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The following paper aims to discuss melanoma located in the eye. Melanoma is a malignant tumor arising from melanocytes, in which a mutation has occurred in the DNA and pathological cells have developed. In most cases, this tumor is located on the skin exposed to sunlight, but it is also rarely located in the structures of the eye, especially in the part called uvea. It consists of the anterior and posterior parts, and in each of them the process of carcinogenesis can occur. The disease can cause very non-specific symptoms, mainly pain, visual disturbances, floaters and photopsia, or exophthalmos, but almost half of the cases are asymptomatic. Treatment is complicated and depends on many factors, radiation therapy, laser therapy, local resection and enucleation are used. Most patients are diagnosed when the changes are already extensive, or metastases occur. In the case of liver metastases, the prognosis is unfavorable. For this reason, we want every doctor to pay attention to the eye symptoms reported by the patient in order to be able to recognize this disease as soon as possible and treat it effectively. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Chronic rhinosinusitis (CRS) is a frequently diagnosed condition in patients seeking medical care. It encompasses a range of disorders that can be classified based on underlying causes, clinical symptoms, or inflammatory types. Although the precise cause of CRS remains unclear, the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020) has recently offered updated insights, treatment strategies, and recommendations. State of knowledge: Recent research has increasingly focused on the role of the microbiota in inflammatory diseases. The optimal bacterial environment in the sinonasal mucosa, where inhaled bacteria, viruses, fungal spores, and particles initially interact, is still not fully understood. The dysbiosis theory, which emphasizes the importance of the microbiome and its relationship with the host, is the predominant model explaining CRS pathogenesis. Disruptions in this balance can lead to a variety of clinical manifestations in CRS patients. Conclusions: Given the impact of CRS treatment on the composition of sinus and nasopharyngeal microbiota, the dysbiosis theory highlights the importance of addressing this aspect in therapeutic strategies. Ongoing research is exploring the potential use of pre- and probiotics as novel treatment options. A more thorough understanding of the microbiological factors involved in CRS is crucial for developing personalized, targeted therapies for affected individuals. [ABSTRACT FROM AUTHOR]

Purpose: To describe the clinical presentation of Tuberculosis uveitis (TBU) in a developed country (tertiary health Care Centre in The UK) and its association with the response to anti-TB treatment (ATT). Methods: A retrospective study, in which, we collected data on ocular TB from a tertiary referral center in a developed country from a total of 100 eyes of 56 patients. The collected data were analyzed from the perspective of visual acuity at the presentation and the last visit, clinical presentation, treatment started, and the need for immune suppressive therapy. Results: Pan uveitis was the most common clinical presentation (40%). All patients received ATT. Comparing mean baseline visual acuity 0.49±0.65 was slightly reduced to 0.45±0.72 (3 months after completing ATT), however, this difference was not statistically significant. The rate of treatment failure was 44%. Twenty-five patients needed additional immunosuppression (steroid alone or combined with immune suppressive therapy) 3 months after completing the ATT because of persistent inflammation. Conclusion: TBU is still a diagnosis that needs to be considered and excluded in developed areas. Long-term Immunosuppressive medication may be needed for cases of TBU with significant intraocular inflammation either during or after ATT. Uveitis pattern and presence or absence of disc edema could predict the need for immunosuppression. [ABSTRACT FROM AUTHOR]

Bipolar disorders (BP) are prevalent neuropsychiatric illnesses affecting 1%–5% of the global population and about 3% of the Saudi population. They are associated with significant comorbidities and negative consequences. Despite being common mental health conditions in Saudi Arabia, stigma persists, with weak character, supernatural beliefs, and weak faith considered as causes. In addition, Saudi patients with BP have been reported to seek help from non-psychiatric healthcare professionals and faith healers. More data are required on BP from Saudi Arabia, including the genetic aspects and their treatment approaches. This narrative review paper explores the epidemiology and clinical manifestations, etiology and biological mechanisms, public knowledge and awareness of the illnesses, and treatment of BP in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Introduction: In today's fast-paced world, depression and anxiety are the most prevalent health problems, generating high economic and social burdens. Interpretation biases seem to play a pivotal role in this emotional problems, influencing how individuals interpret emotionally ambiguous information. These interpretation biases can emerge due to the activation of latent schemas related to how individuals perceive themselves. Therefore, integrating the study of cognitive and self-discrepancy models can offer a comprehensive approach to better understanding the onset or maintenance of emotional symptoms, through their relationship with interpretation biases. In this paper, we aimed to test whether differences in self-perception might act like a cognitive schema that activate cognitive bias, influencing information processing and predicting emotional symptoms. Method: Seventy-three undergraduates completed two different experimental tasks, evaluating self-discrepancies and self-referential negative interpretation bias. Moreover, emotional symptoms were collected after completing the tasks and 1-2 months after, prior to coping with a natural stressor (exam period). The main analyses comprised mediational models, both cross-sectional and longitudinal, with the aim to test whether interpretation bias might act like a mediator in the relation between self-discrepancies and emotional symptoms. Results: First, the results showed significant correlations between higher levels of self-discrepancies (actual-ideal and actual-ought) and higher levels of emotional symptoms (depression and anxiety), as well as with higher negative interpretation biases. Further, cross-sectional mediational models showed that negative interpretation biases partially mediated the relationship between self-discrepancies and emotional symptoms. As for the longitudinal mediation analysis, interpretation bias only mediated the specific relation between actual-ideal self-discrepancies and increases in anxiety symptoms, while the rest of the indirect effects were not significant. Discussion: These results suggest that self-discrepancies could be understood as indices of the activation of latent cognitive schemas, which would influence subsequent stages of information processing, such as negative interpretations of ambiguous information, partly accounting for the emergence and/or maintenance of emotional symptoms. [ABSTRACT FROM AUTHOR]

Neutrosophic Fuzzy Sets (NFS) expand upon classical fuzzy sets in the field of fuzzy set theory by including measures of truth, indeterminacy, and falsity. This paper thoroughly examines the creation and assessment of similarity measures for Single-Valued Neutrosophic Fuzzy Sets (SVNFS). The similarity measure is a crucial metric that quantifies the extent of similarity between two sets. It finds extensive application in various fields such as pattern recognition, medical diagnosis, and decision-making challenges. Nevertheless, the current similarity measures of Neutrosophic Fuzzy Sets(NFS) suffer from limited practicality and interpretation, and do not yield highly reliable outcomes. In order to tackle this issues, We provide a variety of new similarity measures, including the Hausdorff similarity measure, Membership-grade based similarity measure, and Trigonometric Hausdorff similarity measure specifically designed for Neutrosophic Fuzzy Sets(NFS). We conduct a comparison of their performance against existing measures. We verify the efficacy of these approaches by conducting thorough theoretical research and practical trials, showcasing their suitability in pattern recognition. The findings demonstrate substantial enhancements in precision and resilience, offering vital tools for academics and practitioners working with intricate and unpredictable data. The results of our research provide a foundation for future progress in the Neutrosophic Fuzzy Set theory and its practical use in several areas. [ABSTRACT FROM AUTHOR]

Clostridioides difficile (C. difficile) was a gram-positive anaerobic bacterium in the gut, exhibiting clinical manifestations ranging from mild diarrhoea to fatal pseudomembranous colitis. C. difficile infection (CDI) remains a serious public health problem and accounted for an estimated 360,075 cases in the United States in 2021. It has attracted the utmost attention of the world health organization (WHO). Since publication of a review of the diagnosis of CDI in adults, new clinical diagnostic assays have become available and clinical practice guidelines were updated. This paper presents a comprehensive review of contemporary laboratory diagnostic approaches for CDI in adult patients, with a focus on the utilisation and potential advancements of five sophisticated methodologies, CRISPR in conjunction with nucleic acid amplification tests (NAATs), gene sequencing technology, ultra-high performance liquid chromatography-mass spectrometry, Raman spectroscopy, and real-time cell analysis (RTCA). It can provide new perspectives and ideas for the early diagnosis of CDI in clinical settings. [ABSTRACT FROM AUTHOR]

Infectious Agents and Cancer journal has recently launched a new collection of papers about "Point-of-Care (POC) for HPV-related genital cancers" putting together some interesting works on the accuracy of HPV tests for screening. This editorial initiative gave us the opportunity to reflect on the relations between accuracy measures, prevalence and characteristics of the tested population in the case of HPV-based screening. In screening test evaluation, we look at the clinical accuracy of the test as an intrinsic characteristic of the assay, which interacts with the characteristics of the population, the result being the screening performance. In the case of HPV testing, the clinical accuracy should be conceptualized in two steps, the analytical accuracy of the assay for HPV infection and the biological link between HPV infection and the target disease, i.e. the high-grade cervical intraepithelial neoplasia (hgCIN). This approach highlights that just a few false positive cases result from a lack of analytical specificity while most derive from women who have the infection but it did not progress to hgCIN. In addition, increasing prevalence of hgCIN results in relevant increases of PPV only if due or associated with exposures which increase the progression from infection to hgCIN or the duration of the latter; while an increase due to a higher prevalence of HPV infection would only marginally affect PPV. This approach may help in modelling the performance of HPV-based cervical screening. [ABSTRACT FROM AUTHOR]

Introduction and objective: Giant cell arteritis (GCA) is the most common primary systemic vasculitis in Europe. It mainly affects individuals over the age of fifty, its incidence increases with age. The most common clinical manifestation is bilateral headache accompanied by systemic symptoms. The disease may be associated with serious complications, such as permanent vision loss, stroke or rupture of aortic aneurysm. The aim of this study is to discuss the current knowledge about giant cell arteritis and new possibilities of biological treatment. Review methods: To prepare this review, PubMed and Google Scholar databases were used, searching the following terms: "giant cell arteritis," "temporal arteritis," "giant cell arteritis biological treatment," "giant cell arteritis biological therapy," "giant cell arteritis treatment," "giant cell arteritis epidemiology." The search results were limited to publications from 2007 to 2024, as well as key studies from earlier years, including original papers and randomized, double-blind, placebo-controlled studies. Brief description of the state of knowledge: The pathogenesis of GCA remains unclear. Since inflammatory factors appear to play an important role, new therapeutic strategies are aimed in direction to interfere these pathways. Setting a diagnosis of GCA requires imaging studies or a temporal artery biopsy. The results of current treatment with high doses of glucocorticoids are unsatisfying, which has led to ongoing research into new therapeutic options. Summary: Early diagnosis and initiation of treatment are crucial for preventing occurrence of complications. Although the current treatment regimen is effective, it leads to many side effects and does not prevent relapses. This highlights the need to better understand the pathomechanism of the disease to develop more precise therapeutic strategies, including biological treatment. [ABSTRACT FROM AUTHOR]

Background: The subtypes diagnosis of disease symptom clusters, grounded in the theory of "Treatment in Accordance with Three Categories of Etiologic Factors" and International Classification of Diseases 11th Revision (ICD-11), is a vital strategy for Chinese Medicine (CM) in treating unknown respiratory infectious diseases. However, the classification of disease symptom clusters continues to depend on empirical observations and lacks robust scientific evidence. Consequently, this study seeks to explore the temporal, spatial and demographic distributions characteristics of Corona Virus Disease 2019 (COVID-19) symptom clusters in China. Methods: PubMed, Web of Science, Science direct, WHO, Litcovid, CNKI databases were searched from inception until December 31, 2023. Optical character recognition technology and image recognition technology were employed to identify tables within the papers. Four researchers independently screened and extracted data, resolving conflicts through discussion. Heat mapping and hierarchical clustering techniques were utilized to analyze COVID-19 symptom clusters. Data analysis and visualization were conducted using R software (4.2.0), while the association analysis of symptom clusters was performed using Cytoscape (3.10.2). Results: A total of 366 COVID-19 clinical trials with 86,972 cases including 66 clinical symptoms of 7 disease systems and other clinical manifestations in China were included. In temporal distribution, 63 symptoms centered around fatigue and 44 symptoms focused on chest tightness are characteristic of symptom clusters in spring and winter, respectively. With the addition of spatial distribution, the symptom clusters in middle and low latitudes during spring are characterized by 53 symptoms centered around fatigue and cough, and 51 symptoms focused on fatigue, respectively. During winter, the symptom clusters in middle and low latitudes are characterized by 38 symptoms centered around chest tightness and 37 symptoms focused on fever, respectively. When considering demographic distribution, the symptom clusters for < 50 years are characterized by fatigue as the core symptom in middle (44 symptoms)/low (28 symptoms) latitudes during spring and middle latitude (25 symptoms) during winter. For ≥ 50 years, the symptom clusters in middle latitude (49 symptoms) during spring and low latitudes (35 symptoms) during winter are centered around cough, while in low latitude (27 symptoms) focuses on diarrhea during spring, and middle latitude (35 symptoms) emphasizes both diarrhea and chest tightness during winter. Conclusion: In summary, variations in symptom clusters and core symptoms of COVID-19 in temporal, spatial and demographic distributions in China offer a scientific rationale for the "Treatment in Accordance with Three Categories of Etiologic Factors" theory. These interesting findings prompt further investigation into CM patterns in the ICD-11, and suggest potential strategies for personalized precision treatment of COVID-19. High-quality clinical studies focusing on individual symptoms are warranted to enhance understanding of respiratory infectious diseases. [ABSTRACT FROM AUTHOR]

Introduction: Hydrocephalus is a form of communication hydrocephalus syndrome characterized by ventricular enlargement and normal intraventricular pressure. The primary clinical manifestations include gait disturbances, cognitive dysfunction, urinary incontinence, and either elevated or normal intracranial pressure. This paper presents a case of a mental disorder resulting from inadequate drainage following a ventriculoperitoneal shunt procedure for hydrocephalus. The case report aims to enhance clinicians' understanding of such organic brain lesions, which are prone to misdiagnosis and inappropriate treatment, thereby improving differential diagnostic skills. Case presentation: This case report describes a 34-year-old male with a 16-year history of depressive disorder, previously managed with 150 mg of venlafaxine daily, 7.5 mg of zopiclone every night, and 2.4 g of piracetam every day. The patient underwent a ventriculoperitoneal shunt procedure for hydrocephalus, leading to the development of a mental disorder attributable to poor drainage from the shunt tube. Initial symptoms consisted of low mood, decreased interest, and cognitive impairment. Despite psychiatric consultation and antidepressant treatment, there was no improvement in his condition. The final diagnosis was an organic mental disorder. Following an increase in shunt drainage and the administration of a low dose of olanzapine, the patient's psychiatric symptoms showed significant improvement. Conclusion: Reporting this case seeks to enhance clinicians' awareness of the psychiatric manifestations of organic brain lesions, expand the differential diagnostic approach for psychiatrists, and improve diagnostic accuracy. Additionally, it emphasizes the need for cautious use of psychiatric medications, appropriate symptomatic management, and timely referral when necessary. [ABSTRACT FROM AUTHOR]

Simple Summary: Acute myeloid leukemias (AML), mimicking acute promyelocytic leukemia (APL) features but lacking the canonical t(15;17) translocation, are rare but challenging entities, both on a diagnostic and clinical plan. From the first report, in the early 1990s, of an APL-like AML characterized by the t(11;17) translocation, several cases have been described, with significant heterogeneity in terms of presentation, sensitivity to treatments, and prognosis. In this review, we aim to describe APL-like entities reported to-date and discuss their biological background and clinical implications. Acute promyelocytic leukemia (APL) is a rare type of AML, characterized by the t(15;17) translocation and accounting for 8–15% of cases. The introduction of target therapies, such as all-trans retinoic acid (ATRA) and arsenic trioxide (ATO), radically changed the management of APL, making it the most curable AML subtype. However, a small percentage (estimated to be 2%) of AML presenting with APL-like morphology and/or immunophenotype lacks t(15;17). This rare APL-like AML group, whose first case was described in the early 1990s, now includes over 40 entities. These diseases present great heterogeneity in terms of genetic lesions, clinical presentation, sensitivity to targeted agents and chemotherapy, and prognosis. Furthermore, the diagnosis is very challenging. Thus, in this paper, we aim to comprehensively review the literature reports and studies addressing APL-like entities, investigate the biological mechanisms of leukemogenesis, evaluate the clinical characteristics, and discuss future lines of research and possible clinical approaches. [ABSTRACT FROM AUTHOR]

Traumatic symptoms among older persons are a very massive problem in society. The traumatic studies among older adults are significantly less in the research field. It is essential to understand and look after the trauma in the older adults. The main goal of this study is to analyse the traumatic symptoms among the older citizen of 60 and above and how the symptoms affect their Quality of life. This research paper was conducted on the older citizens residing in Tiruchirappalli district. The pattern of findings was obtained after controlling demographics, traumatic events, situations, and symptoms. This result has implications for understanding how the symptoms influence their Quality of life. Data was gathered from 60 older adults (aged 60) housed in Tiruchirappalli district. The traumatic symptoms and quality of life among older persons were measured using the self-structured (trauma checklist) and WHO Breff scale (quality of life scale) questionnaire over 30 females and 30 males in the Tiruchirappalli district. The result of the analysis revealed that the traumatic events happened in their life, but the traumatic symptoms did not affect their Quality of life because the majority of the traumatic symptoms happened a long day before for the respondents, so their Quality of life was not affected because of traumatic symptoms. [ABSTRACT FROM AUTHOR]

The capability of complex fuzzy sets plays a valuable role in resolving many real-life problems. In this paper, we present the compositions of complex fuzzy relations by using the idea of implication operators and max-product compositions of complex fuzzy relations and illustrate these compositions with concrete examples. The converse of these newly invented triangular compositions in terms of compositions of the converse relations is also defined. We also study the interactions with the union and intersection. The main goal of this article is to present a new technique to enhance medical diagnostic models that can assist in improving the features of healthcare systems. We utilize these compositions to diagnose diseases in patients on the basis of the intensity of symptoms. [ABSTRACT FROM AUTHOR]

Aplasia of the lumbar pedicle is a rare condition, frequently associated with low back pain. Its recognition is fundamental in the definition of the correct treatment. We performed a literature review in order to clarify how to best diagnose and treat this rare anatomical condition. A comprehensive literature search for studies published through October 2020 was performed, using the following algorithm: "aplasia" OR "aplastic" OR "hypoplasia" OR "hypoplastic" OR "absent" OR absence" AND "pedicle" AND "lumbar" OR "sacral" OR "lumbosacral". References from reviewed papers were further evaluated for the inclusion of other relevant studies. Eighteen studies were included in the systematic review for a total of 24 adult patients. Another case of left L5 pedicle aplasia treated at our hospital has been described and included in the present review. This anatomical condition may be suspected in plain x-Ray, but CT scan 3D reconstructions may help to confirm the diagnosis in equivocal cases. Low-back pain and radiculopathy are the main signs and symptoms. The treatment was described in 14 cases. Eight patients underwent surgical intervention. In cases with spondylolisthesis, fusion surgery was performed with different techniques, obtaining an excellent clinical outcome. Pedicular aplasia is a rare condition that must be recognized in patients with a low back. When it is associated with spondylolisthesis, fusion surgery should be the preferred option. [ABSTRACT FROM AUTHOR]

Background and Clinical Significance: Multinodular Vacuolating Neuronal Tumors (MVNTs) are mixed glial–neuronal brain lesions classified as World Health Organization (WHO) CNS grade 1 tumors, often associated with long-term epilepsy. First described by Huse et al. in 2013 and included in the WHO CNS classification in 2016, MVNTs present a range of clinical manifestations, from symptomatic to asymptomatic. They typically affect young to middle-aged adults and exhibit diverse presentations. Radiologically, MVNTs are usually supratentorial, frequently located in the temporal lobe but also observed in the frontal and parietal lobes. MRI is essential for diagnosis, revealing multiple coalescing subcortical or cortical nodules with hyperintense signals on T2-weighted/FLAIR sequences, often without peripheral edema or mass effects. Case Presentation: This paper presents two cases: one symptomatic MVNT with significant clinical manifestations, and the other documenting an incidental finding of MVNT in an asymptomatic patient. One case shows typical temporal lobe localization, while the other highlights a rare frontal lobe localization, with clear radiological findings on T2/FLAIR sequences. Conclusions: These cases illustrate the varied clinical presentations of MVNTs and emphasize MRI's critical role in diagnosis and management. Asymptomatic cases often require conservative management, stressing the avoidance of unnecessary invasive procedures and the importance of regular monitoring. [ABSTRACT FROM AUTHOR]

Background: Breast cancer patients experience various adverse symptoms during adjuvant chemotherapy. These adverse symptoms often form symptom clusters and have a negative impact on patients. Aims: To summarise common symptom clusters in different dimensions and their longitudinal changes among breast cancer patients receiving adjuvant chemotherapy. Design: A systematic review. Data Sources: Ten electronic databases were searched from 2001 to January 2024, and the search was last updated on 16 August 2024. Methods: Two reviewers independently assessed the eligibility of each study and extracted data. The Standard Quality Assessment Criteria for Evaluating Primary Research Papers was used to evaluate the quality of included studies. The findings were synthesised narratively. This systematic review has been registered (CRD42022370210). Results: Nine studies with a total of 1454 participants were included. The common symptom clusters in breast cancer patients receiving adjuvant chemotherapy were the gastrointestinal symptom cluster (nausea‐lack of appetite), the fatigue‐pain‐sleep disturbance symptom cluster and the psychological symptom cluster (worry‐sadness‐nervousness‐distress‐feeling irritable‐difficult concentrating). The severity dimension was the most frequently utilised in identifying symptom clusters, with the number and concurrence of symptom clusters showing variation over time. Conclusions: This study summarised common symptom clusters in breast cancer patients receiving adjuvant chemotherapy and revealed their changes from symptom dimensions and the chemotherapy process. These findings support further exploration of symptom cluster changes and underlying mechanisms, facilitating the design of targeted management strategies, including appropriate interventions and measurement dimensions in clinical nursing, to ultimately reduce patients' symptom burden. Impact: Common symptom clusters have been identified in breast cancer patients receiving adjuvant chemotherapy. Clinical nursing in oncology can prioritise these symptom clusters and provide patients with targeted management strategies. Reporting Methods: PRISMA guidelines and SWiM guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objective: N‐methyl‐D‐aspartate receptors are glutamate‐gated ion channels that play a crucial role in brain function. Numerous inherited or de novo variants in the GRIN2A gene, encoding the GluN2A subunit of the receptor, have been identified in patients with epilepsy. In addition, it is worth noting that GRIN2A variants exhibit a strong correlation with epilepsy‐aphasia syndromes, a group of age‐dependent epileptic, cognitive, and language disorders with a characteristic electroencephalographic pattern. Methods: Whole exome sequencing was conducted in enrolled patients with epilepsy‐aphasia syndromes, and GRIN2A variants were screened. The conservation of substituted residues, conformational changes of mutant subunits, and in silico predictions of pathogenicity were thoroughly assessed in our study. Functional alterations of the variants were examined using whole‐cell voltage‐clamp current recordings while the relative surface expression levels of subunit proteins were assessed via immunofluorescence assays. A summary of previously published GRIN2A missense variants was conducted to investigate the genotypic‐phenotypic‐functional correlations. Results: Two missense GRIN2A variants (c. 2482A >G/p. M828V, c. 2627 T >C/p. I876T) were identified, which are located in the transmembrane helix M4 and C‐terminus domain of the GluN2A subunit, respectively. Both variants exhibited reduced current density of NMDARs and surface/total expression levels of GluN2A subunits, while M828V showed a decreased extent of desensitization as well. A further summary of the previously reported GRIN2A variants demonstrated that more variable phenotypes were observed for variants situated in the C‐terminus domain or those with loss‐of‐function effects. Significance: Our study expands the phenotypic and functional range of GRIN2A‐related disorders. In order to optimally establish the domain‐function‐phenotype correlations in GRIN2A variants, it is imperative to gather a more extensive set of clinical and functional data. Plain Language Summary: This study has identified two genetic variants of the GRIN2A gene in patients with epilepsy‐aphasia syndrome. We assess the variants' harmfulness through a variety of functional experiments, including evaluating the expression level of the mutated protein and the resulting changes in electrophysiological activities. Also, we reviewed previously published papers about GRIN2A variants in epilepsy to learn more about the correlations between their locations, functional changes, and clinical manifestations. [ABSTRACT FROM AUTHOR]

Introduction: Invasive meningococcal disease (IMD) has a low incidence but is a life-threatening illness with a 10–15% mortality rate. Even with timely treatment, survivors may experience acute and long-term health complications. While meningococcal vaccines are recommended for adolescents and young adults in the USA, vaccination coverage remains uneven across serotypes. This study investigated the physical, social, psychological, and economic burden of IMD on survivors and their caregivers in the USA during the acute phase (Part 1, presented in this manuscript) and the long-term phase (Part 2, presented in a separate manuscript) of IMD. Methods: This study implemented a non-interventional, mixed-methods approach using a bespoke survey and qualitative interviews (designed on the basis of a preliminary conceptual model of IMD) with US survivors and their caregivers. Results: A total of 11 survivors (1 adolescent, 10 adults) and 3 caregivers participated in the study. Survivors contracted IMD during infancy (n = 2), childhood (n = 3), or adulthood (n = 6), and often described leading healthy lives pre-IMD. At IMD onset, interactions with the healthcare system impacted participants' experiences; confusion and care delays were common, and procedures were often invasive (e.g., amputations). Survivors commonly experienced symptoms including skin rash (7/11), fever (6/11), and unconsciousness (6/11), consistent with caregivers' reports. Survivors able to report on the short-term impacts of IMD (n = 9) described functional limitations (9/9), emotional impacts (6/9) such as fear and trauma, and school (6/9), work (4/9), and financial (5/9) challenges. Caregivers also experienced emotional impacts (3/3) and family (2/3), work (3/3), and financial (3/3) impacts during the acute phase. Conclusions: IMD places a significant humanistic burden on survivors and their caregivers during the acute phase. Results from Part 1 of this study indicate a need for increased disease awareness and healthcare provider education, expeditious diagnosis, and improved access to prevention methods such as available meningococcal vaccines. A video abstract is available with this article. 7CedpUhoy_P6EE5C2Mz6-e Video abstract (MP4 1,24,432 kb) Plain Language Summary: Invasive meningococcal disease (IMD) is an uncommon but serious infection. Even with treatment, IMD is deadly for up to 10–15% of people who get sick, and survivors may experience short-term and long-term health problems. While IMD can be prevented through vaccination, many people are not vaccinated. We asked 11 survivors and 3 of their caregivers in the USA about their experiences with IMD during the time of their infection and initial recovery (the "short term"). We were particularly interested in the symptoms that survivors experienced, their diagnosis and treatment experiences, and the impact on survivors' and caregivers' quality of life. Most survivors described leading healthy lives before getting sick. Severe skin rash, fever, and unconsciousness were common symptoms when survivors got the infection. Most participants were admitted to the hospital when symptoms started (many through the emergency room). However, not everyone was diagnosed quickly or accurately, and many experienced delays in receiving care. Treatments could be drastic, such as immediate surgery to remove arms or legs. Survivors and caregivers described feeling scared and traumatized, and many experienced challenges with day-to-day activities. Healthcare-related expenses and the inability to attend school or work led to financial challenges for some. The burden of IMD infection and initial recovery is significant. There is a need for increased public disease awareness, targeted education for healthcare providers, and improved access to prevention measures such as vaccination. The long-term effects of IMD infection were also explored in this study, and are presented in another paper [1]. [ABSTRACT FROM AUTHOR]

Epithelioid hemangioma of bone is a rare benign vascular tumor. Because of the locally destructive clinical presentation and the presence of atypical histologic features with increased mitotic activity and necrosis, it is often misdiagnosed as low-grade malignant epithelioid hemangioendothelioma or high-grade malignant epithelioid angiosarcoma. Correct diagnosis through imaging studies and histopathological examination is mandatory to determine the appropriate course of treatment, as the prognosis differs from that of other malignant hemangioma tumors. A 69-year-old male who presented with intractable shoulder pain caused by epithelioid hemangioma in the acromion of the scapula was treated with tumor curettage. This paper reports a good result with a review of the relevant literature. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence and the characteristics of pelvic floor dysfunction (PFD) in women with endometriosis. Methods: This is a methodological paper that describes the 'Endometriosis and Pelvic Floor Dysfunction' (EndoPFD) multicenter study protocol. It involves three sites: the University Hospital of Pisa, the San Raffaele Hospital of Milan and the Vanvitelli University Hospital of Naples. Women are recruited through web links and are asked whether they want to participate to the clinical evaluation or only to the web survey. The web survey gathers personal history, endometriosis history and symptoms, and performs a subjective evaluation of PFD through questionnaires: Urinary Distress Inventory 6, Colorectal-Anal Distress Inventory 8, Wexner Scale for Fecal Incontinence, Wexner Constipation Scoring System, and Female Sexual Function Index. Those interested in the clinical evaluation will add to the questionnaires the following exams: gynecological and proctological exam, pelvic ultrasound, urodynamic test, and anorectal manometry. Preliminary results: Recruitment for the web survey was completed. A total of 1,149 women signed the electronic consent, 329 were excluded due to inclusion/exclusion criteria; hence, 525 completed all the questionnaires (response rate of 64.02%). Recruitment for the clinical evaluation is ongoing. Discussion: This study protocol offers the possibility to define the prevalence of PFD in endometriosis patients with a subjective and an objective assessment of signs and symptoms. This may pave the way for changing the approach to patients with endometriosis. Moreover, it demonstrates the validity of the method used (online survey and recruitment) to reach a high number of patients. [ABSTRACT FROM AUTHOR]

Background and objective: It is commonly known that there is a connection between heart disease and depression symptoms. Compared to heart failure patients without concurrent depression, those with depressive symptoms are more likely to have longer hospital stays and more outpatient visits following discharge. Although the exact neurobiological mechanisms causing the correlation between heart disease and depression symptoms are unknown, it is thought that vascular abnormalities may be a major factor. The purpose of this review was to examine the connection between brain networks linked to depression and heart failure (HF). Methods: PRISMA guidelines were followed. We included studies that reported both heart failure as well as depression and neuroimaging. Results: We identified 159 papers, but only 12 articles were included. Our findings show that reduced cerebral blood flow (CBF) following HF, along with other contributing factors such as chronic inflammation and neurovascular dysfunction, can lead to significant brain tissue damage and disruption of neural networks. The resulting alteration in the brain increases the risk of developing depression, as the neural circuits responsible for emotional regulation become compromised. Conclusions: Individuals with heart failure (HF) exhibit reduced regional cerebral blood flow across multiple brain areas, many of which are critical for mood regulation and are commonly implicated in depression, such as the left frontal cortex and right hippocampus. [ABSTRACT FROM AUTHOR]

Simple Summary: Adrenocortical tumors (ACTs) are rare in children and can be benign (adrenocortical adenoma or ACA) or malignant (adrenocortical carcinoma or ACC). Children with Beckwith–Wiedemann spectrum (BWSp) are at an increased risk of developing ACTs, but there is uncertainty around the prognosis, management, and molecular characteristics associated with these tumors. In this study, we provide a literature review of data from 54 published patients with BWSp-ACT and report on one additional new patient, totaling 55 cases: 19 ACA, 33 ACC, and 3 uncertain malignant potential (umACT). Almost half of the ACC patients were clinically diagnosed with BWSp after ACC onset, suggesting that the BWSp clinical diagnostic score has limited value for early diagnosis in this setting. Two patients with metastatic ACC had a low histopathological Wieneke score, confirming limitations of the current histopathological classification, as previously documented. Ultrasound screening failed to identify ACC before metastasis in two cases, indicating a need for new screening strategies for ACTs in children with BWSp. Notably, in some cases, metastatic ACC exhibited unexpectedly indolent behavior, despite their malignancy. Background/Objectives: Adrenocortical tumors (ACTs), including adrenocortical adenoma (ACA) and carcinoma (ACC), represent 0.3–0.4% of pediatric tumors. Beckwith–Wiedemann spectrum (BWSp) confer an increased risk of ACTs, but prognosis, management, and associated molecular characteristics are unclear. Methods: This paper combines a literature review of 54 published cases of BWSp-ACT with a report of one newly identified patient, totaling 55 cases with a confirmed BWSp clinical and/or molecular diagnosis. Results: Nineteen patients with ACA, 33 with ACC, and 3 with ACT of uncertain malignant potential (umACT) were included. Twenty patients had uniparental disomy of chromosome 11p15.5 (patUPD11), 11imprinting Center 2 Loss-of-methylation (IC2-LoM), and had 2 11p15 locus duplication. Eleven patients were diagnosed during cancer screening procedures, including two metastatic at diagnosis ACC. Conclusions: Almost half of ACC patients reached the minimum score for clinical BWSp diagnosis only after ACC onset, suggesting that the BWSp score has limited value for the early diagnosis in such a setting. Two patients with metastatic ACC had a histopathological Wieneke score ≤2, not correlating with clinical malignancy and confirming limitations of the current histopathological classification, as previously documented. Ultrasound screening failed identifying the ACC before metastasis in two cases, indicating an urgent need to develop new strategies for screening of ACTs in BWSp. Furthermore, some cases of metastatic ACC exhibited unexpectedly indolent behavior despite being malignant. [ABSTRACT FROM AUTHOR]

Clinical research is undertaken to improve care for palliative patients, but little is known about how to support the broad uptake of resultant innovations. The objectives of this paper are to: (1) explore the uptake of the Edmonton Symptom Assessment System throughout the global palliative care community through the lens of a bibliometric review — a research method that maps out the journey of new knowledge uptake by evaluating where key articles are cited in published literature; (2) construct hypotheses on attributes of the global community of palliative care learners; and (3) make inferences on approaches that could improve knowledge transfer. While preliminary, results of the study suggest several specific approaches that could support widespread uptake of innovations in palliative care: targeting publication in high impact, international journals; explicitly focusing on how the innovation is applied to best practice; encouraging additional research to expand on early studies; consciously targeting key professional groups and organizations to promote discussion in the grey literature; and early translation and promotion within multiple languages. [ABSTRACT FROM AUTHOR]

BACKGROUND CONTEXT Neck pain is one of the most commonly reported symptoms in primary care settings, and a major contributor to increasing health care costs. Cervical manipulation is a common and clinically effective intervention for neck pain. However, the in vivo biomechanics of manipulation are unknown due to the inability to accurately measure intervertebral kinematics in vivo during the manipulation. PURPOSE The objectives were to characterize manual forces and facet joint gapping during cervical spine manipulation and to assess changes in clinical and functional outcomes after manipulation. It was hypothesized that patient-reported pain would decrease and intervertebral range of motion would increase after manipulation. STUDY DESIGN/SETTING Laboratory-based prospective observational study. PATIENT SAMPLE A total of 15 patients with acute mechanical neck pain (5 M, 10 F; average age 40±14 years). OUTCOME MEASURES Amount and rate of cervical facet joint gapping during manipulation, amount and rate of force applied during manipulation, change in intervertebral range of motion from before to after manipulation, change in pain after manipulation. METHODS Initially, all participants completed a visual analog pain scale (0-10). Participants then performed full range of motion (ROM) flexion or extension, rotation, and lateral bending while seated within a custom biplane radiography system. Synchronized biplane radiographs were collected at 30 images/second for 3 seconds during each movement trial. Next, synchronized, 2.0 ms duration pulsed biplane radiographs were collected at 160 images/second for 0.8 seconds during the manipulation. The manipulation was performed by a licensed chiropractor using the thumb cervical extension technique. For the final five participants, two pressure sensors placed on the thumb of the chiropractor (Novel pliance system) recorded pressure at 160 Hz. After manipulation, all participants repeated the full ROM movement testing and once again completed the visual analog pain scale. A validated volumetric model-based tracking process that matched subject-specific bone models (from CT) to the biplane radiographs was used to track bone motion during manipulation with sub-millimeter accuracy. Facet joint gapping was calculated as the average distance between adjacent articular facet surfaces. Pre- to postmanipulation changes were assessed using paired t -tests. RESULTS The facet gap increased 0.98±0.30 mm during manipulation. The average rate of facet gapping was 7.4±2.9 mm/s. The peak force and rate of force application during manipulation were 65±4 N and 445±105 N/s. Pain score improved from 3.7 before manipulation to 2.0 after manipulation (p<.001). Intervertebral range of motion significantly increased after manipulation by 1.4° (p=.005), 2.2° (p=.01) and 4.1° (p<.001) at the C4/C5, C5/C6 and C6/C7 motion segments, respectively, during flexion/extension, by 1.4° (p=.007),1.2° (p=.035) and 1.0° (p=.003) at the C3/C4, C4/C5 and C6/C7 motion segments, respectively, during rotation, and by 0.7° (p=.01) and 1.0° (p=.04) at the C4/C5 and C5/C6 motion segments, respectively, during lateral bending. CONCLUSIONS This study is the first to measure facet gapping during cervical manipulation on live humans. These results improve our understanding of the basic in vivo biomechanics of spinal manipulation. Continuing this line of research will allow clinicians and researchers to design better interventions that reliably and sufficiently impact the key mechanisms behind manipulation. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs. [ABSTRACT FROM AUTHOR]

Presents abstracts on applied psychophysiology and biofeedback. The theme of the meeting was "Launching New Mind-Body Paradigms".

OBJECTIVE To assess the effectiveness of a portable electronic diary as a data collection device for overactive bladder symptoms, and to evaluate its level of patient acceptability compared with a conventional paper-based voiding diary. PATIENTS AND METHODS Patients were identified through USA and UK hospital incontinence clinics. Patients were trained in the use of paper and electronic diaries before randomization, to complete either diary for 7 days. The diaries were then collected and, after a further training session, patients completed the other diary type for 7 days. RESULTS In all, 35 patients were recruited into the trial; overall, patients using the paper diaries (35) and electronic diaries (33) recorded similar data for the median number of incontinent episodes per week (8.2 and 7.0, respectively) and for the median number of significant leaks per day (0.4 and 0.5, respectively). However, the number of daily micturitions was slightly lower for the electronic than for the paper diary (7.3 vs 8.5, respectively). The frequency of urgency recorded in the electronic diary was higher than that recorded in the paper diary (5.8 vs 4.7). As 94% of patients found the electronic diary easy to use, and the electronic diary reflects real-time data entries, the electronic diary data may provide a more accurate reflection of patient symptoms. CONCLUSION We confirmed that the electronic diary is a novel method of collecting clinically relevant symptom data from patients with an overactive bladder. In addition, the ease-of-use ratings support the use of the electronic diary as a superior alternative to paper diaries, providing real-time data which can be rapidly analysed, and thus allowing a speedy review of data during ongoing clinical studies. [ABSTRACT FROM AUTHOR]

This paper examines the genesis of Leo Kanner's 1943 seminal paper on autism. It shows that describing children as autistic or lacking affective contact with people was not new by this time. But Kanner's proposal that infantile autism constituted a hitherto unidentified condition that was inborn and different from childhood schizophrenia was new. It also shows that Georg Frankl's influence on Kanner was important, but Kanner did not misappropriate his ideas or his research. Kanner developed his views on the basis of his observations of several children, his knowledge of the literature on childhood conditions, and his interactions with many scholars. [ABSTRACT FROM AUTHOR]

Objectives: A new patient-reported outcome (PRO) instrument to measure fatigue symptoms and impacts in relapsing multiple sclerosis (RMS) was developed in a qualitative stage, followed by psychometric validation and migration from paper to an electronic format.Methods: Adult patients with relapsing-remitting multiple sclerosis (RRMS) were interviewed to elicit fatigue-related symptoms and impacts. A draft questionnaire was debriefed in cognitive interviews with further RRMS patients, and revised. Content confirmation interviews were conducted with patients with progressive-relapsing multiple sclerosis (PRMS) and relapsing secondary-progressive multiple sclerosis (RSPMS). Psychometric analyses used data from adult patients with different RMS subtypes and matched non-RMS controls in a multicenter, observational study. After item reduction, the final instrument was migrated to a smartphone (eDiary) and usability was confirmed in interviews with additional adult RMS patients.Results: The qualitative stage included 37 RRMS, 5 PRMS, and 5 RSPMS patients. Saturation of concepts was reached during concept elicitation. Cognitive interviews confirmed that participants understood the instructions, items, and response options of the instrument-named FSIQ-RMS-as intended. Psychometric validation included 164 RMS and 74 control patients. Internal consistency and test-retest reliability were demonstrated. The symptoms domain discriminated along the RMS symptom-severity continuum and between patients and controls. Patients were able to attribute fatigue-related symptoms to RMS. Usability and conceptual equivalence of the eDiary were confirmed (n = 10 participants).Conclusions: With 7 symptom items and 13 impact items (in 3 impacts subdomains: physical, cognitive and emotional, and coping) after item reduction, the FSIQ-RMS is a comprehensive, valid, and reliable measure of fatigue-related symptoms and impacts in RMS patients. [ABSTRACT FROM AUTHOR]

Introduction: Echolalia, the repetition of others' speech, is a common observation in autistic people. Research has established that echolalia is functional and meaningful for many; however, some clinicians and researchers continue to characterise it as pathological and in need of reduction. The aim of this systematic review was to understand the range and impact of interventions for echolalia in autistic children. Method: A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A total of 15 studies met predetermined inclusion criteria. Screening, data extraction and quality rating using the Scientific Merit Rating Scale (SMRS) were performed in duplicate. Results: Ten interventions across 15 papers were found. Results indicated that interventions generally decreased levels of echolalia. However, there were considerable inconsistencies in the definitions and conceptualisations of echolalia, administration, generalisation techniques and the measures used. The quality of the studies was very low. Conclusion: Interventions for echolalia vary widely in terms of administration and measurement. There is limited consensus on the definition of echolalia among the reviewed studies, and no evidence that echolalia is recognised as functional or meaningful to the autistic children. Further, the lack of methodological rigour makes it difficult to draw clinical conclusions about the interventions. WHAT THIS PAPER ADDS: What is already known: Echolalia is the immediate or delayed repetition of others' speech and is a common observation in autistic children and in some older autistic people. While research and practice has established that echolalia is a functional and meaningful form of communication, particularly for those first developing spoken communication, some clinicians and researchers continue to characterise it as problematic and suggest that echolalia should be reduced or eliminated. What this study adds: We systematically searched the literature about echolalia interventions to try to find out about the types of interventions that aim to reduce or eliminate echolalia. We found 15 studies on this topic. The way they defined echolalia was varied, and there was a range of interventions researched. None of the research papers recognised echolalia as functional or meaningful and the quality of the research was very low. What are the potential or actual clinical implications of this work?: Clinicians, families and researchers should think carefully and critically about suggesting any programs or supports that aim to reduce echolalia as no recommendations can be drawn from the research we studied. Echolalia should be considered functional, and efforts made to understand the meaning and purpose of echolalic speech. [ABSTRACT FROM AUTHOR]

This paper is aimed at comprehensively reviewing olfactory and gustatory disorders caused by SARS-CoV-2 in children and adults. An electronic and manual search was done on three data bases: MEDLINE, Embase, and Web of Science. Inclusion criteria included publications written in English, involving humans in the age range of 0 to 99 years that were captured by a controlled vocabulary of thesaurus terms. Olfactory and gustatory disorders rates in COVID-19 ranged from 22% to 71.9% in adults and 16.6% to 25.8% in children. Olfactory and gustatory disorders might appear as the first symptom, and in adults might even be the only symptom (4.8% to 10%). Anosmia is the most common olfactory disorder and hypogeusia is the most common gustatory disorder. In 33% to 89% of cases, olfactory and gustatory disorders resolve spontaneously within a few weeks, coinciding with the resolution of other COVID-19 symptoms, both in adults and children. However, in some patients, olfactory and gustatory disorders persist beyond the resolution of other symptoms. Notably, children generally experience a swifter and more favorable recovery compared to adults. The precise pathogenesis underlying olfactory and gustatory disorders in the context of COVID-19 remains unclear and is likely multifactorial. Presently, no established treatment protocol exists for olfactory and gustatory disorders and current treatments reviewed lack robust evidence and are not readily available for clinical use. Olfactory training represents the only therapy currently recommended by international authorities. Pediatric practitioners and general dental practitioners should be aware of olfactory and gustatory disorders in both pediatric and adult populations, including their biologic mechanisms, treatment options, and recovery rates. [ABSTRACT FROM AUTHOR]

As a requirement for a third year nursing subject based on Australian Indigenous Health and Community Nursing, an assessment was undertaken based on the clinical reasoning cycle. The clinical reasoning cycle refers to clinical judgements and clinical decision-making which can be conceptualised as a logical process of cue collection, processing information, understanding the situation, planning and implementing interventions, evaluating outcomes and reflecting on the process (Levett-Jones et al., 2009). The clinical reasoning cycle for this assessment relates to interactions with Murray (pseudonym), an Australian Indigenous male being treated for alcohol dependence within a community setting. This paper will explore the nursing care of Murray through the clinical reasoning cycle, focusing on community-based, culturally appropriate nursing care. [ABSTRACT FROM AUTHOR]

Background: Anthrax is a zoonotic disease that is still regarded as a public health issue in developing nations. This paper aims to discuss the epidemiology of anthrax in Africa, the current outbreaks in Ghana and Nigeria, clinical presentations, diagnosis, and treatment of anthrax, challenges associated with the transmission of the disease to both countries and recommendations to reduce this current outbreak and curb future outbreaks in Africa. Online databases (PubMed, and Google Scholar) and Nigeria Ministry of Agriculture report were used to provide detailed information on the paper. On June 1, 2023, two suspected human cases of anthrax were reported, via a letter sent to all stakeholders in the country, with one death in Binduri District, Upper East region of Ghana. The cases were due to the consumption of dead cattle. Four cattle were reported dead at the time, and eleven suspected human cases were identified through contact tracing. Afterward, on July 17, 2023, the Federal Ministry of Agriculture and Rural Development of Nigeria announced the first case of anthrax disease in Nigeria. The National Veterinary Research Institute confirmed the case from samples collected from a suspected livestock farm in Niger State, Nigeria. No human case has been reported. Short conclusion: Anthrax poses significant challenges to public health and requires cooperation between nations, especially in regions like Ghana and Nigeria, where animal movement and ecological changes can impact disease transmission. Challenges attributed to the spread of anthrax in both countries were discussed, focusing on the role of government and the general public in addressing this public health concern. Given the endemicity of certain transboundary animal diseases such as anthrax in sub-Saharan Africa, the control of animal movement across intra- and international borders in the region needs to be tightened. Regulations governing the transboundary movement of animals should be based on the World Organisation of Animal Health Terrestrial Code and should be strictly enforced to prevent ongoing and future outbreaks in Africa. [ABSTRACT FROM AUTHOR]

Functional neurological disorder (FND), formerly called conversion disorder, is a condition characterized by neurological symptoms that lack an identifiable organic purpose. These signs, which can consist of motor, sensory, or cognitive disturbances, are not deliberately produced and often vary in severity. Its diagnosis is predicated on clinical evaluation and the exclusion of other medical or psychiatric situations. Its treatment typically involves a multidisciplinary technique addressing each of the neurological symptoms and underlying psychological factors via a mixture of medical management, psychotherapy, and supportive interventions. Recent advances in neuroimaging and a deeper exploration of its epidemiology, pathophysiology, and clinical presentation have shed new light on this disorder. This paper synthesizes the current knowledge on FND, focusing on its epidemiology and underlying mechanisms, neuroimaging insights, and the differentiation of FND from feigning or malingering. This review highlights the phenotypic heterogeneity of FND and the diagnostic challenges it presents. It also discusses the significant role of neuroimaging in unraveling the complex neural underpinnings of FND and its potential in predicting treatment response. This paper underscores the importance of a nuanced understanding of FND in informing clinical practice and guiding future research. With advancements in neuroimaging techniques and growing recognition of the disorder's multifaceted nature, the paper suggests a promising trajectory toward more effective, personalized treatment strategies and a better overall understanding of the disorder. [ABSTRACT FROM AUTHOR]

Objectives: Granulomatous mastitis is a rare benign inflammatory disease of the breast commonly seen in women at childbearing age. The aim of this study is to describe clinical and paraclinical characteristics of GM patients, to demonstrate the management and follow-up experience of our center, and review the literature on the topic. Methods: 30 GM cases were identified among the 3248 patients who applied to the breast health center of the Liv Bona Dea hospital between January 2018 and August 2023. Cases were identified as granulomatous mastitis histopathologically from the biopsy specimens. Patient data was evaluated from the database, and missing information was retrieved by calling the patients. Results: Among the 3248 patients who were admitted to our breast health center, 30 patients (0.9%) had a diagnosis of GM and were identified as applicable to our study. All the patients were female, with a median age of 33, ranging from 27 to 66. Of the 30 patients, 11 were overweight and 7 were obese at the time of diagnosis (mean BMI: 26.7). While the majority (n=23, 76%) of the patients presented with a breast lump, only 1 (3%) of the patient’s only symptom was breast lump. 8 (27%) of the cases had comorbidities, including Hashimoto Thyroiditis (n=1), Hypertension (n=6), Diabetes Mellitus type 1 (=1), Diabetes Mellitus type 2 (n=4), Major Depression (n=1). Of the lesions, 16 (53%) showed high suspicion with a Bi-Rads score ≥ 4, and 14 (47%) showed low suspicion with a Bi-Rads score ≤ 4. 18 (60%) of patients received only medical treatment, 11 (37%) patients received both surgery (excision) and medical treatment, and only 1 (3%) received surgery (excision) alone. Conclusion: Even though idiopathic GM is the most common GM type, results from the paper of Ercan Kokrut et al. suggest that Tuberculosis should not be skipped, especially in developing countries, with reported 20% as a cause of GM. A multidisciplinary team is crucial in the diagnosis and treatment of GM to be able to distinguish it from breast cancer To conclude, Granulomatous mastitis is a tricky condition that can cause high anxiety in physicians as high as in patients. Idiopathic GM is the most common type, but evaluation of other reasons, such as tuberculosis mastitis, must be on the checklist. More research regarding the outcome of different treatment modalities will give a straightforward approach for physicians. [ABSTRACT FROM AUTHOR]

Cerebellar ataxias are a wide heterogeneous group of disorders that may present with fine motor deficits as well as gait and balance disturbances that have a significant influence on everyday activities. To review the ocular movements in cerebellar ataxias in order to improve the clinical knowledge of cerebellar ataxias and related subtypes. English papers published from January 1990 to May 2022 were selected by searching PubMed services. The main search keywords were ocular motor, oculomotor, eye movement, eye motility, and ocular motility, along with each ataxia subtype. The eligible papers were analyzed for clinical presentation, involved mutations, the underlying pathology, and ocular movement alterations. Forty-three subtypes of spinocerebellar ataxias and a number of autosomal dominant and autosomal recessive ataxias were discussed in terms of pathology, clinical manifestations, involved mutations, and with a focus on the ocular abnormalities. A flowchart has been made using ocular movement manifestations to differentiate different ataxia subtypes. And underlying pathology of each subtype is reviewed in form of illustrated models to reach a better understanding of each disorder. [ABSTRACT FROM AUTHOR]

Background: Somatic symptoms and related factors in patients with chronic heart failure have been extensively researched. However, more insight into the complex interconnections among these constructs is needed, as most studies focus on them independently from each other. Aims: The aim of this study is to gain a comprehensive understanding of how somatic symptoms and related factors are interconnected among patients with chronic heart failure. Methods: A total of 379 patients were enrolled. Network analysis was used to explore the interconnections among the somatic symptoms and related risk factors. Results: The four core symptoms of chronic heart failure were daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping. Within the network, the edge weights of depression–anxiety, subjective social support–objective social support, and subjective social support–social support availability were more significant than others. Among physiological, psychological and environmental factors, the edge weights of NYHA–dyspnea, depression–difficulty sleeping, and social support availability–dyspnea when lying down were more significant than others. Depression and anxiety had the highest centrality, indicating stronger and closer connections with other nodes. Conclusions: Psychological and environmental factors stood out in the network, suggesting the potential value of interventions targeting these factors to improve overall health. Summary statement: What is already known about this topic? Limited studies have explored core somatic symptoms in patients with chronic heart failure using network analysis.There is a lack of a holistic perspective when studying symptoms in patients with chronic heart failure and their association with various factors. What this paper adds? This study identifies daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping as the four core symptoms of chronic heart failure.Targeting these core symptoms in treatments and management can potentially lead to improvements in patients' overall health.The network analysis highlights the importance of psychological and environmental factors, suggesting that interventions targeting these factors may contribute to overall health improvement. The implications of this paper: It provides evidence of core symptoms of chronic heart failure.It provides evidence of the complex interconnections among symptoms and related factors in chronic heart failure.It provides implications for future interventions and strategies in managing chronic heart failure. [ABSTRACT FROM AUTHOR]

Background: Behavioural and psychological symptoms of dementia are a group of non‐cognitive symptoms such as agitation, physical aggression, depression, sexual disinhibition and psychosis. Therapeutic approaches vary because of the multifactorial and complex symptomology. The researchers of this study aimed to systematically review the nonpharmacological interventions for BPSD used by nurses in acute and subacute hospital settings. Design: The PRISMA guidelines guided this systematic review. The review was registered with PROSPERO (CRD42020184015). Method: The databases Cumulative Index of Nursing and Allied Health Literature (CINAHL) complete, Medline complete, Excerpta Medica (Embase®) and PsycINFO published by the American Psychological Association (APA) were searched for studies published in English to October 2021. Quality appraisal was performed independently by three reviewers using the Critical Appraisal Skills Program tools. Data were synthesized using a narrative approach. Results: Two studies were identified that focused on interventions used by nurses; findings were positive for the use of nonpharmacological interventions to manage BPSD. Conclusion: Current evidence suggests that nonpharmacological interventions are the best practices to manage BPSD. However, limited, and low‐quality evidence suggests that further investigation is required to understand the factors contributing to the lack of use of nonpharmacological interventions by nurses in acute and subacute hospital settings. Summary statement: What is already known about this topic? Behavioural and psychological symptoms of dementia (BPSD) occur for approximately 95% of patients diagnosed with dementia and significantly impact individuals, families, communities and healthcare systems.Due to the limited benefits and potential harm of pharmacological interventions, nonpharmacological interventions are considered the first line of treatment to manage BPSD in clinical practice.Previous systematic reviews were limited to interventions implemented by a multidisciplinary team or nonpharmacological therapies conducted mainly in a residential or long‐term care setting.What this paper adds? The existing body of evidence ascertains nonpharmacological interventions are effective in managing BPSD in patients with dementia.The authors of this review identified a gap in research for the nonpharmacological interventions used by nurses in acute and subacute hospital settings.The implications of this paper: This systematic review acknowledges the effectiveness of nonpharmacological interventions to reduce aggression and agitation in patients with dementia.It highlights two major gaps in the research: that there are very few studies conducted in hospital settings, and no studies report the use of nonpharmacological interventions by nurses on any symptoms of BPSD other than aggression in the hospital setting. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that sex and onset age are important factors of clinical features in Parkinson's disease. Aim: The study aimed to identify nonmotor symptoms based on sex and onset age in people with Parkinson's disease. Design: This is a cross‐sectional descriptive study. Methods: A total of 210 participants were recruited from the university hospital and the Parkinson's disease association. This study measured the Korean version of the nonmotor symptoms questionnaire which includes gastrointestinal, urinary, apathy/attention/memory, hallucination/delusions, depression/anxiety, sexual function, cardiovascular, sleep disorder, and miscellaneous domains. Results: All participants reported at least one nonmotor symptom. The most commonly reported symptoms were nocturia (65.7%) and constipation (61.9%). The male participants reported more dribbling of saliva, constipation, and impaired sexual function, whereas the female reported more weight change. Young‐onset people with Parkinson's disease reported more depression than late‐onset people with Parkinson's disease. Conclusion: This study contributes to the understanding of symptom experience beyond motor‐related symptomatology for those with Parkinson's disease and adds to the current literature. Individualized symptom assessment and management should be provided by prioritizing prevalent sex or onset age‐specific symptoms, rather than addressing with all nonmotor symptoms. Summary statement: What is already known about this topic? Most people with Parkinson's disease experience nonmotor symptoms including autonomic nervous symptoms as the disease progresses.Nonmotor symptoms can affect quality of life of people with Parkinson's disease, but related factors are not fully understood. What this paper adds? This paper identified the presentations of nonmotor symptoms in people with Parkinson's disease based on sex and onset age. The implications of this paper: Nurses enable people with Parkinson's disease to actively engage in self‐care of their own symptoms by educating Parkinson's disease related and how to cope with the symptoms in advance.Individualized nursing care reflecting the disease characteristics is needed to improve patient engagement in symptom management. [ABSTRACT FROM AUTHOR]

Background: Temperament has long been described as the biological dimension of personality. Due to advancing brain-imaging technology, our understanding of temperament has deepened and transformed over the last 25 years. Temperament combines genetic, neurobiological and trait research. Temperament has been included peripherally in some eating disorder (ED) treatment approaches but has been ignored by most. Temperament fills a fundamental treatment gap by clarifying who is more vulnerable to develop ED and why some individuals are susceptible to specific ED symptoms while others are not. In addition, temperament targets possible treatment solutions. Main text: There is a need for a novel model that incorporates and explores the role of temperament in ED treatment intervention. This paper is a metaphoric temperament model to inform treatment intervention. It describes how temperament traits influences new decisions which impact new behavioural responses. In turn, it neurobiologically tracks how and why the brain efficiently transforms new decisions into new habits. This model integrates both temperament and habit research to explore (a) what temperament is; (b) how new decisions develop into habits neurobiologically; (c) that the brain wires destructive symptoms into habits in the same way that it wires healthy/productive behaviours into habits; (d) traits that trigger ED symptoms are the same traits that influence productive behaviours; and in regard to treatment implications (e) when treatment structure and intervention target client temperaments, the potential for new healthy "trait-syntonic" habits could develop. Conclusions: This paper introduces a metaphoric model that synthesizes and integrates temperament neurobiological and trait findings with ED symptoms, habits, and client trait-based solutions. The model synthesizes and integrates different research domains to establish a brain-based foundation to inform treatment intervention. The model targets clients' temperament traits as central collections of innate self-expressions that could be utilized as tools to redirect client trait-syntonic ED responses into trait-syntonic productive outcomes. The brain bases of temperament and habit formation serve as a biological foundation for ED treatment intervention. Plain English summary: Temperament is the biological, or brain-basis of our personality. It defines who we are and who we are not. Temperament influences how each person thinks, feels, and responds differently. Traits are one's natural personality expressions. For example a person may have natural tendencies, or traits, to be extroverted and determined. A person could express the same traits differently ranging from healthy/productive through unhealthy/destructive responses. Research has found that some traits, when expressed in destructive ways, influence the development of eating disorder symptoms. Some of those traits include perfectionism, impulsivity, and anxiety. However, these very same traits could be expressed in productive ways. In essence, traits are the biological triggers beneath one's responses and set the stage for productive to destructive habitual behaviours. Persons cannot eliminate their traits, but they can express them differently. Treatment could capitalize on client traits to help clients explore productive responses instead of turning to destructive habitual symptoms. Productive habits that are aligned with one's traits could more naturally persist and form long-term habits. Working with a client's temperament, verses overlooking it, holds hope for habitual productive change to replace ED symptoms. [ABSTRACT FROM AUTHOR]

The Dutch Disease is a well-documented phenomenon observed in countries that have experienced a boom in a non-renewable resource such as oil and gas and minerals. The evidence documented from the numerous studies done on Dutch Disease can therefore be used as a guide for policy makers to equip countries in lieu of a resource boom. This paper synthesizes the literature on Dutch Disease to outline the key economic effects documented in the literature. The main thematic areas of economic effects from the countries identified in the literature synthesis were then analyzed using trend analysis from a time series of economic variables for each country to represent the respective thematic areas. The trends were then discussed against the theoretical literature on Dutch Disease. The trend analysis was then extended to the country of Guyana which is on the verge of an oil boom, primarily to identify if the synthesis can provide any possible indications of potential Dutch Disease effects for the country. The synthesis predominantly showed the impacts of Dutch Disease to manufacturing which had a cyclical and downward trend in its contribution to Gross Domestic Product and impacts to the value of the agricultural sector. The synthesis also showed sporadic economic growth and varying effects on the exchange rate and wages in the country. The data for Guyana show a pre-disposition for Dutch Disease effects with the incoming oil boom and the potential existence of the Dutch Disease. [ABSTRACT FROM AUTHOR]

Neuropsychiatric disorders affect the lives of individuals from cognitive, emotional, and behavioral aspects, impact the quality of their lives, and even lead to death. Outside the medical area, these diseases have also started to be the subject of investigation in the field of Artificial Intelligence: especially Natural Language Processing (NLP) and Computer Vision. The usage of NLP techniques to understand medical symptoms eases the process of identifying and learning more about language-related aspects of neuropsychiatric conditions, leading to better diagnosis and treatment options. This survey shows the evolution of the detection of linguistic markers specific to a series of neuropsychiatric disorders and symptoms. For each disease or symptom, the article presents a medical description, specific linguistic markers, the results obtained using markers, and datasets. Furthermore, this paper offers a critical analysis of the work undertaken to date and suggests potential directions for future research in the field. [ABSTRACT FROM AUTHOR]

The article presents information on the abstracts of selected papers from the current literature. The purpose of the abstract "Value of helical computed tomography in the management of upper esophageal foreign bodies," was to analyze the utility of helical computed tomography (CT) in the diagnosis of suspected upper esophageal foreign bodies. The conclusion of the abstract "Sonographic detection of longitudinal ulcers in Crohn Disease," is the ultrasonographic findings of FD sign are correlated with the existence of deep longitudinal ulcers, which are most frequently found in CD. Ultrasonography is a useful diagnostic modality for detecting longitudinal ulcers in patients with CD.

The recommendations of the National Academy of Sciences (NAS) panel are critiqued from a perspective of broad educational policy and legal influence. The report and the accompanying background papers are endorsed with general acceptance of problem identificaion and formulation. However, the report is challenged for recommendations that are too narrowly conceived, raising questions as ro viability of implementation. Specific issues addressed include treating disproportionate placement as a symptom versus problem, legal and professional policy barriers to implementing the report's recommendations, and the role of courts in resolving scientific disputes and programatic concerns. [ABSTRACT FROM AUTHOR]

The study aimed to conduct a literature review as a step of the development of a new questionnaire about the nursing workers' perception of job factors that may lead to musculoskeletal symptoms. An information synthesis was achieved by collecting data from studies that fitted the search criteria. The results showed that despite the existence of several job factors related to musculoskeletal symptoms, no specific questionnaire that evaluates this relationship was found. Therefore, this literature review presents important topics for developing the first questionnaire to analyze work activities that may contribute to pain and discomfort among nursing personnel. [ABSTRACT FROM AUTHOR]