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Context: Sport-related dystonia is a rare form of activity-specific dystonia that can severely impair an athlete's ability to perform. Due to a lack of data on the condition, it is difficult to diagnose and often overlooked, and no gold standard treatment has yet been defined. Case Presentation: We present a rare and challenging case of sport-related dystonia that affected a 24-year-old male professional soccer player. The patient presented with severe rigidity and dystonia of the right lower-extremity, particularly the ankle and foot. The symptoms set on >1 year prior to the presentation to our outpatient clinic. He began to complain of stiffness and difficulty moving his lower limbs, especially his right leg, initially when playing soccer, but then also when walking normally. On presentation, he was unable to run and walked with difficulty, supporting his body weight only on the outside of his right foot. He also reported a motor trick and reverse motor trick involving the oral musculature in order to move his lower limb more freely. Management and Outcomes: An integrated rehabilitation approach based on postural rehabilitation, neuromuscular rehabilitation, and dental intervention was used to successfully treat this condition. The approach included: (1) postural rehabilitation with the Mézières-Bertelè method to reduce muscular stiffness, (2) neuromuscular re-education with Tai Chi exercises and electromyography-guided biofeedback, and (3) dental intervention and swallowing rehabilitation to limit impaired oral habits (due to the relationship between his impaired lower limb movements and motor tricks of the oral musculature). After 7 months of integrated rehabilitation, the patient returned to professional soccer. Conclusions: This case report highlights the potential efficacy of an integrative rehabilitation approach for sports dystonia, particularly in cases where traditional treatments may not be effective. Such an approach could be considered a valuable option in the management of this rare, but debilitating, condition in athletes. Further research is needed to assess the effectiveness of this approach in larger populations. [ABSTRACT FROM AUTHOR]

Context: The medial collateral ligament is the most commonly injured ligament in the knee. The high-speed pivoting and agility movements that are common in the sport of American Football put participants at an increased risk for a valgus force stress from contact or noncontact injuries. Positional release therapy (PRT) also considered strain/counterstrain focuses on releasing the tension in a tissue through unloading the involved body part. Case Presentation: Two male student-athletes participating in football with a mean age of 20.5 years were diagnosed by a physician with medial collateral ligament grade 2 sprain. Both patients sustained their injuries in a regular season game with a contact valgus force from an opposing player. Management and Outcomes: After the initial 72 hours of compression, elevation, and cryotherapy, the patients were both treated with PRT followed by progressive loading exercises. Following 4 treatment sessions of PRT over the next 6 days, the patients started with quadriceps engagement exercises, single-leg squats to 60° knee flexion, side steps, triceps dips, slow controlled lunges, and toe walk. The patients progressed to full body weight squats, single-leg landing, step-up tri-extension, and sidekicks with a leg on table. Then, the patients completed function movements and sports-specific exercises. Conclusions: In this case series, 2 patients competing in intercollege American Football were treated with PRT and progressive loading exercises to facilitate return to unrestricted activities and improve outcome measures. Commonly, a grade 2 medial collateral ligament sprain is conservatively treated with return to sport taking 20 days on average. In this type 2 case series, the clinician found success utilizing PRT early in the recovery process, which in these 2 cases lead to restoration of function, outcome measure improvement, and an expedited return to sport. The expedited return to sport occurred at an average of 18 days for these patients. [ABSTRACT FROM AUTHOR]

Erythroderma, an inflammatory skin condition characterized by widespread erythema with variable degrees of exfoliation, pustulation, or vesiculobullous formation, is associated with high morbidity and mortality. Determining the underlying cause of erythroderma frequently presents a diagnostic challenge, which may contribute to the condition's relatively poor prognosis. This review covers the clinical presentation, pathophysiology, diagnosis, and treatment of erythroderma. It discusses similarities and differences among the many underlying etiologies of the condition and differences between erythrodermic and non-erythrodermic presentations of the same dermatosis. Finally, this article explores current research that may provide future tools in the diagnosis and management of erythroderma. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder is a neurodevelopmental disorder characterized by a wide range of behavioral alterations, including impaired social interaction and repetitive behaviors. Numerous pharmacological interventions have been developed for autism spectrum disorder, often proving ineffective and accompanied by a multitude of side effects. The gut microbial alterations observed in individuals with autism spectrum disorder, including elevated levels of Bacteroidetes, Firmicutes, and Proteobacteria, as well as reduced levels of Bifidobacterium, provide a basis for further investigation. Recent preclinical studies have shown favorable outcomes with probiotic therapy, including improvements in oxidative stress, anti-inflammatory effects, regulation of neurotransmitters, and restoration of microbial balance. The aim of this review is to explore the potential of probiotics for the management and treatment of autism spectrum disorder, by investigating insights from recent studies in animals. Autism spectrum disorder is a neurodevelopmental disorder characterized by a wide range of behavioral alterations, including impaired social interaction and repetitive behaviors. Numerous pharmacological interventions have been developed for autism spectrum disorder, often proving ineffective and accompanied by a multitude of side effects. The gut microbiota is the reservoir of bacteria inhabiting our gastrointestinal tract. The gut microbial alterations observed in individuals with autism spectrum disorder, including elevated levels of Bacteroidetes, Firmicutes, and Proteobacteria, as well as reduced levels of Bifidobacterium, provide a basis for further investigation into the role of the gut microbiota in autism spectrum disorder. Recent preclinical studies have shown favorable outcomes with probiotic therapy, including improvements in oxidative stress, anti-inflammatory effects, regulation of neurotransmitters, and restoration of microbial balance. The aim of this review is to explore the potential of probiotics for the management and treatment of autism spectrum disorder, by investigating insights from recent studies in animals. [ABSTRACT FROM AUTHOR]

Background: Enhancing the interactions between study participants, clinicians, and investigators is imperative for advancing Parkinson's disease (PD) research. The Canadian Open Parkinson Network (C-OPN) stands as a nationwide endeavor, connecting the PD community with ten accredited universities and movement disorders research centers spanning, at the time of this analysis, British Columbia, Alberta, Ontario, and Quebec. Objective: Our aim is to showcase C-OPN as a paradigm for bolstering national collaboration to accelerate PD research and to provide an initial overview of already collected data sets. Methods: The C-OPN database comprises de-identified data concerning demographics, symptoms and signs, treatment approaches, and standardized assessments. Additionally, it collects venous blood-derived biomaterials, such as for analyses of DNA, peripheral blood mononuclear cells (PBMC), and serum. Accessible to researchers, C-OPN resources are available through web-based data management systems for multi-center studies, including REDCap. Results: As of November 2023, the C-OPN had enrolled 1,505 PD participants. The male-to-female ratio was 1.77:1, with 83% (n = 1098) residing in urban areas and 82% (n = 1084) having pursued post-secondary education. The average age at diagnosis was 60.2±10.3 years. Herein, our analysis of the C-OPN PD cohort encompasses environmental factors, motor and non-motor symptoms, disease management, and regional differences among provinces. As of April 2024, 32 research projects have utilized C-OPN resources. Conclusions: C-OPN represents a national platform promoting multidisciplinary and multisite research that focuses on PD to promote innovation, exploration of care models, and collaboration among Canadian scientists. Plain Language Summary: Teamwork and communication between people living with Parkinson's disease (PD), physicians, health professionals, and research scientists is important for improving the lives of those living with this condition. The Canadian Open Parkinson Network (C-OPN) is a Canada-wide initiative, connecting the PD community with ten accredited universities and movement disorders research centers located in – at the time of this analysis–British Columbia, Alberta, Ontario, and Quebec. The aim of this paper is to showcase C-OPN as a useful resource for physician and research scientists studying PD in Canada and around the world, and to provide snapshot of already collected data. The C-OPN database comprises de-identified (meaning removal of any identifying information, such as name or date of birth) data concerning lifestyle, disease symptoms, treatments, and results from standardized tests. It also collects blood samples for further analysis. As of November 2023, C-OPN had enrolled 1,505 PD participants across Canada. Most of the participants were male (64%), living in urban areas (83%), and completed post-secondary education (82%). The average age at diagnosis was 60.2±10.3 years. In this paper, we look at environmental factors, motor and non-motor symptoms, different disease management strategies, and regional differences between provinces. In conclusion, C-OPN represents a national platform that encourages multidisciplinary and multisite research focusing on PD to promote innovation and collaboration among Canadian scientists. [ABSTRACT FROM AUTHOR]

Background: Pain fluctuations are a characteristic phenomenon in advanced Parkinson's disease (PD), but their temporal association with motor and non-motor symptom (NMS) fluctuations remains largely enigmatic. Moreover, data on their importance for disease severity perception and health-related quality-of-life (hr-QoL) is limited. Objective: To dissect pain fluctuations with respect to pain type and frequency patterns, and their association with motor and non-motor fluctuations. Methods: Prospective observational cohort study in advanced PD assessing symptom fluctuations by simultaneous hourly ratings using the PD Home diary (Off, On, Dyskinetic state), a pain diary (assessing 9 pain types) and a non-motor diary (10 key NMS) based on validated instruments. Results: Forty-seven out of 55 eligible participants with fluctuating PD (51% men, median age 65, median disease duration 10 years) had sufficient datasets (>95% of hours) from 2 consecutive days. Pain was reported in 35% of waking hours with clear circadian rhythm peaking in early morning Off periods and clustering during motor Off state (49% of Off state hours with pain). Main NMS co-fluctuating with pain were "Fatigue" and "Inner Restlessness". Simultaneous assessment of global disease severity by participants revealed that pain was associated with worse disease severity only in motor On and Dyskinetic state but not in Off state, which translated into significant correlations of daily pain times with hr-QoL only during motor On and Dyskinetic state. Conclusions: Aside from treating motor Off periods, specific recognition of pain particularly during motor On and Dyskinetic state comprises an important aspect for disease management in advanced PD. Plain Language Summary: Oscillations of the frequency and severity of pain over the day (also called pain fluctuations) are common in advanced Parkinson's disease (PD). However, their relationship with oscillations of motor and other non-motor symptoms remains unclear. Moreover, only very little data exists on how pain impacts disease severity perception and quality of life for the patients. The present study thus aimed to better understand pain fluctuations and their association with motor and non-motor symptoms in advanced PD. We conducted a prospective observational cohort study in advanced PD patients. Participants rated their symptoms hourly on two consecutive days using three diaries: the PD Home diary (for motor fluctuations), a pain diary (assessing several pain types), and a non-motor diary covering 10 key non-motor symptoms. Pain occurred during 35% of waking hours with a clear circadian rhythm peaking in the early morning and clustering during motor "Off" states as characterized by pronounced motor symptoms. The main non-motor symptoms associated with pain were "Fatigue" and "Inner Restlessness." Interestingly, pain severity correlated with health-related quality of life only during motor "On" state (defined as a state with good mobility and motor function) and "Dyskinetic" state characterized by the occurrence of involuntary movements, but not during motor "Off" periods. In conclusion, in managing advanced PD, recognizing pain during motor "On" and Dyskinetic states is crucial beyond just addressing motor "Off" periods. This understanding can significantly impact disease management and improve patients' quality of life. [ABSTRACT FROM AUTHOR]

Paediatric phaeochromocytomas and paragangliomas (PPGLs), though rare tumours, are associated with significant disability and death in the most vulnerable of patients early in their lives. However, unlike cryptogenic and insidious disease states, the clinical presentation of paediatric patients with PPGLs can be rather overt, allowing early diagnosis, granted that salient findings are recognized. Additionally, with prompt and effective intervention, prognosis is favourable if timely intervention is implemented. For this reason, this review focuses on four exemplary paediatric cases, succinctly emphasizing the now state‐of‐the‐art concepts in paediatric PPGL management. [ABSTRACT FROM AUTHOR]

Identification of the molecular culprits of allergic reactions leveraged molecular allergology applications in clinical laboratory medicine. Molecular allergology shifted the focus from complex, heterogeneous allergenic extracts, e.g. pollen, food, or insect venom, towards genetically and immunologically defined proteins available for in vitro diagnosis. Molecular allergology is a precision medicine approach for the diagnosis, stratification, therapeutic management, follow-up and prognostic evaluation of patients within a large range of allergic diseases. Exclusively available for in vitro diagnosis, molecular allergology is nonredundant with any of the current clinical tools for allergy investigation. As an example of a major application, discrimination of genuine sensitization from allergen cross-reactivity at the molecular level allows the proper targeting of the culprit allergen and thus dramatically improves patient management. This review aims at introducing clinical laboratory specialists to molecular allergology, from the biochemical and genetic bases, through immunological concepts, to daily use in the diagnosis and management of allergic diseases. [ABSTRACT FROM AUTHOR]

Introduction: Incidental pulmonary nodules (IPN) are common radiologic findings, yet management of IPNs is inconsistent across Canada. This study aims to improve IPN management based on multidisciplinary expert consensus and provides recommendations to overcome patient and system-level barriers. Methods: A modified Delphi consensus technique was conducted. Multidisciplinary experts with extensive experience in lung nodule management in Canada were recruited to participate in the panel. A survey was administered in 3 rounds, using a 5-point Likert scale to determine the level of agreement (1 = extremely agree, 5 = extremely disagree). Results: Eleven experts agreed to participate in the panel; 10 completed all 3 rounds. Consensus was achieved for 183/217 (84.3%) statements. Panellists agreed that radiology reports should include a standardized summary of findings and follow-up recommendations for all nodule sizes (ie, <6, 6-8, and >8 mm). There was strong consensus regarding the importance of an automated system for patient follow-up and that leadership support for organizational change at the administrative level is of utmost importance in improving IPN management. There was no consensus on the need for standardized national referral pathways, development of new guidelines, or establishing a uniform picture archiving and communication system. Conclusion: Canadian IPN experts agree that improved IPN management should include standardized radiology reporting of IPNs, standardized and automated follow-up of patients with IPNs, guideline adherence and implementation, and leadership support for organizational change. Future research should focus on the implementation and long-term effectiveness of these recommendations in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To examine the bidirectional association between type 2 diabetes (T2D) and irritable bowel syndrome (IBS) in a large prospective population cohort. Methods: Participants free of IBS at baseline in the UK Biobank were included in the analysis of T2D and incident IBS (cohort 1), with 11 140 T2D patients and 413 979 non‐T2D patients. Similarly, those free of T2D at baseline were included in the analysis of IBS and incident T2D (cohort 2), with 21 944 IBS patients and 413 979 non‐IBS patients. Diagnoses of T2D and IBS were based on International Classification of Disease‐10 codes. The Cox proportional hazards model was used to estimate adjusted hazard ratios (HRs). Results: In cohort 1, 8984 IBS cases were identified during a median 14.5‐year follow‐up. Compared with non‐T2D, T2D patients had a 39.0% increased risk of incident IBS (HR = 1.39, 95% confidence interval [CI]: 1.23‐1.56, P <.001), with a higher IBS risk in those with higher fasting blood glucose levels (HR = 1.43, 95% CI: 1.19‐1.72, P <.001) or longer T2D duration (HR = 1.47, 95% CI: 1.23‐1.74, P <.001). In cohort 2, 29 563 incident T2D cases were identified. IBS patients had an 18.0% higher risk of developing T2D versus non‐IBS patients (HR = 1.18, 95% CI: 1.12‐1.24, P <.001). A similar excess T2D risk was observed in IBS patients with a duration of either less than 10 years, or of 10 years or longer. Further sensitivity analysis and subgroup analysis indicated consistent findings. Conclusions: T2D and IBS exhibit a bidirectional association, with an increased risk of co‐morbidity. Awareness of this association may improve the prevention and management of both diseases. [ABSTRACT FROM AUTHOR]

Traditional tumor diagnosis methods rely on tissue biopsy, which can be invasive and unsuitable for long-term monitoring of tumor dynamics. The advent of liquid biopsy has notably improved the overall management of patients with cancer. Liquid biopsy techniques primarily involve detection of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA). The present review focuses on ctDNA because of its significance in tumor diagnosis, monitoring and treatment. The use of ctDNA-based liquid biopsy offers several advantages, including non-invasive or minimally invasive collection methods, the ability to conduct repeated assessment and comprehensive insights into tumor biology. It serves crucial roles in disease management by facilitating screening of high-risk patients, dynamically monitoring therapeutic responses and diagnosis. Furthermore, ctDNA can be used to demonstrate pseudo-progression, monitor postoperative tumor status and guide adaptive treatment plans. The present study provides a comprehensive review of ctDNA, exploring its origins, metabolism, detection methods, clinical role and the current challenges associated with its application. [ABSTRACT FROM AUTHOR]

Verticillium wilt, caused by the soilborne fungus Verticillium dahliae, poses a serious threat to the health of more than 200 plant species worldwide. Although plant rhizosphere‐associated microbiota can influence plant resistance to V. dahliae, empirical evidence underlying Verticillium wilt resistance of perennial trees is scarce. In this study, we systemically investigated the effect of the soil microbiota on the resistance of smoke trees (Cotinus coggygria) to Verticillium wilt using field, greenhouse and laboratory experiments. Comparative analysis of the soil microbiota in the two stands of smoke trees suggested that Bacillus represented the most abundant and key microbial genus related to potential disease suppression. Smoke tree seedlings were inoculated with isolated Bacillus strains, which exhibited disease suppressiveness and plant growth‐promoting properties. Furthermore, repletion of Bacillus agents to disease conducive soil significantly resulted in reduced incidence of smoke tree wilt and increased resistance of the soil microbiota to V. dahliae. Finally, we explored a more effective combination of Bacillus agents with the fungicide propiconazole to combat Verticillium wilt. The results establish a foundation for the development of an effective control for this disease. Overall, this work provides a direct link between Bacillus enrichment and disease resistance of smoke trees, facilitating the development of green control strategies and measurements of soil‐borne diseases. Summary Statement: Bacillus was the key microbial genus responsible for Verticillium wilt disease suppression and plant growth‐promoting and the combination of B. subtilis with a fungicide represented a promising effective control to combat Verticillium wilt. [ABSTRACT FROM AUTHOR]

Introduction: Idiopathic granulomatous mastitis (IGM) is an inflammatory breast disorder of unknown etiology. This benign condition can mimic the clinical presentation of breast cancer and is characterized by symptoms such as breast pain, erythema, and swelling. Over the past few years, Disease-Modifying Antirheumatic Drugs (DMARDs) have been increasingly used to manage this condition. However, strong evidence to support their use is lacking. Objectives: This systematic review aimed to summarize the evidence and evaluate the efficacy of DMARDs in the management of IGM. Methods: A systematic literature review, adhering to PRISMA guidelines, was conducted across electronic databases, including PubMed, EMBASE, SCOPUS, directory of open access journals (DOAJ) and Cochrane Library from their inception until May 2024. We included retrospective and prospective studies while excluding case reports and case series of less than 10 patients. Results: Eighteen studies met our eligibility criteria. Fifteen studies were retrospective, while 2 were prospective. No randomized controlled trials were identified. Of these, 16 papers examined the effect of methotrexate on IGM, revealing significant disease improvement in most cases. Several of the studies indicated that patients treated with azathioprine and mycophenolate mofetil also achieved favorable responses. Conclusion: Given the rarity of IGM, only a limited number of studies have explored the use of DMARDs as a pharmacological treatment option. A significant barrier to advancing our understanding is the substantial heterogeneity in the quality and volume of data provided by these studies. Therefore, there is a need for well-designed, randomized, placebo-controlled trials to rigorously assess the efficacy of DMARDs in the treatment of IGM. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infection (UTI) in infants is a common, potentially life-threatening bacterial infection, and must be managed carefully through the entire chain of care from diagnosis, choice of treatment, follow-up and risk stratification of future complications. This Swedish nationwide study of infant UTI was conducted to evaluate the current management of infant UTI, yield of investigations and the Swedish UTI guidelines' ability to detect abnormalities of importance in the urinary tract. Methods: Infants < 1 year with a first episode of UTI were included in a prospective multicenter study. Treatment and follow-up were provided by local pediatricians. Clinical and laboratory findings and imaging results were reported to the coordinating center. The current management and results were compared with a previous Swedish study. Results: One thousand three hundred six infants were included. Urine sampling was performed with clean catch technique in 93% of patients. Initial oral antibiotic treatment was used in 63%, predominantly third generation cephalosporines. Permanent kidney abnormalities were found in 10% and dilating vesicoureteral reflux (VUR) in 8%. Higher rates of male gender, non-E. coli infection and ultrasound dilatation were seen in infants < 1 month. UTI recurrences were reported in 18%. Conclusions: Infant UTI is still generating a considerable amount of follow-up examinations. There is a significant shift towards clean catch as the main urine sampling method. Voiding cystourethrography is performed less frequently reducing the findings of low grade VUR. The incidence of renal scarring is comparable with earlier studies which suggests that the Swedish guidelines are able to identify individuals with risk for long-term complications. A higher resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Materials and Methods Results Discussion Conclusion To (i) evaluate structured postgraduate part‐time programs in periodontology, including those addressing peri‐implant diseases, among members of the European Federation of Periodontology (EFP), (ii) the impact of the 2018 classification scheme and EFP clinical practice guidelines and (iii) propose a framework for periodontal vocational education and training.A summary of relevant European guidelines for vocational education and training was compiled. In a survey and in a systematic review, current part‐time programs in continuing professional education in periodontology as well as in prevention and management of peri‐implant diseases were examined. The implementation and dissemination of the 2018 classification scheme and the EFP clinical practice guidelines were assessed by literature analysis. Based on these findings, a framework for periodontal vocational education and training was generated.Part‐time programs for professional development in periodontology are established in nine EFP member countries. The systematic review identified lack of knowledge in prevention and management of peri‐implant diseases among dental practitioners and hygienists. Continuing professional development was found to be important for education in prevention, classification and management of periodontal as well as peri‐implant diseases. The proposed European framework consists of an escalator model with three levels (certificate, diploma and master).Considering the identified variation in the national programs, there is a need to improve education in periodontal and peri‐implant diseases. The proposed frameworkmay will help harmonize the national structures.The proposed framework for part‐time professional development is expected to enhance professional qualification. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions Creating an overview of the existing literature about peer support in paediatrics, with a focus on children with chronic diseases.An online search was conducted in MEDLINE and Web of Science. English, Dutch or French articles published between 1 January 2000 and 10 May 2023 were included, based on title and abstract.In this review, 47 articles were included, identifying following themes: Health‐Related Quality of Life (n = 8), peer support for parents/siblings (n = 6), social environment (n = 2), and peer support programme for children (n = 31) subdivided in: general concept (n = 13), online (n = 11), camps (n = 6), and development of a peer support programme (n = 1). Peer support aims to improve disease‐related knowledge, coping, and management of the disease, as well as creating a positive mindset and decreasing the disease burden. There is no consensus regarding which peer group design was superior.Peer groups aim to increase knowledge and psychological adaptation, and decrease physical symptoms and side effects. It is desired to start the peer mentor programme within 1 year after diagnosis or during a critical incident. Further investigation needs to determine the optimal age to start these groups and the format (online or in‐person). Communication between mentors and their mentees was crucial in the succeeding of the programme, as well as creating a safe environment to share experiences. Even though research is still needed concerning peer‐to‐peer support for children, there is already a lot known about similar programmes for parents of children with chronic diseases. [ABSTRACT FROM AUTHOR]

Introduction Design/Method Results Conclusion Clinical relevance Precision Health (PH) holds the promise of revolutionizing healthcare by enabling personalized disease prevention and management through the integration of genomic data, lifestyle factors, environmental influences, and other social determinants of health (SDoH). However, the absence of a baseline assessment of knowledge, skills, and attitudes (KSAs) of practicing nurses' capacity for PH hinders its integration. The purpose of this study is to determine the capacity of practicing Registered Nurses (RNs) for PH across the United States and to assess the validity and reliability of a tool designed for this use—the Precision Health Nurse Capacity Scale (PHNCS).A descriptive exploratory study was conducted to evaluate the capacity of practicing RNs for this evolving phenomenon, PH, using a convenience sample. The survey was sent via email and made available to all members of the American Nurses Association (ANA) who work in a variety of practice environments. The ANA represents the over 4 million nurses practicing in the United States.The majority of nurse respondents felt it is important for nurses to become more educated about all aspects of PH including SDoH but they lack confidence in the integration of PH. The PHNCS was found to be a valid and reliable tool in measuring the capacity of nurses to practice PH.The incorporation of PH into nursing practice suffers an immediate impediment: the lack of know‐how of the US nursing workforce. This inaugural data on KSAs for PH establishes a logical baseline from which the requisite education and training should commence.Precision Health is an emerging healthcare approach in the United States and globally. Enabling it will require a nursing workforce prepared with the requisite KSAs. Determining the capacity of the nursing workforce is a foundational step to begin this process. [ABSTRACT FROM AUTHOR]

Culicoides biting midges (Diptera: Ceratopogonidae) are known vectors of multiple arboviruses of veterinary and medical importance, as well as avian haemosporidian parasites. Despite their significant role as vectors, the distribution of Culicoides species in non‐farmland habitats remains largely unknown. We conducted a study to assess the species community composition, abundance, and host feeding patterns of Culicoides biting midges in urban ecosystems in northern Spain. Light‐baited suction traps were operated biweekly for 6 months across six urban landscapes (three cemeteries and three green areas). In total, 181 Culicoides specimens of 18 species were morphologically identified, with the Obsoletus complex being predominant (43.% of the total catches), followed by Culicoides kibunensis (21.5%). Culicoides midges peaked in early June in green areas and in May in cemeteries. Host feeding patterns revealed avian preferences (mainly Turdus spp.) in four Culicoides species. Despite the low overall number of specimens collected, a high diversity of biting midge species was recorded. These findings offer critical insights into Culicoides ecology and their interactions with hosts in urban settings, which are vital for disease surveillance and management strategies. [ABSTRACT FROM AUTHOR]

Gladiolus, a widely cultivated cut flower known for its aesthetically pleasing multicoloured spikes, has earned significant commercial popularity. A comprehensive understanding of the rhizosphere bacterial community associated with gladiolus is imperative for revealing its potential benefits. Molecular characterization is considered an effective method to gain insights into the structural and functional aspects of microbial populations. The soil characteristics and bacterial communities in the rhizosphere are typically influenced by quorum sensing (QS) and quorum quenching (QQ) mechanisms. This study aims to explore the niceties and diversity of rhizospheric bacterial populations linked with gladiolus corms, with a specific focus on understanding the dynamics of QS and QQ mechanisms in their complex interactions. The isolation of bacterial strains was achieved through the serial dilution method on nutrient agar (NA) media. The identification of the isolates was accomplished by amplifying 16 S rRNA gene sequences via polymerase chain reaction (PCR) via the use of universal primers. Sequence analysis was conducted via BLAST on the National Center for Biotechnology Information (NCBI) database. The characteristics of the isolated bacteria were elucidated via biosensors. This study identified three QS strains and five QQ strains. A consortium of quenchers was formulated utilizing five strains that demonstrated efficacy in mitigating the impact of disease on gladiolus and fostering growth. Among the three treatments—Scale, Descale, and Descale and Cut Half (DSC)—the DSC treatment emerged as the most effective. This treatment exhibited a broader range of variation in biological parameters over time, aligning with prevailing trends in the local market. [ABSTRACT FROM AUTHOR]

High Plains wheat mosaic virus (HPWMoV) is an eriophyid‐mite transmitted virus infecting a number of cereals and grasses worldwide. HPWMoV has recently been reported in Iran; therefore, a comprehensive study was required to elucidate the molecular and biological characteristics of this newly identified virus. In this study, the whole genome sequence, transmission efficiency and partial host range of an Iranian isolate of HPWMoV (HPWMoV‐Ir) were determined. Moreover, a survey was conducted to understand the occurrence of wheat curl mite‐transmitted HPWMoV, wheat streak mosaic virus (WSMV), Triticum mosaic virus (TriMV) and brome streak mosaic virus (BrSMV) as mite‐borne viruses in wheat fields located in central regions of Iran. During a survey of mite‐transmitted viruses, we found that mixed infections of HPWMoV and WSMV (43.7%) were more prevalent than their single infections, while all samples were negative for TriMV and BrSMV. Moreover, other grasses, such as maize, barley, wall barley, oat, rye, Johnson grass and millet, were naturally and experimentally infected with HPWMoV‐Ir at high efficiency. HPWMoV‐Ir was transmitted to wheat by Aceria tosichella with 43% efficiency, which was similar to the transmission rate of HPWMoV in a mixed infection with WSMV. The complete genome sequence comparisons of HPWMoV‐Ir with other HPWMoV isolates showed identities ranging from 79.5% to 98.1%. Remarkably, HPWMoV‐Ir possessed a single variant of the sequence and did not show any heterogeneity in its nucleocapsid protein gene. Phylogenetic analysis of the eight genomic RNA segments positioned HPWMoV‐Ir in group B with isolates from the Midwestern United States and Australia. This discovery can assist researchers in more effectively mitigating the pathogen risks through accurate diagnosis and timely management of the disease. [ABSTRACT FROM AUTHOR]

Background: Some evidence suggests that fluid resuscitation with lactated Ringer's solution (LR) may have an anti-inflammatory effect on acute pancreatitis (AP) when compared to normal saline (NS) and may be associated with a decrease in severity, but existing single-center randomized controlled trials showed conflicting results. The WATERLAND trial aims to investigate the efficacy and safety of fluid resuscitation using LR compared to NS in patients with AP. Methods: The WATERLAND trial is an international multicenter, open-label, parallel-group, randomized, controlled, superiority trial. Patients will be randomly assigned in a 1:1 ratio to receive LR versus NS-based fluid resuscitation for at least 48 h. The primary outcome will be moderately severe or severe AP, according to the revision of the Atlanta classification. The secondary objectives of the WATERLAND trial are to determine the effect of LR versus NS fluid resuscitation on several efficacy and safety outcomes in patients with AP. A total sample of 720 patients, 360 in the LR group and 360 in the NS group, will achieve 90% power to detect a difference between the group proportions of 10%, assuming that the frequency of moderately severe or severe AP in the LR group will be 17%. A loss to follow-up of 10% of patients is expected, so the total sample size will be 396 patients in each treatment arm (792 patients overall). The test statistic used is the two-sided Z test with pooled variance set at a 0.05 significance level. Discussion: The WATERLAND study aims to improve the early management of AP. Fluid resuscitation is an inexpensive treatment available in any hospital center worldwide. If a better evolution of pancreatitis is demonstrated in one of the treatment arms, it would have important repercussions in the management of this frequent disease. Trial registration: ClinicalTrials.gov, NCT05781243. Registration date on January 4, 2023. EudraCT number 2023–000010-18, first posted March 23, 2023. [ABSTRACT FROM AUTHOR]

Community-based chronic care intervention is important in the control and prevention of lifelong conditions such as podoconiosis and similar 'intensive disease management' neglected tropical diseases (NTDs). Despite a call for such interventions, few efforts have been made to identify opportunities and challenges related to their implementation. Employing a qualitative approach, this study explored the possibility of engaging community actors, physical places and networks to promote chronic care management in rural Ethiopia. We gathered data from affected individuals, community members, local leaders, health professionals and community health workers between April and May 2022. The study revealed that affected individuals, family members, religious leaders, traditional leaders, and health professionals have the potential to extend chronic care management in rural areas. Houses, churches, schools, and healthcare facilities are suitable venues at which to perform interventions. Strong community solidarity and political will are vital to chronic care interventions, while lack of understanding about chronic conditions, financial constraints, and limited resources at healthcare facilities could pose challenges. Using community assets has great promise for expanding chronic care management with minimal costs and efforts in under resourced areas. Achieving this will require a successful plan to coordinate the collaboration among the agents and settings. [ABSTRACT FROM AUTHOR]

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), significantly impacts global wheat production, including China. Monitoring Pst virulence is crucial for disease management. This study used 18 Yr single‐gene isogenic lines of wheat to characterize the virulence of 2023 Pst collections in China. A total of 103 isolates were collected from 11 provinces, and 61 races were identified. Frequencies of virulence to the 18 Yr genes varied from 0% to 95.1%, with low frequencies (defined as less than 10%) to Yr85 (7.8%) and Yr10 (8.7%); moderate frequencies (10%–40%) to Yr24 (15.5%), Yr32 (16.5%), YrSP (37.9%) and Yr76 (37.9%); and high frequencies (>40%) to Yr7 (47.6%), Yr1 (68.0%), Yr9 (69.9%), Yr27 (69.9%), Yr17 (79.6%), Yr6 (89.3%), YrExp2 (92.2%), Yr43 (93.2%), Yr8 (95.1%) and Yr44 (95.1%). Yr6, Yr8, Yr17, Yr27, Yr43, Yr44 and YrExp2 have almost lost their effectiveness in all provinces, while Yr10, Yr24, Yr32 and Yr85 are effective in Hebei, Shandong, Shaanxi, Gansu and Anhui. No isolate was virulent to Yr5 or Yr15, indicating their effectiveness against Pst populations in China. The Pst isolates had a wide virulence spectrum ranging from 3 to 16 virulence factors, with an average of 9.5. Comparing 2023 to 2021, the PstCN‐040 and races sharing virulence to Yr1, Yr6, Yr7, Yr8, Yr9, Yr17, Yr43, Yr44 and YrExp2 predominated, with frequencies 16.4% and 25.2%. This study provides valuable information on the virulence composition of Pst populations in China, helping to guide the development of genetic resistance for wheat in China. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsThe focus of research and management of Dupuytren’s disease (DD) is shifting from relieving symptoms in the later stages of disease towards the prevention of contractures. Treatment services might likewise shift towards primary care. Studying characteristics of DD patients who seek medical care for the first time, may identify a symptomatic target group for early DD treatments. We present the first study that estimates the incidence and prevalence of DD in primary care by applying a text-mining algorithm to registration data.This is a population-based cohort study using electronic health records from Dutch general practices involved in a regional research network. Descriptive statistics were used to describe sex, age, comorbidities and lifestyle factors, the latter two were identified via International Classification of Primary Care (ICPC) codes. Incidence rate was calculated as number of patients with a first contact for DD/1000 person years for the years 2017–2021, point prevalence as the percentage of patients with a contact for DD in 2021. DD contacts were identified using a text-mining algorithm.The incidence ranged between 1.41 and 1.72/1000 person years and the overall prevalence was 1.99%. Incidence and prevalence are higher among males and increase with age, peaking between 61 and 80 years.Our results of prevalence and incidence of DD in primary care give an insight into the relevant population of patients with symptomatic DD that might be the future target group for potential disease controlling treatments. [ABSTRACT FROM AUTHOR]

Central serous chorioretinopathy (CSC) is a prevalent exudative maculopathy. Understanding risk factors for CSC is important for disease prevention and to provide evidence‐based advice to patients. In this study, we systematically reviewed the literature and performed meta‐analysis on the association between tobacco consumption and CSC. We searched 12 literature databases on May 5, 2024, and identified 11 eligible studies of 27 595 patients with CSC and 105 354 control individuals. Studies were predominantly clinic‐based case–control studies. We calculated a summary estimate of tobacco consumption as a risk factor for CSC at an odds ratio of 2.99 (95% CI: 1.82–4.93, p = 0.000017), which remained statistically significant in the sensitivity analyses. The exact mechanism by which tobacco consumption contribute to the pathophysiology of CSC remains unclear, although several potential hypotheses exist. However, tobacco consumption is a modifiable behaviour and tobacco cessation is an actionable advice with which patients with CSC themselves can play a large role in disease management. Further studies are warranted to understand the impact of tobacco cessation for risk modification and for the prognosis of patients who already have CSC. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusion Advances in antiretroviral therapy have meant that the focus of HIV care has shifted to chronic disease management. The HIV population is ageing, and the prevalence of frailty is increasing. This study aimed to explore the perspectives and experiences of the impact of living with HIV and frailty and priority outcomes in relation to wellbeing and ageing.In‐depth qualitative interviews were undertaken with older people living with HIV who screened positive for frailty using the FRAIL scale. Participants were recruited from a UK outpatient HIV clinic. Interviews were analysed using reflexive thematic analysis.In total, 24 people living with HIV were interviewed. Frailty was described as not being able to do the things you could and living with limitations that impacted physical, psychological and social wellbeing. Being identified as frail was not always surprising, but acceptance of this diagnosis required an understanding of what frailty means and what they can do to address it. For people living with HIV, the word ‘frail’ was largely acceptable when its clinical meaning was explained. However, participants questioned whether a different term is needed if this is a new ‘HIV‐associated frailty’. Priority outcomes were slowing the progression of frailty, retaining independence and being treated holistically.When talking about frailty with people living with HIV, professionals need to balance honesty and sensitivity and provide clear information about the meaning and impact for the person. Holistic management plans must recognize the physical and psycho‐social impact of frailty and prioritize slowing its progression and reducing its impact on independence. [ABSTRACT FROM AUTHOR]

Background Results Conclusion The coffee crop is prominent in Brazilian agriculture, making the country a global power in this area. One of the main concerns in the coffee sector is disease, which can affect coffee productivity and quality. Thus, it is important to evaluate the factors that may affect coffee quality and thus enhance the development of strategies to reduce coffee losses and costs and optimize production. This study evaluated the influence of the type of irrigation (self‐propelled, drip, and center pivot) on the time until the occurrence of phoma leaf spot on Arabica coffee plants, considering the intensity of the disease. Additionally, the association between longitudinal incidence and the time until an event of interest was assessed based on the joint modeling of longitudinal and survival data.The results of this study identify the effectiveness of drip irrigation system compared with other systems; the use of such systems was associated with an ~46.5% reduction in the risk of leaf spot disease compared with the use of a self‐propelled irrigation system. The use of a center pivot system increased the risk of disease progression compared with a self‐propelled system. An association between the longitudinal and survival processes was also observed.The findings demonstrate the superior performance of the drip irrigation system in controlling phoma leaf spot disease in Arabica coffee plants compared with self‐propelled and center pivot systems. This research highlights the potential of using drip irrigation to establish more effective agricultural practices in coffee cultivation, contributing to better disease management and improved crop quality. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

ABSTRACT Mental health service integration currently has no consensus definition and exists in a variety of settings, including primary care, addiction treatment and chronic disease management, and mental health nurses have often experienced efforts at service integration with varying degrees of success. The intent of mental health service integration is to enable collaboration between mental health services and other healthcare providers to improve service access and the care provided to individuals with mental health issues or mental illness. This scoping review aimed to explore service integration between mental health services and with a specific focus on those evaluated in peer‐reviewed, primary literature, to determine facilitators and barriers to service integration. Using the Arksey and O'Malley's framework for scoping reviews, we located 3148 studies, with screening narrowing final papers for inclusion to 18. Facilitators to service integration included clinician education, adequate resourcing and an interdisciplinary approach, while barriers included staff factors such as a reluctance to work with individuals with mental illness, consumer level barriers such as poor mental health literacy, ‘territorialism’ among staff and organisational climate. Research indicates that service integration is an effective means to detect and treat mental health issues in settings that do not traditionally provide mental health care, lowering the costs of providing healthcare and providing improved care for mental health needs; however, there are several barriers to be addressed to achieve full implementation of integration models. [ABSTRACT FROM AUTHOR]

Background: Currently, most elderly chronic heart failure (CHF) patients go home for rehabilitation after certain treatment in hospitals. However, the results of their rehabilitation at home are not satisfactory. According to studies, dyadic treatments can increase the efficiency of home rehabilitation, enhance both partners' quality of life, lessen the caregiver's load of care, and alleviate the strain of medical resources. Thus, the aim of our research is to design a study protocol that included elderly CHF patients and their informal caregivers as an intervention unit and to explore the impact of the protocol on their health and physical outcomes. Methods: This is a prospective randomized controlled trial conducted in a triple-A hospital. In total, 80 elderly CHF patients and informal caregivers (80 dyads) will be recruited with informed consent. Based on the randomized numbers, they are divided into a control group (40 dyads) and an intervention group (40 dyads), subjects in the control group will receive usual care, and subjects in the intervention group will receive a home-based disease management program based on the Theory of Dyadic Illness Management on the basis of the control group. The duration of the intervention is 3 months, and the follow-up is 6 months. Data is collected at enrolment, 3 months after the intervention, and 3 months after the end of the intervention. The primary outcome is patients' quality of life and readmission. Secondary outcomes include patients' self-management behaviors, anxiety, and depression and caregivers' quality of life and care burden. Discussion: This study focuses on whether this home-based disease management program can improve the quality of life of elderly patients with CHF, reduce the readmission rate, enhance their self-management capacity, reduce negative emotions, and reduce the burden of informal caregivers. It can provide a new perspective on home management and cardiac rehabilitation of heart failure disease in the elderly, as well as alleviate problems such as the burden of healthcare resources. Trial registration: Chinese Clinical Trials Registry ChiCRT2300068026. Registered on 3 February 2023, manuscript Version: 1.0, https://www.chictr.org.cn/. [ABSTRACT FROM AUTHOR]

ABSTRACT Hemoglobin H (HbH) disease, a form of alpha‐thalassemia, poses significant clinical challenges due to its complex molecular underpinnings. It is characterized by reduced synthesis of the alpha‐globin chain. The integration of multi‐omics and precision medicine holds immense potential to comprehensively understand and capture interactions at the molecular and genetic levels. This review integrates current multi‐omics approaches and advanced technologies in HbH research. Furthermore, it delves into detailed pathophysiology and possible therapeutics in the upcoming future. We explore the role of genomics, transcriptomics, proteomics, and metabolomics studies, alongside bioinformatics tools and gene‐editing technologies like CRISPR/Cas9, to identify genetic modifiers, decipher molecular pathways, and discover therapeutic targets. Recent advancements are unveiling novel genetic and epigenetic modifiers impacting HbH disease severity, paving the way for personalized precision medicine interventions. The significance of multi‐omics research in unraveling the complexities of rare diseases like HbH is underscored, highlighting its potential to revolutionize clinical practice through precision medicine approaches. This paradigm shift can pave the way for a deeper understanding of HbH complexities and improved disease management. [ABSTRACT FROM AUTHOR]

Chicken production in Tanzania provides opportunity to local communities in terms of employment, increased income, food security, and manure for cropping. However, diseases like fowl typhoid remain a challenge to livestock keepers. This study was aimed at understanding the attitude and awareness of Poultry keepers about the prevalence of fowl typhoid in chickens kept in Dodoma. A cross-sectional survey using semi-structured interviews was employed to understand farmers' perception of the prevalence of fowl typhoid and associated risk factors amongst poultry farmers in three wards in Dodoma, namely, Nkuhungu, Msalato, and Mnadani. The overall prevalence of fowl typhoid among farmers was 22.30%, with significant differences being noticed in the first quarter (January–March) and the third quarter (July–September) (P < 0.05). Factors such as age and sex, flock size, and management practices influence the prevalence of fowl typhoid significantly (P < 0.05). Furthermore, the farmers had challenges accessing the veterinary services due to their unawareness, the availability of the service, and their distance from the service. The control strategies for fowl typhoid should consider the influencing factors while improving the accessibility and availability of veterinary services to farmers. [ABSTRACT FROM AUTHOR]

Background: Chronic diseases such as type 2 diabetes mellitus and coronary heart disease cause medical, social, and economic burdens worldwide. Disease management programs in Germany mostly lack components to improve patients' self-management and health-promoting lifestyles despite clear guideline recommendations. Therefore, a Personalized Self-Management Support Program (P-SUP) was developed, which includes: (1) peer support groups; (2) telephone coaching; (3) feedback reports and, (4) a web portal. This study aims to explore patients' and implementing stakeholders' experiences in the implementation of P-SUP to identify barriers and facilitators to the implementation of the intervention. Methods: A qualitative study was conducted using face-to-face focus group interviews with participating patients and telephone-based one-to-one expert interviews with implementing stakeholders, involved in the delivery of the intervention. The transcribed interview reports were analyzed using qualitative content analysis, and the contents were categorized according to Donabedian's Structure-Process-Outcome framework. Results: A total of six themes among patients (N = 35) and five themes among implementing stakeholders (N = 32) represent the experiences. The patient themes were: (1) technical conditions, (2) indoor facilities, (3) group composition, (4) acceptance of digital components, (5) supervision and feedback and (6) impact on lifestyle behavior. The themes among the implementing stakeholders were: (1) multiprofessional approach, (2) human resources, (3) patient acceptance, (4) supervision and feedback and (5) impact on lifestyle behavior. Conclusions: Multiprofessional interventions such as P-SUP appear to be valuable for patients and implementing stakeholders. Although infrastructural barriers made the implementation of peer support and digital patient education difficult, patients rated the exchange with peers and experts on health-related topics positively. The lack of supervision and feedback during the course of the intervention might be compensated by regular telephone coaching. The findings from this study can be used in future studies to guide researchers and implementing stakeholders and to improve the feasibility and effectiveness of complex interventions in different contexts. Trial registration: The P-SUP study was registered in the German Clinical Trials Register (DRKS) on 16/07/2020 under the registration number DRKS00020592. [ABSTRACT FROM AUTHOR]

Pressure on healthcare systems to address growing population needs is forcing services to adapt, which includes supporting acute patients in the community. One emerging service in the United Kingdom that offers this level of treatment is "Hospital at Home" (HaH). Self‐management support is an area of particular importance in this context considering that acute treatment is provided in a community setting with limited input and monitoring by healthcare professionals. There is currently limited understanding about the range of formal and informal support and resources needed and accessed by patients in such circumstances, and whether and how HaH professionals engage with the everyday contexts and the network members of patients. Semistructured interviews were conducted with nurses (n = 9) from a single Hospital at Home site to further understand their experiences of providing acute treatments in the context of patients' homes; and how self‐management and social network support roles are perceived. Thematic analysis was used and four themes were identified: The value of prioritising illness work at home within a discourse of person-centered care; the work involved in the "naturally" therapeutic environment of the home; partners as key members of the informal care team; limited awareness and engagement with (in)formal networks. Findings demonstrate tensions between discourses where nurses idealise the value of the home and a holistic service provision, while in practice prioritising illness (over relational, emotional, and practical) work and delivering a service that is routinised, and time‐ and cost‐efficient. Nurses recognise the positive role of network members for illness management in the context of people's everyday life, but awareness and engagement are limited to partners and the formal services that HaH staffs are familiar with. Developing a better understanding of the role of social networks (SNs) in supporting people with acute needs at home can help improve patient experiences and care and HaH services, especially for people who are vulnerable, with complex needs, living alone, and with limited access to resources. [ABSTRACT FROM AUTHOR]

Rice stripe mosaic virus (RSMV) belongs to the Cytorhabdovirus species in the Rhabdoviridae family. Recently, RSMV was widely spread in East Asia and caused severe yield losses. RSMV is transmitted by the planthopper vectors, Recilia dorsalis, Nephotettix virescens, and Nilaparvata lugens, that mostly affect rice. The adult vectors can hibernate, transmit the virus, lay eggs on rice plants, and, finally, multiply in subsequent generations, resulting in new infection outbreaks. RSMV-infected rice varieties display striped mosaicism, mild dwarfism, stiff and twisted leaves, delayed heading, short panicles with large unfilled grains, and yield reduction. In nature, the infection of multiple pathogens in the same host is widespread, which is defined as co-infection. It can be antagonistic or synergistic. Pathological synergistic effects between RSMV and other viruses can generate strains with new genetic characteristics, leading to unpredictable epidemiological consequences. After the first identification of RSMV in 2015, significant advancements in understanding the disease's characteristics, symptoms, cycles, geographic distribution, potential vectors, and synergistic interaction, as well as its management strategies, were developed. To reduce the damage due to RSMV infection, many scientists have recommended pest control techniques to target adult vectors. It is also essential to confirm the actual time of monitoring, development of resistant varieties, and changes in cultivation systems. Due to the limitations of the conventional plant disease control technologies, improvements in efficiency and safety are in high demand. Therefore, to find efficient and environmentally safe controls to mitigate these challenges, reviews of research are the foremost step. In this review, we summarize the basic epidemiological information about the origin of RSMV and its infection symptoms in the field, synergistic interaction with viruses during co-transmission, yield losses, formulation of the disease cycle, and control strategies from several case studies. Finally, we recommend the formulation of the disease cycle and management strategies of RSMV infection. [ABSTRACT FROM AUTHOR]

Background: The coexistence of diabetes and hypertension is prevalent due to shared risk factors. Pharmacological treatment has been reported to be effective in managing both conditions. However, treatment effectiveness depends on the extent to which a patient adheres to their treatment. Poor adherence to long‐term treatment for chronic diseases is a growing global problem of significant magnitude. Several interventions have been developed to help improve medication adherence in patients with coexisting diabetes and hypertension. This review aimed to determine the characteristics of these interventions and their impact on medication adherence. Methods: A systematic review of the literature was conducted using the PRISMA guidelines and registered in the PROSPERO International Registry of Systematic Reviews. Studies were searched in the databases CINAHL, Embase and Medline to identify relevant articles published during 2012–2023. The search concepts included 'medication adherence', 'hypertension', 'diabetes' and 'intervention'. Studies were included if they were in English and evaluated the impact of an intervention aimed at promoting adherence to medications for both diabetes and hypertension. Results: Seven studies met the inclusion criteria, with five demonstrating a statistically significant improvement in medication adherence. Of the five studies that improved medication adherence, four were multifaceted and one was a single‐component intervention. All successful interventions addressed at least two factors influencing non‐adherence. Patient education was the foundation of most of the successful interventions, supported by other strategies, such as follow‐ups and reminders. Conclusion: Multifaceted interventions that also included patient education had a positive impact on medication adherence in patients with coexisting diabetes and hypertension. Improving adherence in patients with coexisting diabetes and hypertension requires a multipronged approach that considers the range of factors impacting medication‐taking. Patient or Public Contribution: This systematic review provides comprehensive insights into the benefits of patient‐centred approaches in intervention development and strengthening. Such patient involvement ensures that medication adherence interventions are more relevant, acceptable and effective, ultimately leading to better health outcomes and more meaningful patient engagement in healthcare research. [ABSTRACT FROM AUTHOR]

In this study, the effect of physician ownership status of individuals on disease management was examined. The population of the study consists of adult individuals residing in the centre of Kahramanmaraş. Questionnaire method was used as the data collection technique of the research. Using convenience sampling method, 410 people were reached. Physician Ownership Scale (PHS) and Disease Management Scale (DMS) were used for the data collection tools of the research. The research data were first checked in excel programme and then analysed using SPSS (Statistical Package for the Social Sciences) and AMOS (Analysis of Moment Structures) package programmes. Cronbach Alpha values were given to analyse the reliability of the scales. The Cronbach Alpha values of the scales are 0.935 and 0.855. respectively. As a result of the analysis, the scales were found to be reliable and suitable for normal distribution. In addition, Confirmatory Factor Analysis (CFA) was conducted to check whether the scales were appropriate for this sample. After the CFA analysis, PATH analysis showing the effect of physician ownership on disease management was conducted. Of those included in the study, 55.9 per cent were female and 57.6 per cent were married. 92% of the participants are 54 years old and below and 66.1% of them are high school graduates. Of those included in the study, 52.9% were not working and 39.8% had been struggling with the disease for one year. These values show that the scales are between good fit and acceptable values. As a result of the study, physician ownership positively affects disease management. [ABSTRACT FROM AUTHOR]

Use of techniques derived from generative artificial intelligence (AI), specifically large language models (LLMs), offer a transformative potential on the management of multiple sclerosis (MS). Recent LLMs have exhibited remarkable skills in producing and understanding human-like texts. The integration of AI in imaging applications and the deployment of foundation models for the classification and prognosis of disease course, including disability progression and even therapy response, have received considerable attention. However, the use of LLMs within the context of MS remains relatively underexplored. LLMs have the potential to support several activities related to MS management. Clinical decision support systems could help selecting proper disease-modifying therapies; AI-based tools could leverage unstructured real-world data for research or virtual tutors may provide adaptive education materials for neurologists and people with MS in the foreseeable future. In this focused review, we explore practical applications of LLMs across the continuum of MS management as an initial scope for future analyses, reflecting on regulatory hurdles and the indispensable role of human supervision. [ABSTRACT FROM AUTHOR]

Motivated by the prevalence of an aging population and the associated increase in chronic diseases, coupled with rising medical expenditure, the Korean government initiated a pilot project in Pyeongchang-gun, Gangwon-do, a rural area, to implement a "smart online-to-offline (O2O) digital health care model" aimed at managing and preventing chronic diseases. However, there is limited understanding regarding perspectives and levels of preparedness for digital health among stakeholders at various levels. In-depth focus group interviews were conducted with elderly and non-elderly community members, health care providers, and staff members at Pyeongchang Health and Medical Center. The study found the presence of both positive and negative perceptions and a lack of preparedness across different levels. At the end-user level, it was observed that community members, especially the elderly, have low levels of health and digital literacy, compounded by limited access to social support. At the health care provider level, there was uncertainty about the acceptance of the digital health program. At the area level, the need to bolster health staff members and enhance their capacity was observed. Recommendations include: customizing the design of the online and offline service components by considering end-user factors (such as age, occupation, and household type) that may contribute to disparities in health; establishing a platform for providers to share their experiences to facilitate the effective incorporation of digital health into their practices; and preparing an appropriate provider payment mechanism. [ABSTRACT FROM AUTHOR]

In Arabidopsis (Arabidopsis thaliana), overproduction of salicylic acid (SA) increases disease resistance and abiotic stress tolerance but penalizes growth. This growth–defense trade-off has hindered the adoption of SA-based disease management strategies in agriculture. However, investigation of how SA inhibits plant growth has been challenging because many SA-hyperaccumulating Arabidopsis mutants have developmental defects due to the pleiotropic effects of the underlying genes. Here, we heterologously expressed a bacterial SA synthase gene in Arabidopsis and observed that elevated SA levels decreased plant growth and reduced the expression of cold-regulated (COR) genes in a dose-dependent manner. Growth suppression was exacerbated at below-ambient temperatures. Severing the SA-responsiveness of individual COR genes was sufficient to overcome the growth inhibition caused by elevated SA at ambient and below-ambient temperatures while preserving disease- and abiotic-stress-related benefits. Our results show the potential of decoupling SA-mediated growth and defense trade-offs for improving crop productivity. Constitutive expression of individual cold-regulated genes can override salicylic acid-induced growth inhibition while maintaining enhanced disease resistance. [ABSTRACT FROM AUTHOR]

Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is primarily recognized for its role in lipid metabolism, but recent evidence suggests that it may have broader implications due to its diverse tissue expression. Objective: This review aims to explore the multifaceted functions of PCSK9, highlighting its pro‐atherosclerotic effects, including its impact on circulating lipoprotein variables, non‐low‐density lipoprotein receptors, and various cell types involved in atherosclerotic plaque development. Conclusions: PCSK9 exhibits diverse roles beyond lipid metabolism, potentially contributing to atherosclerosis through multiple pathways. Understanding these mechanisms could offer new insights into therapeutic strategies targeting PCSK9 for cardiovascular disease management. [ABSTRACT FROM AUTHOR]

Background: Autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD) are major genetic polycystic kidney diseases that can progress to end-stage kidney disease (ESKD). Longitudinal data on the clinical characteristics associated with clinical outcomes in polycystic kidney disease (PKD), including the development of ESKD and cardiovascular disease (CVD) are lacking in Japan. To address this unmet need the authors are establishing a novel, web-based, Nationwide Cohort Registry Study—the Japanese Registry of PKD (JRP). Methods: The JRP is a prospective cohort study for ADPKD (aim to recruit n = 1000 patients), and both a retrospective and prospective study for ARPKD (aim to recruit n = 100). In the prospective registry, patients will be followed-up for 10 years every 6 months and 12 months for patients with ADPKD and ARPKD, respectively. Data collection will be recorded on Research Electronic Data Capture (REDCap) starting on April 1, 2024, with recruitment ending on March 31, 2029. (jRCT 1030230618). Results: Data to be collected include: baseline data, demographics, diagnostic and genetic information, radiological and laboratory findings, and therapeutic interventions. During follow-up, clinical events such as development of ESKD, hospitalization, occurrence of extra kidney complications including CVD events, and death will be recorded, as well as patient-reported health-related quality of life for patients with ADPKD. Conclusions: The JRP is the first nationwide registry study for patients with ADPKD and ARPKD in Japan, providing researchers with opportunities to advance knowledge and treatments for ADPKD and ARPKD, and to inform disease management and future clinical practice. [ABSTRACT FROM AUTHOR]

This commentary delves into the complexities surrounding chronic kidney disease management in Pakistan, specifically examining the critical role played by renal satellite units in providing accessible dialysis services. Chronic kidney disease in Pakistan accounts for 3.9% of total deaths, warranting a focused exploration of challenges and potential solutions. RSUs, smaller entities affiliated with main renal units, emerge as key players in addressing issues of geographic accessibility and diminishing travel burdens for chronic kidney disease patients. Challenges such as financial constraints, limited resources, and staff shortages, particularly in rural settings, pose significant hurdles to the effective functioning of RSUs. This commentary emphasizes the importance of clear eligibility criteria, robust vascular access support, regular physician engagement, and the strategic integration of telemedicine. It explores diverse funding models, including government allocations, community contributions, and philanthropic partnerships, as potential solutions to alleviate cost‐related concerns. The commentary advocates for a holistic, cost‐effective approach to chronic kidney disease care, highlighting the transformative potential of renal satellite units in improving health outcomes across varied settings. [ABSTRACT FROM AUTHOR]

Aim: Gestational diabetes confers short‐ and long‐term risk of mother and offspring health complications. Healthcare professionals such as endocrinologists, diabetes nurses, dietitians, midwives and general practitioners provide gestational diabetes care. We sought to explore healthcare professionals' perspectives on gestational diabetes care during pregnancy and postpartum. Methods: Healthcare professionals in the Republic of Ireland, whose role included gestational diabetes care were invited to complete an online 20‐item survey between June and September 2022. Social media, professional organisations and personal networks were used for recruitment. Questions included guideline use, postpartum diabetes screening and advice practices. Analyses were performed using SPSS statistical software and free text was coded using NVivo. Results: Seventeen healthcare professions across primary and secondary care settings participated (n = 127). No differences were noted between groups (medical, nursing/midwifery, allied health/other); therefore, findings were reported as a single group. Healthcare professionals reported using multiple different guidelines to support gestational diabetes management (n = 14). The most cited were 'Health Service Executive guidelines' (24.5%), 'local guidelines' (13.2%) and National Institute for Clinical Excellence guidelines (11.3%); 12.3% cited uncertainty, and 27.5% reported not to follow any named guidelines. For postpartum follow‐up, 39% felt clear guidelines were available to support practice, 37% felt appropriate systems were in place and 29% reported effective communication between primary and secondary care services. Qualitative findings emphasised a desire for improved communication between systems, participants and providers, clear interdisciplinary guidelines, and adequate resourcing for gestational diabetes management and postpartum diabetes prevention, including comprehensive support and follow‐up. Conclusion: System‐level challenges and ineffective communication across settings are barriers to optimum postpartum care. Nationally agreed guidelines for best practice gestational diabetes management including postpartum diabetes prevention are needed. [ABSTRACT FROM AUTHOR]

The aquaculture sector plays a vital role in global food security, yet it grapples with significant challenges posed by infectious diseases. Piscine lactococcosis is one of the significant threats in rainbow trout aquaculture due to its potential to cause severe economic losses through mortalities, reduced growth rates, and increased susceptibility to other pathogens. It poses challenges in disease management strategies, impacting the sustainability and profitability of rainbow trout farming. The current study focuses on the variations in serum blood parameters of farmed rainbow trout Oncorhynchus mykiss during a lactococcosis outbreak caused by Lactococcus garvieae. Blood samples were collected for biochemical analysis, fish were examined for parasites and bacteria, and DNA from bacterial colonies was PCR‐amplified and sequenced for identification. Overall, 13 biochemical parameters, including proteins, enzymes, lipids, chemicals, and minerals, were measured in serum blood samples from both diseased and healthy fish. The results indicate significant alterations in the levels of these parameters during the outbreak, highlighting the impact of infections on the blood profile of farmed rainbow trout. Urea levels were significantly higher in diseased fish compared to controls, and creatinine, phosphorus, and magnesium also showed similar trends. Alanine aminotransferase and total protein levels were higher in control fish. Chloride levels differed significantly between groups. Iron levels were higher in controls and lower in diseased fish. No significant differences were found in other parameters. This study reveals significant changes in serum blood parameters of rainbow trout during a lactococcosis outbreak caused by L. garvieae. These changes highlight the potential of these parameters as tools for monitoring health status, stress, and aquaculture management. Continuous monitoring can provide valuable insights into disease severity and overall fish health, aiding in the development of improved management practices. The presented data contribute to understanding the pathophysiology of piscine lactococcosis and developing effective mitigation strategies for farmed rainbow trout. [ABSTRACT FROM AUTHOR]

As endovascular neurosurgery techniques continue to evolve, medical students in the United States have widely varying exposures to the field, particularly with respect to opportunities for hands-on experiences. Current medical school curricula could benefit from a novel and adaptive course on vascular neurosurgery to increase student exposure earlier in their training. We launched a yearly hands-on vascular neurosurgery course for medical students and residents. The day-long course is a combination of lectures focused on neurovascular disease and management accompanied by hands-on sessions where students practiced fundamental microsurgery and angiography techniques using real microscopes and angiography simulators. We surveyed the students before and after each of the 2 courses. The survey following the second annual course included quiz questions the students had not previously seen. Over 2 courses, we had 149 attendees, 71.8% of which were first and second-year medical students representing fifteen institutions. The average survey completion rate was 41.4% for the 4 surveys across the 2 courses. Attendees' interest in pursuing a surgical specialty (t = 1.815, P = 0.039) along with their comfort with neuroanatomy (t = 8.780, P ≤ 0.001) and neurosurgical disease (t = 6.133, P ≤ 0.001) was significantly elevated after the completion of the second course. Responses to the post-survey showed a good grasp of the fundamentals with 68% of attendees answering 70% of the quiz questions correctly. An interactive course on vascular neurosurgery may be an effective vehicle to provide medical students with exposure to the field and the opportunity to learn the fundamentals. [ABSTRACT FROM AUTHOR]

Indole derivatives have become an important class of compounds in medicinal chemistry, recognized for their wide-ranging biological activities and therapeutic potential. This review provides a comprehensive overview of recent advances in the evaluation of indole-based compounds in the last five years, highlighting their roles in cancer treatment, infectious disease management, anti-inflammatory therapies, metabolic disorder interventions, and neurodegenerative disease management. Indole derivatives have shown significant efficacy in targeting diverse biological pathways, making them valuable scaffolds in designing new drugs. Notably, these compounds have demonstrated the ability to combat drug-resistant cancer cells and pathogens, a significant breakthrough in the field, and offer promising therapeutic options for chronic diseases such as diabetes and hypertension. By summarizing recent key findings and exploring the underlying biological mechanisms, this review underscores the potential of indole derivatives in addressing major healthcare challenges, thereby instilling hope and optimism in the field of modern medicine. [ABSTRACT FROM AUTHOR]

Simple Summary: The Australian alpaca industry is known for fibre production. Despite the growth of alpaca numbers since their introduction in the 1980s, little is known about their distribution or on-farm management practices in Australia. This study used an online survey to gain insight into the current demographics, animal management practices and key knowledge gaps. Of the 88 respondents, the majority were located in the high-rainfall areas of the east coast of Australia, which could be due to consistent year-round pasture availability and market access opportunities. Of the two alpaca breeds, the Huacaya accounted for 93% of the animal numbers reported in this survey. Twelve key pasture species were identified, with Kikuyu the most common, followed by Subterranean Clover and Phalaris, likely due to the high concentration of respondents in suitable high-rainfall environments. Pasture species were not identified by 25% of respondents. The off-label use of veterinary chemicals for disease and parasite control resulted in a variation in dosage rates and administration frequency, raising concerns for effective management. These results highlight important knowledge gaps in nutritional and health management practices that require further research and practical industry recommendations to improve alpaca health and productivity. The Australian alpaca industry has continued to grow since the introduction of alpacas in the 1980s. Little is known about the geographical distribution of alpacas or on-farm management practices. This study aimed to address this and identify key producer knowledge through an online survey. The survey consisted of 25 questions grouped into 3 areas: demographics, farm production and alpaca nutrition. The highest concentration of alpaca producers was along the east coast of Australia, primarily in high-rainfall zones, which could be attributed to more consistent year-round pasture availability and market access opportunities. The Huacaya breed accounted for 93% of the animal numbers reported in this survey. Respondents identified 12 key pasture species being grazed, with Kikuyu being the most common, followed by Subterranean Clover and Phalaris, likely due to the majority of respondents being located in suitable high-rainfall environments. Pasture species were not identified by 25% of respondents. There are no registered anthelmintics or vaccinations for alpacas, resulting in a variation in dosage rates and administration frequency, raising concerns for effective disease and parasite management. This survey has identified key knowledge gaps in alpaca management practices in Australia that will be further investigated to provide industry recommendations to improve alpaca production. [ABSTRACT FROM AUTHOR]

Background/Objectives: Patients with chronic rhinosinusitis (CRS) accompanied by asthma often show poor prognoses and require continuous management. This study aimed to assess the prognostic value of eosinophil counts in nasal polyp tissue for selecting individuals who would benefit from ongoing management in CRS patients with asthma. Methods: Patients with asthma who underwent endoscopic sinus surgery for CRS with nasal polyps were included in the study. Eosinophil counts in nasal polyp tissues were quantified, and retrospective data were collected from laboratory and clinical findings, including endoscopic examinations, CT scans, and Japan Endoscopic Sinus Surgery Rating and Evaluation Committee (JESREC) scores. Disease control status was evaluated through endoscopic examination 6 months post-surgery. Results: A total of 42 patients were divided into two groups based on their disease management status 6 months post-operation: the well-control group (24 patients, 57.14%) and the poor-control group (18 patients, 42.86%). Demographics and laboratory findings did not show significant differences between the groups. However, the JESREC score (p = 0.04) and tissue eosinophil count (p = 0.02) were significantly different. Multivariate analysis identified tissue eosinophil count as the only risk factor associated with prognosis, with a cut-off value of 90/HPF. Conclusions: In CRS patients with asthma, high tissue eosinophil counts in nasal polyps were associated with poor disease control, which is the most potent predictor of prognosis. The assessment of eosinophil counts in nasal polyp tissue could aid in identifying patients who would benefit from continuous management and tailored interventions for improved outcomes. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) poses significant health challenges globally, particularly in regions like the Middle East. This review evaluates the potential efficacy and safety of Gum Arabic (Acacia senegal), a traditional remedy, in managing CKD. A comprehensive literature review was conducted using databases including PubMed and Scopus, focusing on the biochemical, physiological, and therapeutic impacts of Gum Arabic on renal health. Gum Arabic has demonstrated antioxidative and anti-inflammatory properties that may benefit renal function, as shown in animal studies. Clinical trials suggest improvements in renal biomarkers, though these are limited by scope and methodology. While promising, the clinical application of Gum Arabic requires cautious interpretation due to gaps in understanding its mechanisms of action. Gum Arabic shows potential as an adjunct treatment for CKD, reflecting both traditional use and preliminary scientific evidence. Future research should focus on its long-term efficacy, safety, and underlying biochemical pathways to better guide its therapeutic use. [ABSTRACT FROM AUTHOR]

Background: Reliable Human Papillomavirus (HPV) testing and genotyping are essential for quality assurance in HPV-based primary screening, disease management and for monitoring the impact of HPV vaccination. The clinical validation of HPV molecular diagnostic assays has significantly contributed to these objectives; however, little emphasis has been placed on assuring sample quality. This study aimed to evaluate the accuracy of sample cellularity assessment using the C-C Motif Chemokine Receptor 5 (CCR5) gene target as a marker of sample adequacy in molecular diagnostics. Methods: Jurkat cell line samples were counted using both a Thoma cell-counting chamber and Fluorescence-Activated Cell Sorting (FACS). Jurkat cell line samples at three different concentrations were subsequently evaluated using the OncoPredict HPV Quality Control (QC) real-time PCR assay, employing CCR5 for molecular cellularity quantification. Results: The cellularity values obtained were comparable across the three different methods for all dilutions of the cell line tested. Conclusions: The results obtained from this study show that CCR5 represents a promising molecular marker for the accurate quantification of sample cellularity, confirming its use as a reliable sample adequacy control, thus reducing the risk of "false-negative" results. [ABSTRACT FROM AUTHOR]