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The SARS-CoV-2 pandemic has resulted in 762 million infections worldwide from 2020 to date, of which approximately ten percent are suffering from the effects after infection in 2019 (COVID-19) [1, 40]. In Germany, it is now assumed that at least one million people suffer from post-COVID condition with long-term consequences. These have been previously reported in diseases like Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS). Symptoms show a changing variability and recent surveys in the COVID context indicate that 10-30 % of outpatients, 50 to 70% of hospitalised patients suffer from sequelae. Recent data suggest that only 13% of all ill people were completely free of symptoms after recovery [3, 9]. Current hypotheses consider chronic inflammation, mitochondrial dysfunction, latent viral persistence, autoimmunity, changes of the human microbiome or multilocular sequelae in various organ system after infection. Hyperbaric oxygen therapy (HBOT) is applied since 1957 for heart surgery, scuba dive accidents, CO intoxication, air embolisms and infections with anaerobic pathogens. Under hyperbaric pressure, oxygen is physically dissolved in the blood in higher concentrations and reaches levels four times higher than under normobaric oxygen application. Moreover, the alternation of hyperoxia and normoxia induces a variety of processes at the cellular level, which improves oxygen supply in areas of locoregional hypoxia. Numerous target gene effects on new vessel formation, anti-inflammatory and anti-oedematous effects have been demonstrated [74]. The provision of intermittently high, local oxygen concentrations increases repair and regeneration processes and normalises the predominance of hyperinflammation. At present time only one prospective, randomized and placebo-controlled study exists with positive effects on global cognitive function, attention and executive function, psychiatric symptoms and pain interference. In conclusion, up to this date HBO is the only scientifically proven treatment in a prospective randomized controlled trial to be effective for cognitive improvement, regeneration of brain network and improvement of cardiac function. HBOT may have not only theoretical but also potential impact on targets of current pathophysiology of Post COVID condition, which warrants further scientific studies in patients., Competing Interests: Declarations Conflict of interest The authors declare that the research was conducted in the absence of any financial interest, which could be viewed as a potential conflict of interest. Ethical approval Not applicable. Studies involving humans and/or animals Not applicable. Consent for publication Not applicable. Consent to participate Not applicable., (© 2024. The Author(s).)

Background: Athletic performance can be measured with a variety of clinical and functional assessment techniques. There is a need to better understand the relationship between the brain's electrical activity and the body's physiological performance capabilities in real-time while performing physical tasks related to sport. Orthopedic functional assessments used to monitor the neuroplastic properties of the central nervous system lack objectivity and/or pertinent functionality specific to sport. The ability to assess brain wave activity with physiological metrics during functional exercises associated with sport has proven to be difficult and impractical in real-time sport settings. Quantitative electroencephalography or qEEG brain mapping is a unique, real-time comprehensive assessment of brain electrical activity performed in combination with physiometrics which offers insight to neurophysiological brain-to-body function. Brain neuroplasticity has been associated with differences in musculoskeletal performance among athletes, however comparative real-time normal data to benchmark performance capabilities is limited., Purpose/design: This prospective, descriptive case series evaluated performance of task-driven activities using an innovative neurophysiological assessment technique of qEEG monitored neurophysiological responses to establish a comparative benchmark of performance capabilities in healthy, uninjured Division-I athletes., Methods: Twenty-eight healthy uninjured females (n=11) and males (n=17) NCAA Division-I athletes participated in real-time neurophysiological assessment using a Bluetooth, wireless 21-channel dry EEG headset while performing functional activities., Results: Uninjured athletes experienced standard and regulated fluctuations of brain wave activity in key performance indicators of attention, workload capacity and sensorimotor rhythm (SMR) asymmetries., Conclusion: qEEG neurophysiological real-time assessment concurrent with functional activities in uninjured, Division-I athletes may provide a performance capability benchmark. Real-time neurophysiological data can be used to monitor athletes' preparedness to participate in sport, rehabilitation progressions, assist in development of injury prevention programs, and return to play decisions. While this paper focuses on healthy, uninjured participants, results underscore the need to discen pre-injury benchmarks., Level of Evidence: 4., (© The Author(s).)

Context: In kidney therapy (KT) decisions, goal-concordant decision-making is recognized to be important, yet alignment with patients' goals during dialysis initiation is not always achieved., Objectives: To explore older patients' and caregivers' hopes, goals, and fears related to KT and communication of these elements with members of their health care team., Methods: The study included patients aged ≥75 years with an estimated glomerular filtration rate ≤25 mL/min/1.73 m2 and their caregivers enrolled in a palliative care intervention for KT decision-making. Patients and caregivers were asked open-ended questions about their hopes, goals, and fears related to KT decisions. A survey assessed if patients shared their goals with members of their health care team. Qualitative data underwent content analysis, supplemented by demographic descriptive statistics., Results: The mean age of patients (n = 26) was 82.7 (±5.7) years, and caregivers (n = 15) had a mean age of 66.4 (±13.7) years. Among the participants, 13 patients and 11 caregivers were women, and 20 patients and 12 caregivers were White. Four themes emerged: (1) Maintaining things as good as they are by avoiding dialysis-related burdens; (2) seeking longevity while avoiding dialysis; (3) avoiding pain, symptoms, and body disfigurement; and (4) deferring decision-making. Patients rarely had shared their goals with the key members of their health care team., Conclusion: Patients and caregivers prioritize maintaining quality of life, deferring decision-making regarding dialysis, and avoiding dialysis-related burdens. These goals are often unshared with their family and health care teams. Given our aging population, urgent action is needed to educate clinicians to actively explore and engage with patient goals in KT decision-making., 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.

Background: In non-nephrology settings, specialty Palliative Care (PC) improves decision-making, patient's quality of life (QoL), advance care planning (ACP), and certain indicators of the quality of end-of-life (EoL) care. This pilot RCT explored the feasibility and acceptability of a PC intervention, CKD-EDU, for older adults ≥75 years with eGFR ≤25 ml/min and their caregivers., Methods: Participants randomized to the control group received standard nephrology care and routine kidney therapy (KT) education, while those randomized to CKD-EDU received a decision aid and met with a PC clinician up to three times to discuss KT decisions and EoL planning. Patients were assessed at baseline, 4-6, 12-14, and 24-26 weeks. Main outcomes included intervention feasibility and acceptability, decision-conflict, and patient QoL. The mediating effects of reduced decision conflict on improved QOL were explored, as were the effects of CKD-EDU on ACP, EoL treatment intensity and 6-month-hospitalization. Statistical analyses encompassed descriptive analyses, adjusted repeated-measure-models, mediation analyses and logistic-regression models., Results: Among the 127 eligible patients screened, 58 (44%) consented: 30 were randomized to CKD-EUD and 28 to the control arm. All patients completed baseline assessments, and 89% completed at least one intervention session (n=26/29), underscoring intervention adherence and feasibility. Similarly, assessments completion rates at 4 (83%, n=45/54) ), 12 (93%, n=42/45), and 24 (95%, n=40/42) weeks were high. The intervention received over 85% acceptability ratings for all questions. Patients exposed to CKD-EDU exhibited significant improvement in decisional conflict scale scores (P = 0.003) at 4-6 weeks and improvements in QoL at 24-26 weeks (P=0.02). Exploratory analyses were not statistically significant in this pilot, but all effect sizes were in the predicted direction., Conclusion: This study demonstrates the feasibility and acceptability of CKD-EDU. A larger scale trial is warranted to assess its effectiveness in improving key outcomes important to patients and families., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology.)

Background: Any surgical procedure carries a risk for venous thromboembolism (VTE), albeit variable. Improvements in medical and surgical practices and the shortening of care pathways due to the development of day surgery and enhanced recovery after surgery, have reduced the perioperative risk for VTE., Objective: A collaborative working group of experts in perioperative haemostasis updated in 2024 the recommendations for the Prevention of perioperative venous thromboembolism published in 2011., Methods: The addressed questions were defined by 40 experts (GIHP, SFAR, SFTH and SFMV) and formulated in a PICO format. They performed the literature review and formulated recommendations according to the Grading of GRADE system. Recommendations were then validated by a vote determining the strength of each recommendation. Of note, these recommendations do not cover all surgical specialties. Especially, thromboprophylaxis in cardiac surgery, neurosurgery and obstetrics is not addressed., Results: 78 recommendations were formalized into 17 sections, including patient-related VTE risk factors, types of surgery, extreme body weight, renal impairment, mechanical prophylaxis, distal deep vein thrombosis; 27 were found to have a high level of evidence (GRADE 1) and 41 a low level of evidence (GRADE 2) and 10 were expert opinion. All had strong agreement among the experts., Conclusions: These guidelines help to weigh the perioperative risk for VTE (which includes the risk associated to surgery and the patient-related risk) against the adverse effects of thromboprophylaxis, either pharmacological or mechanical. This includes particularly the bleeding risk induced by antithrombotic drugs as well as costs., (Copyright © 2024. Published by Elsevier Masson SAS.)

Health care disparities refer to differences in health and health care between groups that are closely associated with governmental, social, economic, and/or environmental policies. To address this gap in knowledge, a forum to address health disparities in different regions of the world was developed as an American Academy of Allergy, Asthma & Immunology (AAAAI) presidential initiative (under Dr Jonathan Bernstein) in partnership with the World Allergy Organization to better understand political and socioeconomic issues within different countries and how they affect their health care systems. The first region selected was the Middle East. Representatives from Egypt, Israel, Lebanon, and Iran were invited to speak at this forum. Although we were not able to be inclusive of all countries in this region, it is apparent that the health care systems for those that participated are heterogeneous as a result of socioeconomic, educational, and governmental infrastructures. However, all regions noted health disparities that appeared to be linked to social determinants of health. Unfortunately, conflict in this region has had an additional adverse effect on these health care systems, making solutions even more challenging. However, recognition of the problems that loom large for allergy/immunology in particular can provide an opportunity for international collaboration that focuses on providing patient and physician education and identifying strategies to improve access to specialized health care., Competing Interests: Supported by the AAAAI and WAO. Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest., (© 2024 The Author(s).)

Background and Purpose: The 2014 Clinical Education (CE) Summit and subsequent scholarly work prompted development of collaborative, mutually beneficial, innovative processes to mitigate CE challenges and inefficiencies. Contemporary practice advocates for collaboration among physical therapist (PT) academic programs (Programs) and clinical partners (Partners) to create a sustainable placement process with mutual benefits for stakeholders. The purpose of this article is to describe the design and implementation of the Ohio Kentucky Consortium of Physical Therapy Educators (Consortium) Consortium Core Network's (CCN) centralized PT CE Placement Process (PT-CEPP) model and share participants' experience perspectives., Methods/model Description and Evaluation: The Consortium established the CCN and a Steering Committee, representing stakeholders, and designed a novel 5-phase centralized PT-CEPP model, in Exxat, an educational management platform. The phases included Request, Offer, Placement, Reallocation, and Confirmation and Release. A postimplementation Qualtrics survey was disseminated to obtain participant perspectives. Open-text survey responses were compiled, reviewed, thematically analyzed, and presented in this article (part 1). The resulting quantitative CCN PT-CEPP analyses were deferred to a companion article (part 2)., Outcomes: The CCN participation included invited Partners (n = 101/364; 28%) and Programs (n = 14/14; 100%). During initial PT-CEPP implementation, 1,005 offers resulted in 549 CE placements. Participant perspectives from 20 of 101 SCCEs (20%) and eight of 14 DCEs (57%) were dichotomized into "Benefits and What Worked Well" and "Challenges and What Did Not Work Well." Perspectives were unique to participant roles, with partners valuing "centralization" and Programs "process.", Discussion and Conclusions: Lessons gleaned from the PT-CEPP paradigm shift to a CCN-centralized model may optimize processes and improve sustainability with future iterations., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Academy of Physical Therapy Education, APTA.)

Background and Purpose: It has been suggested that capacity for physical therapy clinical education (CE) experiences is limited; however, data remain unavailable. Regional CE networks have been suggested and may facilitate data collection and management of capacity issues. The Ohio Kentucky Consortium of Physical Therapy Programs developed a Consortium Core Network (CCN) from shared partnerships and implemented a centralized placement process. The purpose of this case report is to begin to describe the capacity of one regional consortium in terms of its demand, supply, and utilization of CE experiences., Case Description: A centralized placement process was implemented in 2022 using Exxat while retaining autonomy for sites and programs. Sites affiliated with 2 or more of the Consortium's 14 physical therapist academic programs (n = 364) were invited to participate, with 101 opting in. Academic programs maintained their individual processes with nonparticipants., Outcomes: Data obtained provide a description of regional CE capacity for 2023. Demand was 2353 CE experiences; total supply obtained was 4,193, with 19% offered on a "first-come, first-served" basis and 24% obtained through the CCN. Within the centralized process, all academic programs received offers. Outpatient (66%) and terminal experiences (42%) were most plentiful. Overall utilization of CCN offers was 54%, with greater use of inpatient (82%), first (68%), and program-specific (63%) offers., Discussion and Conclusion: This collaborative process provided novel data valuable in understanding regional physical therapist CE capacity. Although the total supply obtained seems to exceed demand, alignment between offer type (level, setting, "first-come, first-served" designation) and needs of individual programs and students must be considered further., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Academy of Physical Therapy Education, APTA.)

The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own lives based on their lived experiences. Improving healthcare safety, quality, and coordination, as well as quality of life, is an important aim in the care of patients with chronic conditions. Person-centered care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (1) digital care pathways for rhinitis and asthma multimorbidity and (2) digitally enabled, person-centered care. 1 It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally enabled, patient-centered care. The paper includes (1) Allergic Rhinitis and its Impact on Asthma (ARIA), a 2-decade journey, (2) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (3) mHealth impact on airway diseases, (4) From guidelines to digital care pathways, (5) Embedding Planetary Health, (6) Novel classification of rhinitis and asthma, (7) Embedding real-life data with population-based studies, (8) The ARIA-EAACI (European Academy of Allergy and Clinical Immunology) strategy for the management of airway diseases using digital biomarkers, (9) Artificial intelligence, (10) The development of digitally enabled, ARIA person-centered care, and (11) The political agenda. The ultimate goal is to propose ARIA 2024 guidelines centered around the patient to make them more applicable and sustainable., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The SrFeO 3 nanoparticles doped with 5% and 10% Gd were synthesized using the solution combustion method. The phase formation of the synthesized nanoparticles was confirmed by powder x-ray diffraction analysis. Field emission scanning electron microscope and HRTEM were employed to examine the morphology of the samples, revealing well-ordered, agglomerated nanoparticles. Energy dispersive x-ray spectroscopy analysis was conducted on all samples, confirming the presence of the desired elements. X-ray photoelectron spectroscopy confirmed the presence of mixed oxidation states of Fe 3+ and Fe 4+ . Magnetization studies, performed using a SQUID magnetometer, showed ferromagnetic behaviour in all samples, with a significant increase in magnetic moment observed with higher Gd doping. The enhanced magnetic moments and reduced coercivity in Gd-doped SrFeO 3 suggest that these materials could be suitable for spintronic applications., (© 2024 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

Introduction: Atrial fibrillation (AF) is the most common type of arrythmia affecting approximately 1-2 % of the adult population. Patients with an underlying history of atrial fibrillation have a greater chance of developing venous thromboembolism (VTE). Likewise, patients with VTE are at increased risk for AF. There has been conflicting evidence on the prognostic impact of AF in acute pulmonary embolism (PE) patients. The aim of this retrospective cohort study was to estimate the impact of AF on the clinical outcomes of hospitalization for PE., Method: The 2016-2021 National Inpatient Sample database was searched for adult patients hospitalized with PE with associated history of AF as the principal discharge diagnosis. The primary outcome was inpatient mortality, while the secondary outcomes were length of stay (LOS), total hospital charge (THC), cardiogenic shock, acute respiratory failure, in-hospital cardiac arrest (IHCA). The outcomes were analyzed using multivariable logistic and linear regression analyses., Results: A total of 1,128,269 patients were admitted for PE, 12.4 % of whom had underlying AF. The AF and non-AF cohorts had a mean age of 73.6 years and 61.6 years, respectively. PE patient with AF had significantly higher mortality compared to non-AF patients with PE (6.05 % vs 2.75 %, adjusted odds ratio of 1.67 [95 % CI 1.56-1.79; p  < 0.0001]). The PE with AF cohort had increased odds of cardiac arrest, cardiogenic shock, respiratory failure requiring intubation, higher average length of stay (5.66 days vs 4.18 days, P  < 0.001) and a higher total hospital cost (65,235 vs 50,118, P < 0.001)., Conclusion: AF was associated with increased inpatient mortality and worse clinical outcomes in hospitalization for acute PE., Competing Interests: All Authors declare no competing financial or non-financial interest., (© 2024 The Authors.)

Rationale & Objective: Older adults in the United States often receive kidney therapies that do not align with their goals. Palliative care (PC) specialists are experts in assisting patients with the goals of care discussions and decision support, yet views and experiences of older patients who have received PC while contemplating kidney therapy decisions and their nephrologists remain unexplored. We evaluated the acceptability of CKD-EDU, a PC-based kidney therapy decision support intervention for adults ≥75 years of age., Study Design: Qualitative study., Setting & Participants: Two trained research coordinators interviewed patients and nephrologists participating in the CKD-EDU study., Analytical Approach: Three coders analyzed the qualitative data using a thematic analysis approach to identify salient themes pertaining to intervention acceptability., Results: Patients (n = 19; mean age: 80 years) viewed the PC intervention favorably, noting PC physicians' excellent communication skills, whole-person care, and decision-making support, including comprehension of prognostic information. Nephrologists (n = 24; mean age) welcomed PC assistance in decision making, support for conservative kidney management, and symptom management; a minority voiced concerns about third-party involvement in their practice., Limitations: Single-center study., Conclusions: Overall, patients and nephrologists generally found the PC intervention to be acceptable. Future testing of the current PC-based decision support intervention in a larger randomized controlled trial for older people navigating kidney therapy decisions is needed., (© 2024 The Authors.)

Rapid automatized naming (RAN) has surged in popularity recently as an important indicator of reading difficulties, including dyslexia. Despite an extensive history of research on RAN, including recent meta-analyses indicating a unique contribution of RAN to reading above and beyond phonemic awareness, questions remain regarding RAN's relationship to reading. Specific questions exist regarding how PA mediates that relationship and how best to use data from RAN measures to identify risk for reading failure. Through multiple studies, we demonstrate that RAN is not merely subsumed by skills typically assessed when conducting universal screening for reading difficulties (i.e., phonemic segmentation fluency and letter naming fluency), but contributes unique information above and beyond these measures. Additionally, we discuss the process for the development of cut points for risk for Acadience RAN, along with guidance regarding how educators can interpret RAN scores as an indicator of risk for future reading difficulties. The results presented here support the idea that difficulties associated with RAN are not merely reflections of difficulties with other early literacy skills typically assessed during universal screening, but constitute separate and distinct difficulties that may precipitate later reading problems., (© 2024. The Author(s), under exclusive licence to The International Dyslexia Association.)

Soil-transmitted helminthiases (STH) are among the neglected tropical diseases and infect more than 24% of the world population. The World Health Organization recommends regular monitoring of STH's prevalence and intensity following mass drug administrations to evaluate their effectiveness and inform future control strategies. This study evaluated the prevalence, intensity, and risk factors of STH infections among school children aged 6 to 14 years old in northwestern Tanzania. A cross-sectional study was conducted among 728 school children in the Kagera region in 2021. Participants were selected using a two-stage cluster sampling method. A questionnaire was used to collect data on the risk factors. Stool samples were examined using the Kato-Katz technique. The data were analysed using STATA. The overall prevalence of STH was 56.2% (95% CI: 52.5-59.8, 409/728). About 5.7% and 1.1% of the infected children had moderate-intensity infections with Ascaris lumbricoides and Trichuris trichiura, respectively. Risk factors included the mother's occupation as a farmer (aOR: 1.2, p = 0.002) and not washing hands with water and soap (aOR: 1.4, p = 0.035). Washing one's hands after using the toilet (aOR: 0.6; p = 0.024) is a preventive measure against STH infections. STH was prevalent in the study area. The mother's occupation (farmer) and the lack of handwashing with water and soap influenced STH transmission. Conversely, washing hands after visiting the toilet and after playing with soil reduced the risk of STH infection.

This study explores the challenge of antimicrobial resistance by investigating the utilization of zinc oxide (ZnO) and copper oxide (Cu 2 O) nanoparticles (NPs) to combat antibiotic-resistant bacteria in wastewater treatment plants (WWTPs). The synthesized metal oxide NPs underwent thorough characterization through various analytical techniques, confirming their nanoparticulate nature. Electronic absorption and X-ray diffraction (XRD) analyses revealed successful reduction processes and crystalline properties, respectively. Fourier transform infrared spectroscopy (FTIR) results indicated the stabilization of nanoparticles in solution. Scanning electron microscopy (SEM) observations revealed well-defined spherical and flower-like morphologies for the zinc and copper oxide nanoparticles, with sizes approximately ranging from 50 nm to 25 nm Notably, the synthesized nanoparticles exhibited heightened efficacy in impeding biofilm formation, with zinc oxide NPs displaying superior antibacterial activity compared to copper. These findings suggest the promising potential of these nanoparticles in controlling antibiotic-resistant organisms, even following WWTP treatment processes. This research contributes to the ongoing advancements in nanotechnology aimed at combating antibiotic resistance, offering new prospects for the development of effective wastewater treatment strategies.

Background: Type 2 Diabetes Mellitus (T2DM) represents a significant and pressing worldwide health concern, necessitating the quest for enhanced antidiabetic pharmaceuticals. Guanidine derivatives, notably metformin and buformin, have emerged as pivotal therapeutic agents for T2DM management., Aims: The present study introduces an efficient one-pot synthesis method for the production of symmetrical guanidine compounds., Methods: This synthesis involves the reaction of isothiocyanates with secondary amines, employing an environmentally friendly and recyclable reagent, tetrabutylphosphonium tribromide (TBPTB)., Results: A comprehensive assessment of the biological activity of the synthesized guanidine compounds, specifically in the context of T2DM, has been rigorously conducted., Conclusion: Additionally, computational analyses have unveiled their substantial potential as promising antidiabetic agents. Results highlight the relevance of these compounds in the ongoing pursuit of novel therapeutic solutions for T2DM.

Objective: Subclinical leaflet thrombosis (SLT) develops in 15% of patients undergoing trans-catheter aortic valve replacement (TAVR). TAVR is a procedure in which a faulty aortic valve is replaced with a mechanical one. An aortic valve replacement can be done with open-heart surgery; this is called surgical aortic valve replacement (SAVR). A significant problem is defining the best course of treatment for asymptomatic individuals with SLT post-TAVR, including the use of oral anticoagulation (OAC) in it., Study Design: Systematic review., Method: The most pertinent published research (original papers and reviews) in the scientific literature were searched for and critically assessed using the online, internationally indexed databases PubMed, Medline, and Cochrane Reviews. Keywords like "Transcatheter valve replacement" and "Subclinical leaflet thrombosis" were used to search the papers. Selected studies were critically assessed for inclusion based on predefined criteria., Results: The review examined the prevalence and characteristics of SLT after TAVR. To note, the incidence of SLT is seen to be higher in TAVR compared SAVR. Dual antiplatelet therapy, which is utilized in antithrombotic regimens post-TAVR, can possibly hasten SLT progression which could result in the impaired mobility of leaflets and the worsening of pressure gradients., Conclusion: The use of dual antiplatelet drugs in routine antithrombotic therapy tends to accelerate initial subclinical leaflet thrombosis after TAVI, which results in a developing restriction of leaflet mobility and an increase in pressure differences., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Introduction: Effective academic-clinical partnerships require a greater understanding of how academic programs can best support clinical education (CE) faculty. This study aimed to determine resources and support that clinical partners need., Review of Literature: As the number of physical therapist (PT) programs, cohort sizes, and CE weeks have risen, so has demand for CE sites. Conversely, staffing reductions, increased administrative duties, and rising productivity expectations have decreased the time available for clinical instruction. To promote a successful CE experience, there must be a renewed understanding of CE faculty needs., Subjects: Clinical education faculty affiliated with any of the 8 contributing programs from the Ohio-Kentucky Consortium participated in survey research (n = 24) and subsequent interview (n = 4) and focus group (n = 6) research., Methods: Constructivist grounded theory design was used to explore the needs of CE faculty. Academic and clinical partners developed the initial survey and used survey results to establish interview questions. The investigators iteratively assessed data saturation and clarity of results of coded survey, interview, and focus group data to determine whether the study's aims of identifying CE faculty needs had been met., Results: The aggregated results yielded 5 main themes of Director of Clinical Education support for CE faculty needs: student readiness for CE experience; effective academic-clinical partner communication; collaborative management of exceptional students; judicious standardization of CE processes; and provision of CE faculty development resources., Discussion and Conclusion: Clinical education faculty have noted challenges that affect their ability to mentor students. They want academic programs to be more collaborative and proactive with communication, resources, and support. Future research should address aids and barriers to proactive communication, resource provision, and academic-clinical partner collaboration., Competing Interests: The authors report no conflict of interest., (Copyright © 2024 Academy of Physical Therapy Education, APTA.)

Background: Primary care in the US faces challenges with clinician recruitment, retention, and burnout, with further workforce shortages predicted in the next decade. Team-based care can be protective against clinician burnout, and opportunities for interprofessional education (IPE) on professional development and leadership could encourage primary care transformation. Despite an increasingly important role in the primary care workforce, IPE initiatives training physician assistants (PAs) alongside physicians are rare. We describe the design, curriculum, and outcomes from an interprofessional primary care transformation fellowship for community-based primary care physicians and PAs., Methods: The Community Primary Care Champions (CPCC) Fellowship was a one-year, part-time fellowship which trained nine PAs, fourteen physicians, and a behavioralist with at least two years of post-graduate clinical experience in six content pillars: quality improvement (QI), wellness and burnout, mental health, social determinants of health, medical education, and substance use disorders. The fellowship included a recurring schedule of monthly activities in self-study, lectures, mentoring, and community expert evening discussions. Evaluation of the fellowship included pre, post, and one-year follow-up self-assessments of knowledge, attitudes, and confidence in the six content areas, pre- and post- wellness surveys, lecture and discussion evaluations, and midpoint and exit focus groups., Results: Fellows showed significant improvement in 24 of 28 self-assessment items across all content areas post-fellowship, and in 16 of 18 items one-year post-fellowship. They demonstrated reductions in emotional exhaustion and depersonalization post-fellowship and increased confidence in working in interprofessional teams post-fellowship which persisted on one-year follow-up assessments. All fellows completed QI projects and four presented their work at national conferences. Focus group data showed that fellows experienced collaborative, meaningful professional development that was relevant to their clinical work. They appreciated the flexible format and inclusion of interprofessional community experts in evening discussions., Conclusions: The CPCC fellowship fostered an interprofessional community of practice that provided an effective IPE experience for physicians and PAs. The learning activities, and particularly the community expert discussions, allowed for a flexible, relevant experience, resulting in personal and professional growth along with increased confidence working within interprofessional teams., (© 2024. The Author(s).)

We prepared a naturally occurring flavanoid namely quercetin from tea leaves and analyzed by Absorption, Emission, FT-IR, 1 H, 13 C nmr spectra and ESI-MS analysis. The inclusion behavior of quercetin in cyclodextrins like α-, β-, γ-, per-6-ABCD and mono-6-ABCD cavities were supported such as UV-vis., Emission, FT-IR and ICD spectra and energy minimization studies. From the absorption and emission results, the type of complexes formed were found to depend on stoichiometry of Host:Guest. FT-IR data of CD complexes of quercetin supported inclusion complex formation of the substrate with α-, β- and γ-CDs. The inclusion of host-guest complexation of quercetin with α-, β-, γ-CDs, per-6-ABCD and mono-6-ABCDs provides very valuable information about the CD:quercetin complexes, the study also shows that β-CD complexation improves water solubility, chemical stability and bioavailability of quercetin. Besides, phase solubility studies also supported the formation of 1:1 drug-CD soluble complexes. All these spectral results provide insight into the binding behavior of substrate into CD cavity in the order per-6-ABCD > Mono-6-ABCD > γ-CD > β-CD > α-CD. The proposed model also finds strong support from the fact with excess CD this exciton coupling disappears indicates the formation of only 1:1 complex., 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 B.V. All rights reserved.)

Background: The use of marijuana, derived from the Cannabis plant, has a lengthy history dating back thousands of years. With the recent legalization of marijuana in many US states, concerns about its health effects have grown. Despite traditional beliefs in its cardioprotective properties, there is a rising incidence of marijuana-induced pericarditis. This article presents a case that highlights the potential connection between marijuana use and cardiac complications. We herein present a case of a 30-year-old male with habitual marijuana use coming in with pericarditis., Case: A 30-year-old male, a habitual marijuana user, presented to the emergency department with recurrent chest pain and shortness of breath. Notably, similar episodes were resolved when he abstained from marijuana. Diagnostic findings upon admission included elevated inflammatory markers, EKG showing diffuse ST segment elevations and PR depressions, echocardiographic evidence of pericardial effusion and EKG consistent with pericarditis. After excluding other causes, marijuana was identified as the likely trigger for his cardiac symptoms., Decision Making: NSAIDS and colchicine were started at therapeutic doses for the patient. Cardiology and Cardiothoracic Surgery were consulted. No drainage was planned as patient was clinically stable and improved with medical management alone., Conclusion: The emerging link between marijuana use and pericarditis presents a unique clinical challenge. Comprehensive population-based studies are needed to understand the cardiovascular implications of marijuana use and to develop appropriate management guidelines. Clinicians should approach marijuana use cautiously, considering potential cardiovascular risks, and remain vigilant for pericarditis as a potential consequence of marijuana use during patient evaluations., Competing Interests: Conflict of interest: The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication., (© 2024 Greater Baltimore Medical Center.)

Objective: Several studies have previously assessed the value of changes in the fetal adrenal gland to predict preterm labor. The aim of this study is to evaluate the correlation between fetal adrenal gland measurements after 36 weeks and obstetrical outcomes., Methods: Abdominal two-dimensional (2D) ultrasound is used to measure in the transversal plane the length of fetal zone (D1), the width (D2), and the length (D3) of fetal adrenal gland, and, subsequently, the fetal zone enlargement (FZE), in 98 primigravida women after 36 weeks. Labor and delivery outcomes were assessed and compared with these measurements., Results: FZE changes had no association with spontaneous onset of labor. No association was found between all adrenal gland measurements and delivery onset. There was a significant relationship between D1, D2, and D3 and the delivery method. Patients delivered by cesarean section had smaller fetal adrenal gland dimensions, defining D1= 0.16 cm, D2 = 0.7 cm, and D3 = 2.37 cm as cutoff levels based on receiver operator characteristics curves., Conclusion: The 2D measurement of the fetal adrenal gland after 36 weeks seems to predict the delivery method in low-risk primigravida women., Key Points: · We evaluate fetal adrenal gland measurements after 36 weeks versus the obstetrical outcome.. · No association was found between all adrenal gland measurements and delivery onset.. · Patients delivered by cesarean section had smaller fetal adrenal gland dimensions.., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: Our objective is to evaluate ultrasound differences in uterine scar between techniques using extramucosal suturing and full thickness suturing of the uterine incision., Study Design: A retrospective observational study included cases of primary cesarean section. At 6-week postpartum, we evaluated by endovaginal ultrasound two elements in the sagittal view: the thickness of the uterine scar and the surface of defect (niche). Hysterotomy sites closed using a running full-thickness technique including the uterine mucosa (group 1) were compared to hysterotomies operated by the same surgeon but with extramucosal suturing (group 2). The operator switched from the running suture technique to extramucosal in 2013., Results: The study included 241 patients (115 cases in group 1 that were compared to 126 cases in group 2). There were no significant differences in age or body mass index between the two groups. Cesarean scar and niche were detectable in the entire studied population. There was a significant difference in both uterine scar thickness (5.8 vs. 6.2 mm, p  = 0.02) and the presence and size of the niche (49 vs. 40 mm 2 , p  = 0.001) in transvaginal ultrasound performed at 6-week postpartum., Conclusion: Extramucosal suturing of the uterine scar seems to be associated with a better outcome on the postpartum ultrasound evaluation., Key Points: · The technique for suturing the hysterotomy can be the source of healing changes.. · An extramucosal suturing of the uterus seems to give a better aspect at the postpartum ultrasound.. · Decreasing the niche at cesarean scar may be beneficial for future pregnancies.., Competing Interests: None declared., (Thieme. All rights reserved.)

Soil-transmitted helminth (STH) infections are caused by roundworms, hookworms, whipworms, and thread worms. Accurate diagnosis is essential for effective treatment, prevention, and control of these infections. This study evaluates a new diagnostic method called Single-image Parasite Quantification (SIMPAQ), which uses a lab-on-a-disc (LoD) technique to isolate STH eggs into a single imaging zone for digital analysis. The study evaluates the purification performance of the SIMPAQ technique for detecting STH eggs in animal samples. This was a cross-sectional study conducted among 237 pigs and 281 dogs in the Morogoro region in Tanzania. Faecal samples were collected and processed with the LoD technique, as well as flotation and McMaster (McM) methods for comparison purposes. The overall prevalence of STH infections was high as per the LoD technique (74%), followed by McM (65.44%) and flotation (65.04%). Moreover, the overall performance of the LoD technique, using McM as the gold standard, was 93.51% (sensitivity), 60.89% (specificity), 81.91% (PPV), and 83.21% (NPV). The LoD technique exhibited high prevalence, sensitivity, and NPV, which demonstrates its value for STH egg detection and its crucial role in the era of accurate STH diagnosis, promoting proper management of the infection.

Introduction: This study focuses on the gas chromatography-mass spectrometry (GC-MS) analysis of Kabasura Kudineer, a Siddha formulation renowned for its properties against cold and exclusively utilized during the coronavirus disease 2019 (COVID-19) pandemic., Methods: The medication was obtained from a reputable Siddha vendor in Chennai, India, and subsequently extracted and subjected to GC-MS analysis., Results: The GC-MS profiling revealed the presence of several molecules, including benzoic acid, eugenol, alpha-ylangeneol, trans-2,4-dimethylthiane, S, S-dioxide, humulene, methyl 4,7,10,13-hexadecatetraenoate, 17-octadecynoic acid, 1-hexadecyn-3-ol, 3,7,11,15-tetramethyl, sulfurous acid, butyl heptadecyl ester, chloroacetic acid, tetradecyl ester, n-propyl cinnamate, oleyl alcohol, trifluoroacetate, 1-heptatriacotanol, and fenretinide. These compounds exhibit expansive medicinal roles., Conclusion: Kabasura Kudineer emerges as a highly effective remedy for cold-related ailments, particularly owing to the presence of bioactive compounds such as eugenol and humulene. These constituents play pivotal roles in antimicrobial and anti-inflammatory activities. Further investigations into the individual medicinal efficacy of each identified molecule are warranted to substantiate the therapeutic potential of Kabasura Kudineer, providing valuable insights for future applications., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: The scientific validity of contemporary and alternative medicinal practices, such as Ayurveda and Siddha, holds significant importance in today's context., Aim and Objective: The present study employs gas chromatography-mass spectrometry (GC-MS) analysis to investigate a pain-relieving Ayurvedic oil, Dhanwantharam Thailam, aiming to establish correlations between its medicinal activity and the biomolecules it contains., Materials and Methods: Procured sample from a reputable Ayurvedic vendor in Chennai, Dhanwantharam Thailam underwent GC-MS analysis using standard procedures., Results and Discussion: The resulting profile revealed the presence of crucial molecules like oleic acid, dodecanoic acid, 1,2,3-propanetriyl ester, ethenyl ester, and 9,12-octadecadienoyl chloride (Z, Z), aligning with the medicinal properties attributed to Dhanwantharam Thailam., Conclusion: The identification of these biomolecules supports the role of Dhanwantharam Thailamas an effective pain-relieving oil., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: There is a relationship between low back pain (LBP) and central nervous system dysfunction. Needling therapies (e.g. acupuncture, dry needling) are proposed to impact the nervous system, however their specific influence is unclear., Purpose: Determine how needling therapies alter functional connectivity and LBP as measured by functional magnetic resonance imaging (fMRI)., Methods: Databases were searched following PRISMA guidelines. Studies using fMRI on individuals with LBP receiving dry needling or acupuncture compared to control or sham treatments were included., Results: Eight studies were included, all of which used acupuncture. The quality of studies ranged from good (n = 6) to excellent (n = 2). After acupuncture, individuals with LBP demonstrated significant functional connectivity changes across several networks, notably the salience, somatomotor, default mode network (DMN) and limbic networks. A meta-analysis demonstrated evidence of no effect to potential small effect of acupuncture in reducing LBP (SMD -0.28; 95% CI: -0.70, 0.13)., Conclusion: Needling therapies, like acupuncture, may have a central effect on patients beyond the local tissue effects, reducing patients' pain and disability due to alterations in neural processing, including the DMN, and potentially other central nervous system effects. The meta-analysis should be interpreted with caution due to the narrow focus and confined sample used.

Objectives: To analyze the reasons for refusal of aneuploidy screening in a multicultural Middle Eastern population., Methods: The study included patients delivering in a university hospital, who had refused aneuploidy screening during their pregnancy. We evaluated through a questionnaire submitted during the postpartum period the sociodemographic characteristics, beliefs, attitudes, and the main reason underpinning their choice. Religious, ethical, and financial factors, personal beliefs, medical information, perceived media information, and familial input were assessed through a Likert scale., Results: Our pilot study included 70 patients. The main reason (33 %) was the refusal to terminate pregnancy if the screening tests ultimately led to a diagnosis of aneuploidy. Lack of adequate information on the availability and benefits of this screening method (28 %), religious beliefs (17 %), in addition to other minor reasons such as financial considerations, familial recommendations, late pregnancy follow-ups, and media influence were also identified as contributing factors., Conclusions: Aneuploidy screening is routinely offered to couples, with varying uptake rates observed worldwide. Sufficient information on prenatal screening and diagnosis should be provided to all pregnant women, presenting all available options, thus enabling them to make a free and informed choice during their pregnancy., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Vertebral compression fractures (VCFs) can affect the entire spinopelvic complex and cause unpredictable patterns of back pain due to their effects on spinal tensegrity and biomechanical compensation. They can lead to significant morbidity and mortality in the aging population and are difficult to diagnose. We aimed to establish a relationship between VCFs and sacroiliac (SI) joint pain., Objectives: Demonstration of SI joint (SIJ) pain relief at up to 6 months after kyphoplasty (KP) in patients with VCFs and diagnosed SI dysfunction., Study Design: Retrospective study., Setting: All patients were from a private chronic pain and orthopedics practice in the northeastern United States., Methods: Fifty-one patients with VCFs diagnosed through imaging and SIJ dysfunction diagnosed through 2 diagnostic SIJ blocks who had failed conservative management were considered for KP. Numeric Rating Scale (NRS 11) scores were recorded at the baseline, after each SIJ block, and at 4 weeks and then 6 months after KP., Results: Forty-nine patients underwent KP. At 4 weeks after the procedure, there was an 84% average reduction in NRS scores from the baseline (P < 0.01). At 6 months after the procedure, there was an 80% reduction in NRS scores from the baseline (P < 0.01)., Limitations: Larger sample sizes and a randomized control trial would be important steps in furthering the relationship between VCFs and SIJ., Conclusion: VCFs can cause a referred pain pattern to the SIJ that is best treated by KP for long-term management.

There is a lack of consensus over the description and severity assignment of allergic adverse reactions to immunotherapy, although there seems to be a consensus at least in terms of using the World Allergy Organization (WAO) grading systems to describe local adverse events for Sublingual Immunotherapy (SLIT) and Systemic Allergic Reactions (SARs) to Subcutaneous Immunotherapy (SCIT) amongst the major national/regional allergy societies. In this manuscript, we propose a modification of the previous WAO Grading system for SARs, which aligns with the newly-proposed Consortium for Food Allergy Research (CoFAR) Grading Scale for Systemic Allergic Reactions in Food Allergy (version 3.0). We hope this can facilitate a unified grading system appropriate to SARs due to allergen immunotherapy, independent of allergen and route of administration, and across clinical and research practice., (© 2024 The Authors.)

Ticks are blood-feeding arthropods responsible for the transmission of disease-causing pathogens to a wide range of vertebrate hosts, including livestock and humans. Tick-borne diseases have been implicated in significant economic losses to livestock production, and this threat will increase as these obligate parasites widen their geographical ranges. Similar to other ectotherms, thermal stress due to changing global temperatures has been shown to influence tick survival and distribution. However, studies on the influence of extreme temperatures in ticks have focused on advanced, mobile stages, ignoring immobile stages that cannot move to more favorable microhabitats. In this study, low- and high-temperature regimens were assessed in relation to egg viability for hard tick species-Amblyomma maculatum (Gulf Coast tick), Ixodes scapularis (black-legged tick), Dermacentor variabilis (American dog tick), and Rhipicephalus sanguineus (Brown dog tick). Tick eggs exposed early in development (freshly laid during early embryo development) were significantly more susceptible to thermal stress when compared with those exposed later in development (late embryo development denoted by a fecal spot). Based on our studies, differences in egg hatching success among treatments were greater than in hatching success when comparing species. Lastly, there was evidence of extreme thermal exposure significantly altering the hatching times of tick eggs for specific treatments. These results provide insights into the critical period for tick egg viability in relation to thermal exposure and tick survival associated with stress and climate change., (© The Author(s) 2023. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This study investigates a crucial aspect of inventory management, which is the process of replacing failed items. In dynamic commercial environments, it is essential to efficiently and strategically replace failed items to maintain operational efficiency and ensure profitability. We consider a two-commodity retrial queueing-inventory system with vacation interruption. Upon purchasing the first commodity, the second commodity is provided as a complimentary item. In contrast, no item is given as a complimentary for the purchase of the second item. Only the first commodity is stored in a dedicated pooled storage for replacement when it fails. The ( s , Q ) policy governs replenishing the first commodity while the second is replenished through instantaneous ordering. The model considers the multi-component demand rate for customer arrivals. Server vacations are initiated during customer absence in waiting hall or when the first commodity is unavailable. We formulate a level-dependent quasi-birth-and-death process, and its steady-state probability vector is computed using Neuts and Rao's truncation method. The stability condition for the system is derived, and various system performance measures, including expected total cost, number of replaceable items, and customers in the waiting hall and orbit, are established. The comparative analysis between the system with replacement is done with the regular model without replacement, which revealed the efficiency of replacement. The analysis of multi-component demand towards homogeneous arrival highlights the impact of multi-component demand on boosting customer arrival. Also, parametric sensitivity analysis has been conducted numerically over total cost, mean number of failed items for replacement, and mean number of customers in the waiting hall and orbit., Competing Interests: The authors declare that they have no conflicts of interest., (© 2024 The Author(s).)

Background: Moxonidine, an imidazoline I 1 receptor agonist, is an effective antihypertensive drug that was shown to improve insulin sensitivity. RAAS-blockers are recommended as first-line therapy in patients with diabetes, alone or in combination with a calcium-channel antagonist or a diuretic., Aims: This study compared the effects of moxonidine and ramipril on blood pressure (BP) and glucose metabolism in overweight patients with mild-to-moderate hypertension and impaired fasting glucose or type 2 diabetes., Methods: Treatment-naïve patients for hypertension and dysglycemia were randomized to 12 weeks of double-blind moxonidine 0.4 mg or ramipril 5 mg once-daily treatment. At 12 weeks, for a further 12 weeks non-responders received combination of mox/ram, while responders continued blinded treatment., Results: Moxonidine and ramipril were equivalent in lowering SiDBP and SiSBP at the end of the first 12 weeks. The responder rate was approximately 50% in both groups, with a mean SiDBP and SiSBP decrease of 10 and 15 mm Hg in the responders, respectively. The normalization rate (SiDBP < 85 mm Hg) was non significantly different between treatments groups. Moxonidine reduced heart rate (HR) (average -3.5 bpm, p  = 0.017) during monotherapy, and when added to ramipril. HbA1c decreased significantly at Week 12 in both groups. Neither drug affected glucose or insulin response to the oral glucose tolerance test. In non-responders, moxonidine/ramipril combination further reduced BP without compromising metabolic parameters., Conclusion: Moxonidine 0.4 mg and ramipril 5 mg were equally effective on BP lowering and were well tolerated and mostly metabolically neutral either as monotherapies or in combination. HR was lowered on moxonidine treatment., Competing Interests: Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: PV discloses the following potential conflicts of interest: lectures for Abbott, AstraZeneca, Bayer, Eli Lilly, Hikma Pharmaceuticals, Merck Sharp & Dohme, Novo Nordisk, Novartis, Pfizer, Sanofi, Servier; research grants from Abbott, Bristol-Myers Squibb–AstraZeneca, Novo Nordisk; participation in expert committees for AstraZeneca, Boehringer Ingelheim, Novo Nordisk, Daiichi Sankyo, Sanofi, Servier.

Objective: Breast conserving surgery is an excellent option in the treatment of breast cancer. To achieve a good result with this modality, a surgeon needs to identify and excise the tumor with adequate margins. The radiofrequency identification (RFID) technique is a wireless localization technique used for intraoperative breast lesion identification. We assessed the efficacy and outcomes of the RFID technique in breast cancer patients at our institution., Materials and Methods: This is a single institution, retrospective study (BSMH 22-02X-MWH) of 73 patients. We analyzed the medical records of women with biopsy-proven breast cancer from June 2020 to August 2022; participants received surgical care at Mercy Health West Hospital. Data collected included demographics, clinicopathological characteristics, and surgical procedure. The primary objective was to determine the safety and efficacy of RFID. The secondary objective was to assess the impact of obesity and breast density on the RFID outcomes., Results: A total of 73 female patients met the eligibility criteria with stage I (59%) and grade 1 (51%) breast cancer with mean age of at diagnosis of 66.8 years and mean body mass index of 31.4 kg/m2. Patients had invasive ductal carcinoma (61%), hormonal positive (56%), and human epidermal growth factor receptor 2 negative (68%) disease. All RFID tags were placed under image guidance with 100% accuracy of placement with no evidence of migration or procedure revision. Ninety percent of patients had free surgical margins and only seven patients needed margin re-excision with successful removal of the lesion and the tag., Conclusion: RFID localization technique is a safe, effective and reliable procedure that results in favorable patient outcomes and quality of life., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (©Copyright 2024 by the Turkish Federation of Breast Diseases Societies / European Journal of Breast Health published by Galenos Publishing House.)

Purpose: There is a shortage of available methods to accurately inform the developmental status of children whose cultural and linguistic backgrounds vary from the mainstream. The purpose of this review article was to describe different approaches used to support the accurate characterization of speech, language, and functional communication in children speaking Jamaican Creole and English, an understudied paradigm in the speech pathology research., Method: Approaches used across four previously published studies in the Jamaican Creole Language Project are described. Participants included 3- to 6-year-old Jamaican children ( n = 98-262) and adults ( n = 15-33). Studies I and II described validation efforts about children's functional communication using the Intelligibility in Context Scale (ICS; speech) and the Focus on the Outcomes of Communication Under Six (FOCUS; speech and language). Study III described efforts to accurately characterize difference and disorder in children's expressive grammar using adapted scoring, along with adult models to contextualize child responses. Last, Study IV applied acoustic duration (e.g., whole word) and an adapted scoring protocol to inform variation in speech sound productions in the Jamaican context where a post-Creole continuum exists., Results: Studies I and II offered promising psychometric evidence about the utility of the ICS and the FOCUS. Study III revealed strong sensitivity and specificity in classifying difference and disorder using adult models. Last, in Study IV, linguistically informed acoustic analyses and an adapted protocol captured variation in speech productions better than a standard approach., Conclusions: Applying culturally responsive methods can enhance the accurate characterization of speech, language, and functional communication in Jamaican children. The innovative methods used offer a model approach that could be applied to other linguistic contexts where a mismatch exists between speech-language pathologists and their clientele., Presentation Video: https://doi.org/10.23641/asha.23929461.

This practice guideline follows the mission of the World Association of Perinatal Medicine in collaboration with the Perinatal Medicine Foundation, bringing together groups and individuals throughout the world, with the goal of improving the management of preterm labor. In fact, this document provides further guidance for healthcare practitioners on the appropriate use of examinations with the aim to improve the accuracy in diagnosing preterm labor and allow timely and appropriate administration of tocolytics, antenatal corticosteroids and magnesium sulphate and avoid unnecessary or excessive interventions. Therefore, it is not intended to establish a legal standard of care. This document is based on consensus among perinatal experts throughout the world in the light of scientific literature and serves as a guideline for use in clinical practice., 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 © 2023 Elsevier B.V. All rights reserved.)

Unlike the mechanism of ballistospore discharge, which was not solved until the 1980s, the operation of asci as pressurized squirt guns is relatively straightforward and was understood in the nineteenth century. Since then, mycologists have sought to understand how structural adaptations to asci have allowed the ascomycetes to expel spores of different shapes and sizes over distances ranging from a few millimeters to tens of centimeters. These modifications include the use of valves at the tips of asci that maintain ascus pressure and expel spores at the highest speeds, and gelatinous appendages that connect spores after release and create larger projectiles with greater momentum than single spores. Clever experiments in the twentieth century coupled with meticulous microscopic studies led investigators to understand how asci with complicated apical structures worked and mathematical models produced estimates of launch speeds. With the recent application of high-speed video microscopy, these inferences about ascus function have been tested by imaging the motion of spores on a microsecond timescale. These experiments have established that ascospore discharge is the fastest fungal movement and is among the fastest movements in biology. Beginning with the history of the study of asci, this review article explains how asci are pressurized, how spores are released, and how far spores travel after their release. We also consider the efficiency of ascospore discharge relative to the mechanism of ballistospore discharge and examine the way that the squirt gun mechanism has limited the morphological diversity of ascomycete fruit bodies., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: Lumbar kyphosis occurs in approximately 8-20% of patients with myelomeningocele (MMC). The purpose of this article is to analyze the risks and benefits of vertebrectomy and spinal stabilization in MMC children with severe lumbar kyphosis and to establish treatment guidelines., Methods: This is an IRB-approved retrospective analysis of 59 patients with MMC who underwent kyphectomy and posterior instrumentation in three centers. Average age at surgery was 7.9 years (2 weeks-17 years). Sitting trunk position, skin status, kyphosis angle, and thoracic lordosis were analyzed preoperatively, postoperatively, and at an average follow-up of 8.2 years (range 2.5-16). The correction was maintained by applying a short posterior instrumentation in 6 patients, and extending to the pelvis in 53 cases. Pelvic fixation was achieved using the Warner and Fackler technique in 24 patients, the Dunn-McCarthy in 8, Luque-Galveston in 8, sacral screws in 2, and ilio-sacral screws in 11., Results: Sitting position improved postoperatively in 47 of the 53 patients who underwent pelvic fixation and only in one patient with short instrumentation. All 6 patients with long instrumentation and poor postoperative sitting balance were in the Dunn-McCarthy fixation group. Skin sores at the apex of the deformity disappeared postoperatively in all patients but recurred in two patients with short instrumentations. Kyphosis angle improved from 109° (45°-170°) preoperatively to 10° (0°-45°) postoperatively and 21° (0°-55°) at last follow-up. The best results were seen in cases where a cross-k-wire fixation of the kyphectomy site was used, augmented with a long thoraco-pelvic instrumentation consisting of Luque sublaminar wires in the thoracic region and a Warner-Fackler type of pelvic fixation. Good results were also found with the bipolar technique and ilio-sacral screw fixation. Six over 24 patients with the Warner and Fackler technique showed gradual dislodgment or hardware failure, with subsequent nonunion of the kyphectomy site in four. Infection, with or without wound dehiscence and/or hardware exposure, occurred in 17 cases, necessitating hardware removal in 9 patients., Conclusion: Lumbar kyphosis in MMC children is best managed by resection of enough vertebrae from the apex to produce a flat lumbar spine, with perfect bone-to-bone contact and long thoraco-pelvic instrumentation using the Warner and Fackler technique through the S1 foramina or the bipolar technique with ilio-sacral screw fixation. Additional local fixation of the osteotomy site using cross-wires with or without cerclage increases the stability of the construct. The majority of complications occurred in patients with short instrumentations or where residual kyphosis persisted postoperatively regardless of the type of pelvic fixation or hardware density. The Dunn-McCarthy technique for pelvic fixation following kyphectomy in MMC was less successful in producing stable pelvic fixation and should not be considered in this patient category., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The rapid proliferation of microplastics (MPs) and nanoplastics (NPs) in our environment presents a formidable hazard to both biotic and abiotic components. These pollutants originate from various sources, including commercial production and the breakdown of larger plastic particles. Widespread contamination of the human body, agroecosystems, and animals occurs through ingestion, entry into the food chain, and inhalation. Consequently, the imperative to devise innovative methods for MPs and NPs remediation has become increasingly apparent. This review explores the current landscape of strategies proposed to mitigate the escalating threats associated with plastic waste. Among the array of methods in use, microbial remediation emerges as a promising avenue for the decomposition and reclamation of MPs and NPs. In response to the growing concern, numerous nations have already implemented or are in the process of adopting regulations to curtail MPs and NPs in aquatic habitats. This paper aims to address this gap by delving into the environmental fate, behaviour, transport, ecotoxicity, and management of MPs and NPs particles within the context of nanoscience, microbial ecology, and remediation technologies. Key findings of this review encompass the intricate interdependencies between MPs and NPs and their ecosystems. The ecological impact, from fate to ecotoxicity, is scrutinized in light of the burgeoning environmental imperative. As a result, this review not only provides an encompassing understanding of the ecological ramifications of MPs and NPs but also highlights the pressing need for further research, innovation, and informed interventions., 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 © 2023 Elsevier B.V. All rights reserved.)