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Tenebrio molitor larvae are the first insect species to be given a favorable assessment by the European Food Safety Authority (EFSA) as a novel food source, enabling consumption of whole insect larvae or larvae that have been powdered and processed into a variety of food products. Pressure from economic hardships and increase in population growth have paved a way for the realization of an alternative food source in Zimbabwe. This study focused on determining the potential toxicity of Tenebrio molitor larvae powder as an alternative food source for humans. To determine the sub-chronic toxicity of Tenebrio molitor, the powder was administered daily by oral gavage to Sprague-Dawley rats at dose levels of 0, 300, 1000 and 3000 mg/kg for 70 days. A toxicological assessment which included mortality, appearance of clinical symptoms, food consumption, organ and body weight changes were performed. There were no treatment-related mortalities, clinical signs, changes in food consumption, body and organ weights observed during the treatment period. The study's findings suggest Tenebrio molitor larvae to be a good alternative as it did not appear to affect the rats' normal physiological and metabolic processes hence can be considered safe for human consumption. However, further studies on hematological, histological and biochemical markers may be necessary for confirmation of these current results.

# Background Previous studies exploring the application of noninvasive ventilation or high-flow nasal cannula in patients with COVID-19-related acute respiratory distress syndrome (ARDS) have yielded conflicting results on whether any method of respiratory support is superior. Our aim is to compare the efficacy and safety of respiratory therapy with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure in treatment of COVID-19-related ARDS. # Methods This is a retrospective cohort study based on data from patients who received respiratory support as part of their treatment in the COVID intensive care unit at the University Hospital Centre Zagreb between February 2021 and February 2023. Using propensity score analysis, 42 patients treated with high-flow nasal cannula (HFNC group) were compared to 42 patients treated with noninvasive ventilation with continuous positive airway pressure (CPAP group). Primary outcome was intubation rate. # Results Intubation rate was 71.4% (30/42) in the HFNC group and 40.5% (17/42) in the CPAP group (*p* = 0.004). Hazard ratio for intubation was 3.676 (95% confidence interval \[CI\] 1.480 to 9.232) with the HFNC versus CPAP group. Marginally significant difference in survival between the two groups was observed at 30 days (*p* = 0.050) but was statistically significant at 60 days (*p* = 0.043). # Conclusions Respiratory support with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure yielded significantly different intubation rates in favour of continuous positive airway pressure. The same patients also had better 30-day and 60-day survival post-admission.

Abstract Background The anesthetic management of parturients with ascending aortic aneurysm for cesarean section can be particularly challenging, primarily because of increased risk for aortic dissection or aneurysm rupture. Case presentation We present some aspects of the anesthetic management of two parturients with ascending aortic aneurysm for cesarean sections; amongst, the use of remifentanil with its effects on patient and newborn. We emphasize the importance of a cardio-obstetric team in the context of preoperative planning of such patients. Also, we reviewed some literature on the anesthetic management with its effect on peri-operative hemodynamic stability. Conclusion Maintaining hemodynamic stability is paramount in the prevention of the rupture or dissection of ascending aortic aneurysm during labor of parturient.

Background: Reporting quality of systematic reviews and meta-analyses is of critical importance in dermatology because of their key role in informing health care decisions. Objective: To assess the compliance of systematic reviews and meta-analyses in leading dermatology journals with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. Methods: This review was carried out in accordance with PRISMA guidelines. Included studies were reviews published across 6 years in the top 4 highest-impact-factor dermatology journals of 2017. Records and full texts were screened independently. Data analysis was conducted with univariate multivariable linear regression. The primary outcome was to assess the compliance of systematic reviews and meta-analyses in leading dermatology journals with the PRISMA statement. Results: A total of 166 studies were included and mean PRISMA compliance across all articles was 73%. Compliance significantly improved over time (β = .016; P =

Non‐adherence was associated with non‐disclosure of positive HIV status. The rate was reduced among participants reporting no difficulty in taking medication as prescribed. [ABSTRACT FROM AUTHOR]

Abstract Background Nivolumab, a programmed death-1 (PD-1) inhibitor, is an immune checkpoint inhibitor particularly used in the treatment of malignant melanoma, non-small cell lung cancer and renal cell carcinoma. Immune-related adverse events are frequent under immunotherapies. Cardiotoxic side effects, initially thought to be rare, are more often encountered paralleling the expanding use of immune checkpoint blockade. Among them, pericardial effusion and tamponade deserve attention as they may present with unusual symptomatology. Case presentation We report three cases of pericardial effusion under nivolumab for lung adenocarcinoma. Two cases of early and late-onset pericardial effusion were symptomatic with tamponade and one case occurred without any symptoms. Pericardiocentesis with pericardial biopsy was performed in symptomatic pericardial effusion followed by the administration of a corticotherapy. Pericardial biopsies showed infiltration of T-lymphocytes, mostly CD4+. Nivolumab was stopped in two cases and resumed for one patient. Pericardial effusion evolved positively in all cases with or without treatment. Conclusions We review the literature on pericardial effusion under nivolumab to further discuss the hallmarks of pericardial effusion under nivolumab and the management of nivolumab therapy in this situation. In conclusion, pericardial effusion as an immune-related adverse event under nivolumab appears less rare than initially thought and may require particular attention.

Background As part of the scale-up of the Patient Care Collaborative (PCC) at our institution, we explored staff perceptions and patient outcomes at different levels of model implementation in three general internal medicine units.Methods We conducted a mixed-methods embedded experimental healthcare improvement initiative. In the qualitative strand, we conducted five focus group discussions. In the quantitative strand, we used hospital administrative data to compare outcomes (falls per 1000, median length of stay in days and resource use measured as resource intensity weights (RIW), before and after the implementation of the PCC, using χ2 tests, Wilcoxon’s rank sum tests and interrupted time series analyses.Results Staff showed considerable knowledge and acceptance of the PCC but expressed mixed feelings with regards to patient safety, workload, communication and teamwork. Staff perceptions varied by level of implementation of the PCC. A number of falls (overall) in the full implementation phase were not significantly different from the preimplementation phase (227 per 1000 vs 200 per 1000; p=0.449), but the number of moderate to severe falls dropped (12 vs 2 per 1000); p

Background: Childhood and adolescent malnutrition is a function of inadequate intake. Cookies are favourite snacks of children and adolescents. Objective: This work determined the nutrient, antinutrient, and phytochemical compositions of two local cowpea (oraludi and apama) flours and evaluated the organoleptic properties of their wheat-based cookies. Design: The two local cowpea species were processed into flours separately and blended with wheat on a 56-g protein basis. Chemical compositions of the processed cowpea flours were analysed using standard methods. Organoleptic attributes were evaluated with a nine-point Hedonic scale. Statistical analysis, which involved mean and standard deviations, were computed by analysis of variance, and Duncan's new multiple range tests were used to separate and compare group means of sensory evaluation data, with significance accepted at P

Glutathione (GSH) is implicated in the pathophysiology of schizophrenia. Previous brain spectroscopy studies, however, have been inconsistent, and there is little data available from first episode psychosis patients. This study compared brain GSH in a first episode cohort (n=30) to controls (n=18), using magnetic resonance spectroscopy (MRS), examining a temporal lobe voxel. Short-echo (TE 30 ms) acquisition proton MRS was performed on a 3T clinical magnetic resonance scanner. Comparison of the first-episode and control groups' GSH concentrations revealed a significant main effect of group (F1,46=4.7, p=0.035), but no main effect of hemisphere (F1,46=2.3, p=0.137) or group-by-side interactions (F1,46=0.4, p=0.513). Medial temporal lobe GSH concentrations in the first episode group were 22% higher than those in the control group. This study provides further evidence of significant perturbations in brain GSH in first episode psychosis, and supports a broader involvement of GSH in the pathophysiology of schizophrenia.