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Purpose: This review aims to discuss the psychological aspects of Graves’ ophthalmopathy (GO), estimate the prevalence of depression and anxiety disorders in GO, examine whether these psychiatric disorders are more prevalent in GO than in Graves’ disease (GD) without eye disease, and evaluate the main contributors for depression and anxiety in GO. Methods: A review of the literature. Results: Both depression and anxiety are associated with GO. The prevalence of depression and anxiety disorders specifically in GO patients was estimated at 18–33% and 26–41%, respectively. The reported prevalence in GD patients ranged from 9% to 70% for depression and from 18% to 88% for anxiety disorders. Significantly higher levels of depression and anxiety were found in GD patients compared with patients with non-autoimmune hyperthyroidism. Conflicting results have been reported regarding the association of antithyroid autoantibodies with depression and anxiety disorders. Serum thyroid hormone levels do not correlate with the severity of depression and anxiety. An improvement of psychiatric symptoms is observed in hyperthyroid patients after treatment of thyrotoxicosis. Moreover, depression and anxiety are significantly related to impaired quality of life (QoL) in GO. Exophthalmos and diplopia were not associated with depression nor anxiety, but orbital decompression and strabismus surgery do seem to improve QoL in GO patients. Conclusions: The results of this review suggest that altered thyroid hormone levels and autoimmunity are prognostic factors for depression and anxiety in GO. With regard to the visual and disfiguring aspects of GO as contributing factors for depression and anxiety, no decisive conclusions can be made.

The COVID-19 pandemic, surprised many through its impact on the food systems, resulting in collapses in the food production value chains and in the integrated pest disease management sector with fatal outcomes in many places. However, the impact of COVID-19 and the digital experience perspective on Integrating Pest Management (IPM) is still yet to be understood. In Africa, the impact was devastating, mostly for the vulnerable smallholder farm households, who were rendered unable to access markets to purchase inputs and sell their produce during the lockdown period. By using a holistic approach the paper reviews different Information and Communications Technologies (ICTs), digitalization, and how this enhanced the capacity of smallholder farmers resilient, and inform their smart-IPM practices in order to improve food systems' amidst climate change during and in the post-COVID-19 period. Different digital modalities were adopted to ensure continuous food production, access to inputs and finances, and selling surplus production among others. This was largely possible by using ICTs to deliver these needed services digitally. The study shares contributions and capacity perspectives of ICTs for empowering smallholder farmers to boost the resilience of their food systems based on COVID-19 successful experiences. Thus digital solutions must be embraced in the delivery of extension service on pest management and good agronomic practices, money transfers for purchasing inputs, receiving payment for sold farm produce, and markets information exchange. These are key avenues through which digital solutions strategically supported smallholder-based food systems through the pandemic.

Teaching Point: Myxopapillary ependymoma presenting as a highly destructive lesion in the sacrum is rare but should be included in the differential diagnosis.

Local activity of the DNA methylation machinery remains poorly understood. Here, the authors present a theoretical and experimental framework to infer methylation and demethylation rates at genome scale in mouse embryonic stem cells, finding that maintenance methylation activity is reduced at transcription factor binding sites, while methylation turnover is elevated in transcribed gene bodies.

The majority of mammalian promoters are CpG islands; regions of high CG density that require protection from DNA methylation to be functional. Importantly, how sequence architecture mediates this unmethylated state remains unclear. To address this question in a comprehensive manner, we developed a method to interrogate methylation states of hundreds of sequence variants inserted at the same genomic site in mouse embryonic stem cells. Using this assay, we were able to quantify the contribution of various sequence motifs towards the resulting DNA methylation state. Modeling of this comprehensive dataset revealed that CG density alone is a minor determinant of their unmethylated state. Instead, these data argue for a principal role for transcription factor binding sites, a prediction confirmed by testing synthetic mutant libraries. Taken together, these findings establish the hierarchy between the two cis-encoded mechanisms that define the DNA methylation state and thus the transcriptional competence of CpG islands.

Solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is a rare tumor of low malignant potential that occurs most often in young females. Imaging and histopathology are necessary to confirm the diagnosis as most have no symptoms. Lack of access to these technologies in sub-Saharan Africa contributes to the difficulty in making an early and accurate diagnosis, and hence, impedes treatment. We present two cases of SPEN of the pancreas in young female patients at a rural, teaching hospital in Cameroon. The diagnosis was made only with histopathology. Computed tomography scan with intravenous contrast was essential to planning a safe surgical resection. Both patients had complete surgical resection with good results. [ABSTRACT FROM AUTHOR]

Abstract Drilling engineers continue to grapple with the persistent challenge of maintaining wellbore stability. Throughout the drilling process, the wellbore pressure experiences fluctuations induced by various factors such as swab and surge pressure, leading to potential instability. This study employs a numerical approach, utilizing Abaqus software, to investigate the impact of swab and surge pressure on the natural fracture growth within the wellbore and the evolving pore pressure. A computational tool developed with MATLAB is then utilized to ascertain a safe operational mud window by assessing the time-dependent collapse and fracture pressures. The findings illustrated a notable increase in fracture width as a function of time in response to swab and surge pressure, with the most significant percentage increase reaching 69.92%. Notably, a 69.16% augmentation in fracture width is observed in the immediate vicinity of the wellbore following the application of swab and surge pressure. However, parameters such as fracture length, loss circulation rate, and pore fluid pressure exhibited marginal changes post-integration of swab and surge effects. The examination of the time-dependent wellbore stability after integration of swab and surge pressure indicated a narrowing of the initial mud window as a function of time, with a 14.33% increase in collapse pressure and a 13.80% decrease in fracture pressure. The numerical model verification against analytical solutions demonstrated good agreement, highlighting its potential utility in optimizing particle size for wellbore reinforcement and mitigating lost circulation through natural fracture sealing.

DNA methylation is an epigenetic modification associated with transcriptional repression of promoters and is essential for mammalian development. Establishment of DNA methylation is mediated by the denovoDNA methyltransferases DNMT3A and DNMT3B, whereas DNMT1 ensures maintenance of methylation through replication (1). Absence of these enzymes is lethal (2), and somatic mutations in these genes have been associated with several human diseases (3,4). How genomic DNA methylation patterns are regulated remains poorly understood, as the mechanisms that guide recruitment and activity of DNMTs invivo are largely unknown. To gain insights into this matter we determined genomic binding and site-specific activity of the mammalian de novo DNA methyltransferases DNMT3A and DNMT3B. We show that both enzymes localize to methylated, CpG-dense regions in mouse stem cells, yet are excluded from active promoters and enhancers. By specifically measuring sites of de novo methylation, we observe that enzymatic activity reflects binding. De novo methylation increases with CpG density, yet is excluded from nucleosomes. Notably, we observed selective binding of DNMT3B to the bodies of transcribed genes, which leads to their preferential methylation. This targeting to transcribed sequences requires SETD2-mediated methylation of lysine 36 on histone H3 and a functional PWWP domain of DNMT3B. Together these findings reveal how sequence and chromatin cues guide de novo methyltransferase activity to ensure methylome integrity., Several models of DNMT targeting have been proposed based on biochemical, structural and functional studies (5). These include readout of histone modifications, binding to nucleosomes, recruitment by accessory proteins, as [...]

In this paper, a bibliometric analysis of research on wearable technologies for cardiovascular diseases was conducted with Bibliometrix and based on 1675 papers collected in Scopus from 2000 to 2022, and interesting results were presented. The US and China stood out for their sustained productivity in the field of cardiovascular diseases. The examination of the authors' keywords revealed that between 2000-01 and 2009-12, "Respiration" and "personalized applications" were the most popular research topics, however from 2010-01 to 2019-12, attention was given to "ECG," "Wearable devices," "Wearable sensors," and "heart rate". This study suggests that in the present decade, researchers should focus on topics related to artificial intelligence, hypertension, ECG, wearable sensors, and African countries must address their technological gap in the coming years. [ABSTRACT FROM AUTHOR]

Medical practitioners are entrusted with the pivotal task of making optimal decisions in healthcare delivery. Despite rigorous training, our confidence in reasoning can fail when faced with pressures, uncertainties, urgencies, difficulties, and occasional errors. Day-to-day decisions rely on swift, intuitive cognitive processes known as heuristic or type 1 decision-making, which, while efficient in most scenarios, harbor inherent vulnerabilities leading to systematic errors. Cognitive biases receive limited explicit discussion during our training as junior doctors in the domain of paediatric cardiology. As pediatric cardiologists, we frequently confront emergencies necessitating rapid decision-making, while contending with the pressures of stress, fatigue, an earnest interest in “doing the right thing” and the impact of parental involvement. This article aims to describe cognitive biases in pediatric cardiology, highlighting their influence on therapeutic interventions for congenital heart disease. Whether future pediatric cardiologists or experienced professionals, understanding and actively combating cognitive biases are essential components of our ongoing medical education. Furthermore, it is our responsibility to thoroughly examine our own practices in our unwavering commitment to providing high-quality care.

Abstract Food production and food security depend on the ability of crops to cope with anthropogenic climate change and successfully produce seed. To guarantee food production well into the future, contemporary plant scientists in Latin America must carry out research on how plants respond to environmental stressors such as temperature, drought, and salinity. This review shows the opportunities to apply these results locally and abroad and points to the gaps that still exist in terms of reproductive processes with the purpose to better link research with translational work in plant breeding and biotechnology. Suggestions are put forth to address these gaps creatively in the face of chronic low investment in science with a focus on applicability.