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Brassica is one of the crops sensitive to low copper supply, leading to Alternaria blight. The present study reflects the synthesis of myco-derived copper oxide (M-CuO) nanoparticles (NPs) from Trichoderma asperellum and investigates their effect against Alternaria blight of Brassica in two soil types, alluvial and calcareous. Foliar applications of different treatments were used to treat plants: T1 (mancozeb@0.2%), T2 (propiconazole@0.05%), T3 (T. asperellum filtrate), T4 (M-CuO NPs), T5 chemically synthesized (C-CuO NPs), and T6 bulk phase (BP-CuO @25, 50, 100, 150, and 200 ppm) of each in twice such as protectant and curative method under pot experiments. M-CuO NPs in two protective sprays exhibit up to 75% disease suppression in alluvial soil, compared to 68.9% suppression in curative spray at 200 ppm. Maximum seed yield and seed number were obtained, 1.95 g/plant and 850 seeds/plant in alluvial soil, but in calcareous soil, seed yield (1.14 g/plant) and seed number 414 seeds/plant were recorded in plants supplemented with M-CuO NPs as a protectant. In both soils, maximum plant height was increased by protective applications of M-CuO NPs at 200 ppm. Thus, the present study suggested that among foliar sprays of copper nanocompounds, protective activity shows better results as compared to curative activity. Among all the treatments, M-CuO NPs were found to be most effective in suppressing disease and improving productivity and growth-promoting effects of Brassica.

The care provided to the victims of burn injury immediately after sustaining burns can largely affect the extent and depth of the wound. Although standard guidelines have been formulated by various burn associations, they are still not well known to public at large in our country. In burn injuries, most often, the bystanders are the first care providers. The swift implementation of the measures described in this article for first aid in thermal, chemical, electrical and inhalational injuries in the practical setting, within minutes of sustaining the burn, plays a vital role and can effectively reduce the morbidity and mortality to a great extent. In case of burn disasters, triage needs to be carried out promptly as per the defined protocols. Proper communication and transport from the scene of the accident to the primary care centre and onto the burn care facility greatly influences the execution of the management plans

The mortality and morbidity from burns have diminished tremendously over the last six to seven decades. However, these do not truly reflect whether the victim could go back to society as a useful person or not and lead a normal life because of the inevitable post-burn scars, contractures and other deformities which collectively have aesthetic and functional considerations. This article gives an overview of the post-burn scars and scar contractures, especially their prevention, minimisation and principles of management.

Purpose: To summarize advances in research on the epidemiology, pathogenesis, diagnosis, and treatment of Kawasaki Disease (KD), a systemic inflammatory illness of unknown etiology that affects children globally., Recent Findings: The epidemiology of KD was affected by the COVID-19 pandemic and advances in molecular immunology and machine learning have enabled research into its pathogenesis. There is ongoing research into agents that can be used to intensify initial treatment and accumulating evidence supporting the use of certain rescue regimens for refractory disease over others. There is promise surrounding a new coronary artery aneurysm prediction model. Research into the post-acute morbidity of KD continues. The COVID-19 pandemic temporarily reduced the incidence of KD. The NLRP3 inflammasome plays a key role in KD pathogenesis. Intensified initial treatment benefits high-risk patients, yet no intensification regimen shows superiority over another. Corticosteroids, infliximab, or combination therapy with IVIg plus another agent may be superior rescue regimens compared to IVIg alone for refractory KD. The Son score, developed in North America, predicted coronary artery lesions in Japanese and Italian cohorts. Patients with a history of KD may carry long-term physical and emotional burdens that persist into adulthood yet appear to have typical neurocognitive development. Successful transition to adult healthcare presents a challenge., Competing Interests: Declarations. Conflict of Interest: The authors declare no competing interests. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Immune checkpoint inhibitors (ICIs) are associated with immune-related adverse events (irAEs), but psoriasis and psoriatic arthritis (PsA) after use of dostarlimab have not been reported. We present a woman who received dostarlimab for endometrial cancer and subsequently developed rash and polyarthralgia, diagnosed as overlapping palmoplantar pustular and plaque psoriasis with PsA. She was treated with discontinuation of dostarlimab, topical steroids, oral methylprednisolone and methotrexate. This case highlights phenotypic heterogeneity in cutaneous irAEs influenced by malignancy and ICI type and underscores the need for multidisciplinary care in treating irAEs. We review three current professional society guidelines for managing irAEs, highlighting their emphasis on management based on severity grading, early initiation of systemic corticosteroids and steroid-sparing agents and discontinuation of ICI for severe events. Certain recommendations deviate from typical approaches to idiopathic rheumatologic disease. Further research is needed to support the ongoing development of approaches to irAE management., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Colorectal surgery has progressed greatly via minimally invasive techniques, laparoscopic and robotic. With the advent of ERAS protocols, patient recovery times have greatly shortened, allowing for same day discharges (SDD). Although SDD have been explored through laparoscopic colectomy reviews, no reviews surrounding robotic ambulatory colorectal resections (RACrR) exist to date. A systematic search was carried out across three databases and internet searches. Data were selected and extracted by two independent reviewers. Inclusion criteria included robotic colorectal resections with a length of hospital stay of less than one day or 24 h. 4 studies comprising 136 patients were retrieved. 56% of patients were female and were aged between 21 and 89 years. Main surgery indications were colorectal cancer and recurrent sigmoid diverticulitis (43% each). Most patients had low anterior resections (48%). Overall, there was a 4% complication rate postoperatively, with only 1 patient requiring readmission due to postoperative urinary retention (< 1%). Patient selection criteria involved ASA score cut-offs, nutritional status, and specific health conditions. Protocols employed shared similarities including ERAS education, transabdominal plane blocks, early removal of urinary catheters, an opioid-sparing regime, and encouraged early oral intake and ambulation prior to discharge. All 4 studies had various follow-up methods involving telemedicine, face-to-face consultations, and virtual ward teams. RACrRs is safe and feasible in a highly specific patient population; however, further high-quality studies with larger sample sizes are needed to draw more significant conclusions. Several limitations included small sample size and the potential of recall bias due to retrospective nature of 2 studies., (© 2024. The Author(s).)

The multisystem inflammatory syndrome in children (MIS-C) is a known complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the pediatric population. Recent studies have demonstrated high efficacy of a two-dose vaccine series in preventing MIS-C among adolescents. To date, such studies have only included children exposed to SARS-CoV-2 prior to the emergence of the Omicron variant (B.1.1.529). We report a case of an adolescent who received three doses of a vaccine yet developed MIS-C following known exposure to SARS-CoV-2. Given the uncertainty in whether current vaccines offer as much protection against MIS-C due to the Omicron variant or any potential new variants as they have for older variants, pediatric providers should maintain a high index of suspicion for MIS-C regardless of vaccination status.

Context: Given the high prevalence of burdensome symptoms in palliative care (PC) and increasing use of complementary and integrative medicine (CIM) therapies, research is needed to determine how often and what types of CIM therapies providers recommend to manage symptoms in PC., Objectives: To document recommendation rates of CIM for target symptoms and assess if, CIM use varies by provider characteristics., Methods: Nationwide survey's of physicians (MD and DO), physician assistants, and nurse practitioners in PC., Results: Participants (N = 404) were mostly female (71.3%), physicians (74.9%), and cared for adults (90.4%). Providers recommended CIM an average of 6.82 times per-month (95% CI: 6.04-7.60) and used an average of 5.13 (95% CI: 4.90-5.36) out of 10 CIM modalities. Respondents recommended mind-body medicines (e.g., meditation, biofeedback) most, followed by massage, and acupuncture and/or acupressure. The most targeted symptoms included pain; followed by anxiety, mood disturbance, and distress. Recommendation frequencies for specific modality-for-symptom combinations ranged from little use (e.g., aromatherapy for constipation) to occasional use (e.g., mind-body interventions for psychiatric symptoms). Finally, recommendation rates increased as a function of pediatric practice, noninpatient practice setting, provider age, and proportion of effort spent delivering palliative care., Conclusion: To the best of our knowledge, this is the first national survey to characterize PC providers' CIM recommendation behaviors and assess specific therapies and common target symptoms. Providers recommended a broad range of CIM but do so less frequently than patients report using CIM. These findings should be of interest to any provider caring for patients with serious illness., (Copyright © 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Background: The use of complementary and integrative medicine (CIM) continues to grow in palliative care. While research supports the use of many CIM therapies for symptom relief, the scope of provider-focused research on CIM remains poorly characterized., Objectives: We conducted a scoping review to characterize provider-focused research on CIM in palliative care in order to map existing evidence and identify knowledge gaps., Methods: We developed a protocol outlining the study population, concept, and context; then used a validated approach per the JBI manual and searched MEDLINE, EMBASE, CINAHL, and AMED., Results: We identified 34 studies that were conducted primarily in the US (n = 9) and UK (n = 6), focused mostly on nurse (n = 29) and physician (n = 22) providers, and employed questionnaires (n = 16) or qualitative (n = 15) methods. Studies investigated 58 CIM modalities, including massage (n = 13), music therapy (n = 12), and aromatherapy (n = 10), to address common symptoms including pain (n = 17), fatigue (n = 6), and nausea/vomiting (n = 6). Study outcomes included perceived benefits of CIM (n = 17) and types of CIM modalities that providers offer (n = 15). Uncommonly studied phenomena included referral patterns (n = 4), facilitators of provider recommendation of CIM (n = 3), and rates of CIM use (n = 3)., Conclusion: Provider-focused research on CIM in palliative care can expand its scope by addressing perspectives of interdisciplinary providers, examining CIM modalities that patients report using, addressing symptoms commonly encountered in palliative care, and researching provider-use-focused outcomes. We identify these possibilities for future studies in addition to opportunities for systematic investigations to enhance the safe and efficacious delivery of CIM in the palliative care setting.

Background: A frequent concern surrounding amplification with hearing aids for patients with sensorineural hearing loss is whether these devices negatively affect hearing ability. To date, there have been few studies examining the long-term effects of amplification on audiometric outcomes in adults., Purpose: In the present study, we examined how hearing aids affect standard audiometric outcomes over long-term periods of follow-up., Research Design: We retrospectively collected audiometric data in adults with sensorineural hearing loss, constructing a model of long-term outcomes., Study Sample: This retrospective cohort study included 802 ears from 401 adult patients with bilateral sensorineural hearing loss eligible for amplification with hearing aids at a single institution., Intervention: Of the eligible patients, 88 were aided bilaterally, and 313 were unaided., Data Collection and Analysis: We examined the standard three-frequency pure-tone average (PTA 3-Freq ), a novel extended pure-tone average (PTA Ext ), and word recognition score (WRS) per-ear at each encounter. We then modeled the association between the use of hearing aids for 5 years and these audiometric outcomes using targeted maximum likelihood estimation., Results: In comparing aided and unaided ears at the end of 5 years, there were discernible effects for all measurements. The PTA 3-Freq was 5 dB greater in aided ears (95% CI: 1.37-8.64, p  = 0.007), WRS was 4.5 percentage points lower in aided ears (95% CI: -9.14 to 0.15, p  = 0.058), and PTA Ext was 5 dB greater in aided ears (95% CI: 2.18-7.82, p  < 0.001), adjusting for measured confounders., Conclusion: Our analysis revealed discernible effects of 5 years of hearing aid use on hearing ability, specifically as measured by the PTA 3-Freq , novel PTA Ext , and WRS, suggesting a greater decline in hearing ability in patients using hearing aids. Future studies are needed to examine these effects between treatment groups over longer periods of time and in more heterogeneous populations to improve clinical practice guidelines and safety of both prescriptive fitting nonprescriptive amplification., Competing Interests: None declared., (American Academy of Audiology. This article is published by Thieme.)

Unicameral bone cysts have been treated by a variety of methods including nonoperative treatment, bone packing, and methylprednisone acetate injection. This article reviews the methods of treatment and classification of unicameral bone cysts. Three calcaneal unicameral bone cysts were injected with methylprednisone acetate and were followed for 8 to 32 months. Two unicameral bone cysts were unresponsive to methylprednisone acetate and were classified as "persistent." One unicameral bone cyst was moderately responsive and was classified as "incompletely resolved."

Thirty-five feet that have undergone an off-set V osteotomy with screw fixation are reviewed in this retrospective study. The average length of follow-up is 3 years. The osteotomy successfully reduced the intermetatarsal angle, proximal articular set angle, and hallux abductus angle while leaving the first metatarsal length and first metatarsal declination angle unchanged. Aside from effectively correcting the clinical values, this procedure was also rated very high in patient satisfaction. Satisfaction (excellent and good) with the procedure as reported by 33 (94%) and complete relief from pain was described by 23 (66%) of the respondents. The authors highly recommend this procedure based on successful reduction of radiographic angles, minimal complications, and high patient satisfaction.

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