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The prebiotic inulin has been vaunted for its potential to reduce the risk of colorectal cancer. Inulin fermentation resulting in the production of short-chain fatty acids, primarily butyrate, has been reported to be associated with properties that are beneficial for gut health and has led to an increased consumption of inulin in the Western population through processed food and over-the-counter dietary supplements. However, in clinical trials, there is limited evidence of the efficacy of inulin in preventing colorectal cancer. Moreover, recent data suggest that improper inulin consumption may even be harmful for gastro-intestinal health under certain circumstances. The main objective of this review is to provide insight into the beneficial and potentially detrimental effects of inulin supplementation in the context of colorectal cancer prevention and enhancement of treatment efficacy., Competing Interests: The authors declare no conflicts of interest in this study., (© The Author(s) 2024. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-sen University.)

Purpose: Anastomotic leak (AL) is a major complication in colorectal cancer surgery and consists of the leakage of intestinal content through a poorly healed colonic wound. Colorectal cancer recurrence after surgery is a major determinant of survival. We hypothesize that AL may allow cancer cells to escape the gut and lead to cancer recurrence and that improving anastomotic healing may prevent local implantation and metastatic dissemination of cancer cells., Experimental Design: We investigated the association between AL and postoperative outcomes in patients with colorectal cancer. Using mouse models of poor anastomotic healing, we assessed the processes of local implantation and dissemination of cancer cells. The effect of dietary supplementation with inulin and 5-aminosalicylate (5-ASA), which activate PPAR-γ in the gut, on local anastomotic tumors was assessed in mice undergoing colonic surgery. Inulin and 5-ASA were also assessed in a mouse model of liver metastasis., Results: Patients experiencing AL displayed lower overall and oncologic survival than non-AL patients. Poor anastomotic healing in mice led to larger anastomotic and peritoneal tumors. The microbiota of patients with AL displays a lower capacity to activate the antineoplastic PPAR-γ in the gut. Modulation of gut microbiota using dietary inulin and 5-ASA reinforced the gut barrier and prevented anastomotic tumors and metastatic spread in mice., Conclusions: Our findings reinforce the hypothesis that preventing AL is paramount to improving oncologic outcomes after colorectal cancer surgery. Furthermore, they pave the way toward dietary targeting of PPAR-γ as a novel way to enhance healing and diminish cancer recurrence., (©2023 American Association for Cancer Research.)

Objectives: To evaluate the impact of text mining (TM) on the sensitivity and specificity of title and abstract screening strategies for systematic reviews (SRs)., Study Design and Setting: Twenty reviewers each evaluated a 500-citation set. We compared five screening methods: conventional double screen (CDS), single screen, double screen with TM, combined double screen and single screen with TM, and single screen with TM. Rayyan, Abstrackr, and SWIFT-Review were used for each TM method. The results of a published SR were used as the reference standard., Results: The mean sensitivity and specificity achieved by CDS were 97.0% (95% confidence interval [CI]: 94.7, 99.3) and 95.0% (95% CI: 93.0, 97.1). When compared with single screen, CDS provided a greater sensitivity without a decrease in specificity. Rayyan, Abstrackr, and SWIFT-Review identified all relevant studies. Specificity was often higher for TM-assisted methods than that for CDS, although with mean differences of only one-to-two percentage points. For every 500 citations not requiring manual screening, 216 minutes (95% CI: 169, 264) could be saved., Conclusion: TM-assisted screening methods resulted in similar sensitivity and modestly improved specificity as compared to CDS. The time saved with TM makes this a promising new tool for SR., Competing Interests: Declaration of competing interest J.K., S.T., G.G., P.R.B., A Subota, S.L., K.S., A.A.I., F.R., K.C., Y.K., N.M.S., A Soumana, S.K., and N.M. report no conflicts of interest. J.L. is supported by the Fonds de Recherche Québec–Santé. K.B.F. is supported by a Senior salary support award from the Fonds de Recherche Québec–Santé and a William Dawson Scholar award from McGill University. He holds research grants from the Canadian Institutes of Health Research and has received honoraria from Quebec's Institut national d'excellence en santé et services sociaux and a stipend from the Canadian Network for Observational Drug Effect Studies. N.J. received grant funding paid to her institution for grants unrelated to this work from NINDS, NIH U24NS107201, NIH IU54NS100064, and NIH U24NS113849) during the study period and was the Bludhorn Professor of International Medicine at the Icahn School of Medicine at Mount Sinai. She receives an honorarium for her work as an Associate Editor of Epilepsia. GS Day's research is supported by NIH (K23AG064029, U01AG057195, U19AG032438), the Alzheimer's Association, and Chan Zuckerberg Initiative. He serves as a consultant for Parabon Nanolabs Inc., as a Topic Editor (Dementia) for DynaMed (EBSCO), and as the Clinical Director of the Anti-NMDA Receptor Encephalitis Foundation (Inc., Canada; uncompensated). He is the co-Project PI for a clinical trial in anti-NMDAR encephalitis, which receives support from Horizon Pharmaceuticals. He has developed educational materials for PeerView Media, Inc., and Continuing Education Inc. He owns stock in ANI pharmaceuticals. Dr. Day's institution has received support from Eli Lilly for Dr. Day's development and participation in an educational event promoting early diagnosis of symptomatic Alzheimer’s disease. J.I.R. reports fellowship salary support from Canadian Network of MS Clinics and travel support from the Rebecca Hotchkiss International Scholar Exchange. M.R.K. reports unrestricted educational grants from UCB, Eisai, and Jazz Pharmaceuticals, research grants for investigator-initiated studies from UCB and Eisai as well as from government entities (Canadian Institutes of Health Research, Fonds de Recherche Québec–Santé), academic institutions (Center Hospitalier de l’Université de Montréal), and foundations (TD Bank, TSC Alliance, Savoy Foundation, Quebec Bio-Imaging Network). M.R.K.’s salary is supported by the Fonds de Recherche Québec–Santé., (Copyright © 2023 Elsevier Inc. All rights reserved.)

In this work, a novel experimental investigation of photoluminescence properties of Znq 2 thin films co-doped with different concentrations of DCM were performed. The thin films were successfully deposited on glass substrates with different compositions, under high vacuum, by using the vacuum evaporation technique. For all compositions, the photoluminescence was measured at room temperature and also at low temperature in a wide range from 77 to 300 K with a step of 25 K in a high vacuum. The lifetime of the sample studied in real time was also measured using the decay time technique. The results obtained confirm that the doping influences the intensity of the DCM photoluminescence and also shows a complete energy transfer occurred from Znq 2 to DCM which may have shifted the photoluminescence peak from Znq 2 to the orange wavelength region which is related to DCM. The lifetime of the sample studied in real time was about 4.47 ns for Znq 2 and while all the other samples showed two decay time components. As a result, the doping influences the optical properties of Znq 2 and makes it a potential candidate for optoelectronic applications., (© 2022. The Author(s).)

Objective: Colorectal cancer (CRC) is the third most diagnosed cancer, and requires surgical resection and reconnection, or anastomosis, of the remaining bowel to re-establish intestinal continuity. Anastomotic leak (AL) is a major complication that increases mortality and cancer recurrence. Our objective is to assess the causal role of gut microbiota in anastomotic healing., Design: The causal role of gut microbiota was assessed in a murine AL model receiving faecal microbiota transplantation (FMT) from patients with CRC collected before surgery and who later developed or not, AL. Anastomotic healing and gut barrier integrity were assessed after surgery. Bacterial candidates implicated in anastomotic healing were identified using 16S rRNA gene sequencing and were isolated from faecal samples to be tested both in vitro and in vivo ., Results: Mice receiving FMT from patients that developed AL displayed poor anastomotic healing. Profiling of gut microbiota of patients and mice after FMT revealed correlations between healing parameters and the relative abundance of Alistipes onderdonkii and Parabacteroides goldsteinii . Oral supplementation with A. onderdonkii resulted in a higher rate of leaks in mice, while gavage with P. goldsteinii improved healing by exerting an anti-inflammatory effect. Patients with AL and mice receiving FMT from AL patients presented upregulation of mucosal MIP-1α, MIP-2, MCP-1 and IL-17A/F before surgery. Retrospective analysis revealed that patients with AL present higher circulating neutrophil and monocyte counts before surgery., Conclusion: Gut microbiota plays an important role in surgical colonic healing in patients with CRC. The impact of these findings may extend to a vast array of invasive gastrointestinal procedures., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and study aims  A novel endoscopic optical diagnosis classification system (SIMPLE) has recently been developed. This study aimed to evaluate the SIMPLE classification in a clinical cohort. Patients and methods  All diminutive and small colorectal polyps found in a cohort of individuals undergoing screening, diagnostic, or surveillance colonoscopies underwent optical diagnosis using image-enhanced endoscopy (IEE) and the SIMPLE classification. The primary outcome was the agreement of surveillance intervals determined by optical diagnosis compared with pathology-based results for diminutive polyps. Secondary outcomes included the negative predictive value (NPV) for rectosigmoid adenomas, the percentage of pathology exams avoided, and the percentage of immediate surveillance interval recommendations. Analysis of optical diagnosis for polyps ≤ 10 mm was also performed. Results  399 patients (median age 62.6 years; 55.6 % female) were enrolled. For patients with at least one polyp ≤ 5 mm undergoing optical diagnosis, agreement with pathology-based surveillance intervals was 93.5 % (95 % confidence interval [CI] 91.4-95.6). The NPV for rectosigmoid adenomas was 86.7 % (95 %CI 77.5-93.2). When using optical diagnosis, pathology analysis could be avoided in 61.5 % (95 %CI 56.9-66.2) of diminutive polyps, and post-colonoscopy surveillance intervals could be given immediately to 70.9 % (95 %CI 66.5-75.4) of patients. For patients with at least one ≤ 10 mm polyp, agreement with pathology-based surveillance intervals was 92.7 % (95 %CI 89.7-95.1). NPV for rectosigmoid adenomas ≤ 10 mm was 85.1 % (95 %CI CI 76.3-91.6). Conclusions  IEE with the SIMPLE classification achieved the quality benchmark for the resect and discard strategy; however, the NPV for rectosigmoid polyps requires improvement., Competing Interests: Competing interests Dr. von Renteln is supported by a “Fonds de Recherche du Québec Santé” career development award. He has also received research funding from ERBE, Ventage, and Pentax, and is a consultant for Boston Scientific and Pendopharm. The study ClinicalTrials.gov (NCT03515343) was funded by Pentax., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

The coronavirus COVID-19 pandemic is the worst health crisis of our time and the greatest challenge we are facing since World War II. It has caused a negative impact on engineering and construction industry, and huge uncertainty about the ability to anticipate a planned recovery for the industry. Waiting for an effective recovery that may take a long time, science has to provide solutions to coexist with this virus and resume the work on construction sites. In fact, it is not the first time that health and safety science deals with such a risk of infection, as many guidelines treat the manner to reduce the risk of infection to at-risk employees in construction, renovation, installation, and maintenance activities. This article aims to perform an infection risk analysis, taking into consideration COVID-19 particularities, and to identify control measures to ensure COVID-19 infection prevention and management on site. The study will be based on a probabilistic approach using the Fault Tree Analysis method.

The global health system is currently facing the new SARS-COV 2 pandemy. This exceptional situation requires, from our African health systems, to reorganize and readapt the usual protocols when they were carried out before the crisis and/or their urgent implementation otherwise. As imaging is one of the pillars of the diagnosis of infection with this emerging virus, it was essential to rethink the imaging department organization so as to dedicate a unit to COVID-19 activity while maintaining the usual emergency activity within the Ibn Sina university hospital in Rabat. The protection of exposed personnel and the bio-cleaning of radiology equipment and rooms also became an evidence. The active involvement of the administration, the Clinical Pharmacy Department and the Nosocomial Infections Control Committee is a key to the success of this reorganization., Competing Interests: The authors declare no competing interests, (©Fatima Zahrae Laamrani et al.)

Blastomycosis is a rare case. We report a first Moroccan case. A 41-year-old male presented with a 6-month history of dyspnea, fever and significant chest pain associated with night sweats and weight loss. The physical examination disclosed a firm painful paravertebral mass. The chest radiograph demonstrated a left apical opacity. The thoracic scan showed parenchymal infiltration of the apico-dorsal segment of the left upper lobe with vertebral and costal lytic lesions. Surgical biopsy showed granulomatous inflammation with giant-cell intracytoplasmic inclusions. Fungal studies yielded Blastomyces dermatitidis which responded excellently to ketoconazole. Outcome has been excellent at 3.5 years months follow-up. The clinical and radiographic presentation of blastomycosis is non-specific and can be mistaken for a neoplasm. Delay in diagnosis is common., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Patients frequently require a tracheostomy for a variety of indications, but its prolonged use is associated with several complications, including fracture of the tube. Metallic tracheostomy tubes, which are often used in developing countries, are predisposed to such a complication essentially because of corrosion from prolonged used. We report 2 cases of a fractured tracheostomy tube inserted into the central airways, with different clinical presentations. Fractured pieces were successfully removed using a flexible bronchoscope under topical anesthesia.

The effects of the damaged car evacuation (P(exit)) and the collision (P(col)) probabilities on the traffic flow behavior of a car accident are investigated in the one-dimensional cellular automaton Nagel-Schreckenberg model, with injecting (alpha) and extracting (beta) rates in parallel dynamics. In this study, we suppose that the car involved in collision is evacuated from the road, with an exit probability P(exit). It is found that the behaviors of density, current, and (alpha,beta) phase diagram topology depend strongly on the values of P(exit) and P(col). Indeed, the high-density region shrinks when increasing P(exit). Moreover, the critical value alpha(c)(beta), at which the low-density-high-density transition occurs, increases when increasing P(col) and/or P(exit). Furthermore, the critical value at which the transition high-density-low-density occurs decreases when increasing beta and increases with alpha.

Rhinoscleroma is a chronic infectious disease caused by Klebsiella rhinoscleromatis. It initially involves the nasal cavity and can occasionally extend to the rest of the upper respiratory tract. We report a case of rhinoscleroma involving both the larynx and the tracheobronchial tree, presenting with recurrent respiratory infection.

Background: In recent years, medication error has received considerable attention because it causes substantial mortality, morbidity, and additional health care costs. Collecting information in this field depends on the willingness of health professionals to report their errors. Another important point is to identify patients at high risk for an adverse drug event (ADE) to oversee the quality of the entire drug distribution chain, including prescription, drug choice, dispensing, and preparation to the administration of drugs., Objective: To assess the prevalence rate of ADEs. To ascertain those related to medication errors to develop prevention strategies., Design: Prospective cohort study., Setting: Multicenter study, 7 intensive care unit in academic and military hospital of Rabat., Period: Three months., Patients: Adult and pediatric patients in medical/surgical intensive care units. COLLECTION DATA: One coordinator for each participating ward collaborates with a pharmacist investigator from Moroccan pharmacovigilance center in the detection of ADEs., Measurements and Main Results: Of the 696 patients studied, the investigators identified 108 incidents (15.5 %) (95% confidence interval, 14.1-16.9). The reviewers concluded that 56 (70%) of 80 ADEs were nonpreventable, which, by definition, are considered as ADRs. Among the 52 medication errors, 28 (53.8%) led to potential ADEs and 24 (46.2%) led to actual preventable ADEs. There were 7.7 medication errors for 1000 patient-days. We noted that the preventable ADEs occurred in the prescribing (71.1%), administration (21.2%), transcription (5.7%), and dispensing stages. Errors of wrong or improper drug use accounted for the majority of potential and actual preventable ADEs (23%), followed by improper dose (21.1%), wrong duration of treatment (19.2%),wrong rate of administration(13.5), errors due to drug omission (9.6%), wrong administration technique (5.8%), wrong dosage form (3.8%), and wrong administration timing (1.9%)., Conclusions: This study argues the need for pharmacovigilance to extend its scope to medication errors to improve the safety of drugs. Our results underlined that medication errors are likely to be more serious than ADRs. Our approach based on the collaboration between the pharmacovigilance center and clinicians can be a powerful tool for incorporating error reporting into the culture of medicine.

Objective: To evaluate the prevalence of respiratory symptoms, ventilatory function disorder and immediate hypersensitivity reactions in a population exposed to flour and cereal dusts in five flour mills in Morocco., Methods: The study of 373 exposed and 301 non-exposed subjects consisted of an analysis of working conditions and a medical survey., Results and Conclusion: The prevalence of clinical respiratory symptoms was 64.1% among exposed subjects and 41.2% among non-exposed subjects. Cough, expectoration, rhinitis, conjunctivitis, dermatitis, asthma and chronic bronchitis were more frequent among mill-workers. Spirometry was abnormal in 31.6% of those exposed: anomalies were found in both flow and volume. Among exposed subjects with a ventilatory disorder, 77.9% had only small airways syndrome or a light deficit. Smoking was the cause of excess morbidity. Skin prick tests were positive for at least one allergen in 65.4% of exposed compared to 27.2% non-exposed subjects. The prevalence of positive skin tests to occupational allergens alone was higher among those exposed (42.4%) than among the non-exposed (9.9%). The implementation of adequate medical and technical prevention may reduce this risk.