Search results for “Literature”

Acquired Haemophilia: A Case Report and Literature Review

Acquired haemophilia (AHA) is a rare coagulation disorder secondary to autoantibodies against coagulation factor, most commonly factor VIII with potential for life threatening bleeding episodes. We report a case of an 88-year-old female presenting with frank haematuria three weeks after catheter insertion. Her background was of Alzheimer’s Dementia, Asthma and Bullous Pemphigoid for which she was on low dose maintenance prednisolone (5mg). Laboratory tests showed haemoglobin 98g/dl and partial thromboplastin time (PTT) of 60s, with corrected prothrombin time 52s. Fibrinogen 5.39. As such coagulation factors were tested which revealed factor VIII of 0%. Her case was complicated by urinary tract sepsis, as such she was treated with oral prednisolone 60mg without immunosuppressive agent usage. A pan-CT scan revealed likely mesothelioma for which she declined further investigation. This case report will describe a rare presentation of AHA associated with bullous pemphigoid and mesothelioma, complicated by infection and frailty.

The Dose Modulates the Body’s Physiology: Literature Review

The body interacts with endogenous and exogenous molecules through various receptor networks at the cellular and organismal levels by which the different physiological processes of the organ systems get activated. Life could no longer exist without the body’s interaction with these signaling molecules. The number of molecules interacted with a receptor type within the body determines the efficiency of biological processes that would determine the biochemistry and anatomy behind the basic body functions. The dose plays a complex role in multiple physiological processes by modulating the natural processes of the different biological systems. It is always connected to the physiological and anatomical aspects of the biological sciences in which it manifests the biological sensitivity that would determine the efficiency of biological responses of the body systems. There are always physiologic and non-physiologic doses for every compound administered into the biological systems. The does that facilitated the body to manifest that biological sensitivity which has maintained the physiological processes of the body systems was noted as physiologic dose, whereas the dose that has suppressed the biological sensitivity of the body that became inefficient in maintaining the physiological processes of the different biological systems was termed non-physiologic dose. It is important to adjust the dose or dosage based on physical and biological factors such as the efficiency of the different organ systems, body weight, and the timing of the dose triggering a biological response to maintain the natural processes of the body systems. This means that integrated biological data is required in order to be able to identify the physiologic and non physiologic doses for biological or pharmacological use.

Health Practitioner Burnout, Safety Implications, and Programmatic Fixes: A Systematic Literature Review of Current Literature Reviews—200 Proof*

High rates of workplace psychological stress and burnout have been chronic among Healthcare Practitioners. Research shows that Healthcare Practitioner psychological stress / burnout is related to poor quality of care and a high probability of making medical errors and mishaps resulting in harm to patients and even workers themselves. In response, relatively impactful programs have been developed to address Practitioner burnout. To derive a better understanding of the subject and inform best practices and policy regarding the problem and its fixes, this article reports findings from a novel study of a systematic (PRISMA-based) literature review of current (circa ~10 years <) literature reviews; or a distillation of reviews already at 100 proof then undergoing a further distillation into a review of 200 proof.* This study employed a grounded theoretic qualitative methodology to iteratively generate and enumerate descriptive themes from the study’s literature review articles. This article reports on what is currently known regarding the precipitants of Health Practitioner Burnout, Burnout itself, its relationship to Safety lapses and mishaps, and Programmatic Interventions (i.e., Fixes). The primary conclusion is that Health Practitioners are the foundation of healthcare organizations and key to quality care and management / leadership should be concerned for their wellbeing; and this article provides a general blueprint in terms of addressing burnout and safety. Study Limitations and Future research are also discussed.

Primary Healthcare Services and Health-Related Quality of Life of Older Persons with Non-Communicable Diseases: A Narrative Literature Review

In response to the rising burden of non-communicable disease (NDC), the World Health Organization (WHO) developed tools to enable early detection and management of NCDs in Primary Healthcare centers (PHC). Globally, the prevalence of NCDs remains alarmingly high with 41 million deaths annually. Of these, 17 million people die before the age of 70, and 86% of these premature deaths occur in low-and middle-income countries. This narrative review aimed to assess the effect of PHC services on health-related quality of life (HRQoL) of older persons with NCDs, to critically analyze the potential of the existing literature in informing improvements in PHC services. We searched various databases (PubMed, Springer, Scopus, and ScienceDirect) for relevant literature. Peer-reviewed articles on the influence of PHC services on HRQoL among older persons with NCDs written and published in English between January 2013 and May 2024 were considered. The review indicates that effective PHC services are linked to good HRQoL. However, PHC services are sub-optimal and poor in low- and middle-income countries, hence more health interventions are essential to improve PHC services to enhance HRQoL of older persons.

Unveiling Gender Disparities in ADHD: A Literature Review on Factors and Impacts of Late Diagnosis in Females (2010-2023)

This exploratory study investigates factors and consequences of underdiagnoses or late diagnoses of attention deficit hyperactivity disorder (ADHD) in females favoring males in the referral, diagnosis, and treatment processes resulting in  gender disparities. A literature review in PubMed, PsychINFO, PsychArticles, and PsychiatryOnline from 2010 to 2023 underscores significant implications of delayed ADHD diagnosis in females, hindering timely access, support, and interventions during critical developmental years. Factors associated with underdiagnosis of ADHD among girls include gender differences in symptomology presentation, comorbidity, and gender bias among parents, teachers, and healthcare providers. We highlight the role of ethnicity and cultural factors. This bias prevents girls from receiving necessary ADHD support and treatment, impacting their health, social, and economic outcomes into adulthood. We summarize strategies to urgently address gaps in ADHD research and practice. Raising awareness among communities, healthcare providers, educators, and parents is vital to alleviate these gender disparities. By illuminating factors contributing to delayed diagnoses, the study informs policymakers and stakeholders, facilitating targeted interventions to improve early detection and treatment outcomes for females with ADHD.

The Effects of Dairy Consumption on Vaccine Immune Response and Immunoglobulins: A Systematic Literature Review

Public health interest in vaccinations and immune protection has increased with the COVID-19 pandemic. Dairy products are an important source of protein and other nutrients, and there are unresolved research questions regarding the potential health impact of dairy products on the enhancement of immune response. A systematic literature review was conducted to synthesize the published literature reporting the effects of dairy interventions on: 1) the vaccine-specific immune response and 2) immunoglobulins in the absence of vaccination. To assess study validity and quality, we used the Academy of Nutrition and Dietetics Quality Criteria Checklist. Sixty-one studies (59 clinical trials, 1 cohort, 1 cross-sectional survey) were included, spanning 1983-2017. Ten trials evaluated the effect of dairy intervention on vaccine-specific IgG, IgA, IgM, vaccine-specific antibody titers, seroprotection rates, or seroconversion rates. Of these, 7 reported significant increases with dairy interventions for post-vaccine tetanus antibodies, mean change in tetanus antibody level, total antibody titers to flagellin from Salmonella Adelaide, mean antibody titers to influenza B, influenza-specific IgA and IgG levels, and seroconversion or seroprotection rates for influenza A and B. Fifty-six studies evaluated dairy’s effects on immunoglobulins without vaccinations. The results were heterogenous, with some studies reporting significant enhancement of immunoglobulins (IgA, IgE, or IgG), while others observed no differences between groups. Clinical relevance of the immunoglobulin changes was not investigated in these studies. Dairy products and their components could enhance the efficacy of vaccines. This review highlights the evidence gaps and provides a potential roadmap for additional research.

Primary Leiomyosarcoma of the Thyroid; a Case Report and a Review of Recent Literature

A case report of primary thyroid leiomyosarcoma with literature review. It discusses diagnostic pitfalls, histologic criteria, and management options.

Non-Specific Steroid Cell Tumor of The Ovary: Case Report And Review of The Literature

Steroid cell tumors of the ovary are particularly rare, secreting sex hormones, characterized by steroid cell proliferation and represent only 0.1% of all ovarian tumors. They are classified into three subtypes according to their cell of origin: stromal luteoma, Leydig cell tumors and a third subtype of unknown lineage corresponds to a not specified steroid cell tumor (SCT-NOS). This third subtype accounts for 60% of steroid cell tumors. The clinical manifestations of SCT-NOS can take many forms, including pain, abdominal distension, but perhaps the most visible presentations are those related to hormonal activity and virilization of the tumor. We present a rare case of a 48-year-old woman with vaginal bleeding and a history of trunk obesity, hirsutism for 2 years and hypothyroidism with hormone replacement therapy. Clinical examination revealed a characteristic of obesity, virilization. Serum testosterone was 3.62 µg / L and CA-125 was 40.67. Magnetic resonance imaging identified a left ovarian solid mass and histopathology confirmed a steroid cell tumor not specific. The patient underwent exploratory laparotomy and left salpingoophorectomy. Macroscopically, the mass is well circumscribed, solid, homogeneous and yellowish. Microscopically, the tumor is mainly composed of eosinophilic or vacuolar granular cytoplasm. Immunohistochemistry showed that the tumor cells were strongly positive for inhibin. The postoperative period was uneventful. Through this rare observation, we will discuss the aspects that characterize this type of tumor and present some guidelines to be used in the differential diagnosis, as well as the difficulties encountered in the clinical, radiological and therapeutic fields.

A Review of Literature and Article on Importance of Nidan Panchak Ayurveda

Nidana Panchaka is one of Ayurveda's several diagnostic procedures. It is the most significant way for determining the source of an illness, as well as predicting its prognosis. Nidana Panchaka comprises of five items which are Nidana (etiological factors), Purvaroopa (primordial symptoms), Roopa (signs and symptoms), Upashaya (like and dislike) and Samprati (etiopathogensis) (etiopathogensis). Diagnosis of sickness depends on Tridoshas which are Vata, Pitta, Kapha which are responsible for any disease that arises in the body. These imbalances in the Doshas of the body are caused by etiological variables such as a person's lifestyle and eating habits. Prior to seeking therapy for a condition, a proper diagnosis is required. There are numerous additional procedures for diagnosing the ailment, such as Ashtavidha Pareeksha, Dashavidha Pareeksha, and Chaturvidha Pareeksha, but the focus of this article is on the significance of Nidana Panchaka.

Biological Effects of High Radiofrequency Radiation on Wistar Rats: A Literature Review

Aim and Objective Despite the growing concerns about the relationship between exposure to radiofrequency radiation (RFR) and detrimental health effects due to the changes in biological processes of experimental animals, there is still ongoing debate on the significance of these findings in causing significant public health problems with the growing advancement in internet technology. The aim of this study is to review existing literature on the effects of high RFR on wistar rats. Method A search was conducted on Google scholar and PubMed to identify relevant peer-reviewed articles to be included into the review. Studies eligible for inclusion included free full text articles on wistar rats exposed to ≥ 2.45GHz RFR conducted in the past 5 years. Studies included in this review were written or transcribed in English language. From 286 titles, 36 eligible studies were included in the review and assessed for quality using the Strengthening the Report of Observational Studies in Epidemiology – Veterinary Extension (STROBE-Vet) quality assessment tool. Results Studies included in this review generally had good quality (>60%) based on the STROBE-Vet assessment. This review identified numerous biological changes in wistar rats exposed to high RFR including variations in biochemical, cholinergic, genetic, histopathologic, psychological, optical, and dermatological parameters. In this review, studies identified variations in protein and liver enzymes while high RFR was found to induce oxidative stress and cellular damage of exposed wistar rats compared to the unexposed groups. This was seen in the changes in protein, lipids, enzymatic and non-enzymatic antioxidants. Studies also identified changes in expression of genes and neurotransmitters with imbalance in hormones. In addition, this review identified structural changes of cells, tissues and organs indicative of apoptosis, damage and death. Exposed rats were identified to have behavioral changes indicative of anxiety and memory decline while studies identified optical and dermatologic changes in exposed rats compared to the unexposed. Conclusion With numerous biological changes identified in wistar rats exposed to high RFR, there is an increasing risk of detrimental health events giving the advancement in internet technology and limited regulations to control exposures to RFR. Therefore, studies should be conducted to identify strategies to mitigate human exposure to RFR while policies are developed and enforced to protect human health.

Metastatic Malignant Melanoma of the Gastrointestinal Tract: A Rare Case and Review of Current Literature

Malignant melanoma the most common malignancies associated with GI involvement. They usually manifest clinically at an advanced stage of neoplasm. Surgery is also recommended for palliative treatment of GIT metastases. A case of a 67-year-old male diagnosed with malignant melanoma for 7 months had burning epigastric pain and bloatedness. Esophagogastroduodenoscopy showed multiple flat lesions. Biopsy findings were consistent with malignant melanoma. Malignant melanoma has an early tendency to metastasize and has a high mortality rate due to its complications. In patients with malignant melanoma since Gastrointestinal involvement is now being documented as part of metastatic work up esophagogastroduodenoscopy is suggested as an important tool in the treatment and patient’s +outcome. Although metastases to the stomach is rare, it is essential to be thorough and include an upper endoscopy to rule out metastatic disease, especially in symptomatic patients.

Clinical Case of Bilateral Mandibular Auto Transplantation for Missing Bilateral First Molars: Case Report and Review of Literature

Auto transplantation is a fast and economical option when a suitable donor tooth is available for replacement of a tooth considered impossible to treat. The purpose of this case report is to describe methods used for autotransplantation and its advantages for cases with a missing bilateral mandibular firstmolar, as compared with a dental implant, removable partial denture, and other methods of prosthesis. In the present patient who underwent auto transplantation, clinical and radiographic outcomes were considered satisfactory at one and two years postoperatively. Bone healing was observed around the roots of transplanted teeth, which showed good function. In autotransplantation cases, even when the donor tooth has complete root formation, a high success rate can be achieved when the patient is properly selected and treated. Although the chance of root resorption remains because of necrotic pulp and periodontal irritation during manipulation, auto transplantation should be considered as a good treatment modality in feasible cases. Based on the present findings, even though autotransplantation is not common in general dental practice, we consider that it offers a clinically and economically viable alternative as compared to other more complicated prosthetic and dental implant treatments. The purpose of this report is to show that auto transplantation is a superior treatment method for single molar defects as compared to other prosthetic methods, as the periodontal ligament of the patient can be used and cutting adjacent teeth is avoided. In addition, it is a treatment method that can effectively utilize a wisdom tooth.

Fetal Abdominal Cystic Lesion: A Diagnostic Dilemma and Prognostic Challenge-Report of Two Cases of Mesentric Lymphangioma with Review of Literature

Fetal mesentric lymphangioma, a congenital fetal abdominal cystic malformation has a rare occurrence. Antenatal detection, its differential diagnosis, prenatal management options and parental counseling regarding postnatal prognosis of such a case are thus rarely discussed. We report two cases of antenatally detected fetal cystic abdominal mass with a provisional diagnosis of abdominal lymphangioma. Postnatally one of the neonates developed features of intestinal obstruction and required surgical intervention. Intra-operative findings and histopathology report confirmed a mesentric lymphangioma. The other neonate had associated subcutaneous lymphangiectasia in left lumbar region, left sided inguinal hernia, undescended testes and was asymptomatic postnatally and managed conservatively.

A Comprehensive Research Study Literature Review of EPIC© in Terms of Enabling Healthcare Agility: A Report Card

Background As healthcare markets have become more dynamic and turbulent, healthcare organizations have evolved by becoming increasingly “Smart-Agile” in their business practices. Smart-Agility definition-ally ensures success due to its inherent ability to rapidly detect and react appropriately to varied and evolving unclear, complex, and seemingly tumultuous situations and produce high-quality, low-cost goods and services with high customer satisfaction. Thus, there is a vital need for Smart-Agile healthcare IT systems for collection, analyses, and reporting of substantial quantities of healthcare data to inform patient treatment and organizational decisions. EPIC® and its meaningful-use components appear increasingly popular, capturing a majority portion of the healthcare Electronic Healthcare Records (EHR) IT market (>~30%).Yet, there are few, if any, studies reporting on EPIC in terms of Smart-Agility. Aim The intent of this article is to report a systematic review of scientific literature regarding EPIC’s healthcare IT systems meaningful-use features cross-compared with Smart-Agility aspects to produce a positive vs. negative report card—and whether its features are critical vs. non-critical in terms of Smart-Agility. Method Findings reported herein derive from a grounded, iterative review of open-source, peer-reviewed scientific literature following PRISMA. Findings Report card results were mixed. EPIC clearly succeeds and excels (better than average) on Smart-Agile healthcare IT system core aspects that are the most central, critical and valuable in terms of informing healthcare organizations’ decisions and their patients’ care (6 out of 7; B+, -A), specifically: Standardized Data Collection / Connectivity, Real-Time Data Warehousing/Outcome Measures, Enhanced Patient Safety, Patient Tracking and Follow-up (Continuity of Care), Patient Involvement, and Potential Use in Medical Education. The only critical core criterion it failed on was End-User Satisfaction, and some of that appears to dissipate with new users’ software familiarity. Conclusion EPIC provides a solid and relatively inexpensive foundation with great potential for enabling Smart Agility in healthcare organizations with its high-quality collection and management of vast amounts of inter-connected raw data, auto-analysis, and fast report generation. But it does so with hidden costs and inefficiencies. Avenues of further inquiry are suggested.

Can Vitamin D Mitigate Osteoarthritic Hip Joint Arthroplasty Infections Among Older Adults? A Narrative Overview of the Literature Amidst COVID-19 Lockdowns and Beyond

Background Older adults with hip joint osteoarthritis, a major cause of chronic progressively disabling highly painful functional experiences, may require a surgical joint replacement procedure known as total joint arthroplasty surgery. Objective This review aimed to address the question of whether there an association between hip joint arthroplasty infection rates and prevailing pre or preoperative vitamin D levels that warrants consideration in efforts to prevent or minimize infection related hip arthroplasty complications among older adults particularly during the current ongoing COVID-19 pandemic. Methods PUBMED, SCOPUS, and WEB OF SCIENCE articles related to the topic and published between January 2016-2021 were searched, examined, and summarized. Results Older adults with hip joint osteoarthritis and low vitamin D serum levels who undergo total hip joint arthroplasty surgery may be at higher risk for post-operative infections than those with adequate vitamin D serum levels. Conclusion More research to verify whether efforts to screen for, and maximize vitamin D levels, before and after surgery, as indicated, may be helpful in the context of minimizing total hip joint arthroplasty surgery infection susceptibility and severity among older vitamin D deficient severely disabled hip osteoarthritis cases.

Sudden Death Due to Spontaneous Rupture of the Urinary Bladder following Acute Alcohol Inebriation- A Case report and Review of Literature

Spontaneous rupture of the urinary bladder (SRUB) is a rare clinical condition. Prompt diagnosis is often difficult both clinically and radiologically and necessitates a high index of suspicion as the patients present with non-specific abdominal pain and may not offer a clear history. The depressant effect of alcohol further complicates the diagnosis. We report a case of a young male who was unable to seek medical support and was found dead within 12 hours of the onset of abdominal discomfort following acute alcohol intoxication. At autopsy, rupture of the urinary bladder with blood and blood clots was found in the pelvic cavity with no any corresponding external injury. Spontaneous rupture of the urinary bladder is a rare cause of death in acute alcohol intoxication. In order to further understand this rare condition, the review of related literature has been done.

Use of Photovoice Methods in Research on Informal Caring: A Scoping Review of the Literature

The purpose of this scoping review was to examine the use of Photovoice in caring research. The review assessed the existing literature using the Arksey and O’Malley scoping review methodology. Database searches of relevant literature published worldwide between 1997–2019 yielded 25 articles in the English language that were included in this review. The authors summarized thematic findings. Three themes emerged from data analysis: 1) strengths of using Photovoice; 2) challenges of using Photovoice, and; 3) methodological complexities in Photovoice studies. The small number of studies included in the review (n=25) indicate the limited use of Photovoice in caring research, reflecting missed opportunities for action-oriented research. The scoping review recommends ways that researchers can better address the needs of carers using Photovoice, particularly as a tool for knowledge translation, advocacy, and empowerment.

Glandular and Cystic Bladder Cystitis: Case Report and Review of the Literature

Glandular-cystic bladder cystitis is a rare, benign non-tumor condition, preferentially located on the area of the bladder trigone and can simulate a malignant tumor. It is a benign reactive metaplasia of the bladder submucosa, characterized by hyperplasia of the islets of Von Brunn and cystic. It is classified among reactive epithelial anomalies of the urothelium, such as islet hyperplasia of Von Brünn, cystitis, glandular cystitis, nephrogenic metaplasia and epidermoid metaplasia. It presents a clinical diagnostic challenge having the expression of a simple recurrent cystitis and misleading the radiological diagnosis evoking a malignant tumor of the bladder. Its certainty diagnosis is histological. We report the case of a 38-year-old young man who consulted for recurrent cystitis. The CT scan showed a vegetative tissue structure of the middle and left medial vesical floor, sawtooth 3 cm long axis suspecting a tumor of the bladder. The patient underwent transurethral resection of the bladder lesion. The histological and immunohistochemical examination concluded with glandular and cystic cystitis (minor form). In the light of this observation, we will discuss the diagnostic difficulties, the pathophysiological mechanisms, the radiological aspects, the anatomopathological, therapeutic features and the prognosis of this rare condition. The literature regarding this entity has been reviewed and the differential diagnosis was discussed.

Management of Plastıc Bronchıtıs in Chıldren: A Case Report and Lıterature Revıew

Plastic bronchitis (PB) is a rare disease characterized by the presence of mucofibrinous plugs which may occlude and conform the shape of tracheobronchial tree. These casts are exteremely cohesive. Most common presenting symptoms include cough, fever and dyspnea and if the cohesive casts occlude the airway totally life-threatening complications and even death may occur. The aim of treatment is to remove the casts and adress the symptoms. In this study a 6-year-old boy with PB is presented. In addition to medical treatment obstructing casts were removed via rigid bronchoscope. It is aimed to review the clinical and radiographic features and choices of treatment in this disease.

A Meningeal Syndrome Revealing A Tetanus in A Togolese: Case Report and Review of the Literature

Although it is a vaccine-preventable disease, tetanus is frequently found in sub-Saharan Africa. Because of its rarity, this disease poses two problems for doctors of the 21st century: to make early diagnosis in order to refer patients to appropriate care structures, and to continue to ensure correct prevention of an affection that few current doctors have met. In it generalized form, the diagnosis of tetanus is easy, but when the beginning is localized, tetanus can be change with other diseases leading to a diagnostic wandering and a delay of adequate management. We report a case of tetanus in an 18-year-old male, who was received for neck pain and stiffness of the neck with a positive Kernig sign associated to fever since 48 hours. Initially treated for meningitis, the patient will develop at day 3 of hospitalization, the signs of generalized tetanus which led to evoked the diagnosis of tetanus. This diagnosis was reinforced by the notion of a rusty nail injury to the soles of the right foot 3 weeks before hospitalization and the absence of anti-tetanus vaccination. After using tetanus serum and vaccination with antibiotics (Metronidazole and Penicillin) and Diazepam in association with stripping of the wound under the foot, the patient was improved. This case illustrates that any neurological sign with the first trismus must evoke until proof of the contrary, a tetanus especially in case of association with a wound even if the immunization schedule is up to date.

Melanoma of the Breast with Smoothened (SMO) Mutation: Case Report and review of the Literature

We report the case of a 75 year-old female with past history of ampullary adenocarcinoma presenting with a rapidly enlarging breast mass, initially misclassified on fine needle aspiration as a probable sarcoma, which was ultimately diagnosed as melanoma on resection in the absence of a known cutaneous primary lesion. Next-generation sequencing (NGS) of the tumor revealed a mutation in the Smoothened oncogene (SMO) of unknown significance and wild-type BRAF. To our knowledge, SMO mutation in melanoma of any site has not been previously reported, though the effectiveness of SMO inhibitors has been studied in both in vivo and in vitro models of melanoma. Currently, these inhibitors have not been studied in SMO mutant melanoma. The patient declined further therapy after resection due to multiple comorbidities. She expired two years after presenting with the breast mass from complications of high grade urothelial carcinoma.

A Rare Variant of the Stafne Bone Cavity Localized to the Subcondylar Region of the Mandible: A Case Report with Review of the Literature

An anatomical variant of the Stafne bone cavity (SBC) located in the right subcondylar region of the mandible is presented. Such an occurrence of the SBC in this region near the parotid gland is considered rare and poses a diagnostic challenge for the dentist and radiologist. Knowledge of head and neck clinical anatomy and imaging studies such as plain film panoramic radiographs and cone beam CT scans can assist the clinician in arriving at a correct definitive diagnosis without surgical intervention.

Literature Review Paper on Mechanical Properties of Types of Carbon Nanotubes

Among the numerous potential uses of carbon nanotubes (CNT), its utilization to fortify polymers was given careful consideration. This reason can be because of the remarkable firmness, magnificent quality, and the low thickness of CNT. This has given various chances to the innovation of new material frameworks for applications requiring high quality and high modulus. Exact control over preparing factors, including safeguarding flawless CNT structure, uniform scattering of CNT inside the polymer grid, compelling filler– lattice interfacial communications, and arrangement/introduction of polymer chains/CNT, add to the composite strands' unrivalled properties. Consequently, manufacture techniques assume an imperative part in deciding the composite filaments' microstructure and extreme mechanical conduct. The present best in the class of polymer/CNT elite composite filaments, particularly concerning processing– structure– execution, were looked into in this commitment. Future requirements for material by configuration approaches for handling these nano-composite frameworks were likewise examined.

Statins and Lung Cancer: A Review of Current Literature

Cardiovascular disease and lung cancer are two of the most common causes of death in the United States. The cardioprotective benefits of statin class drugs is predominantly mediated through the inhibition of 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) reductase, decreasing available mevalonate, and thus limiting in vivo cholesterol biosynthesis. Mevalonate and its metabolites have significant roles in cellular membrane synthesis, which is dysregulated during tumorigenesis, and is therefore a potential source for anti-tumor effects of statins. Similarly, dysregulation of cellular signaling is a hallmark of tumorigenesis. In vitro studies of EGFR, RAS, and AKT signaling pathways in cancer cells can all be reformed back to states more indicative of normally functioning cells when treated with statins. Statins have also been shown to exert beneficial properties in the presence of chemotherapeutic medications and radiation therapies by modulating the deleterious effects of reactive oxygen species, decreasing tumor cell resistance, and minimizing damage to surrounding native tissues. There is abundant of in vitro evidence to support the beneficial effects of statins on lung cancer patients. Prospective studies to determine the value of statin therapy on lung cancer prevention could lead to a significant change in lung cancer treatment.

Giant Ileal Conduit Stone: Feasibility of Endoscopic Lithotripsy: A Case Report and Review of Literature

Ileal conduit has been considered the urinary diversion of choice following radical cystectomy although orthotopic bladder substitution is gaining popularity. Urinary diversions are associated with complications including stone formation in up to 54%. We report the management of the largest ileal conduit stone reported in the literature.

Pericentric Inversion in Chromosome 10 in a Girl, Inherited from a Phenotypically Normal Mother: Case Report and Literature Review

Pericentric inversions in chromosome 10 are regarded as both common and rare conditions, based on breakage and rearrangement within each specific segment. We present phenotypic and cytogenetic characterizations of a rare recombinant chromosome 10, namely inv(10)(p11q26), in a 13-month-old flabby girl associated with a maternal pericentric inversion. A review of the literature on the different aspects of this condition is also provided.

Wernicke Encephalopathy after Sleeve Gastrectomy. A Review of the Literature

Objectives: Bariatric surgery has been established as the cornerstone of treatment of morbid obesity with good immediate and long-term results. Nutrient deficiencies though, can be an important long-term complication and may lead to hematological, metabolic and especially neurological disorders which are not always reversible. Thiamine (vitamin B1) deficiency has been reported both after restrictive and malabsorptive procedures. The aim of this study is to review all cases that presented with Wernicke Encephalopathy after sleeve gastrectomy. Methods: A review of the literature was conducted to evaluate all sleeve gastrectomies performed till today and caused Wernicke encephalopathy to the patients. Demographic data, operative parameters, postoperative outcomes were collected and assessed. Results: A total of 13 studies, including 13 patients were analyzed. Patients ranged in age from 17 to 55 years. The onset of Wernicke encephalopathy occurred as early as 3 weeks after surgery to as late as 60 weeks after surgery. When symptoms of Wernicke encephalopathy developed, patients had lost from 19 kg up to 60 kg of body weight. Conclusions: Micronutrient deficiencies and particularly B1 deficiency can occur after LSG, although rarely. Preoperative nutritional assessment and postoperative follow-up plan, should signs of Wernicke’s encephalopathy be traced, is recommended in all patients.

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

Objective: Individuals diagnosed with Down syndrome (DS) are predisposed to obstructive sleep apnea (OSA). The aim of this study is to assess the prevalence of OSA and factors associated with OSA in this population. Study Design: Systematic literature review and meta-analysis. Methods: Studies of DS and OSA in the English language through May 2017 were reviewed. Since parental report of symptoms has limited validity related to the diagnosis of OSA, only studies using in laboratory polysomnography to diagnose OSA were included. Results: Twenty three studies examining OSA among 1,469 people with DS were found. Among ten studies using community referred samples, 71.5% of people with DS had OSA, compared to 69.6% in referred community samples suspected of having respiratory events. There was an inverse relationship between apnea hypopnea index (AHI) cutoffs and OSA prevalence as higher cutoffs were associated with somewhat lower prevalence. Examining age groups, adults had a higher prevalence of OSA (90.0%) compared to infants (66.5%) and children between 2-21 years of age (69.9%). Oxygen desaturation and gender did not affect prevalence. Although surgery had less effect on successfully treating OSA among DS individuals compared to those without DS in prior studies, lingual tonsillectomy had the greatest effect (mean AHI decrease of 9.0). Conclusion: OSA appears to occur frequently in children and adults with DS. Untreated, OSA may contribute to health problems and premature death, highlighting the potential importance of identifying OSA among people with DS. Even after traditional surgeries (i.e., adenotonsillectomy, tonsillectomy, adenoidectomy), repeating PSG is highly recommended as residual OSA can persist

Primary Malignant Melanoma Of The Parotid Gland Combined 18F-FDGPET/CT And Immunochemical Diagnosis with Literature Review

Summary Primary malignant melanoma arising from the parotid gland is extremely rare and only sporadic cases have been described. This entity is characterized by delayed diagnosis, poor prognosis and controversial pathogenesis. We report a case of primary malignant melanoma of the parotid gland in a 54-year-old man. The initial diagnosis, made by fine needle aspiration cytology, was malignant tumor without precision. Radical parotidectomy was performed. Diagnosis of primary melanoma of the parotid gland was confirmed by immunochemical analysis revealing positive staining for S-100, HBA-45 and Melan A. Computed Tomography and whole-body 18F-FDGPET/CT image were made to evaluate metabolic and morphologic characteristics of the primary melanoma, to identify potential systemic metastasis at early stage and to exclude primary melanoma elsewhere in the body. The clinical, pathological, immunohistochemical and the role of combined FDG PET/CT features of this lesion are discussed compared to a literature review.

Adenosquamous Cell Carcinoma of the Stomach 18F-FDG PET/CT Diagnosis and Review of Literature

Adenosquamous carcinoma of the stomach (ASCS) is extremely rare with less than one hundred cases published in the world literature. It is defined by combined adenocarcima and squamous cells carcinoma of the stomach. ASCS is clinically aggressive and has a poor prognosis, even when discovered at an early stage. This intriguing entity is characterized by non specific symptoms or radiological signs. Integrate 18F-fluorodeoxyglucose positron emission tomography/computed tomography 18F FDG.PET/CT is useful morphologic and functional modalities for evaluating primary tumor, local extend and invasion beyond gastric wall or distant metastatic and eventually for management. Diagnosis of ASCS requires immunohistochemical confirmation. We report a 77-year-old man who was admitted to hospital because of epigastric pain, vomiting and melena since more than a month. Gastroscopy with biopsies had initially suggested gastric squamous cell carcinoma .Thoracic and abdominal computed tomography scan (CT) showed a huge mass in the gastric body, largely necrotic, infiltrating the adjacent structures without metastases. Partial gastrectomy with resection of the proximal 2/3 of the stomach, the spleen, the body and tail of pancreas and the left transverse colon was performed. Immunohistochemical analysis demonstrated ASCS with mixed adenocarcinomatous and squamous cells carcinoma with invasion of gastric lymph nodes. Unfortunately, two months after surgery, a CT of the abdomen revealed diffuse metastasis and the patient died three months later. In light of this case, we discuss the pathogenesis, staging and monitoring of this rare entity by combined 18F-FDG PET/CT with review of the literature.

Oral Ellis-Van Creveld Syndrome: A Brief Review of Literature and A Case Report

EVC syndrome is a rare autosomal recessive genetic syndrome which its exact prevalence is unknown. The main manifestations of EVC include condro-ectodermal dysplasia, polydactyly, congenital heart defects and tooth and nail hypoplasia, and the survival rate of patients depends on the heart disease. EVC should be differentiated from other chondrodystrophia such as Achondroplasia and Jeune syndrome. Few cases of this syndrome have been reported in dental literature. This article is a brief review about the main orofacial features of EVC and reported all Prosthodontics and Restorative treatment of a 7-year-old girl that was born in prone family to EVC and presenting typical features of this syndrome.

Obstructive Sleep Apneas, Cervical Osteophytosis and Sudden Death: A Paradigmatic Case and a Brief Overview of the Literature

Obstructive sleep apnea (OSA) syndrome is a common disease characterized by partial or complete collapse of the upper airway during sleep secondary to functional or anatomical factors. The gold standard method for OSA diagnosis is an overnight polysomnogram demonstrating repetitive obstructive apneas and hypopneas during sleep. OSA syndrome is associated with cardiovascular diseases, stroke and rarely with sudden death. OSA and cervical spine osteophytes share some common risk factors, and their coexistence may cause mechanic respiratory obstruction with a severe sleep apnea. We present a brief overview on this syndrome, its links to the cervical spine pathology and their combined effect on a patient presenting with neurological signs who suddenly died before an effective treatment was possible to perform. This case highlights how a rapid deterioration of the functional balance may be possible even when a clinical condition has been present, known and unchanged for a long period of time and the need to treat adequately a not-so-innocuous pathology without an excessive delay.

Multiple Cerebral, Calcified and Infected Hydatid Cysts Case Report and Literature Review

Calcified and Infected Hydatid Cysts Case Report and Literature Review

Syndrome of inappropriate antidiuretic hormone secretion in a patient with a Nodular Lymphocyte-Predominant Hodgkin Lymphoma. A case report and review of literature

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a known side effect of several oncology drugs, but it is rarely seen secondary to vinblastine with only a few cases reported worldwide. Herein we present a patient with nodular lymphocyte-predominant Hodgkin disease that developed a severe acute hyponatremia seven days after her first cycle of chemotherapy with R-ABVD. After fluid restriction, symptoms and concentration of blood sodium were restored. After a comprehensive review of the literature vinblastine was thought to be the cause and avoided in the second infusion of chemotherapy without recurrence of the SIADH.

RETRACTED: Fibrous Dysplasia of the Thyroid Cartilage – A Case Study and Review of the Literature

This article has been retracted on 25 March 2016. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5867) Fibrous dysplasia is a rare disorder of bone that is uncommon in the head and neck region. Herein, we present a rare case of polyostotic fibrous dysplasia involving the right temporal bone and thyroid cartilage in a 19-year-old male. This unique location necessitates close surveillance due to the proximity to the airway and the potential for malignant degeneration.

Retraction Note: Fibrous Dysplasia of the Thyroid Cartilage – A Case Study and Review of the Literature

Leiomyosarcoma of the Thyroid Gland: A Review of the Literature and our Experience

Primary thyroid leiomyosarcoma, is extremely rare, with only 19 cases reported in the literature to date. Onset of the tumor, which usually develops in only one lobe of the thyroid, is sudden and the tumor spreads rapidly to surrounding tissues. Preoperative differential diagnosis is extremely difficult. The long-term prognosis for the patient is extremely poor and unrelated to treatment. Indeed, thyroidectomy and neck dissection followed by adjuvant chemotherapy and/or radiation therapy have not been shown to affect rate of recurrence and long-term survival. The authors describe the case of a patient with leiomyosarcoma of the thyroid gland and review the relevant literature, considering the differential diagnoses and alternative treatment strategies.

An Extremely Rare Case of Thoracic Intramedullary Melanocytoma: Case Report and Review of Literature

Melanocytoma is a rare benign lesion arising from leptomeningeal melanocytes. Meningeal melanocytomas are commonly seen in the thoracic region of the spinal canal and may also arise in the cervical or lumbar region, most often located in the intradural extramedullary compartment 1. To our knowledge, only 21 cases of intramedullary melanocytomas have been reported in the literature to date. The authors present a rare case of thoracic intramedullary melanocytoma and the review of the literature pointing out the role of diagnosis, surgical treatment and follow-up.

Diagnostics of Progressive Multifocal Leukoencephalopathy in a Patient with Concomitant Lymphoma Infiltration of Central Nervous System During R-CHOP Chemotherapy- A Case Presentation and Review of the Literature.

Progressive multifocal leukoencephalopathy (PML) is a rare complication associated, inter alia, with rituximab-based lymphoma treatment. PML diagnosis is made easier with the criteria recently published by the American Academy of Neurology. Unambiguous diagnosis of PML can be achieved by demonstration of the histopathological triad comprising:(1) demyelination, (2) bizarre astrocytes and (3) enlarged oligodendroglial nuclei together with detection of viral particles by electron microscopy. However, symptoms of PML may be similar to those observed during lymphoma progression into the central nervous system (CNS). Here we report the case of a patient with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP who developed clinical signs indicating PML. Intravital diagnostic methods failed to yield an unequivocal diagnosis of PML or lymphoma progression in the CNS. However, a post-mortem examination of brain biopsy specimens performed by electron microscopy demonstrated lesions typical for PML and the presence of viral particles. In addition, immunohistochemical assays identified a massive infiltration of lymphoma cells. The case thus suggests either the extremely rare coexistence of two complications: lymphoma CNS infiltration and PML or induction structural CNS lesions by lymphoma infiltration indistinguishable from PML. The presented findings thus highlight the need for a further review of the current diagnostic criteria for PML.

Rhabdomyolysis in a HIV-infected Patient Following the Addition of Raltegravir, A Case Report with Review of the Literature

Antiretrovirals have traditionally been associated with much toxicity. Newer antiretrovirals are considered much less toxic relative to older antiretrovirals. Upon its FDA-approval in 2009, raltegravir’s adverse drug reaction profile was found to be similar to placebo. However, recently there have been reports of increased creatine kinase and rhabdomyolysis following the initiation of raltegravir. We describe a 52-year-old, African-American man who developed rhabdomyolysis after starting raltegravir for HIV. Rhabdomyolysis resolved upon discontinuation of raltegravir. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 6). Although raltegravir is a well-tolerated antiretroviral, clinicians should be aware of the possibility of rhabdomyolysis when prescribing this medication.

Apomorphine Subcutaneous Infusion is More Efficient Than foslevodopa/foscarbidopa Subcutaneous Infusion in the Treatment of Advanced Parkison´s Disease for the Spanish National Health System

Objectives Motor fluctuations and non-motor disorders not manageable by first-line treatments in advanced Parkinson's disease require continuous dopaminergic stimulation strategies such as subcutaneous infusions of apomorphine (APO) or foslevodopa/foscarbidopa (FLD/FCD). A Budget Impact Analysis (BIA) was performed to estimate the cost difference between both treatments assuming equivalent clinical efficacy and safety. Material and methods The efficacy results of pivotal clinical trials at 12 and 52 weeks of treatment and the safety profile of APO vs FLD/FCD were compared, based on latest scientific publications and other available clinical data. A comparative BIA was performed, based on estimated annual drug treatment costs at Spanish published prices. Results The efficacy of APO (16 h/day) and FLD/FCD (24 h/day) in reduction of OFF hours (2.47 vs 2.75, 12 weeks; 3.66 vs 3.50, 52 weeks; respectively) and increase of ON hours without disabling dyskinesias (2.77 vs 2.72, 12 weeks; 3.31 vs 3.80, 52 weeks; respectively) could be considered clinically equivalent, as well as their safety profiles. However, a significant discrepancy is observed in the costs of the aforementioned alternatives. Considering published prices and the average dose reported in the literature, in Spain the annual cost of APO would be €13,980 compared to €55,198 for FLD/FCD. Consequently, the financial resources required for the treatment of FLD/FCD would enable the treatment of approximately three to four patients with APO. The BIA indicated the potential for annual savings in more than €2,500 million, considering a total target population of over 60,000 patients per year. Finally, an univariant sensitivity analysis was performed, considering a scenario in which the hospital acquisition cost of FLD/FCD decreased between 20%-30% (€44,159- €38,638/year). In this scenario, the total annual savings range between €1,875-€1,532 million per year. Conclusions Overall APO is more efficient than FLD/FCD, as it provides similar clinical efficacy at a lower treatment cost. The selection of an appropriate treatment option is to be determined by clinical criteria and patient characteristics, but cost evaluation should be considered to select the most cost-effective therapeutic option.

On Terms: Maladaptive Behavior

There is no shortage of terms that are used to describe and articulate the strategies, practices, and underpinnings associated with the work engaged in by behavior analysis. Two terms that a clinic-focused behavior analyst may hear often are maladaptive behavior and problem behavior. These terms are not only common within our everyday practice, but they are also peppered throughout behavioral literature. Despite their permanency in the behavior analyst's repertoire, their meanings remain inconsistent, interchangeable, and conceptually unclear. For over a century, this lack of precision has gone unchecked, despite extensive research on undesirable or clinically significant behaviors. This article offers individuals a recount of the history, definitional limitations, and functional implications of these terms. From the perspective of early psychological scholarship and contemporary behavior-analytic sources, I argue that the field of Applied Behavior Analysis (ABA) will benefit from distinguishing maladaptive behavior as the presence of behavior that adversely affects the individual, while problem behavior should refer to the absence or inhibition of adaptive responses in relation to others' social behaviors. Furthermore, I propose that both terms be used to describe the effects on the person engaging in the behavior, instead of others around the individual, as a method of improving directionality and functional clarity. As a field focused on verbal behavior, becoming more conceptually precise with our own verbal behavior will lead to a more coherent basis for interpreting and treating behaviors that interfere with individuals' adaptation and well-being.

Maxillary Sinus Lift Using the Lateral Window Technique with Hydroxyapatite and Beta-Tricalcium Phosphate (β-TCP) Graft

This narrative literature review investigates the clinical feasibility of maxillary sinus lift using the lateral window (or traumatic) technique, employing a grafting material composed of hydroxyapatite associated with beta-tricalcium phosphate. The study is based on the premise that bone resorption and sinus pneumatization—common in edentulous posterior maxillae—pose a challenge to achieving primary stability during dental implant placement. Given the limitation imposed by reduced residual bone height, bone-grafting surgical techniques become necessary to enable implant-supported rehabilitation. The objective of this work is to analyze, through a literature review, the efficacy of combining synthetic biomaterials as an alternative to autogenous bone grafts, which are considered the gold standard in implant dentistry. A bibliographic search was conducted in the PubMed and LILACS databases and through the VHL portal, prioritizing articles addressing the biological properties of alloplastic grafts, the indications of the lateral window technique, and the clinical success rates of implants placed in previously grafted areas using such materials. The findings demonstrated that hydroxyapatite associated with beta-tricalcium phosphate exhibits favorable osteoconductive characteristics, such as adequate porosity and gradual resorption, while allowing the formation of viable bone within a clinically acceptable timeframe. The combination of these materials eliminates the need for a second surgical site, reduces morbidity, and maintains treatment predictability. It is concluded that the lateral window technique associated with synthetic biomaterials is a safe and effective alternative for patients with maxillary bone atrophy, capable of promoting suitable bone beds for dental implant placement and stabilization, with lower surgical risk and satisfactory clinical outcomes.

How Intensive Short-Term Dynamic Psychotherapy Merges with Hypnotism and Solution- Focused Methods

Intensive Short-Term Dynamic Psychotherapy (ISTDP) has proven effective in over 120 outcome studies, particularly for anxiety, depression, and personality disorders. This conceptual paper proposes a theoretical integration of ISTDP with Solution- Focused Brief Therapy (SFBT) and clinical hypnosis. Each modality offers unique strengths—ISTDP enables rapid emotional processing, SFBT builds client resilience and solutions, and hypnosis enhances neuroplasticity and emotional receptivity. Drawing on existing empirical and neuroscientific literature, this paper synthesizes these modalities into a unified clinical framework. The integrated model emphasizes accelerated change through emotional access, strategic future orientation, and unconscious facilitation. Case examples illustrate the framework's practical applications across complex clinical presentations. The integration addresses gaps in single-modality treatments and provides a cost-effective, neurobiologically supported method of intervention. This article offers clinicians structured decision- making strategies and practical tools for real-time integration, while outlining future directions for empirical research.

Correlation of Fast Food Consumption and Overweight/Obesity among Undergraduate Students at the University of Hargeisa in Hargeisa, Somaliland

Background Fast food consumption is the major cause of obesity and overweight in worldwide affecting more than 2 billion people, especially developing countries and low income countries. It can lead to hyperinsulinemia and development of insulin resistance, high energy density, high glycemic index, and fatty acid composition of fast foods may increase the prevalence of obesity and cardiovascular risk factors Objectives The main aim of this study was, to assess fast food consumption and its association with overweight /obesity among undergraduate students of University Hargeisa, Somaliland, 2023. Methods The study was carried out from May 01 to July 20, 2023 at University of Hargeisa using an institutional based cross-sectional study design to among 260 students. The study participants were selected using a simple random sampling technique. A structured questionnaire was prepared based on review literatures and dig out from related studies. The anthropometric data was taken by data collectors to measure weight and height using a stadiometer. Data was entered and checked for errors using EPI-info version 7.1.5.0 and then, data were exported to statistical package for social sciences (SPSS) software version 21 and STATA software version 14 for data processing and analysis. Descriptive statistics such as; frequencies, means and proportion was used for present the findings. A variable with P-values of less than 0.25 in the binary logistic regression analysis was entered into a multivariable logistic regression analysis to identify the independent predictors of stunting. Finally, variable at P-value less than 0.05 in multivariable logistic regression analysis was considered as a statistically significant variable. Results In this study, the majority 235 (90.4%, CI: 86.5- 93.8) of the study participants were fast food consumers. The study revealed that, from the total study participants 46(17.7%),127(48.8%),84(32.3%), 3(1.2%) were underweight, normal, overweight and obese respectively. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. On multi-variable logistic regression model educational level of the students (AOR = 12.45 (95% CI: 1.7, 14.6)) and frequency of fruit (AOR = 0.76, 95% CI (0.7, 0.8)) and vegetable consumptions (AOR = 0.51, 95% CI (0.47, 0.575)) were found to be significantly associated with fast food consumptions (p < 0.05). Conclusion In this study, of the total 90.4% number of fast food consumers. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. Educational level of the students and frequency of fruit and vegetable consumptions were found to be significantly associated with fast food consumptions. Effort should be made to increase access to fast food-related information and counseling.

Insect-Based Foods: A Comprehensive Review on Nutritional Benefits and Environmental Sustainability

The growing population demands and environmental concerns associated with traditional protein sources have prompted the exploration of alternative and sustainable food sources. The purpose of this comprehensive review is to highlight the nutritional benefits and sustainability of insect-based foods as a promising solution. Global population growth necessitates innovative approaches to meet the demand for nutritious and sustainable protein sources. There are numerous challenges associated with traditional livestock farming, including land use inefficiency, high water usage, and greenhouse gas emissions. As a result, edible insects have emerged as a viable alternative, providing proteins (35-77% of dry matter), healthy fats (10-50%), essential amino acids, and micronutrients such as iron (up to 31mg/100g) and zinc (up to 20mg/100g), vitamins, and minerals. In contrast to livestock, which requires 22,000-43,000 liters of water to produce 1 kg of beef, insect farming consumes significantly less water and land resources. Insects have the potential to address nutritional deficiencies and strengthen food security as they are recognized for sustainable production. The study thoroughly investigates the literature addressing environmental and sustainability concerns associated with edible insect farming, using a rigorous bibliometric and scientometric analysis via Vos viewer. With the help of Vos Viewer, it was possible to identify the geographical distribution of countries that contributed to the field of edible insects and their acceptance, as well as the top ten documents in this field with the most citations and mostly used keywords in this field of research. Future research and implementation strategies will be able to benefit global food security and environmental conservation through these alternative protein sources.

Existential Therapy and the Contextual Model: Unified by Presence, Flexibility, and Meaning-Making

This article offers a literature review and theoretical synthesis and application of existential therapy and the contextual model. It reviews the contextual factors that may be predictive of positive therapy outcomes in general, identifies distinct types of existential therapy, highlights core commonalities in these existential branches, and explores how the main aims of the existential therapy approach may be foundational in facilitating improved mental health treatment outcomes and well-being. The author asserts that presence-both intrapersonal and interpersonal are at the heart of the contextual factors, along with flexibility, and meaning-making. This assertion has implications for therapist education, development, training, and supervision.

Molecular Control of Human Embryonic Development: A Comprehensive Study

Human embryonic development is a highly coordinated and complex process that transforms a single fertilized cell into a fully formed human organism. This process is governed by intricate molecular mechanisms involving genetic regulation, signal transduction pathways, and intercellular communication. This study explores key molecular pathways controlling human embryonic development, focusing on the roles of morphogens, transcription factors, signaling molecules, and epigenetic modifications. By reviewing the most recent literature and experimental studies, we aim to highlight the molecular orchestration that directs cell fate decisions, tissue patterning, and organogenesis in humans.

Proteomic and Genomic Techniques in Medical Research: Applications in Cancer, Diagnostics, and Personalized Medicine

Advancements in proteomic and genomic technologies have transformed molecular biology by enabling comprehensive analysis of biological systems at the molecular level. This literature review explores the evolution, methodologies, and practical applications of key proteomic and genomic techniques. In proteomics, tools such as two-dimensional electrophoresis, mass spectrometry, Western blotting, Edman degradation, and functional protein microarrays have facilitated high-throughput protein identification, post-translational modification analysis, and biomarker discovery. Similarly, genomic methodologies like PCR, recombinant DNA technology, gel electrophoresis, and Southern blotting have revolutionized gene detection, manipulation, and expression profiling. The review also highlights the interdisciplinary impact of these technologies across clinical diagnostics, oncology, autoimmune disorders, infectious disease surveillance, cardiovascular research, and personalized nutrition. Integrative approaches combining proteomics and genomics are enabling the discovery of novel therapeutic targets, improving disease classification, and advancing precision medicine. Despite current limitations, such as the absence of amplification techniques for proteins and challenges in data interpretation, ongoing innovations promise to bridge these gaps. This synthesis underscores the pivotal role of molecular techniques in deepening our understanding of human biology and accelerating biomedical advancements for improved healthcare outcomes.

Review on Frequency Neurofeedback on Autism Spectrum Disorder: Overview, Efficacy and Research Direction

Frequency neurofeedback (FNF) is a biofeedback method that targets frequencies between 1 and 50 Hz. The efficacy of FNF with autism has been labeled ‘probably efficacious’ in literature reviews in the last decade, despite new research pointing towards a higher standard. The aim of this review was to analyze key features of these studies, with a goal of determining the efficacy standard of FNF on autism and establishing a research direction. Electronic databases and literature reviews were used to collect a total of ten randomized and/or matched controlled trials. FNF reaches a Level 4 efficacy standard, with an impact on a broad range of factors including core autistic traits, social communication, emotional regulation, cognitive flexibility, executive function, behaviors of concern, attention, metabolic or thermal activity, and EEG e.g. decreased absolute power, mu rhythm, coherence and hyperconnectivity. Current evidence generalizes to male children, up to 18 years, with a low-average or higher intellectual functioning, with autism as the only diagnosis. A meta-analysis suggests a large superior effect when compared to wait list controls. Current research does not meet the higher efficacy standards outlined by Arns et al. (2020). Small samples plague most studies, and the maintenance of improvements post-training are yet to be assessed adequately. Eight recommendations are made.

Electromagnetic Fields and Osteoarthritis 2025

This mini review examines the potential efficacy of applying electromagnetic field therapy for purposes of reducing osteoarthritis pain and other related disease features such as frailty, muscle sarcopenia, obesity, bone loss and fragility, and cartilage derangements and degradation in the older adult. Based on selected English language literature published largely on PUBMED between January 2000 and October 2025, papers describing the impact and potential synthetic and disease modifying impact of electromagnetic stimuli are explored. These data reveal a high degree of promise in fostering joint tissue reparative efficacy trends post electromagnetic stimulation. Its usage may allay the extent of the disease and its degree of disablement, while facilitating function.

Artificial Intelligence in Healthcare: Enhancing Efficiency, Ensuring Equity, and Restoring Empathy

Artificial Intelligence (AI) is emerging as a transformative force across many sectors, with healthcare representing both one of the most promising and most challenging areas of application. This review summarizes current and future applications of AI in healthcare, focusing on its potential to improve diagnosis, therapy, chronic disease management, and overall patient care, while also alleviating physicians’ workload. Recent literature demonstrates that AI systems can reduce diagnostic errors/delays by mitigating cognitive biases, support imaging and pathology through improved accuracy and speed, and prevent prescribing errors by integrating pharmacogenomic and clinical data into decision-support systems. In chronic disease management, AI-powered wearable devices enable continuous monitoring and early detection of conditions such as atrial fibrillation, thereby reducing the risk of stroke and long-term disability, particularly in elderly people. Therapeutic applications include AI-driven drug discovery, personalized oncology, and tailored medicine that integrates multi-omics and lifestyle data. Beyond direct medical intervention, AI contributes by automating routine tasks, optimizing workflows, and facilitating greater patient–clinician interaction. Despite these benefits, significant challenges remain, including issues of data quality, privacy, security, equity, and the need for transparency and trust in “black box” systems. Looking ahead, the integration of multimodal data, digital twins, and robotics is expected to advance more comprehensive, equitable, and human-centered care. We conclude that, when applied ethically and responsibly, AI should not replace clinicians but rather serve as a powerful partner that enhances medicine by restoring empathy and humanity.

Bridging Gaps in Blood Transfusion Services through Collaborative Healthcare Systems in Cameroon: The Cornerstone University Blood Management System version 1.0

The rising need for structured and efficient blood transfusion services in low-resource settings has driven the adoption of collaborative blood transfusion management systems (CBTMS). This study explores the functionality and impact of the Cornerstone University Blood Management System version 1.0 (CUBMS vs 1.0) in Cameroon. This study was an exploratory research design which used a system interface analysis, comparative case reviews from four countries, and literature synthesis, to reveal that CUBMS improves accessibility, data management, inventory control, emergency responsiveness, and community engagement. Despite infrastructural challenges in rural regions, the system can enhance efficiency, transparency, and safety in blood services. The success of CBTMS in Cameroon is linked to digital infrastructure, training, and culturally relevant community engagement. The Ministry of Public Health of Cameroon should prioritize the nationwide implementation of CBTMS, ensuring consistency in digital health tools.

Global importance of supporting the krill to whale component of the pelagic food web associated with migrations following deep sea seamounts

The main diet of baleen whales is krill in the Arctic, Antarctic and during migrations in the Atlantic, Pacific and Indian Oceans. Hence, the aim of this paper is to quantify the global importance of the krill to baleen whale component of the pelagic food web and possible feedback loops. That was undertaken by comparing the results of Ecopath Models in the Antarctic and Arctic Oceans and to migration areas in the North Atlantic and Alaska, was well as the large Seamount area from the Antarctic and Arctic. Biological production transfer is the essential component of the prey to predator pelagic food web, which maintains the production of predators. The importance of sustaining global baleen whale migrations is to support ecosystem production by whale defecation contribution to nutrient recycling. It is important to sustain krill and fish abundance in whale migration feeding areas using ecosystem-based fishery management (EBFM) fishing rates. It was shown by the literature that migrations tended to followed deep-sea seamounts, and baleen whale defecation and nutrient cycling at seamounts led to the effects of nutrient upwelling by deep sea currents at seamounts. Hence, it is suggested seamounts be protected as important marine ecosystems. Therefore, those processes indicate sustaining krill and whale abundance is likely to support global marine ecosystem stability in open ocean migration areas.

A Case of Postoperative Hematoma Mimicking Giant Hydrocele

Background In adult males, non-communicating hydroceles are non fluctuant scrotal swellings that are formed when there is an imbalance of fluid secretion and absorption between the parietal and visceral layers of the tunica vaginalis. Giant hydroceles are a rare manifestation and have previously been classified as hydroceles that drain more than 1000 mL of fluid. In this report, we describe a case of a giant hydrocele requiring surgical management and highlight a review of the literature. Case Presentation A 34-year-old male presented with complaints of large right-sided scrotal swelling, accompanied by scrotal discomfort. Ultrasound of the right testicle revealed a large hypoechoic space with a complex collection and posterior displacement of the testicle, indicating a possible hydrocele. The patient was taken to the operating room for a right hydrocelectomy. Approximately 2 liters of fluid were drained from the sac.  Discussion Hydroceles are defined as straw-colored fluid collections within the parietal and visceral layers of the tunica vaginalis. Giant hydroceles, defined as fluid collections within the tunica vaginalis exceeding 1000 mL, are rare and the management of such cases is sparsely documented in the literature. While most asymptomatic fluid collections resolve spontaneously, larger collections with inflammatory changes within the testicular wall may require surgical intervention, either laparoscopic or open. 

Ecosystem-Based Fishery Management of Antarctic Krill (Euphausia superba) to Support Baleen Whales and other Predators Production Adapted for Potential Climate Change Effects

Antarctic krill is an important component of the zooplankton production in the Southern Ocean and is a major food source for baleen whales. The role of commercial fishing and predation by whales on Krill abundance has been investigated here using the innovative ecosystem-based fishery management, EBFM which maintains the krill to whale food web ecosystem stability. The literature indicates the Krill fishery may have been overfished, so it was reduced to the current annual upper limit of 0.62 million tonnes for support other predators of krill, such as seals, penguins and flying sea birds. However, recent literature suggests a moderate reduction in krill catch in the Antarctic Peninsula area due to its importance for whale migration to temperate areas. The Peninsula area catch was estimated to be reduced by about 10% due to additional concerns about climate change effects on krill abundance in the Southern Ocean, reducing overall catch to 0.556 million tonnes, moderately higher than the maximum taken in 2022. Hence, the krill biomass fishing was reduced to allow for predation by baleen whales and other predators, giving a full ecosystem-based fishing mortality similar to that previously estimated to maintain krill production in the Southern Ocean.

To Achieve High-Quality Agricultural Development is the General Trend of the Times

Farming development has gone through a long process. After a review of literatures, the results showed that according to the efficiency of resource utilization by plants, the whole process of farming development can be divided into three stages, the whole process of farming development can be divided into three stages: Low level development stage or primitive farming, Level improvement stage and high-quality development new stage. The direction of Farming development is High-quality development. Farming High-quality development is to take some effective measures or methods to make land produce maximum yield and benefit to meet the people’s needs for a better life and safe food, which is the general trend of the times.

The Relationship Between Abnormal Sleeping Patterns and ADHD

The objective of this focused literature review includes establishing and explaining the high correlation between sleep issues and ADHD. Through a systematic review of sources, a high correlation between sleep issues in those with ADHD was established with multiple theories lending explanation to this comorbidity. Neurological pathways in the brain already afflicted by the disorder of ADHD may cause direct effect on sleep pathways in their dysfunction. Other comorbid sleep conditions were found to occur in high frequency with ADHD however, a common etiology of these issues is yet to be established. The major conclusion of this study includes that there are multiple mechanisms through which sleep disturbances may be caused in ADHD patients, all of which must be considered in future research.

Internal Jugular Phlebectasia; A Challenging Neck Mass in Children

Cystic neck masses are uncommon in children, and a minority of them are soft. Internal jugular vein phlebectasia (IJVP) is a rare cause of soft neck cysts. It presents usually as a unilateral soft neck mass of changing size. In most cases it is unilateral, right sided and predominantly in males. Imaging study modalities are diagnostic and helpful for observation and follow up. In the vast majority of cases, it decreases in size with time requiring only conservative treatment. However, surgery might be necessary in large or complicated phlebectasia. IJVP is underdiagnosed or misdiagnosed especially in pediatrics, with few cases documented in medical literature. To improve awareness of presentation and management-plan of this rare case, the authors present an extremely rare case of huge left internal jugular phlebectasia in a 14 year-old boy worsened and complicated over years of wait and see approach that needed surgical treatment.

Delving into the Ideas of Charles Darwin: A Study of His Pre-Beagle Musings, Beagle Expedition, and Subsequent Developments

Charles Darwin's exploration of the Galápagos Islands in 1835 and his subsequent formulation of the theory of evolution in 1839 were significantly influenced by his observations of land-birds, including finches, larks, owls, and mockingthrushes. Despite a primary focus on geology during his voyage on the HMS Beagle, Darwin meticulously documented various species in his field notebooks. Early observations during his youth at Edinburgh University and the Beagle expedition reflected Darwin's growing curiosity about species variation. However, it was not until his return to England and his interaction with ornithologist John Gould that Darwin began to recognize the significance of the finches he had observed in the Galápagos. This review synthesizes existing literature on Darwin's transition from geological interests to his groundbreaking insights into evolution. By examining primary sources, historical interpretations, and contemporary analyses, this paper highlights how Darwin's observations and Gould's influence shaped his revolutionary theory of species transmutation—the gradual transformation of one species into another over time. The review aims to provide a comprehensive understanding of Darwin's contributions, illustrating how his Galápagos observations and collaboration with Gould laid the foundation for modern evolutionary biology and continue to influence scientific thought on species adaptation and natural selection.

Impact of Climate Change on Public Health in Rwanda

Rwanda is a small Central African country. A land with thousands of hills and mountains. It is a low-income country and one of Africa's fastest-growing economies. It is home to a variety of ecosystems, such as mountainous rainforests, gallery forests, savanna woodlands, wetlands, aquatic forests, and agroecosystems. From rising temperatures to changing rainfall patterns, the hidden dangers of climate change are unmasking themselves in the form of various health risks. Every year, many deaths, bodily injuries, and house collapses, among other repercussions, are documented as detrimental effects of climate change events on public health. This article delves into the intricate relationship between climate change and public health in Rwanda, exploring the adverse effects it has on vulnerable communities. By shedding light on this pressing issue, we can better understand the urgency of taking action to mitigate the impact of climate change on public health as well as potential solutions to the current predicament. The authors researched several literatures to develop their perspectives on the subject and explored potential solutions to protect the well-being of Rwandans in the face of this global crisis.

Primary Membranous Nephropathy Flare After COVID-19 Vaccination

Primary membranous nephropathy (MN) is due to autoantibodies to phospholipase A2 receptor (PLA2R Ab). It is unclear whether COVID-19 vaccines can trigger flares of glomerular diseases such as primary MN. There have been increasing reports of glomerular diseases presenting or flaring after receipt of COVID-19 vaccines. We present a patient with primary MN who developed nephrotic syndrome after receiving her second mRNA-1273 COVID-19 vaccine with positive PLA2R Ab. Renal biopsy confirmed primary MN. She was treated for her primary MN flare with rituximab in a manner similar to non-vaccine-associated MN, which led to significant reduction in both PLA2R Ab level and proteinuria. This case adds to the growing literature on MN flares after receipt of mRNA COVID-19 vaccines. Close follow-up of patients with primary MN and other glomerular diseases after COVID-19 vaccination is warranted. Further research is needed to determine the pathophysiology behind vaccine-induced MN flares and whether there is a potential association between exposure to SARS-CoV-2 antigens and loss of tolerance to the PLA2R antigen.

Leflunomide-Induced Cystoid Macular Edema: A Rare Case Report

Introduction Cystoid macular edema (CME) is a sight-threatening condition caused by fluid accumulation in the macula due to blood-retinal barrier disruption. Various factors, including drug reactions, can lead to retinal fluid leakage. Leflunomide, a disease-modifying anti-rheumatic drug, marked significant progress in managing rheumatoid arthritis. Although effective, Leflunomide has rarely been linked to CME. This report presents a unique case of Leflunomide-induced CME, adding to the limited literature on this subject. Methods We report the case of a 75-year-old female with rheumatoid arthritis treated with Leflunomide, presenting with bilateral CME and reduced visual acuity (VA). Comprehensive ophthalmic evaluations, including VA tests, fundus examination, and optical coherence tomography, were conducted. Results The patient presented with CME and decreased VA in both eyes for several months. She had undergone cataract surgery 20 years prior and was using topical nepafenac, dorzolamide, and dexamethasone. Initial VA was OD 20/50 and OS 20/40. VA improved with treatment, but CME recurred upon discontinuation. The patient had been on Leflunomide for one year. After consulting with the Rheumatology department and considering a previous case of bilateral Leflunomide-induced CME, the drug was discontinued. CME resolved without recurrence or the need for topical treatment. At her final visit, VA was OU 20/25. Conclusion This case highlights Leflunomide as a potential, though rare, cause of CME. It emphasizes considering systemic medications in CME diagnosis. Timely discontinuation of Leflunomide may resolve CME and prevent further visual impairment. Further studies are needed to understand this rare side effect comprehensively.

Osteoarthritis in Older Adults: Is More Emphasis on Managing and Mitigating its Stressful Ramifications, and Enhancing Coping, and Self Efficacy Cognitions Indicated?

Efforts to mitigate or prevent painful disabling osteoarthritis have been pursued for more than a century with limited success. This current overview briefly summarizes how selected beliefs and behaviors, including coping and stress management approaches are potential mediators or moderators of osteoarthritis pain and its overall common adverse prognosis and outcome. Published data housed predominantly in PUBMED, PUBMED CENTRAL, SCIENCE DIRECT, and GOOGLE SCHOLAR sites and pertaining to selected aspects of the literature of current interest, cumulative results reported as of May 30, 2024, show a modest to strong rationale exists for considering the abovementioned factors in efforts to reduce pain and enable daily functions. Accordingly this line of research should be continued, and translated clinically without undue delay, especially in the face of increases in the aging population and osteoarthritis prevalence and undue suffering.

Mental Health Disparities Among LGBTQ+ Youth and The Strategies to Promote Their Well-Being

Introduction Compared to their heterosexual counterparts, cisgender LGBTQ+ youth are more likely to experience numerous mental health conditions, for instance, suicidal ideation, stress, and anxiety. This study aimed to explore mental health disparities among LGBTQ+ youth while identifying strategies to promote their well-being. Methodology Incorporating a systematic approach, studies were selected according to the predefined inclusion criteria, ensuring recentness and relevance. Five databases were systematically searched while the PRISMA flowchart was employed for illustrating the systematic selection process. The PEO framework directed the study selection. Thematic analysis was applied to identify themes that were related to the study aim. Results Five themes were emerged including policy changes and legal frameworks, contextual and cultural factors, family and social support, underlying factors of mental health, and healthcare services access. The synthesis of the literature uncovers the multifaceted relationship between cultural and contextual factors and policy changes, social and family support and healthcare services. The study also underlines the importance of implementing an intersectional minority stress model for comprehensively understanding mental health disparities among LGBTQ+ youth. Conclusion The results emphasize the importance of ongoing research in policy alterations, accessibility to healthcare, and creating supportive surroundings to tackle differences in mental health. Recognizing the complexity of these issues, this paper requires an in-depth examination that considers intersecting factors, promotes inclusivity, and involves long-term studies in providing mental health support to enhance the well-being of LGBTQ+ young individuals.

RETRACTED: Leap into Fetal Surgery; In Utero Placental Mesenchymal Stem Cell Therapy, A Contemporary Approach to Treating Myelomeningocele

This article has been retracted on April 10, 2025. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2997-2086.jfs-25-5857) Myelomeningocele (MMC), a class of spina bifida is a type of neural tube defect. According to the U.S. Centers for Disease Control and Prevention, each year approximately 1,400 babies born in the United States have spina bifida. The disease manifests with the lack of skin and bone covering the caudal part of the spinal cord. The patient developing such a condition often develops lifelong impaired lower limb mobility accompanied by hydrocephalus, and urinary and bowel incontinence. The available interventions include prenatal and postnatal surgery to fuse the dura. Prenatal surgery performed before 26 weeks of gestation reduces the risk of death or the need for ventriculoperitoneal shunting. It also enhanced results on a comprehensive index for mental and motor function. When compared to postnatal surgery, prenatal surgery reduces the manifestation of several secondary outcomes, including the degree of hindbrain herniation seen in the Chiari II malformation. Stem cell therapy for MMC on animal models of chick, ovine, and rodents with reported cases 15/63, 15, and 136, respectively, using human Embryonic Stem Cells (hESCs), Neural Stem Cells (NSCs), Mesenchymal Stem Cells (MSCs) showed significant coverage of MMC defect and slight neurogenesis was also observed. With an understanding of medical literature about in-utero regenerative capacity, it is to be appreciated that placental stem cells surgically seeded within a biocompatible scaffold of the cell patches can play a part in alleviating the spinal cord manifestation associated with MMC. Documented animal studies show that incorporating Placental Mesenchymal Stem Cells in prenatal surgery has reported improved neurogenesis and lower limb mobility. In an ovine myelomeningocele model, the development of in-utero myelomeningocele repair with human Placental Mesenchymal Stem Cells seeded onto an extracellular matrix (PMSC-ECM) enhances motor findings. The clinical trial for the first stem cell therapy on human subjects known as the “CuRe Trial: Cellular Therapy for In Utero Repair of Myelomeningocele.” is expected to be finished by 2030. So far, the cases undergoing treatment have shown significant leg movement and a greater degree of bowel and urinary control. This FDA-approved clinical trial is envisioned to be the future of treating MMC.

The Role of Non-Pharmacological Interventions for Disrupted Sleep in the Moderate-Severe Dementia Population: A Systematic Review

This study systematically reviews the literature on non-pharmacological interventions for disrupted sleep-in people meeting established criteria for moderate-severe dementia, and to analyze the methodological quality of the included studies. The PubMed, PEDro, Cochrane, Virtual Health Library, APA PsycInfo databases were searched using a systematic literature review approach to identify various types of non-pharmacological treatments that improve disrupted sleep-in subjects with moderate-severe dementia. In accordance with the inclusion criteria, eight studies were systematically reviewed and analyzed according to the type of non-pharmacological treatment carried out. This systematic review showed that 50% of the studies used bright light therapy, 12.5% ​​the use of manual therapy, and 37.5% sleep hygiene or walking or a combination of these interventions. Based on the results of the present study, although there is some evidence to support these strategies, it is not significantly supported and highlights variation in the way the interventions were delivered. Disrupted sleep is highly prevalent in people with dementia and have a negative impact on the quality of life of the sufferer and the caregiver. Non-pharmacological approaches to its treatment are increasingly popular as an alternative to drugs, whose efficacy and side effects have raised concerns among the population. Currently, there is a need to carry out more future research to establish its effectiveness and to be able to provide clear guidelines at the time of clinical practice.

Rights of Women with Mental Illness (WWMI): Nigeria in Context

Introduction This study addresses the critical issue of the rights of Women with Mental Illness (WWMI) in Nigeria, emphasizing the intrinsic link between mental health and human rights. Recognizing the unique challenges faced by women, particularly those with mental health conditions, is essential for achieving global goals related to well-being and gender equality. The aim of the study was to explore the rights of women with mental illness in Nigeria, factors that may be responsible for the difficulty in ensuring that the rights of women with mental illness in Nigeria are protected, and then provide policy suggestions to combat the highlighted challenges. Method A comprehensive literature review was conducted, utilizing databases such as PUBMED, Google Scholar, and African Index Medicus. Key search terms included Women’s rights, Human rights, Mental Health, Nigeria, and UN SDGs. Results The studies selected for the review focused on highlighting the challenges faced in women mental health rights, and identified socioeconomic, traditional and cultural factors as the major challenges to the protection of WWMI. Conclusion The study revealed a complex interplay of societal, cultural, and economic factors contributing to the abuse of rights among WWMI in Nigeria. However, to begin to resolve these challenges, it proposed the need to visibly increase female representation in policy-making, enhance mental health access, and target research efforts. Addressing these issues is crucial for upholding the fundamental human rights of WWMI, ultimately leading to improved mental well-being within society.

Histomorphomertric Analysis Of Hormonal Contraceptive Pills On Anterior Pituitary Gland In Female Wister Rats

Millions of women use hormonal contraceptive pills around the world and though the physical effects are thoroughly described in the literature and clinical setting. The psychological effects have been largely ignored until recently. Recent studies have found that the use of hormonal contraceptives has an effect on women’s hormones and psychological well-being. The aim of this present research was to check the effect of hormonal contraceptive pills on anterior pituitary gland among female wister rat histomorphometrically. Thirty (30) female wister rats of 3 month old weighing 150 – 200g were used for the study. They were divided into three (3) groups of 10 rats each. Group one (1) received Microlut Levonorgestrel 30mg at a dose of 0.18g/kg while group two (2) received a combination of microgynon levonorgesrel 150mg and ehinylestadiol 130mg at a dose of o.18g/kg in 5 days cycle while group three (3) serve as control group. The experiment last for 72 days. Histomorphometrical analysis of anterior pituitary gland was carried out. The findings revealed that combined oral contraceptive pills adversely cause the decrease in the cells of the anterior pituitary more than the progestin only pills.

The Effectiveness of Treating Anxiety with Reiki

The effectiveness of treating anxiety with Reiki is explored within ten quantitative studies. Methodology utilized for a critical appraisal and systematic review of the literature is explained with inclusion and exclusion criteria. Theoretical framework for the project is grounded in the work of Hildegard Peplau, whose nursing theory based on the therapeutic use of self is foundational for Reiki implementation. A thorough critique of the literature is conducted for key components of robustness and believability. This critique is conducted using a structured guide addressing synthesized strengths and weaknesses of the body of literature. A synthesis of the literature explores the findings of the studies. This synthesis reports on Reiki’s effectiveness in treating anxiety within a variety of patient settings and populations, its effect on subscales of anxiety, physiological manifestations of anxiety and pain associated with anxiety. Cultural considerations effecting Reiki’s potential effectiveness are discussed. Gaps in the literature are examined, including the studies’ narrow sample population, lack of participant exclusionary factors for controlled outcome data, and the lack of studies across time. Implications for future research are discussed with recommendations for expanded research that includes a broader variety of settings, age groups, and patient diagnoses, including anxiety disorders, for research data that is transferable. Implications for further practice for the advanced practice registered nurse (APRN) are explored, with the potential benefits for both providers and patients, including improved patient satisfaction and expansion of provider treatment modalities.

Research Gaps In Contaminants Of Emerging Concern (CECs): Routes To The Standardization Of Chemical Test Methods By GC/LC-Mass Spectrometry: A Review

A literature review was undertaken with a focus on 1) identifying the research gaps regarding CECs, 2) identifying the most common ones, and 3) identifying the typical analytical methods/technologies employed, for their analysis. A total of 214 papers were noted, with a total of 21 review articles (9.8%). Of this total, a surprisingly high number were from South Africa alone: 117 (54.7%), of which 44 (20.6%) reports were associated with South Africa’s Water Research Commission (WRC). The top three CECs research gaps were (decreasing rank: Number of “gaps”, %): 1) Toxicity/Risk/Impact (260, 21.5%), 2) Analysis/Tests/Methods (118, 9.8%) and 2) Future research/studies (118, 9.8%), and 3) Monitoring (89, 7.4%). The common classes of CECs that were reported on, were : (i) Chemical: pharmaceuticals, personal care products, steroids, chlorinated and brominated contaminants, PAHs, PCBs, phthalates, alkyl phenols, herbicides, organochlorine pesticides, engineered nanomaterials and (ii) “Microbiological”: antibiotic resistance genes, human enteric bacteria and viruses, microbial pathogens (e.g., E Coli, rotavirus, Crypto, etc.), infectious biological water contaminants (e.g., E Coli isolates), cyanobacterial blooms (Microcystis). Common test methods used for analysis of the chemical contaminants were found to be chromatography (gas, liquid)-mass spectrometry; for the microbial contaminants, they were culture-based methods, ELISA, fluorescence microscopy, qPCR, RT-qPCR, gel electrophoresis, Raman spectroscopy, and also chromatography (largely liquid)-mass spectrometry, were also used. Some proposals were additionally made to address the very common, significant research gaps noted in CECs research, especially the standardization of analytical chemical test methods, based on chromatography-mass spectrometry, for quantification.

Spontaneous Subgaleal Hemorrhage in a Child with Autism

Severe ascorbic acid (Vitamin C) deficiency, commonly known as “scurvy,” continues to be a problem in malnourished populations across the world but is relatively rare in the United States. Early features of this condition include general weakness, fatigue, and aching limbs. An extremely rare and late feature of this condition is subgaleal hemorrhage. Scurvy has such a low prevalence in First World countries that it is often misdiagnosed or not diagnosed at all. The subject in this case report presented acutely and is one of few to involve a subgaleal hemorrhage to be documented in medical literature to date. Laboratory studies and clinical improvement through treatment established the diagnosis. Ascorbic acid deficiency should be considered when evaluating children with poor nutrition despite socioeconomic status, living conditions, or access to health care. This case also reminds us that neurodivergent children are a vulnerable population and more research will need to be conducted to determine just how detrimental the pandemic has been to patients with ongoing problems who were lost to follow up.

The trajectory of immunoglobulins immune response against the different amounts of xenobiotics matches the trajectory of biological changes associated with ageing: A systematic review

Background Ageing is a life process in which progressive molecular, cellular, physiological and anatomical changes manifesting in humans and animals including other organisms lead to the decline of biological functions. Immunoglobulins (Igs) are glycoprotein molecules produced by white blood cells mainly B lymphocytes following signal transduction as a result of their interaction with pathogenic microbes or poisonous substances introduced into the body systems. They elicit responses against the side effects of pathogens and poisons in which their response efficiency usually declines as we are ageing. Objective Thus, the similarities between Igs’ immune response against the different amounts of xenobiotics and the biological changes associated with ageing have been systematically assessed using the reports of different study results on humans and animals. Methods First, a literature search was carried out in google, PubMed and google scholar using planned search terms related to the title of this study. Review and original articles were retrieved, downloaded and saved on a computer. And then the effects of different factors i.e. xenobiotics, age, sex and lifestyle-based practices on the levels of serum Igs (IgG, IgA and IgM) in animals and humans have been studied using a systematic review of different literature sources. Finally, the relationship between the findings of various studies has been assessed and judgment on the possible cause of ageing has been made. Results The findings of different research have demonstrated that the signaling efficiency of immunoglobulin M (IgM) has been limited by the amount of test compounds administered to study Balb c mice in the oral route. The response efficiency of IgM immune response against the lower doses of test compounds were high compared to the higher doses of test compounds which was low. The results of different other studies also demonstrated that the decline of serum IgM levels was associated with ageing. The relationship between alcohol consumption and the concentration of serum Igs was also described in the report of different studies. These studies have shown that there was lower level of IgG in the blood serum of alcohol consumers compared to non-consumers. The study has also demonstrated a lower level of serum IgM with higher alcohol consumption and higher serum concentration with moderate beer consumption. Conclusion The trajectory of Igs’ immune response against different amounts of xenobiotics was highly associated with the trajectory of biological changes during ageing. These research findings might be the possible evidence to conclude that ageing is caused by the foodstuffs and non-foodstuffs we usually consume, the lifestyles we usually experience and the way of life we usually live in the environment which gradually defiling the natural processes of the body.

A review of ultrasound for the diagnosis of acute appendicitis in adults

Acute appendicitis is one of the most common surgical emergencies globally, with a lifetime incidence of 8.6% in men and 6.7% in women. While acute appendicitis should be managed promptly to reduce the morbidity associated with perforated appendicitis, morbidity from negative appendicectomy is similar to morbidity from uncomplicated appendicitis. Computer tomography is widely used to aid in the diagnosis of acute appendicitis, however, is costly, often has a slow turn around time, and is associated with exposure to ionising radiation. In contrast, ultrasound is cheap, widely available, requires minimal patient preparation, and does not require exposure to ionising radiation. Ultrasonography is becoming increasingly used for adult patients in emergency settings. The literature has estimated the sensitivity of ultrasound for acute appendicitis in adult patients as between 39-96.4%. The sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis is significantly increased when the appendix is visualised. In cases of a non visualised appendix, indirect ultrasound signs can improve the sensitivity to 93.9% and specificity to 85.7%. The variation in sensitivity and specificity for ultrasound in the diagnosis of acute appendicitis in adults may be due to multiple factors. Ultrasonographer experience, a retrocaecal appendix and obesity have all been described. Given the availability, cost and potential to reduce the rate of negative appendicectomy, ultrasound should be considered as the first line imaging modality for adult patients presenting with suspected AA.

Distribution of protected area and large-sized mammals order in Ethiopia

Ethiopia is one of the countries found in the eastern horn of Africa, which is endowed with beautiful landscape and topography from which diverse habitats and fauna composition. The objective of this paper is to review relevant documents on distribution of protected area and large-sized mammals order in Ethiopia. The Method of the data were by compiling related information from different sources like published articles grey literature and other office reports from concerned institutions. Altitudinal and geographical variations made the Ethiopia to be among the biodiversity-rich nations in the world. Mammal fauna in Ethiopia consists of 326 species, among 144 genera, 43 families and 14 orders; out of which 32 mammals of the country categories under critically threated group. Among the mammals in Ethiopia eight of them are endemic. Among mammals’ antelopes are flagships (charismatic). The large mammals are mainly concentrated in the south and southwest border.

Primary Breast Sarcoma

Introduction Primary sarcomas of the breast are <0.1% of all malignant tumours of the breast. To date, there are 13 major breast sarcoma series in English literature. This study adds to these series characterizing primary breast sarcoma among Philippine patients. Methods All breast biopsies from the pathology records of the University of the Philippines-Philippine General Hospital (UP-PGH) were searched for breast sarcoma cases from January 2000 to December 2010. Metaplastic carcinomas and phyllodes tumors were excluded. Results There were 52 patients (45 female, 7 male) ranging in age 25-83 years (median 46 years). Majority had lump, ten cases with pain. No history of previous cancer was given. No history of prior radiation was found. Histopathological diagnoses were spindle cell sarcoma (n=13), fibrosarcoma (n=6), liposarcoma (n=6), MPNST (n=5), stromal sarcoma (n=5), angiosarcoma (n=4), MFH (n=4), leiomyosarcoma (n=3), rhabdomyosarcoma (n=3), chondrosarcoma (n=2), and synovial sarcoma (n=1). Tumors were with grade 1 (n=18), grade 2 (n=8), and grade 3 (n=10). Necrosis was noted in 6 cases. Simple mastectomy was done in 19 cases (37%), MRM in 31 cases (59%), while 2 far advanced had no surgery (3%). None had adjuvant radiotherapy or chemotherapy. The duration of follow-up for 45 patients ranged from 1 – 117 months, excluding those who were lost to follow-up. All 15 deaths were due to progressive disease. Recurrences were observed in 9 patients. The disease-free survival (DFS) and overall survival (OS) was 73%and 75%, respectively. On multivariate analysis, DFS and OS were significantly correlated with size (HR=113.63; p=0.019 and HR=77.36; p=0.037), grade (HR=20.73 ; p=0.003andHR= 39.57; p= 0.004), and having a histology of angiosarcoma (HR=35.20 ; p=0.005and HR= 50.74; p=0.007), respectively. Conclusion Sarcoma remains an important clinical entity among primary breast cancers.

A Patient with Monoclonal Gammopathy of Undetermined Significance and Detected Philadelphia Chromosome

Background Monoclonal gammopathy of undetermined significance (MGUS) and chronic myeloid leukemia (CML) are diseases of different lineages. The diagnosis of both MGUS and CML in the same patient is a rare occurrence and has not been reported in much literature. Case Presentation We describe a 56-year-old man with a history of rheumatoid arthritis incidentally found to have an increase in IgA paraprotein. With less than 10% monoclonal plasma cells on the bone marrow biopsy and absence of hypercalcemia, renal failure, anemia and bone lesions, MGUS was diagnosed. The conventional cytogenetics at the time showed the presence of the Philadelphia chromosome in 30% of metaphases. However, there was no morphologic evidence of CML in the peripheral blood or bone marrow. Patient received no treatment and lost follow-up until 3 years later when a routine CBC showed leukocytosis and thrombocytosis. CML, chronic phase was diagnosed following a bone marrow aspiration and biopsy with Philadelphia chromosome observed in 100% of metaphases. Patient was treated with imatinib and later switched to dasatinib and complete molecular remission was continued to be achieved. Discussion and Conclusion Here we report a case of pre-leukemic CML as an incidental finding during the diagnosis of MGUS. The possible underlying mechanisms of the association are discussed although the exact cause of the coexistence is unclear.

Calcinosis Cutis on Vulgar Wart. Report of a Case

Verruca vulgaris is a very common lesion, of viral etiology, benign clinical behavior and different types of simple treatments. Its epidemiological, morphological, histological and therapeutic study has been sufficiently reflected in the literature. We present a peculiar clinical case in which calcium deposits developed on a common wart without any alterations in its metabolism being observed in the analytical studies carried out (calcinosis cutis). A 9-year-old male patient attended the dermatology service due to an excrescent keratotic lesion of recent appearance and rapid growth. We have conducted an unsucessful bibliographic search of this relationship, possibly because these have not been communicated because it is simply a morphological finding with no clinical significance.

Covid-19 Pandemic and Persons with Disabilities: Impacts and Risk Factors, Lessons for Future Interventions

Background The pandemic has disrupted the lives of many globally including persons with disabilities. These disruptions are universal. However, the vulnerable communities are more affected. Purpose The study examines impacts on persons with disabilities to share knowledge and inform interventions that ensure persons with disabilities are supported. Methodology The study is a systematic literature review using different search engines to search for scholarly articles all over the globe. Results Persons with disabilities have been negatively impacted in numerous ways: lack of access to healthcare services, inadequate rehabilitation services, increased human rights violation, stigmatization and discrimination, increased risk of dying, being subjected to violence, losing financial income, lack of access to education and treatment, increased in neglect and traumatization, poverty, lack of access to food, decreased in community support; and worse of all, in comparison with the overall population, the death of persons with disabilities during the Covid-19 is higher. These impacts were precipitated by inaccessible built environment and sense of touching, lack of disability sensitive policies, increased prevalence of risk factors, difficulties in adhering to WHO recommendations, pervasiveness of underlying health conditions, lack of disability-friendly information and inclusive intervention, national budget cuts; and poorly funded institutions. Conclusion Persons with disabilities have been negatively impacted due to many risk factors peculiar to them.

Use of Tactile Contact Accompanying Health Promotion Messages During Routine Health & Physical Examinations: A Technique for Improving Compliance

A daunting challenge for health providers and medical practitioners is communicating the vital importance of health promotion and medical treatment adherence and compliance. This article is an evidence-based, best-practices commentary advocating the use of touch-accompanied verbal suggestions during the touching portions of routine, near-universal Health & Physical examinations. Notional case examples are presented; based on the professional literature, underlying Behavioral Mechanics are discussed. Touch-accompanied verbal health promotion messages skillfully deployed in routine Health & Physical examinations offer a non-harmful and efficient technique to synergistically and substantially enhance the probability of patient compliance with health improvement and medical treatment regimens. Though it is not a magic panacea, the public health applications, extensions and benefits are incalculable in terms of healthy behavior adoption. Additionally, if deftly conducted in accordance with best practices, it has the potential to greatly improve practitioner-patient relations and increase patient satisfaction. Further avenues of research inquiry are considered.

The Use of Metabolomic Tool in Assessing Environmental Exposure

The impact of the environment on the development of non-communicable chronic diseases has gained prominence in recent years. In this context, a new chemical exposure assessment strategy is needed that is capable of revealing multiple exposures, as well as reflecting the cumulative interaction between such environmental contaminants in the biological system. From this perspective, metabolomics emerges as a promising tool in this field of knowledge, since it is able to identify changes in metabolism and/or gene expression resulting from exposure to environmental factors. The aim of this study was to describe important concepts, as well as the steps that permeate the metabolomics analysis, and also to present some relevant works with the application of metabolomics in the assessment of chemical exposure. A literature review showed a significant increase in the use of metabolomics in environmental toxicology in recent years. This increase is mainly due to advances in analytical techniques and the improvement of data processing tools. However, this field of investigation remains little explored, especially with regard to the study of toxicity associated with chronic exposure to low levels of chemical agents. Thus, it is urgent that omic biomarkers can be used as a tool for decision-making, especially with a view to protecting, diagnosing and recovering human health.

Prolonged Thrombin Time in Asymptomatic Patient with Hypo Dysfibrogememia Tucson

A 61 years female patient with known diagnosis of the breast cancer in remission for more than 10 years has Renaud’s disease. During her work up for lupus and lupus anticoagulant which both were negative a prolonged thrombin time was noted which was done by mistake. She has no history of bleeding or thrombosis and last recent surgery was 5 years ago for spinal stenosis and was uncomplicated. Her clinical examination is normal without evidence of any spontaneous bruises but colder hands. The thrombin time was greater than 125 seconds on two different occasions and correction of it by addition of normal plasma was down to 56 seconds and was thus incomplete. Her prothrombin time and PTT were normal and there was no evidence of FDP or D-Dimers. There was no evidence of circulating heparins. The fibrinogen level was normal. The para proteinmia was excluded by normal serum protein electrophoresis and by immunofixation . Thus it is felt that this patient has dysfibrinogenemia or hypo dysfibrinogenemia without bleeding or thrombotic complication. The literature review shows approximately 55% of dysfibrinogenemia patients do not have bleeding or thrombotic complications.

RETRACTED: Postulation of the Effect of Unpredicted Predisposing Factors for Post-Tonsillectomy Bleeding

This article has been retracted on 20 January 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5850) Back ground and Objectives Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. Hence the tonsils and peritonsillar tissues are highly vascular zone that supplied by direct branches of external carotid artery thus the post-tonsillectomy bleeding remains one of significant issues in relation to this widely performed procedure. The post-tonsillectomy bleeding needs frequently to be postulated for its incidence, prevalence, etiology, predisposing factors, management and prevention. This subject constitutes one of most risky aspects that increase wariness of the surgeons regarding this commonly conducted procedure. Although there are huge numbers of presentative literatures coming from American as well as western institutes that tried to put guidelines for purpose of prevention and management of post-tonsillectomy bleeding but broadly at our middle-east region and locally at our Libyan society we found for some extent difficulties to apply all these guidelines. For this reason this issue has been take the wider spectrum of ENT surgeons’ concentration, discussions, and researches. Therefore this study was conducted prospectively and for long time to confirm the possible predisposing factors that could be responsible for increasing the risk of post-tonsillectomy bleeding at our region and in the same time to illustrate the concluded recommendations to prevent the occurrence of this important complication. Patients and Methods 2880 patients aged from 8 months to 85 years presented at ENT department-AL-hawari ENT and urology teaching center- Benghazi-city – Libya as well as AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city – Libya at period in between September 2003 to March 2015 as cases of chronic adeno-tonsillitis and solitary acute as well as chronic related palatine tonsillar disease with variable patterns of indications for tonsillectomy namely snoring and apnea attacks, recurrent attacks of acute tonsillitis, persistent otitis media with effusion, recurrent attacks of acute suppurative otitis media, failure to thrive, recurrent attacks of chest infection, mal-occlusive dental deformity, unilateral enlarged tonsils, post-traumatic avulsed tonsils, history of quinsy abscess and persistent halitosis. All patients were assessed intra-operatively and post-operatively too for any evidences of primary, reactionary, or secondary hemorrhage in relation to wide spectrum of factors as patient's demographic, medical, and socio-habitual factors, in addition to technical as well as post-operative care factors. Results This presenting study confirmed that the most common type of post-tonsillectomy bleeding was the secondary variety (71%) as compared to primary (22%) and reactionary (7%) among all presented post-tonsillectomy bleeding cases. Although through this presenting serial study there were multifactorial pre-dispositions elucidated for secondary post-tonsillectomy hemorrhage but as general poor post-operative care can be considered as the cornerstone for the pathogenesis of this significantly raised incidence of secondary post-tonsillectomy bleeding this may be in form of inadequate patient's hydration and nutritional supply (47%), poor patient's antibiotic compliance (23%), and child's maternal negligence (19%). The time of surgery was found to be another important pre-disposing factor for post-tonsillectomy bleeding, it was postulated that the incidence of reactionary as well as secondary post-tonsillectomy hemorrhage significantly increased at summer and autumn seasons (69%) as compared to other seasons. The place of surgery was another interesting proposed studied factor among this serial presentation it was observed that the incidence of post-tonsillectomy bleeding among patients who operated at AL-hawari ENT and urology teaching center-Benghazi-city significantly higher (63%) than that among cases who interfered at AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city. Conclusion Generally speaking, post-tonsillectomy bleeding is considered as one of important issues in ENT and one of significant post-tonsillectomy complications which may create a critical morbidity that may rarely extend to post-operative mortality. Hence the most common pattern of post-tonsillectomy bleeding is the secondary type; however this type of post-tonsillectomy hemorrhage is pre-disposed and induced by many factors. Most of these factors are treatable and curable thus the prophylaxis against this significant complication can be achievable.

Critical Review of Teaching and Learning Methodologies for Learners with Special Educational Needs in the 21st Century and Beyond

The number of children with SEN is continuously growing, leading to pressure on the few special schools available in the USA. Furthermore, the adoption of a special school system has been criticized on the basis that it isolates and discriminates against children with special educational needs and disabilities. Even though inclusive education can address such limitations, the application of the most appropriate pedagogical approaches for SEN learners is still a challenge. The presented study focused on critically appraising the pedagogical approaches for SEN learners in the 21st century and beyond. In order to achieve this goal, a systematic review of the literature approach was adopted. The literature search process was conducted on three databases: Education Full Text, Linguistics and Language Behavior Abstracts, and PsycINFO. The selection of these databases was influenced by their reputation of hosting high quality and up-to-date literature about special education. The initial literature search process generated 6129 hits, but only ten studies were finally selected for review after the application of inclusion and exclusion criteria. A critical review of the evidence presented in the selected studies generated eight themes describing various pedagogical approaches for special education, within both blended and mainstream learning environment. Knowledge generated in this systematic review can be used by the special education sector of the U.S to develop pedagogical approaches for SEN students, leading to improved performance and social skill development.

Analgesic and Anti-Pyretic Activities of the Root Bark of Rutidea Parviflora (Rubiaceae)

This study aims at investigating the antipyretic activity of different solvent fractions of the root bark of Rutideaparviflora(Rubiaceae). This plant is used ethno-botanically by the people of Ethiope East-West Local Government Area of Delta State, Nigeria to treat various ailments such as inflammation, fever and pain. This necessitated this research to validate its local use, due to the scanty literature and information present about this plant. It has also shown some anti-cancer and anti-inflammatory activity in previous researches. The present study is a randomized control study. Acetic acid induced writhing was employed for analgesic testing. Acetic acid was used to induce writhing in Wistar rats which were divided into fourteen (14) groups. The groups were administered extracts and fractions of the plant (200 mg/kg and 400 mg/kg). The animals were observed for number of writing movements and the percentage writhing was calculated. Baker’s yeast induced pyrexia was employed for the antipyretic testing. The animal groups were administered extracts and fractions of the plant (200 mg/kg and 400 mg/kg), with Paracetamol as the standard drug (100 mg/kg) and Normal saline (control) for both experiments. The body temperature of the rats was measured rectally over a period of five (5) hours. All values of P<0.05 were taken as significant. The organic extract, aqueous extract and various fractions (n-hexane, ethyl-acetate, n-butanol and aqueous) produced significant inhibition of writhing responses and pyrexia in a dose dependent manner and time dependent manner respectively. The aqueous extract at a dose of 400mg/kg showed the greatest reduction in writhing, 91.58% compared to the standard drug (paracetamol) which may suggest that the fraction possesses better efficacy than paracetamol as an analgesic. The observed activities could be attributed to these bioactive compounds: Palmatine, Urs-12-ene-24-oic-3-oxo-methyl ester and Gallic acid contained in R. parviflora.

Review article on Analytical Techniques of Lamivudine Determination in Different Matrices

In this literature review, we will introduce most of up-to-date reported methods that have been developed for determination of lamivudine in its pure form, combined form with other drugs, combined form with degradation products, and in biological samples.

Osteoarthritis, COVID-19 Social Isolation-Impacts, and Counter Solutions

Background to the Issue Many older adults, including those already suffering from chronically painful disabling osteoarthritis of one or more joints remain more susceptible than healthy age and gender matched adults to the COVID-19 corona virus. Aims This report sought to examine what has been published in 2020 on this health condition from the perspective of the variable of widely imposed social isolation strategies designed to mitigate the spread of this highly infectious disease, and to especially keep older community dwelling adults ‘safe’ from infection. Methods Reviewed were all articles published in 2020 in PUBMED from January 1-December 24, 2020 on osteoarthritis and COVID-19 isolation impacts, plus relevant past osteoarthritis and isolation literature among older adults. The focus was on ascertaining how social isolation and distancing strategies might impact current community-dwelling adults diagnosed with osteoarthritis and whether more should be done specifically to mitigate any potentially preventable ‘socially’ induced negative health impact among this group, in spite of the laudable goals of this public health strategy. Results Older adults with osteoarthritis living in the community who are asked to self-isolate, may incur more osteoarthritis pain and disability than would otherwise be encountered if actions taken to counter this possibility are not forthcoming. Advocated over and above basic care approaches are several psychosocial strategies including the role of mobilizing various forms of social support. Conclusion Data indicate a need for concerted thoughtful and immediate attention to offset isolation, fear, and anxiety and depression effects as part of a carefully devised integrated plan of management to reduce excess osteoarthritis disability, as well as excess COVID-19 risk among otherwise free living older adults already compromised by osteoarthritis.

A Systematic Review of the Antimony Content of the Normal Human Prostate Gland

The prostate gland is subject to various disorders. The etiology and pathogenesis of these diseases remain not well understood. Moreover, despite technological advancements, the differential diagnosis of prostate disorders has become progressively more complex and controversial. It was suggested that the antimony (Sb) level in prostatic tissue plays an important role in prostatic carcinogenesis and its measurement may be useful as a cancer biomarker. These suggestions promoted more detailed studies of the Sb content in the prostatic tissue of healthy subjects. The present study evaluated by systematic analysis the published data for Sb content analyzed in prostatic tissue of “normal” glands. This evaluation reviewed 1998 studies, all of which were published in the years from 1921 to 2020 and were located by searching the databases PubMed, Scopus, ELSEVIER-EMBASE, Cochrane Library, and the Web of Science. The articles were analyzed and “Median of Means” and “Range of Means” were used to examine heterogeneity of the measured Sb content in prostates of apparently healthy men. The objective analysis was performed on data from the 23 studies, which included 1173 subjects. It was found that the range of means of prostatic Sb content reported in the literature for “normal” gland varies widely from 0.0066 mg/kg to 0.071 mg/kg with median of means 0.0085 mg/kg on a wet mass basis. Because of small sample size and high data heterogeneity, we recommend other primary studies be performed.

COVID-19, and Vitamin D, and Air Pollution Global Epidemics Impact on Older Adults

Background Most current Corona virus or COVID-19 pandemic deaths have been found to occur among populations older than 65 years of age, who often suffer from the presence of an array of chronic diseases that may be related to a co-occurring vitamin D deficiency. Another factor affecting older adults’ immune response mechanisms is air quality. In turn, air quality can impact the absorption of vitamin D from sunlight sources, a factor which could explain why older people, who are often vitamin D deficient, may be more likely than younger adults or healthy adults to be at risk for COVID-19 and poor outcomes. Aim This work was designed to examine the recent literature on COVID-19, vitamin D and air pollution and what it might imply for public health workers, policy makers, and others. Methods Available data accessed largely from the PUBMED data base for the year 2020 using the key words COVID-19, air pollution, and vitamin D deficiency were sought and selected items were carefully examined and documented in narrative and tabular formats. Results Many publications on COVID-19 prevail, but far fewer focus specifically on vitamin D deficiency and its possible role in explaining COVID-19 global health risk among older adults. A similar, albeit small number of publications, discuss the global pandemics of air pollution and its possible COVID-19 association, as well as its impact on vitamin D production. However, while most related articles support a possible independent as well as a dual role for both factors in COVID-19 the realm of this highly infectious widespread disease, very few actual studies have been conducted to date on any of these topical issues Conclusion More research to examine if vitamin D-based nutrients or supplements may provide some degree of community wide protection against COVID-19 in the older vitamin D populations, especially among those living in highly polluted areas may prove highly valuable. Controlling air pollution emissions globally and locally may also prove to be a highly impactful public health approach to reducing overall COVID-19 risk, and extent, and warrants study.

Effect of Drought and Salt Stress on Cereal Crop Plants and their Proteomic and Physiological Studies

The photosynthetic potential and underlying internal metabolism of a plant are some of the most commonly affected physiological functions as a direct consequence of stresses due to salt and water resulting in hindering plant growth and productivity. Under the influence of such detrimental stresses, a drastic alteration in a plant's osmotic requirements, hormonal production, shedding of leaves, and closure of stomata, along with a lessening in the diffusion and transportation of CO2 and H2O are commonly seen. This review unfolds with a description of the basic methodology involved in the proteomic analysis of various proteins involved in stress response along with a brief idea on identifying and obtaining a genomic sequence for proteomic studies. It then dives deep into understanding the impact of abiotic stresses such as salinity, drought and high temperatures on cereal crops such as rice and sorghum as well as the internal dynamics of tolerance mechanism unfolding during stresses have also been described. Extensive literature describing the proteomic and physiological responses to primary and secondary effects of salt stress in cereal crops emphasizing on ROS production and apoptosis, the role of osmolytes as ROS scavengers during osmotic stress and vacuolar antiporters in ionic stress along with the responses during drought stress such as the accumulation of LEA proteins and ABA-based signaling has been reviewed and critically discussed. The study also sheds light on some experimental proteomic studies conducted on the seedlings, root tissues, and shoots of rice cultivars.

Reactive Stepping Responses Mediated by Predictable Manual Waist-Pull Perturbations are Associated with Fall History in Older Adults

Background and Purpose The ability to respond effectively to perturbations is a key element of reactive postural control and is a crucial mediator of falls. Several studies exist in the literature that determine older adults’ responses to perturbations, however those studies typically involve procedures that lack objectivity or applicability outside a laboratory. A study involving waist-pull perturbations with a spring-scale (SS) is an exception. In that study, fall history was most accurately differentiated by a reactive stepping response to a perturbing force of 10% total body weight. Using data from that study, we retrospectively examined the association between fall history and the number of steps accompanying a SS perturbing force of 10% total body weight in older adults. For perspective, the association of fall history with Timed-Up-and-Go (TUG) and single limb stance (SLS) times was also determined. Methods Fifty-eight healthy older adults (mean age = 80.7 years) participated in the study. Their 2-year fall history (yes, no) was recorded. All participants underwent SS testing with one-pound incremental, horizontal sagittal plane manual waist-pull perturbations. The number of steps in response to perturbation with 10% total body weight was recorded; TUG and SLS tests were performed. Associations between variables were examined using Spearman (rank-biserial) correlations. Results The median number of steps for fallers was 5 in both anterior and posterior directions. For non-fallers, the median number of steps was 1 and 2 in the anterior and posterior directions, respectively. The significant correlations between fall status and number of steps were 0.772 and 0.813 for the anterior and posterior directions, respectively. Similarly, the significant correlations between fall status and balance tests were 0.722 and -0.456 for the TUG and the SLS, respectively. Conclusions The number of steps accompanying waist-pull perturbations with forces of 10% of body weight were highly explanatory of experiencing a fall during the preceding 2 years.

Effects of Selected Secondary Metabolites in Leaf Extract of Jatropha Tanjorensis on Some Gonadal Hormones in Male Wistar Rats

Background and Objective The use of medicinal plants in industrialized societies for extraction and development of many drugs and other chemotherapeutics and traditionally for herbal remedies has increased in recent times. Plant–based medicine is essential in health care services with about 80% global population relying on it because of its cheap source and availability. Jatropha tanjorensis is one such plant used by males and females of childbearing age for treatment of reproductive problems such as infertility. Literature on isolation and characterization of the secondary metabolites in this plant may not be common. Against this backdrop, this research work was carried out to isolate, characterize and determine the effects of J. tanjorensis on the gonadal hormones of male wistar rats. Materials and Methods The secondary metabolites were isolated, characterized, and identified using nuclear magnetic resonance. The experiment was conducted using 25 male wistar rats weighing between 180-200 g randomized into 5 groups, 3 controls and 2 treatment groups of 5 rats each. The treatment groups received 25 mg/kg body weight of phytol and lupeol orally by gastric lavage for 14 days. The animals were anaesthetized and blood samples collected for hormonal assay. Result The experimental data was analyzed using one-way analysis of variance (ANOVA) with Statistical Package for Social Sciences (SPSS) version 17.0, while the post hoc test assessed using Duncan Multiple Range Test at p ≥ 0.05. There was a significant decrease (p ˂ 0.05) in the levels of FSH, LH and TST in the treatment groups when compared to the control groups. The motility and sperm count decrease significantly (p ˂ 0.05) when treatment groups were compared to the control animals. The secondary metabolites, phytol and lupeol present in the leaf extract of Jatropha tanjorensis were responsible for the decrease in some of the gonadal hormones studied.

Review on 3D Printed Bone Scaffold and Biocompatible Material

Bone Scaffold is a three-dimensional porous construction which provides support to promote natural cell growth in damaged or broken section of bone. In recent years researchers from various departments like biomedical, mechanical, orthopedics, have shown significant interest in adopting ‘Bone Scaffolds’ as a promising treatment for bone defects. ‘Bone Scaffold’ is a honeycomb-like architecture composes of bio-compatible material having grater advantages over current grafting solution. In this paper, the authors try to review the available e-articles in an organized way on the bone scaffold in the field of biomedical implants with 3D printing. The selected literature mainly focuses on the biocompatible material and various advanced manufacturing methods used for manufacturing / preparing of bone scaffolds. This article tries to padding the gap between theoretical and actual implementation of ‘Bone Scaffolds’ by properly analyzing selected research and allowing future opportunities for reinventing the new possibilities in the field of biomedical.

Is the Onion Router a Secure Network?

This paper attempts to answer the question of how government agencies use The Onion Router, or Tor, in conducting investigations. The essay observes that Tor is free open-source software that can be used by anyone who desires to communicate with others in a secure manner. In surveying the literature, it is found that Tor can be employed for both legal and illegal purposes. As the major financial contributor, Tor is used by government to secure its communications. Because Tor by bad actors, and because many of the Tor relays are operated by government agencies, Tor has been successfully employed in catching unsuspecting criminals. The conclusion of this exposition is that if one wants to communicate securely with someone else, and not be visible to government agencies, Tor should not be the vehicle of choice. There are alternative modes of communication that can thwart the risk of government surveillance.

General Doctor's Consultation Work Begins before Entering the Patient and does not End when Patient Comes Out

The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.

Adaptive Artificial Passive Immunity as a Suggested Strategy for Treatment of COVID-19 Critical Cases

Currently, the emergence of a novel human corona virus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-14 days, facilitating its spread via droplets, contaminated hands or surfaces, resulting in high spread and death rates according to date, time and place of infection. We therefore reviewed the literature on all available information about the treatment of the cases, especially critical cases to decrease the mortality rate, the spread and incubation time of the virus by using the adaptive artificial passive immunity (anti-bodies from fully recovered patients with COVID-19).  

Analysis and Forecast Based on the Kinetic Equation for Changing the Numerical Composition of Living Systems

The possibility of applying the kinetic theory of aging of biological species published earlier by the authors of this work to assess and predict changes in the number of specific populations is evaluated. The populations of the USA, China and Russia, as well as the population of mice observed in the experiment "mouse paradise" of the American scientist John Calhoun are considered. To this end, a historically consistent analysis of the main previously proposed multi-scenario mathematical models describing demographic data and predicting the dynamics of the population was performed. The results of these models show a decrease in the population growth rate, a tendency toward a limit with an increase in historical time, the achievement of such a limit in some developed countries with a relatively high level of social security, a subsequent decrease in the number and further uncertainty of the final population outlook in the distant future. In addition, these models made it possible to establish that the observed population growth in developed countries is unambiguously accompanied by its aging - a relative predominant increase in the number of elderly people compared to the number of the younger generation (people are aging, the population of countries is aging). In this work, the assumption was made and confirmed that the dynamics of the aging of the population of the countries of the World corresponds to the dynamics of aging of a person of one generation and is mathematically described by the differential equation of the kinetic theory of aging of living systems of the same type with close values of the parameters. The biophysical meaning of the parameters of the kinetic equation reflects G. Selye's concept of the determining role of stress in human life and populations. An analysis of the changes in the numbers of the considered populations of humans and mice at various stages of their development is qualitatively commented on from the standpoint of comparative tension according to G. Selye. To assess the degree of aging of a biological object of one population in kinetic theory, the probability of death during life is selected as an indicator of aging. In this work, the probability of reaching the maximum population size was chosen as an indicator of the aging of a biological object of various populations. The published literature predicts various options for changing the population after reaching a maximum - maintaining the reached maximum level and decreasing to a certain limit, less than the maximum achieved. In this paper, based on an analysis of its results and an analogy with the complete degeneration of mice in the “mouse paradise” experiment, a conclusion is drawn about a hypothetically possible third variant of the limiting decrease in the population - its complete degeneration.

Observations and analysis of risk factors for GDV in a single institution: a case-control study

Objective To evaluate/ determine the risk factors for dogs presented with Gastric Dilation- Volvulus (GDV) to a referral veterinary centre and to compare the results with those currently reported in veterinary literature. Materials and Methods The observational case-control study comprised a population of 215 dogs that attended the referral centre between 2000 and 2018. Medical records were searched for GDV and those matching the criteria were manually reviewed. A questionnaire was completed by the owners of the dogs involved in the study (both case and control populations) in order to gain further information that could be considered relevant to GDVs. In particular, information included the dogs’ behaviour and the dogs daily activities. Results The study included 115 cases of GDV and 115 controls. Out of the GDV dogs 13% (15/115) were small breed dogs and the remaining 87% (100/115) either large or giant breeds. The following risk factors for developing a GDV have been identified: Purebred dogs over 3 years old and either large of giant breeds, weighing > 30 kg. Foreign body ingestion, diarrhoea, and grass consumption were also associated to increase the likelihood in developing GDV. Behavioural temperament was not associated with developing GDV. Clinical Significance The findings support previously identified risk factors in the development of GDV, but characteristics related to the dogs temperament warrant further investigation. Knowledge of these results will further allow clinicians to make evidence‐based recommendations to owners in attempting to prevent GDV in dogs. Furthermore this paper confirms that the risk of GDV in certain breeds and in certain conditions is always high and that GDV is still an extremely current disease.

RETRACTED: Amino Acid Imbalance in Atherosclerosis

This article has been retracted on 18 March 2021. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-7835.ijn-25-5865) A mini-review of literature data on the mechanisms of formation of the stock of free amino acids and their derivatives in atherosclerosis and methods for correcting metabolic imbalance.

Amino Acids and their Derivatives in Pathogenesis and Treatment of Liver Diseases

A mini-review of literature data on the mechanisms of formation of the stock of free amino acids and their derivatives in liver pathology and methods for correcting metabolic imbalance