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Tick control mainly depends on using chemical acaricides that have led to the emergence of resistant tick populations along with environmental hazards. Natural alternatives including essential oils are now widely used to avoid the undesirable effects of chemicals on human, animals and environment. In this study, three commercial oils (myrrh, patchouli, and cypress) and their nanoemulsions (NEs) were tested against Rhipicephalus sanguineus sensu lato unfed adults. Transmission electron microscopy (TEM) and dynamic light scattering (DLS) were used to characterize the nanoemulsions. Four concentrations with three replicates were used in the bioassay of oils and NEs against ticks using an adult immersion test. Furthermore, a toxicity study of the three oils and their NEs using normal fibroblast cells (BJ-1) was performed. TEM revealed particle size ranges from 29 to 211 nm with spherical droplets. The droplet size and polydispersity index were (29.30 nm & 0.367), (211.6 nm & 0.221) and (164.2 nm & 0.237) for myrrh NE, patchouli NE, and cypress NE, respectively. Myrrh and patchouli oils recorded high acaricidal activity followed by cypress oil with LC 50 value 5 days after treatment of 9.01, 12.40, and 15.21%, respectively. The acaricidal efficacy of oil was potentiated in the NEs form which was proved by the reduction in LC 50 values that were recorded 7 days after treatment 4.17, 8.57, and 5.04%, for myrrh, patchouli, and cypress NE, respectively. As an alternative for lab animals, we applied the cytotoxicity of myrrh, patchouli, and cypress on normal fibroblast cells. The oils showed low cytotoxic activity of 10.6, 21.5, and 23.6% for Myrrh, Patchouli, and Cypress, respectively. The nanoemulsion was revealed to be safe for normal cells up to a concentration of 0.62% (cytotoxicity%= 24.4, 34.4, and 16.3%, respectively), and the moderate cytotoxic effect appeared at around a concentration of 1.25% (cytotoxicity%= 42.2%, 57.0%, and 36.8% respectively). In conclusion, the three oils and their NEs have good acaricidal activity against Rhipicephalus sanguineus unfed adults. Further toxicity studies on mammals are needed to ensure the safe use of these formulations for the control of ticks on infested animals., (© 2024. The Author(s).)

Background: In large supplementary feeding programs for children, it is challenging to create and sustain contextual, acceptable, nutritionally complete, and diverse supplemental foods. For example, the Indian Supplementary Nutrition Program (SNP) supplements the dietary intake of children, pregnant and lactating women, and severely acutely malnourished (SAM) children by offering dry take home rations (THRs) or hot cooked meals (HCMs) across India, but an optimization tool is necessary to create local contextual recipes for acceptable and nutritionally adequate products., Objectives: This study aimed to create a linear programming (LP) model to optimize diverse food provisions for a SNP to meet its program guidelines, using locally available foods, within budgetary allocations., Methods: A LP algorithm with appropriate constraints was used to generate an optimal THR based on raw foods, or an optimal weekly HCM menu comprised of a lunch meal with mid-morning snacks, based on user choices of foods and recipes. The database of foods used was created by a prospective survey conducted across all states of India for this purpose, such that the recipe and food optimization was diverse and specific to the guidelines for each beneficiary group., Results: An interactive web-based app, which can optimize feeding programs at any population level, was developed for use by program implementers and is hosted at https://www.datatools.sjri.res.in/SNP/. In the Indian example analyzed here, the recommended optimized diets met the guidelines for diversified and nutritionally complete SNP provision but at a cost that was almost 25% higher than the present Indian budget allocation., Conclusions: The optimization model developed demonstrates that contextual SNP diets can be created to meet macronutrient and most essential micronutrient needs of large-scale feeding programs, but appropriate diversification entails additional costs., (© 2024 The Authors.)

Transcarotid transcatheter aortic valve replacement (TAVR) is increasingly accepted as a safe and efficacious alternative when transfemoral access is contraindicated. Technical and anatomic considerations unique to transcarotid access warrant several adaptations to the routine TAVR procedure. This report describes an approach to overcome these challenges and improve efficiency, including adoption of the "flip-n-flex" technique originally developed for right transaxillary TAVR. This technique has been used at Tufts Medical Center (Boston, MA) since 2019 in both left and right transcarotid TAVR approaches with success to ensure coaxial alignment of the transcatheter heart valve to the aortic root., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Internal hernias through the foramen of Winslow are very rare. An 80-year-old female patient presented with epigastric and right upper quadrant pain associated with abdominal distention, nausea and vomiting for 1 day. A CT scan showed an internal hernia with terminal ileum and caecum identified within the lesser sac. The diagnosis was confirmed by laparotomy. A right hemicolectomy was performed to prevent further recurrence. We reviewed case reports with the same presentation by searching the Pubmed database using the keywords: 'foramen Winslow hernia, cecum'. We identified 23 publications. Our review extracted the following information: presentation, anatomical findings, pathological causes and surgical management. Misdiagnosis was common due to the limitations of plain abdominal X-rays. Abdominal CT scan is now the preferred radiological study and is more effective in establishing a diagnosis. Surgical treatment options varied. Right hemicolectomy has emerged as the preferred procedure to decrease the rate of recurrence., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

An excessive and uncontrolled systemic inflammatory response is associated with organ failure, immunodepression, and increased susceptibility to nosocomial infection following trauma. Interleukin 6 (IL-6) plays a particularly prominent role in the host immune response after trauma with hemorrhage. However, as a result of its pleiotropic functions, the effect of IL-6 in trauma and hemorrhage is still controversial. It remains unclear whether suppression of IL-6 after hemorrhagic shock and trauma will attenuate organ injury and immunosuppression. In this study, C57BL/6 mice were treated with anti-mouse IL-6 monoclonal antibody immediately prior to resuscitation in an experimental model combining hemorrhagic shock and lower-extremity injury. Interleukin 6 levels and signaling were transiently suppressed following administrations of anti-IL-6 monoclonal antibody following hemorrhagic shock and lower-extremity injury. This resulted in reduced lung and liver injury, as well as suppression in the levels of key inflammatory mediators including IL-10, keratinocyte-derived chemokine, monocyte chemoattractant protein 1, and macrophage inhibitory protein 1α at both 6 and 24 h. Furthermore, the shift to TH2 cytokine production and suppressed lymphocyte response were partly prevented. These results demonstrate that IL-6 is not only a biomarker but also an important driver of injury-induced inflammation and immune suppression in mice. Rapid measurement of IL-6 levels in the early phase of postinjury care could be used to guide IL-6-based interventions.