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Background: Gastric cancer ranks as the fifth most frequently diagnosed cancer and the seventh most prevalent overall. The lifetime risk of developing gastric cancer is 1.87% for males and 0.79% for females worldwide., Aim: This systematic review and meta-analysis aimed to determine whether Extensive Intraoperative Peritoneal Lavage (EIPL) provides short-term benefits or improved survival outcomes for patients undergoing gastrectomy., Methods: A comprehensive search spanned PubMed, Embase, Cochrane Library, clinicaltrials.gov, and Web of Science, from their inception up to October 2023, adhering to predefined inclusion and exclusion criteria. The quality of the studies was analyzed using the Cochrane Collaboration Risk of Bias Tool. Data analysis was done using Review Manager 5.3, utilizing a random-effects model., Results: Our analysis incorporated seven randomized controlled trials with 2602 patients. The follow-up time for all outcomes varied from 30-60 months. For our primary outcomes, EIPL demonstrated a significant benefit over surgery alone in terms of recurrence (RR=0.73; 95% CI: 0.65 to 0.83, P<0.00001) and postoperative complications (RR=0.67; 95% CI: 0.51 to 0.87, P=0.003). For our secondary outcomes, postoperative hospital stay (MD=-0.35; 95% CI: -1.11 to 0.41; P-value=0.37), 3-year overall survival (OR=1.44; 95% CI 0.84 to 2.47; P-value=0.19), 3-year disease-free survival (HR=0.93; 95% CI: 0.78 to 1.13; P-value=0.48), and time to first flatus (MD=-0.17; 95% CI: -0.35 to 0.01; P-value=0.06), no statistically significant differences were observed between the EIPL and control groups., Conclusion: While there is a marginal difference in survival outcomes, EIPL holds promise in significantly reducing overall cancer recurrence and suggests an enhancement in postoperative recovery., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: Digital substance use treatment programs present an opportunity to provide nonresidential care for people with problematic substance use. In June 2021, the provincial government in Ontario provided free access to Breaking Free Online (BFO), a digital behavioral change program for people with substance use disorders., Methods: An observational study was conducted with retrospective data to characterize clients' use and engagement patterns in BFO and examine changes in self-reported outcomes., Results: In total, 6,370 individuals registered for BFO between June 2021 and October 2022, of whom 3,650 completed the intake assessment. Most of these clients were self-referred (64%), with 37% having been referred by health service providers. More than one-half of the clients (52%) resided in Ontario West or East regions. Support for addressing problematic alcohol use was the most requested program (40%). By October 2022, about 44% of the clients had completed between one and four of 12 program strategies. Analysis revealed significant changes in pre-post scores across four validated scales (p<0.001), indicating a decrease in anxiety and depression, an increase in quality of life, an improvement in recovery progression, and a decrease in severity of symptoms associated with substance use disorders., Conclusions: BFO clients with higher completion rates had the most improvement across the scales used; however, clients with lower and medium completion rates also had improvements. Because of the shame and stigma associated with substance use, digital supports with low barriers to entry can help support the autonomy, privacy, and preferences of individuals seeking help for problematic substance use., Competing Interests: The authors report no financial relationships with commercial interests.

Background: To address the anticipated rise in mental health symptoms experienced at the population level during the COVID-19 pandemic, the Ontario government provided 2 therapist-assisted internet-delivered cognitive behavioral therapy (iCBT) programs to adults free of charge at the point of service., Objective: The study aims to explore the facilitators of and barriers to implementing iCBT at the population level in Ontario, Canada, from the perspective of patients and therapists to better understand how therapist-assisted iCBT programs can be effectively implemented at the population level and inform strategies for enhancing service delivery and integration into the health care system., Methods: Using a convenience sampling methodology, semistructured interviews were conducted with 10 therapists who delivered iCBT and 20 patients who received iCBT through either of the publicly funded programs to explore their perspectives of the program. Interview data were analyzed using inductive thematic analysis to generate themes., Results: Six salient themes were identified. Facilitators included the therapist-assisted nature of the program; the ease of registration and the lack of cost; and the feasibility of completing the psychoeducational modules given the online and self-paced nature of the program. Barriers included challenges with the online remote modality for developing the therapeutic alliance; the program's generalized nature, which limited customization to individual needs; and a lack of formal integration between the iCBT program and the health care system., Conclusions: Although the program was generally well-received by patients and therapists due to its accessibility and feasibility, the digital format of the program presented both benefits and unique challenges. Strategies for improving the quality of service delivery include opportunities for synchronous communication between therapists and patients, options for increased customization, and the formal integration of iCBT into a broader stepped-care model that centralizes patient referrals between care providers and promotes continuity of care., (©Serena Thapar, Megan Nguyen, Bilal Noreen Khan, Roz Fanaieyan, Vanessa Kishimoto, Rebecca Liu, Blanca Bolea-Alamañac, Marisa Leon-Carlyle, Anne O’Riordan, Maggie Keresteci, Onil Bhattacharyya. Originally published in JMIR Formative Research (https://formative.jmir.org), 19.02.2024.)

Heavy metal pollution in aquatic environments threatens marine life and lowers the quality of freshwater supplies. This research aimed to quantify the heavy metal concentration in fish, avian tissue, and water of the Mangla reservoir. Concentrations of heavy metals such as Cu, Cd, Cr, and Pb were determined in five vital organs of six species of fishes ( Cirrhinus cirrhosis, Catla catla, Hypophthalmichthys molitrix, Wallagu attu, Cyprinus carpio, Sperata seenghala ) and five species of migratory birds ( Anas strepera, Aythya ferina, Anas platyrhynchos, Anas crecca, Anas clypeata ) and water of Mangla dam. Heavy metal concentration was observed with AAS' help after the samples' complete chemical digestion. The average concentration of these metals in water samples was higher than the mean values in fish and birds. Heavy metals damaged fish and birds in the same order: Cd > Cu > Cr > Pb. The results of this research will hopefully prompt further consideration on the dangers of heavy metal contamination in freshwater ecosystem., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors.)

Overuse of pesticides in agricultural soil and dye-polluted effluents severely contaminates the environment and is toxic to animals and humans making their removal from the environment essential. The present study aimed to assess the biodegradation of pesticides (cypermethrin (CYP) and imidacloprid (IMI)), and dyes (malachite green (MG) and Congo red (CR)) using biofilms of bacteria isolated from pesticide-contaminated soil and dye effluents. Biofilms of indigenous bacteria, i.e., Bacillus thuringiensis 2A (OP554568), Enterobacter hormaechei 4A (OP723332), Bacillus sp. 5A (OP586601), and Bacillus cereus 6B (OP586602) individually and in mixed culture were tested against CYP and IMI. Biofilms of indigenous bacteria i.e., Lysinibacillus sphaericus AF1 (OP589134), Bacillus sp. CF3 (OP589135) and Bacillus sp. DF4 (OP589136) individually and in mixed culture were tested for their ability to degrade dyes. The biofilm of a mixed culture of B. thuringiensis + Bacillus sp. (P7) showed 46.2% degradation of CYP compared to the biofilm of a mixed culture of B. thuringiensis + E. hormaechei + Bacillus sp. + B. cereus (P11), which showed significantly high degradation (70.0%) of IMI. Regarding dye biodegradation, a mixed culture biofilm of Bacillus sp. + Bacillus sp. (D6) showed 86.76% degradation of MG, which was significantly high compared to a mixed culture biofilm of L. sphaericus + Bacillus sp. (D4) that degraded only 30.78% of CR. UV-VIS spectroscopy revealed major peaks at 224 nm, 263 nm, 581 nm and 436 nm for CYP, IMI, MG and CR, respectively, which completely disappeared after treatment with bacterial biofilms. Fourier transform infrared (FTIR) analysis showed the appearance of new peaks in degraded metabolites and disappearance of a peak in the control spectrum after biofilm treatment. Thin layer chromatography (TLC) analysis also confirmed the degradation of CYP, IMI, MG and CR into several metabolites compared to the control. The present study demonstrates the biodegradation potential of biofilm-forming bacteria isolated from pesticide-polluted soil and dye effluents against pesticides and dyes. This is the first report demonstrating biofilm-mediated bio-degradation of CYP, IMI, MG and CR utilizing soil and effluent bacterial flora from Multan and Sheikhupura, Punjab, Pakistan.

Parasites are a significant component of biodiversity. They negatively affect fish appearance, growth, and reproduction. In this study, the prevalence of infection, diversity, and mean intensity of parasites were examined in 9 freshwater fish species (45 samples per fish species). Ecto-parasites were examined on the skin, gills, and fins with a hand lens. Wet mounts were prepared using mucosal scrapings from all the external and internal organs of the sampled fish. Microscopy, muscle compression, and the pepsin-HCL artificial digestion technique were also performed. In this study, 26 species of parasites were identified including three taxa belonging to 9 species of protozoan parasites, 11 treamtodes, and 6 monogenean parasites. The identified protozoan parasites were Entamoeba histolitica , Chilodonella sp., Coccidia sp., Costia sp., Cryptobia sp., Ichthyopthiris-multifilis , Microsporidia , Piscinoodinium sp., and Ichthyobodo necator . The identified trematode parasites were Fasciola gigantica , Echinostoma revolutum , Fasciola hepatica , Haplorchis pumilio , Brachylaima cribbi , Echinostoma cinetorchis , Neascus sp., Deropegus sp., Trematode Soldier , Centrocestus formosanus , and Clinostomum marginatum. The identified monogenean parasites were Dactylogyrus limipopoensis , Dactylogyrus anchoratus , Dactylogyrus myersi , Dactylogyrus vastator , Gyrodactylus salaris, and Ancyrocephalus . The diversity of parasites was maximum at the Okara site. The host's organs that were targeted for parasitic infection included the intestine, liver, gills, fins, skin, and kidneys. The majority of the parasites were identified in Labeo rohita followed by Hypophthalmichthys molitrix , Ctenopharyngodon idella , Oreochromis niloticus , Cyprinus carpio , and Wallagu attu . Two species appeared to be resistant species because none of the parasites were observed in Notopterus notopterus or Sperata seenghala . This study also concluded that the prevalence of parasites increased with increasing length, size, and age of fish.

This review article describes the application and characteristics of certain biomedical materials in orthodontic appliances. The elastic recoil of shape memory polymers, determination of the forces and moments experienced by the brackets and eventually by the tooth, reduction in treatment time by employing self-healing smart brackets and decreased enamel lost during debonding due to usage of biomimetic adhesives such as dihydroxyphenylalanine (DOPA) is discussed. Increased plaque retention and microbial attachment around brackets and teeth is of profound concern and by utilisation of hydrophobic properties of self-cleaning materials, this can be reduced significantly. Implantation of bioresorbable temporary anchorage devices, which resorb once their purpose is accomplished and increasing the concentration of fluoride in the oral environment to counter the deleterious consequences of orthodontic treatment such as white spot lesions and caries, are also discussed briefly.