultimate Flowable, Omnichroma Flow, Beautifil Flow Plus F00), giving 4 groups with 2 types of resin composite in each. 40 samples were prepared for each group/resin type, for a total of 320 samples. After initial surface roughness measurements by a mechanical profilometer, the samples were divided into 4 subgroups (n = 10) and immersed in solutions (distilled water, tea, coffee, or wine) for 12 days. The samples were then subjected to 10,000 cycles of brushing simulation and 10,000 cycles of thermal aging. Surface roughness measurements were repeated after the procedures. For statistical analysis, the 3-way analysis of variance and the Tukey test were used (p

Abstract Background By evaluating nurses’ attitudes and behaviors regarding narcotic drug safety and addiction, effective strategies need to be developed for combating addiction in healthcare institutions. This study, aimed at providing an insight into patient and staff safety issues through the formulation of health policies, aimed to evaluate nurses’ attitudes and behaviors regarding narcotic drug safety and addiction. Methods The study was conducted in a descriptive cross-sectional design. It was carried out with 191 nurses in a public hospital between March 2023 and August 2023. Data were collected through face-to-face interviews, gathering socio-demographic information and utilizing the Addictive Substance Attitude Scale. The data were analyzed using independent sample t-tests, one-way ANOVA tests, and regression analysis (P

Laboratory animal nutrition plays a crucial role in ensuring the health, welfare, and scientific validity of research studies involving animals. Technological advancements in feed processing have provided researchers with innovative tools and techniques to enhance the nutritional quality and stability of laboratory animal diets. Recent developments in feed processing technology have focused on improving the precision, consistency, and nutrient bioavailability of laboratory animal diets. Techniques such as pelleting, extrusion, and coating have been utilized to create homogeneous feed formulations with controlled nutrient profiles. In addition to advances in feed processing, new feeding approaches have emerged to address the specific nutritional requirements of laboratory animals. Precision feeding technologies, incorporating real-time monitoring systems and data analytics, allow for the customization of feed formulations based on individual animal needs. Overall, the integration of technological processes and new feeding approaches in laboratory animal nutrition represents a promising avenue for advancing animal welfare, research quality, and scientific outcomes in preclinical and biomedical research. By leveraging cutting-edge feed processing techniques and tailored feeding strategies, researchers can ensure the optimal nutrition, health, and well-being of laboratory animals, fostering both ethical research practices and robust scientific results. This review provides an overview of the technological processes applied to laboratory animal feeds and introduces new feeding approaches aimed at optimizing animal health and research outcomes.

Abstract Background Microplastics are ubiquitous, widespread environmental pollutants with unavoidable human exposure. Herein, it was aimed to investigate the presence of microplastics in prostate tissue. Methods Prostate tissues from 12 patients who underwent Trans Urethral Resection of the Prostate (TUR-P) were analyzed to investigate the presence of microplastics. Initially, the prostate tissues were analyzed for microplastic particles using a light microscope after extraction. Subsequently, the chemical composition of the particles found in the prostate tissues was characterized using Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) spectrophotometry. Results Microplastic particles of various types were detected in 6 out of 12 patients. All detected plastic particles in this study were microplastics, with sizes below 26 μm in size. These microplastics exhibited different shapes as pellets, spheres or fibers. Overall, among the 12 analyzed prostate tissue samples, four different types of plastic were identified in six samples. The most common type of microplastic detected was Polyamide (Nylon 6), found in samples from three patients. Other detected types, Polypropylene, Polyacrylic Acid and Poly (dimethylsiloxane) were each determined in samples from one patient. Conclusions This is the first study to demonstrate the presence of microplastics in prostate tissue, serving as an exploratory investigation, which can trigger further research to validate the results in a larger patient cohort.

Malignant psoas syndrome (MPS) is associated with proximal lumbosacral plexopathy and is characterized by severe intractable pain, despite multimodal medical treatment. Spinal dexmedetomidine and lumbar sympathetic nerve block in combination with pulsed radiofrequency (PRF) are rarely performed for intractable lumbosacral plexopathy pain. We present a combination of spinal dexmedetomidine lumbar sympathetic nerve block and caudal-epidural PRF in the management of MPS, refractory to medical and physical treatment. A 49-year-old female with recurrent lung adenocarcinoma was admitted with shooting pain on the right side over the psoas muscle with irradiation into the right groin and weakness of quadriceps at motion. She was managing her pain with a number of opioids, including oxycodone, morphine, fentanyl, and intramuscular meperidine. The total oral morphine equivalent opioid dose equaled 460 mg. At the first admission, we successfully palliated pain with spinal dexmedetomidine and simultaneously reduced the patient’s opioid addiction. On the second admission, lumbar sympathetic nerve block at L3 with additional caudal-epidural PRF led to a significant reduction in her thigh pain visual analog scale (VAS) score to 1–2/10. In addition, improvement in quadriceps functionality and sleep quality, along with a remarkable reduction in analgesic medicine doses, earned patients high satisfaction. Our patient passed away 6 months later with average VAS severity of 4/10. Spinal dexmedetomidine, caudal-epidural PRF, and lumbar sympathetic nerve block should be added as a therapeutic option to the treatment guidelines for the management of MPS, acquired due to lumbosacral plexopathy.

Abstract The agricultural sector, particularly in emerging economies like Africa, faces significant challenges in weed management, directly impacting yield, production costs, and crop quality. Accurate and early weed identification is pivotal for effective weed control strategies. In response, our research extends beyond conventional deep learning methodologies by integrating Convolutional Neural Networks (CNN) with Grey Wolf Optimization (GWO) and Support Vector Machine (SVM) for enhanced plant seedling classification. Leveraging a dataset of 5539 images across 12 plant species, including essential crops such as Common Wheat, Maize, and Sugar Beet, alongside nine weed types, we embarked on a comprehensive analysis employing four advanced CNN architectures: ResNet-50, Inception-V3, VGG-16, and EfficientNet-B0. Our approach involved initial model training and validation, followed by the application of GWO for feature optimization and SVM for refined classification. Post-optimization, the EfficientNet-B0 model emerged as the frontrunner, showcasing exemplary performance with a remarkable training accuracy of 99.82% and a test accuracy of 98.83%. These results highlight the efficacy of combining CNNs with evolutionary algorithms and machine-learning techniques in agricultural applications. This study illustrates the capabilities of CNNs in agricultural contexts and emphasizes the added value of optimization algorithms in improving model performance. The integration of GWO and SVM presents a significant advancement in plant seedling classification, offering a powerful tool for precision agriculture. Our findings hold great promise for enhancing crop management and yield in Africa and other emerging economies, contributing to the evolution of sustainable farming practices through innovative technological solutions.

There was this professor, called Mali. Actually, his name was Ali, a common enough name for a Turkish man. However, during his time as a student in France, he had [...]

Summary: Synucleinopathies are a class of neurodegenerative diseases defined by the presence of α-synuclein inclusions. The location and composition of these α-synuclein inclusions directly correlate to the disease pattern. The inclusions in Multiple System Atrophy are located predominantly in oligodendrocytes and are rich in a second protein, p25α. P25α plays a key role in neuronal myelination by oligodendrocytes. In healthy oligodendrocytes, there is little to no α-synuclein present. If aberrant α-synuclein is present, p25α leaves the myelin sheaths and quickly co-aggregates with α-synuclein, resulting in the disruption of the cellular process and ultimately cell death. Herein, we report that p25α is susceptible for 20S proteasome-mediated degradation and that p25α induces α-synuclein aggregation, resulting in proteasome impairment and cell death. In addition, we identified small molecules 20S proteasome enhancers that prevent p25α induced α-synuclein fibrilization, restore proteasome impairment, and enhance cell viability.

Background We sought to measure frequency of achieving an optimal outcome after stage 1 palliation (S1P) for hypoplastic left heart syndrome and variants, determine factors associated with optimal outcomes, and compare outcomes after stage 2 palliation (S2P) using the National Pediatric Cardiology Quality Improvement Collaborative database (2008–2016). Methods and Results This is a retrospective cohort study with optimal outcome defined a priori as meeting all of the following: (1) discharge after S1P in

Introduction In paediatric oncology, ‘breaking bad news’—BBN—like cancer diagnosis is perceived as particularly challenging. Enabling a trialogue between children with their relatives and health professionals requires profound communication skills. Lacking the skills, experience or adequate support tools might result in negative consequences for both paediatric oncologists as BBN transmitters and BBN receivers as children with cancer and their relatives.In contrast to oncology for adults, multiperspective studies that explore BBN experience and specific support needs are rare, especially in Germany. Systematically developed and practically piloted support instruments, which address the specific needs of paediatric oncology, are missing.Objective To systematically design and mature in practice an orientation compass for preparing, delivering and following up on BBN conversations in paediatric oncology—so-called Orientierungskompass zur Übermittlung schwerwiegender Nachrichten in der Kinderonkologie (OKRA).Methods and analysis OKRA is based on a QUAL-quant mixed study design, comprising two phases. Four groups will contribute (1) experts through personal experience (representatives for children receiving BBN and their parents), (2) medical care providers and representatives of national medical societies, (3) ambulant psychosocial/psychological support providers and (4) researchers. In phase 1, multiperspective knowledge is generated through a participatory group Delphi that involves in-depth interviews, focus group discussions and questionnaires. This process culminates in formulating theses for a high-quality BBN process (output phase 1). In phase 2, based on the theses, a pilot orientation compass is designed. Through iterative cycles with the participatory action research method, this instrument will be piloted in three paediatric oncological settings and consequently optimised.Ethics and dissemination OKRA was approved on 19 September 2023 by the ethics committee of the Medical Faculty of the University of Cologne (No. 23-1187). After project completion, the OKRA compass will be distributed to multidisciplinary paediatric oncology teams throughout Germany.Trial registration number DRKS00031691.

Introduction: Elevating Voices, Addressing Depression, Toxic Stress and Equity (EleVATE) is a group prenatal care (GC) model designed to improve pregnancy outcomes and promote health equity for Black birthing people. This article outlines the foundational community-engaged process to develop EleVATE GC and pilot study results. Methods: We used community-based participatory research principles and the Ferguson Commission Report to guide creation of EleVATE GC. The intervention, designed by and for Black birthing people, centers trauma-informed care, antiracism, and integrates behavioral health strategies into group prenatal care to address unmet mental health needs. Using a convenience sample of patients seeking care at one of three safety-net health care sites, we compared preterm birth, small for gestational age, depression scores, and other pregnancy outcomes between patients in individual care (IC), CenteringPregnancy? (CP), and EleVATE GC. Results: Forty-eight patients enrolled in the study (n=11 IC; n=14 CP; n=23 EleVATE GC) and 86% self-identified as Black. Patients participating in group prenatal care (EleVATE GC or CP) were significantly less likely to experience a preterm birth

Ensuring food safety and protecting consumers are major aspects for commercialized products. Honey, the most prominent in the class of bee products, requires special regulations due to its origin as a natural product. Mislabeling, imitation, and adulteration represent a source of risks for human health. Specific determinations and analyses are essential for controlling the sector and preventing unfair competition. To compare and establish the correct labeling of several different honeys, melissopalynological, physicochemical, mineral content, and microbiological analyses were carried out on 18 samples commercially available in different countries, namely Türkiye, Romania, Bulgaria, and Northern Cyprus. The honey labels were in accordance with the determined pollen content. The physiochemical parameters showed high variability: 4.07–5.25 (pH), 79.95–83.45 (°Brix), 0.262–1.452 µS/cm (electrical conductivity), and 14.6–18.4% (moisture). The samples were quantitatively high in K, P, Na, and Ca, with the highest cumulative mineral content being found for honeys containing Fagaceae pollen. Additionally, the antimicrobial potential of the various honey samples was evaluated against selected bacteria, employing the disk diffusion and serial dilution methods. Results revealed that the honey samples exhibited increased antibacterial activity against Gram-negative bacteria, with notable activity against S. typhimurium, and moderate activity against Gram-positive S. aureus.

Declines in biodiversity generated by anthropogenic stressors at both species and population levels can alter emergent processes instrumental to ecosystem function and resilience. As such, understanding the role of biodiversity in ecosystem function and its response to climate perturbation is increasingly important, especially in tropical systems where responses to changes in biodiversity are less predictable and more challenging to assess experimentally. Using large-scale transplant experiments conducted at five neotropical sites, we documented the impacts of changes in intraspecific and interspecific plant richness in the genus Piper on insect herbivory, insect richness, and ecosystem resilience to perturbations in water availability. We found that reductions of both intraspecific and interspecific Piper diversity had measurable and site-specific effects on herbivory, herbivorous insect richness, and plant mortality. The responses of these ecosystem-relevant processes to reduced intraspecific Piper richness were often similar in magnitude to the effects of reduced interspecific richness. Increased water availability reduced herbivory by 4.2% overall, and the response of herbivorous insect richness and herbivory to water availability were altered by both intra- and interspecific richness in a site-dependent manner. Our results underscore the role of intraspecific and interspecific richness as foundations of ecosystem function and the importance of community and location-specific contingencies in controlling function in complex tropical systems.

For millennia, healing and psychoactive plants have been part of the medicinal and ceremonial fabric of elaborate rituals and everyday religious practices throughout Mesoamerica. Despite the essential nature of these ritual practices to the societal framework of past cultures, a clear understanding of the ceremonial life of the ancient Maya remains stubbornly elusive. Here we record the discovery of a special ritual deposit, likely wrapped in a bundle, located beneath the end field of a Late Preclassic ballcourt in the Helena complex of the Maya city of Yaxnohcah. This discovery was made possible by the application of environmental DNA technology. Plants identified through this analytical process included Ipomoea corymbosa (xtabentun in Mayan), Capsicum sp. (chili pepper or ic in Mayan), Hampea trilobata (jool), and Oxandra lanceolata (chilcahuite). All four plants have recognized medicinal properties. Two of the plants, jool and chilcahuite, are involved in artifact manufacture that have ceremonial connections while chili peppers and xtabentun have been associated with divination rituals. Xtabentun (known to the Aztecs as ololiuhqui) produces highly efficacious hallucinogenic compounds and is reported here from Maya archaeological contexts for the first time.