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We have read with interest the article "Decision-To-Scope Score: A novel tool with excellent accuracy in predicting foreign bodies in the esophagus" published in I Clinical Gastroenterology and Hepatology i by Silva et al.[1] This large retrospective cohort study aimed to create a score able to discriminate patients who are candidates to emergent EGD in this scenario. Decision-to-scope score: a novel tool with excellent accuracy in predicting foreign bodies in the esophagus However, symptoms-driven decision to delay EGD for management of these objects based on DTS-Score may be counterproductive as initially symptoms may be innocuous. [Extracted from the article]

Competing Interests: Declarations Conflict of interest The authors declare no competing interests.

Aims: Present study demonstrates dose and time dependent effects of NiONPs (<30 nm) on the ovaries of Wistar rat., Methods: Female rats were gavaged NiONPs or NiOMPs (5 mg/kg b.w.) for 24 h, 15 days and 30 days, euthanized and ovaries thus removed were analyzed for nickel bioaconcentration and processed for scanning electron microscopy. Serum samples were analyzed to compare the effects of nickel nano & microparticles on progesterone and estradiol values., Results: Results confirmed the bioaccumulation of Ni in ovarian tissue. Its concentration was higher in NiONPs treated rats than NiOMPs treated rats. Progesterone level increased whereas estradiol values decreased in NiONPs and NiOMPs treated rats. SEM results also exhibited dose dependent effects on the morphology of corpoluteal complex. The structural changes varied from formation of blebs to distorted microvilli and germinal epithelium., Conclusion: It is hypothesized that NiONPs/NiOMPs are biodegraded into smaller fragments that conjugate with amino acids and or alter downstream signaling pathways, generate ROS and modulate protein structure activity relationships. Finally, these processes manifest into morphological alterations in the ovary. Biopersistence of nickel in female reproductive system may compromise with fertility and reproductive performance of exposed population., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

In recent decades, artificial intelligence (AI) has infiltrated a variety of domains, including media, education, and medicine. There exists no glossary, lexicon, or reference for the uninitiated medical professional to explore the new terminology. As AI-driven technologies and applications become more available for clinical use in healthcare settings, an understanding of basic components, models, and tasks related to AI is crucial for clinical and academic appraisal. Here, we present a glossary of AI definitions that healthcare professionals can utilize to augment personal understanding of AI during this fourth industrial revolution. LEVEL OF EVIDENCE: Level V, expert opinion., (Copyright © 2024 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)

Purpose: To develop and validate a multiplex conventional PCR assay to simultaneously detect Cryptosporidium spp., Entamoeba histolytica, and Giardia lamblia in diarrheal samples as a rapid, cost-effective, and sensitive diagnostic tool for prevalent co-infections for improved diagnostic accuracy and efficiency in resource-limited settings., Methods: Stool samples collected from patients with gastrointestinal symptoms after taking written consent, processed via wet mount, iodine mount, and PCR assays. Cohen's kappa statistical analysis was done to test agreement., Result: Among 240 patients, 28.75% showed intestinal protozoa via Microscopy; Single-plex and multiplex PCR demonstrated 100% concordance, detecting 27.9%; confirmed by sequencing. Highest parasite positivity was observed in transplant and immunocompromised patients, with moderate to almost perfect agreement between microscopy and molecular methods., Conclusion: Multiplex-conventional PCR offers superior sensitivity and specificity over microscopy and 100% concordance with single-plex PCR, enabling rapid, cost-effective diagnosis of multiple parasites from single stool sample. Its adoption could revolutionize parasitic infection management in routine diagnostics., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

A new class of anion-π + AIEgens based on ring-fused annulated oxazolium architectures is reported, which can be readily synthesized via a single-step dual C-H activation annulative π-extension (APEX) protocol from simple oxazolium salts. The crucial and decisive role of anion-π + interactions in their solid-state structural arrangement was analyzed to correlate their tunable AIE features and solid-state quantum yields.

Renal arteriovenous malformations (AVM) represent an uncommon vascular condition characterized by an abnormal direct communication between an intrarenal artery and vein. Though asymptomatic in many individuals, treatment is often indicated if the AVM causes flank pain, hematuria, or medically refractory hypertension, or if there is an associated renal artery aneurysm. We present a case of a large right renal AVM with associated renal artery aneurysm and large varix which was incidentally found on magnetic resonance imaging of the spine. Endovascular and open surgical options were considered, including ex-vivo renal vascular reconstruction and nephrectomy. The patient was successfully treated with endovascular embolization of the AVM with coil packing of the arterial aneurysm and inflow artery. The patient recovered uneventfully with well-maintained renal function and blood pressure control. We review and discuss the literature on the etiology and treatment options for renal AVM., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Bow Hunter syndrome (BHS) is a rare disorder characterized by mechanical occlusion of the vertebral artery (VA) during neck rotation, resulting in symptomatic, transient, and positional vertebrobasilar insufficiency. We describe a case of a 76-year-old female who presented with dizziness and right ear tinnitus triggered by right head rotation. Her symptoms would immediately resolve upon returning her head to the neutral position. CT angiogram showed 80% stenosis of the left subclavian artery origin, 50%-70% stenosis of the proximal right internal carotid artery (ICA), and near occlusive stenoses of the origins of the bilateral VAs. After failing conservative management, the patient was treated with left subclavian artery stenting, followed by a right carotid endarterectomy (CEA) 6 weeks later. Follow-up at 1 month showed resolution of paroxysmal symptoms and no neurological sequelae. To our knowledge, there have not yet been reported cases of patients with concurrent BHS, subclavian artery stenosis, and carotid artery stenosis. We suggest that global revascularization via subclavian artery stenting and CEA may be considered as treatment for patients with BHS complicated by other cerebrovascular disease secondary to stenoses of the ICA and subclavian artery. This approach obviates the need for more complex surgery or endovascular intervention of the VA., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, or publication of this article.

3D volume construction of the maxillary sinus is important for understanding the 3D surface morphology of the maxillary sinuses and detecting changes or obstruction in sinuses. It is important to detect the pathological conditions affecting the sinuses and to determine the treatment outcomes. The cases of sinusitis and various other pathoses in maxillary sinuses are getting comparatively higher than in other sinuses. Therefore, analysis of maxillary sinus structure has some clinical importance. 3D volume construction from Computed Tomography (CT) can help in the volumetric study of the maxillary sinus. Nonetheless, CT imaging is expensive and has a higher radiation dose than X-ray imaging. Thus, the 3D construction from X-ray images is a challenging problem. This paper proposed a 3D construction method for maxillary sinus from lateral and Posterior-anterior (PA) 2D X-ray images. A novel 3D maxillary sinus construction model (2D-to-3D-MaxiDeform) is proposed which evolves the shape and size of the maxillary sinus providing the required volume, and other linear measurements in mesh format. The 2D-to-3DMaxiDeform uses a 3D point cloud template of the maxillary sinus and applies for registration on the template model. The deformation moves the 3D template points to the required positions of the X-ray image contours. The registration of the template model before deformation into the required shape makes sure the size, position, and angle of the template model are mapped with the input X-ray contours. The evaluation of the 2D-to-3DMaxiDeform achieves an average accuracy of 0.83, mDSC (mean Dice similarity coefficient) of 0.80, mIoU (mean Intersection over Union) of 0.67, recall of 0.90, precision of 0.74, specificity of 0.78 and RMSE of 2.3 mm. The proposed method is the first and novel approach for maxillary sinus 3D construction from X-ray images. The result shows that the proposed method could be a valuable tool for generating 3D models of the maxillary sinus to be used in a clinical setting., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Diabetes mellitus (DM) and epilepsy and the psychological and socio-economic implications that are associated with their treatments can be quite perplexing. Metformin is an antihyperglycemic medication that is used to treat type 2 DM. In addition, metformin elicits protective actions against multiple diseases, including neurodegeneration and epilepsy. Recent studies indicate that metformin alters the resident gut microbiota in favor of species producing agmatine, an arginine metabolite which, in addition to beneficially altering metabolic pathways, is a potent neuroprotectant and neuromodulant., Methods: We first examine the literature for epidemiological and clinical evidences linking DM and epilepsy. Next, basing our analyses on published literature, we propose the possible complementarity of agmatine and metformin in the treatment of DM and epilepsy., Results: Our analyses of the clinical data suggest a significant association between pathogeneses of epilepsy and DM. Further, both agmatine and metformin appear to be multimodal therapeutic agents and have robust antiepileptogenic and antidiabetic properties. Data from animal and clinical studies largely support the use of metformin/agmatine as a double-edged pharmacotherapeutic agent against DM and epilepsy, particularly in their concurrent pathological occurrences., Conclusion: The present review explores the evidences and available data on possible uses of metformin/agmatine as pertinent antidiabetic and antiepileptic agents. Our hope is that this will stimulate further research on the therapeutic actions of these multimodal agents, particularly for subject-specific clinical outcomes., Competing Interests: Declarations. Ethics approval: The study was conducted in accordance with the principles stated in the Declaration of Helsinki. No primary data was generated in this study. Human Ethics approval: Not applicable. Consent to Participate: Not applicable as no primary data was generated in this study. Consent to Publish: Not applicable as no primary data was generated in this study. Competing Interests: The authors have no relevant financial or non-financial interests to disclose., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)