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Introduction: Xanthelasma palpebrarum is considered to be a cutaneous marker for cardiovascular diseases, and there is a known association with hypertension, insulin resistance, diabetes mellitus, obesity and stroke. Objectives: Our aim was to study the association and identify the predictors of Metabolic Syndrome in patients of xanthelasma palpebrarum. Methods: An observational study was conducted on 55 patients in which patients of both sexes between the ages of 20-70 years without any other skin condition were included after written informed consent. After history and examination, blood pressure and waist circumference were measured in all the subjects. Investigations were sent for fasting blood sugar levels and serum lipid profile. The 2006 IDF Definition of Metabolic Syndrome was used as assessment criteria. Results: Among the 55 patients, metabolic syndrome was present in 23 patients (41.82%). There was a statistically significant (p

Many people with bipolar disorder have disrupted circadian rhythms. This means that the timing of sleep and wake activities becomes out-of-sync with the standard 24-hour cycle. Circadian rhythms are strongly influenced by light levels and previous research suggests that people with bipolar disorder might have a heightened sensitivity to light, causing more circadian rhythm disruption, increasing the potential for triggering a mood switch into mania or depression. Lithium has been in clinical use for over 70 years and is acknowledged to be the most effective long-term treatment for bipolar disorder. Lithium has many reported actions in the body but the precise mechanism of action in bipolar disorder remains an active area of research. Central to this project is recent evidence that lithium may work by stabilising circadian rhythms of mood, cognition and rest/activity. Our primary hypothesis is that people with bipolar disorder have some pathophysiological change at the level of the retina which makes them hypersensitive to the visual and non-visual effects of light, and therefore more susceptible to circadian rhythm dysfunction. We additionally hypothesise that the mood-stabilising medication lithium is effective in bipolar disorder because it reduces this hypersensitivity, making individuals less vulnerable to light-induced circadian disruption. We will recruit 180 participants into the HELIOS-BD study. Over an 18-month period, we will assess visual and non-visual responses to light, as well as retinal microstructure, in people with bipolar disorder compared to healthy controls. Further, we will assess whether individuals with bipolar disorder who are being treated with lithium have less pronounced light responses and attenuated retinal changes compared to individuals with bipolar disorder not being treated with lithium. This study represents a comprehensive investigation of visual and non-visual light responses in a large bipolar disorder population, with great translational potential for patient stratification and treatment innovation.

Background: Medicine is prescribed to help the patient. But it can cause unwanted effects in the patient if one take too much or multiple medicines that don’t go together. Many patients have problems each year, some serious, because of taking the wrong medicine or not taking the right medicines correctly. This cross-sectional study was done to assess the effectiveness of patient medication counseling in a tertiary care hospital. Methods: This cross-sectional questionnaire-guided study was carried out in the dispensary of a tertiary care hospital, from January to April 2024. convenient sampling technique was employed to select study participants. Results: A total of 540 respondents were included in this study. Only 50.3% of the participants knew the correct frequency and dose of the prescribed medications. Majority of the patients did not knew the indications of the medication they were taking. Conclusion: There is a need to strengthen the patient medication counselling process so that patients understand & remember what have been advised during counselling. As a healthcare provider, it is our responsibility to educate the patient about the prescribed medicines to obtain the positive healthcare and ensure safe use of medicines.

Introduction: Region-specific data on individual factors associated with uptake of breast and cervical cancer screening or early testing in diverse Indian populations are limited. Aim: To assess the prevalence and individual determinants of uptake of breast and/or cervical cancer screening or testing among women aged 30–69 years in regionally representative populations of two large Indian cities: New Delhi and Chennai. Methods: We conducted an analysis of the cross-sectional data (2016–2017) nested within the Centre for Cardiometabolic Risk Reduction in South Asia cohort, established in 2010–2011 with 12,271 participants (5365 in New Delhi; 6906 in Chennai). Among 3310 women participants, we evaluated the associations of demographic, socioeconomic, lifestyle, medical, psychosocial, and reproductive factors with breast and/or cervical cancer screening or testing using multivariable logistic regression models with results expressed as adjusted odds ratios (OR) and 95% confidence intervals (CI). Results: At any point prior to 2016–2017, 193 women self-reported having undergone evaluations for breast and/or cervical cancer. The reasons for evaluation were ‘general examination’ or ‘physician’s advice’ (i.e., screening) or ‘being symptomatic’ (i.e., early testing). The overall prevalence was 5.8% for screening or testing and 2.5% for screening alone. Formal education (OR:1.88; 95% CI:1.12–3.15), high monthly household income (OR:2.27; 95% CI:1.59–3.25) and less ‘fear-of-judgement’ (OR:1.65; 95% CI:1.05–2.58) were positively associated with screening or testing uptake. When screening uptake was analysed separately, the results were generally similar. Conclusion: Our findings may have important implications for interventions at community-level (e.g., reducing ‘fear-of-judgement’, increasing awareness to screening programs and early symptoms) and health-system level (e.g., opportunistic screening).

Systemic sclerosis (SSc) is a rare, chronic disease with diverse clinical presentations, and only a few cases with ocular manifestations have been reported in the literature. In this case report, we describe the case of a 51-year-old South Asian woman who initially complained of painless swelling in her left upper eyelid. An ultrasound examination of the left eye revealed an enlarged lacrimal gland with increased vascularity. The presence of dacryoadenitis, which was unresponsive to initial conservative management with oral antibiotics and warm compresses, along with positive antinuclear antibodies, prompted further investigation. Dacryoadenitis or orbital inflammation is a common presentation in systemic conditions such as Sjogren’s syndrome, systemic lupus erythematosus, sarcoidosis, or granulomatosis with polyangiitis. However, it can also be a rare initial symptom in a patient with CREST syndrome. To our knowledge, this is only the second case in the literature of dacryoadenitis in the context of calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome. This case highlights the significance of serological markers and peripheral clinical presentations in individuals with chronic orbital inflammation, emphasizing the importance of considering further systemic associations.

Academic literacies (AL) research has made significant contributions to understandings of student writing and literacy across higher education and particularly learning development. However, researchers and practitioners both within and external to the AL movement have struggled to clarify the relationship between AL and pedagogy. English for Academic Purposes researchers have highlighted the lack of a workable AL pedagogy, whilst AL researchers maintain that the model represents a design space or heuristic for thinking about practice in context, rather than a source of pedagogic prescriptions. This theoretical discussion elaborates concerns with the structural coherence of the AL model, its broadly social constructivist underpinnings and evidence base, and the impact of its ideological orientation on the pedagogy we derive from it. Underpinning these critiques is a suspicion that the interpretation of social constructivist epistemology on which AL relies to pinpoint weaknesses in the models of literacy/writing which it subsumes cannot generate a practical pedagogy. We argue that these structural and ideological tensions in the AL model help to explain confusion over its interpretation and implementation. We speculate that this singular focus on social constructivist-derived theory, though well-intentioned, does more to reinforce a particular ideological commitment than to enhance student learning.

Introduction Accurate identification of Aged Care residents accessing hospital services is challenging due to multiple hospital Electronic Health Record (EHR) systems and entry points resulting in inconsistent addresses and coding. Improving accuracy and completeness of addresses is crucial for cohort identification and data linkage. Objective Develop methods to validate cross-sectoral data linkages to improve identification of aged care residents within EHR systems. Approach Among individuals aged ≥65 years (or ≥50 identifying as Aboriginal or Torres Strait Islander) between January 2013 to December 2023 within our Data Platform, we first used data items mandated by the Department of Health to identify aged care residency. Data quality was enhanced using a residential address index derived from Australian Geocoded National Address File (G-NAF). We evaluated sensitivity, specificity, and Positive Predictive Values (PPVs) of recorded addresses against the Australian Institute of Health and Welfare (AIHW) aged care services list. Results Among 409,677 addresses extracted, 55.4% (raw) had sufficient data for validation. This increased to 89.9% (enhanced) with G-NAF. Among 79,028 admitted and 88,876 emergency patients, 22.7% and 18.4% respectively were aged care residents. We compared performance of raw vs enhanced comparisons were: sensitivity (admission: 34.1% vs 73.8%), (emergency: 42.6% vs 66.2%); specificity (admission: 96.2% vs 90.9%), emergency (96.8% vs 95.2%); Positive Predictive Value (admission: 61.3% vs 58.8%), (emergency: 64.2% vs 65.3%). Conclusions and Implications Our approach significantly increased sensitivity without sacrificing specificity, enhancing Aged Care resident identification in EHR data. It also improved linkage with external datasets and Statistical Area Level 1 (SA1) mapping.

Objective & Approach Routine optometry examinations, which may include retinal images, have been free to everyone in Scotland since 2006. Images and patient data are stored locally on non-interoperable systems, usually without unique identifiers. The Scottish Collaborative Optometry-Ophthalmology Network for e-research (SCONe) aimed to create a secure, longitudinal repository collating community-acquired images linked to national, routinely-collected healthcare data. We developed bulk export processes to retrieve images and patient data from current and archived systems and a series of deterministic and probabilistic algorithms to match images to patients. Results We successfully exported images and patient data from several commonly used systems. Exact matching of available data between image and clinical systems within practices linked 78% of images (IQR 71.2-84.1). Our algorithms increased match rate to 90% (IQR 83.5-98.6) of images, efficiently reducing risk of systemic bias in the cohort. Match method is included in the repository metadata to facilitate quality assurance checks after national linkage and pseudonymisation. To date over 600k images have been processed and delivered to the National Safe Haven for linkage to healthcare data. Conclusions & Implications Breakthrough research into early detection and pre-symptomatic disease can be facilitated by harnessing community-acquired retinal images which capture normal ageing and disease progression. Rather than await interoperability and widespread use of unique identifiers, this has been achieved through innovative solutions to real-world issues around time-pressured clinical data entry and non-standardised data storage. The SCONe repository continues to grow. It is currently supporting ocular disease prediction research and offers the potential for much more.

Las palmeras son una parte integral del paisaje urbano de Florida. La pudrición de las palmas por Ganoderma, una enfermedad causada por el hongo Ganoderma zonatum, que descompone la madera, es una de las principales preocupaciones bióticas para la industria del paisajismo. La enfermedad letal prevalece en las regiones de cultivo de palmeras en los EE. UU., y se cree que todas las especies de palmeras son susceptibles a este hongo. La palma enferma puede tardar entre seis meses y un año en morir una vez que aparecen los síntomas iniciales. Pero con la disponibilidad de un ensayo de diagnóstico de enfermedades, este patógeno fúngico se puede detectar utilizando muestras de aserrín recogidas de palmas en declive, varios meses antes de que aparezcan los síntomas. Aquí se indican los pasos a seguir.

Background The brain reserve hypothesis posits that larger maximal lifetime brain growth (MLBG) may confer protection against physical disability in multiple sclerosis (MS). Larger MLBG as a proxy for brain reserve, has been associated with reduced progression of physical disability in patients with early MS; however, it is unknown whether this association remains once in the secondary progressive phase of MS (SPMS). Our aim was to assess whether larger MLBG is associated with decreased physical disability progression in SPMS.Methods We conducted a post hoc analysis of participants in the MS-Secondary Progressive Multi-Arm Randomisation Trial (NCT01910259), a multicentre randomised placebo-controlled trial of the neuroprotective potential of three agents in SPMS. Physical disability was measured by Expanded Disability Status Scale (EDSS), 9-hole peg test (9HPT) and 25-foot timed walk test (T25FW) at baseline, 48 and 96 weeks. MLBG was estimated by baseline intracranial volume (ICV). Multivariable time-varying Cox regression models were used to investigate the association between MLBG and physical disability progression.Results 383 participants (mean age 54.5 years, 298 female) were followed up over 96 weeks. Median baseline EDSS was 6.0 (range 4.0–6.5). Adjusted for covariates, larger MLBG was associated with a reduced risk of EDSS progression (HR 0.84,95% CI:0.72 to 0.99;p=0.04). MLBG was not independently associated with time to progression as measured by 9HPT or T25FW.Conclusion Larger MLBG is independently associated with physical disability progression over 96 weeks as measured by EDSS in SPMS. This suggests that MLBG as a proxy for brain reserve may continue to confer protection against disability when in the secondary progression phase of MS.Trail registration number NCT01910259.

Development of mitigation strategies to combat climate change necessitates an advanced analysis of the historical connection between crops and climate. Such an analysis is lacking for the cotton (Gossypium hirsutum L.)-climate research in Mississippi (MS). Hitherto, research has been confined to small-scale experimental settings, leaving an opportunity to explore large-scale inferences. Therefore, the present study aimed to compute MS climatic trends during the cotton growing period (CGP) from 1970 to 2020 using the Mann-Kendall and Sen slope methods. The impact of climate change on MS cotton yield was assessed using the autoregressive distributed lag (ARDL) model. The climatic variables considered were maximum temperature (Tmax), minimum temperature (Tmin), diurnal temperature range (DTR), precipitation (PR), and CO2 emissions (COE). A required series of statistical tests, including pre- and post-analysis, model robustness, and goodness-of-fit were performed, and data met all criteria. Results revealed that Tmin (79.6 %) contributed more than Tmax (20.4 %) to the MS-climate warming over CGP. From 1970 to 2020, the Tmax, Tmin, DTR, and PR changed by + 0.30 °C, +1.17 °C, −1.07 °C, and + 22.54 mm, respectively, exhibiting change rate per decade of + 0.06 °C, +0.23 °C, −0.21 °C, and + 4.42 mm, respectively. Precipitation had no effect on cotton yield in the long or short-term. However, cotton yield significantly decreased with a rise in Tmax, and increased with a rise in Tmin and COE in the long-term. Conclusively, a 1 °C increase in Tmax reduced cotton yield by 6.1 %, a 1 °C increase in Tmin improved it by 5.5 %, and a unit increase in COE increased it by 0.45 % over the long run. Overall, the crop-climate link in MS cotton marked a varied sensitivity towards short and long-term, indicating the need to reassess current mitigation strategies. Additionally, testing the best agronomic practices in a controlled environment at the actual rates of climate change identified by the current study could provide cotton stakeholders with more precise and valuable insights.

Excitotoxicity, a neuronal death process in neurological disorders such as stroke, is initiated by the overstimulation of ionotropic glutamate receptors. Although dysregulation of proteolytic signaling networks is critical for excitotoxicity, the identity of affected proteins and mechanisms by which they induce neuronal cell death remain unclear. To address this, we used quantitative N-terminomics to identify proteins modified by proteolysis in neurons undergoing excitotoxic cell death. We found that most proteolytically processed proteins in excitotoxic neurons are likely substrates of calpains, including key synaptic regulatory proteins such as CRMP2, doublecortin-like kinase I, Src tyrosine kinase and calmodulin-dependent protein kinase IIβ (CaMKIIβ). Critically, calpain-catalyzed proteolytic processing of these proteins generates stable truncated fragments with altered activities that potentially contribute to neuronal death by perturbing synaptic organization and function. Blocking calpain-mediated proteolysis of one of these proteins, Src, protected against neuronal loss in a rat model of neurotoxicity. Extrapolation of our N-terminomic results led to the discovery that CaMKIIα, an isoform of CaMKIIβ, undergoes differential processing in mouse brains under physiological conditions and during ischemic stroke. In summary, by identifying the neuronal proteins undergoing proteolysis during excitotoxicity, our findings offer new insights into excitotoxic neuronal death mechanisms and reveal potential neuroprotective targets for neurological disorders.

Almond consumption can improve cardiometabolic (CM) health. However, the mechanisms underlying those benefits are not well characterized. This study explored the effects of consuming a snack of almonds vs. crackers for 8 weeks on changes in metabolomic profiles in young adults (clinicaltrials.gov ID: NCT03084003).Participants (n = 73, age: 18-19 years, BMI: 18-41 kg/m2) were randomly assigned to consume either almonds (2 oz/d, n = 38) or an isocaloric control snack of graham crackers (325 kcal/d, n = 35) daily for 8 weeks. Blood samples were collected at baseline prior to and at 4 and 8 weeks after the intervention. Metabolite abundances in the serum were quantified by hydrophilic interaction chromatography quadrupole (Q) time-of-flight (TOF) mass spectrometry (MS/MS), gas chromatography (GC) TOF MS, CSH-ESI (electrospray) QTOF MS/MS, and targeted analyses for free PUFAs, total fatty acids, oxylipins and endocannabinoids. Linear mixed model analyses with baseline-adjustment were conducted, and those results were used for enrichment and network analyses. Microbial community pathway predictions from 16S rRNA sequencing of fecal samples was done using PICRUST2.Almond consumption enriched unsaturated triglycerides, unsaturated phosphatidylcholines, saturated and unsaturated lysophosphatidylcholines, tricarboxylic acids, and tocopherol clusters (p