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Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Early recognition and prompt intervention are crucial in managing aconite poisoning. Rapid treatment with intravenous magnesium sulfate and amiodarone can stabilize severe cardiac arrhythmias. Vigilant monitoring and tailored therapeutic strategies enhance recovery and improve patient outcomes in acute poisoning cases., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)

Well-orchestrated carbon nanostructure with superb stable framework and high surface accessibility is crucial for zinc-ion hybrid capacitors (ZIHCs). Herein, a hydrogen-bonded micelle self-assembly strategy is proposed for morphology-controllable synthesis of conjugated microporous polymers (CMPs) derived carbon to boost zinc ion storage capability. In the strategy, F127 micellar assembly through intermolecular hydrogen bonds serves as structure-directed agents, directing CMPs' oligomers grow into nanospherical assembly. The nanospherical carbon frameworks derived from CMPs (CNS-2) have shown maximized surface accessibility due to their plentiful tunable porosity and hierarchical porous structure with abundant mesoporous interconnected channels, and superb stability originating from CMPs' robust framework, thus the CNS-2-based ZIHCs exhibit ultrahigh energy density of 163 Wh kg -1 and ultralong lifespan with 93 % capacity retention after 200, 000 cycles at 20 A g -1 . Charged ion storage efficiency also lies in dual-ion alternate uptake of Zn 2+ and CF 3 SO 3 - as well as chemical redox of Zn 2+ with carbonyl/pyridine motifs forming O-Zn-N bonds. Maximized surface accessibility and dual-ion storage mechanism ensure excellent electrochemical performance. Thus, the hydrogen-bond-guide micelle self-assembly strategy has provided a facile way to design nanoarchitectures of CMPs derived carbon for advanced cathodes of ZIHCs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: We aim to provide a pictorial representation of the broad spectrum of intracranial hemorrhages associated with cerebral venous thrombosis (CVT), emphasizing atypical locations and rare intracerebral hemorrhage (ICH) types. We also hypothesize the pathophysiology leading to atypical locations of the ICH in CVT and the outcomes with anticoagulation therapy., Background: ICH complicates about 40% of cases with CVT and is known to cause various types of ICH, including subarachnoid hemorrhage (SAH) and subdural hemorrhage (SDH). A combination of hemorrhages is also reported., Methods: Patients with computed tomography and magnetic resonance imaging findings consistent with CVT examined between January 2011 and June 2014 were included in this retrospective review. Demographic and clinical data and imaging findings were reviewed with particular attention to the type and location of ICH and sinus involvement. Treatment details and 3-month outcomes, assessed using the modified Rankin Scale, were analyzed., Results: Eleven patients (9 males), ranging in age from 22 years to 58 years, were included. The most common clinical presentations were headache (n = 8) and seizures (n = 7). Intraparenchymal hemorrhages were most common (n = 7), followed by SDH and SAH (n = 4), intraventricular hemorrhage (IVH; n = 3), and juxtacortical hemorrhage (n = 1). All patients who received anticoagulation therapy (n = 11) experienced complete resolution of their symptoms, and the median modified Rankin Scale was 0., Conclusions: The spectrum of intracranial hemorrhages seen in association with CVT is broad, encompassing atypical locations like basal ganglia, external capsule, and cerebellar hemispheres, and involves multiple intracranial compartments-IVH, SAH, and SDH. While SAH and SDH are seen with superior sagittal sinus thrombosis, ICH is common with lateral sinus thrombosis, and IVH with deep venous thrombosis., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Aims: The long-term outcomes of percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel disease remain debated., Methods: The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry was used to analyse 57 097 revascularized patients with NSTEMI with multivessel disease in Sweden from January 2005 to June 2022. The primary endpoint was all-cause mortality, encompassing both in-hospital and long-term mortality; the secondary endpoints included myocardial infarction (MI), stroke, new revascularization, and heart failure. Multilevel logistic regression with follow-up time as a log-transformed offset variable and double-robust adjustment with the instrumental variable method were applied to control for known and unknown confounders., Results: Percutaneous coronary intervention was the primary therapy in 42 190 (73.9%) patients, while 14 907 (26.1%) received CABG. Percutaneous coronary intervention patients were generally older with more prior cardiovascular events, whereas CABG patients had higher incidences of diabetes, hypertension, left main and three-vessel disease, and reduced ejection fraction. Over a median follow-up of 7.1 years, PCI was associated with higher risks of death [adjusted odds ratio (aOR) 1.67; 95% confidence interval (CI) 1.54-1.81] and MI (aOR 1.51; 95% CI 1.41-1.62) but there was no significant difference in stroke. Repeat revascularization was three times more likely to PCI (aOR 3.01; 95% CI 2.57-3.51), while heart failure risk was 15% higher (aOR 1.15; 95% CI 1.07-1.25). Coronary artery bypass grafting provided longer survival within 15 years, especially in patients under 70 years of age, with left main disease or left ventricular dysfunction, though this benefit diminished over shorter time horizons., Conclusions: Coronary artery bypass grafting is associated with lower risks of mortality, MI, repeat revascularization, and heart failure in patients with NSTEMI, particularly in high-risk subgroups. However, its survival benefit lessens with shorter life expectancy., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Glioblastoma (GBM) is the deadliest malignant brain tumor, with a survival of less than 14 months after diagnosis. The highly invasive nature of GBM makes total surgical resection challenging, leading to tumor recurrence and declined survival. The heterocellular composition of the GBM reprograms its microenvironment, favoring tumor growth, proliferation, and migration. The innate immune cells in the GBM tumor microenvironment, including microglia, astrocytes, and macrophages, express pattern recognition receptors such as NLRs (Nucleotide-binding domain and leucine-rich repeat-containing) that sense pathogen- and damage-associated molecular patterns initiating inflammation. Upon activation, NLRP3 promotes inflammation by NLRP3 inflammasome formation. Auto-proteolytic cleavage and activation of Caspase-1 within the inflammasome leads to caspase-1-mediated cleavage, activation, and conversion of pro-IL-1ß and pro-IL-18 to IL-1ß and IL-18, leading to pyroptosis. In contrast, NLRP12 downregulates inflammatory responses in microglia and macrophages by regulating the NF-κB pathway. NLRP3 and NLRP12 have been implicated in the disease pathophysiology of several cancers with cell-context-dependent, pro- or anti-tumorigenic roles. In this review, we discuss the current literature on the mechanistic roles of NLRP3 and NLRP12 in GBM and the gaps in the scientific literature in the context of GBM pathophysiology with potential for targeted therapeutics., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

5-Hydroxymethylfurfural (5-HMF) is an important chemical generated from lignocellulosic biomass (LCB) to produce a wide variety of value-added chemicals, biofuels, and biochemicals. Different forms of ionic liquids (ILs) have been utilized for the formation of 5-HMF from LCB. However, 5-HMF is highly soluble in imidazolium-based ionic liquids (IMILs), which makes it difficult to separate after its formation from LCB. In this manuscript, we perform all-atom molecular dynamics simulations to investigate the performance of several aprotic solvents in the extraction of 5-HMF from various IMILs. We consider twelve aprotic solvents with different physicochemical properties, such as acetonitrile (AN), acetone (AT), 1,4-dioxane (DI), N , N -dimethyl acetamide (DMA), N , N -dimethyl formamide (DMF), dimethyl sulfoxide (DMSO), gamma-butyrolactone (GBL), gamma-valerolactone (GVL), hexamethylphosphoramide (HMPA), N -methyl pyrrolidone (NMP), propylene carbonate (PC), and sulfolane (SF). We analyze various structures and dynamics and perform a detailed thermodynamic analysis to understand the underlying molecular behavior. The results indicate that solvents AT and DI showed the least favorable interactions with 5-HMF, whereas HMPA showed the most favorable interactions with 5-HMF. Based on the detailed structural insights, HMPA enhances the separation of 5-HMF from the ILs. Furthermore, different anion combinations were tested to benchmark their separation capability. Overall, the results presented in this manuscript guide the selection of solvent and IL combinations for the effective separation of 5-HMF.

Wild bees pollinate crops and wildflowers where they are frequently exposed to pesticides. Neonicotinoids are the most commonly used insecticide globally, but restrictions on their use and rising pest resistance have increased the demand for alternative pesticides. Flupyradifurone is a novel insecticide that has been licenced globally for use on bee-visited crops. Here, in a semi-field experiment, we exposed solitary bees (Osmia lignaria) to a commercial pesticide formulation (Sivanto Prime) containing flupyradifurone at label-recommended rates. We originally designed the experiment to examine sublethal effects, but contrary to our expectations, 100 % of bees released into pesticide-treated cages died within 3 days of exposure, compared to 0 % in control plots. Bees exposed to flupyradifurone a few days after the initial application survived but endured prolonged sublethal effects, including lower nesting success, impairment to foraging efficiency, and higher mortality. These results demonstrate that exposure to this novel insecticide poses significant threats to solitary bees and add to a growing body of evidence indicating that this pesticide can have negative impacts on wild bees at field-realistic concentrations. In the short-term, we recommend that commercial formulations containing flupyradifurone should be restricted to non-flowering crops while a reassessment of its safety can be conducted. In the long-term, environmental risk assessors should continue to develop risk assessments that are truly holistic and incorporate the ecological and life history traits of multiple pollinator species., Competing Interests: Declaration of competing interest The authors declare they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The construction of complex systems by simple chemicals that can display emergent network dynamics might contribute to our understanding of complex behavior from simple organic reactions. Here we design single amino acid/dipeptide-based systems that exhibit multiple periodic changes of (dis)assembly under non-equilibrium conditions in closed system, importantly in the absence of evolved biocatalysts. The two-component based building block exploits pH driven non-covalent assembly and time-delayed accelerated catalysis from self-assembled state to install orthogonal feedback loops with a single batch of reactants. Mathematical modelling of the reaction network establishes that the oscillations are transient for this network structure and helps to predict the relative contribution of the feedback loop to the ability of the system to exhibit such transient oscillation. Such autonomous systems with purely synthetic molecules are the starting point that can enable the design of active materials with emergent properties., Competing Interests: Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Genitourinary syndrome of the menopause (GSM) is a chronic, often progressive condition, characterised by symptoms relating to oestrogen deficiency including; vaginal dryness, burning, itching, dyspareunia, dysuria, urinary urgency and recurrent urinary tract infections. GSM affects up to 70% of breast cancer survivors with a tendency to particularly severe symptoms, owing to the effects of iatrogenic menopause and endocrine therapy. Patients and clinicians can be reluctant to replace oestrogen vaginally due to fear of cancer recurrence. Vaginal laser is a novel therapy, which may become a valuable nonhormonal alternative in GSM treatment. There are currently 6 published studies regarding Erbium:YAG laser treatment for GSM, 41 studies regarding CO2 laser treatment for GSM and 28 studies regarding vaginal laser treatment for GSM in breast cancer survivors. Number of participants ranges from 12 to 645. The majority of studies describe a course of 3 treatments, but some report outcomes after 5. Significant improvements were reported in vaginal dryness, burning, dyspareunia, itch, Vaginal Health Index Scores (VHIS), Quality of Life, and FSFI (Female Sexual Function Index). Most studies reported outcomes at short-term follow-up from 30 days to 12 months post-treatment. Few studies report longer-term outcomes with conflicting results. Whilst some studies suggest improvements are sustained up to 24 months, others report a drop-off in symptom improvement at 12-18 months. Patient satisfaction ranged from 52% to 90% and deteriorated with increasing time post-procedure in one study. The findings in this review must be validated in robust randomised sham-controlled trials of adequate power. There remain a number of unanswered questions in terms of which laser medium to use, optimal device settings, ideal interval between treatments, pre-treatment vaginal preparation, as well as safety and efficacy of repeated treatments long term. These issues could be addressed most efficiently with a mandatory registry of vaginal laser procedures., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Kershaw and Jha.)

The heterogeneous nuclear ribonucleoproteins (hnRNPs) are central regulators of several fundamental biological processes across eukaryotes. hnRNPs have been implicated in transcriptional and post-transcriptional regulation, telomere maintenance, stem cell maintenance, among other processes in major model organisms. Though hnRNPs are known to be conserved in eukaryotes, the evolutionary conservation/diversification of their functions across species is yet to be understood. To this end, the present work employed computational analyses to identify potential hnRNP orthologs in eighty eukaryotic species, and their interactors. Subsequently, a comprehensive analysis of the biological processes influenced by hnRNP interactomes showed alternative splicing and splicing regulation to be commonly associated with most species, while a few processes were uniquely associated with particular species. Further studies of the clustering patterns of the top-ranking hub nodes of the hnRNP protein networks revealed a notable clustering pattern of hnRNP K orthologs from five species. Subsequent analysis of the genes with overrepresented hnRNP K target sites within their untranslated regions showed hnRNP K orthologs from humans and Ciona intestanilis to potentially target transcripts involved in membrane-related processes. Remarkably, the hnRNP K ortholog from Lottia gigantea was found to possibly regulate other RNA-binding proteins (RBPs), suggesting a regulatory cascade involving hnRNPs and other RBPs. Further experimental studies in this regard would be of scientific and clinical importance, owing to the druggability of several human hnRNPs., Competing Interests: Declarations Competing Interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Damage from insect herbivores can elicit a wide range of plant responses, including reduced or compensatory growth, altered volatile profiles, or increased production of defence compounds. Specifically, herbivory can alter floral development as plants reallocate resources towards defence and regrowth functions. For pollinator-dependent species, floral quantity and quality are critical for attracting floral visitors; thus, herbivore-induced developmental effects that alter either floral abundance or attractiveness may have critical implications for plant reproductive success. Based on past work on resource trade-offs, we hypothesize that herbivore damage-induced effects are stronger in structural floral traits that require significant resource investment (e.g. flower quantity), as plants reallocate resources towards defence and regrowth, and weaker in secondary floral traits that require less structural investment (e.g. nectar rewards)., Methods: In this study, we simulated early-season herbivore mechanical damage in the domesticated jack-o-lantern pumpkin Cucurbita pepo ssp. pepo and measured a diverse suite of floral traits over a 60-d greenhouse experiment., Key Results: We found that mechanical damage delayed the onset of male anthesis and reduced the total quantity of flowers produced. Additionally, permutational multivariate analysis of variance (PERMANOVA) indicated that mechanical damage significantly impacts overall floral volatile profile, though not output of sesquiterpenoids, a class of compounds known to recruit specialized cucumber beetle herbivores and squash bee pollinators., Conclusions: We show that C. pepo spp. pepo reduces investment in male flower production following mechanical damage, and that floral volatiles do exhibit shifts in production, indicative of damage-induced trait plasticity. Such reductions in male flower production could reduce the relative attractiveness of damaged plants to foraging pollinators in this globally relevant cultivated species., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

N-acetyl-aspartate (NAA) and myo-inositol (mI) are neurometabolites reflecting neuronal viability and astrocyte activity, respectively. These are quantified using proton magnetic resonance spectroscopy (1H-MRS) and may be biomarkers for Alzheimer's disease dementia (AD). Our objectives were: 1) Compare dorsolateral prefrontal cortex (DLPFC) NAA and mI levels between AD and cognitively healthy control participants (HC) 2) assess if NAA/mI ratio can distinguish groups, and 3) explore the relationship between metabolites and cognition. The study included 64 participants over 55, 41 with AD. Bilateral DLPFC NAA and mI levels were quantified using 3 T 1H-MRS and normalized to H2O. NAA and NAA/mI ratio were lower in AD vs. HC. mI was unchanged. The NAA/mI ratio at a cut-off value of 1.69 showed 59% sensitivity and 87% specificity at distinguishing AD from HC. NAA was associated positively with cognition. In conclusion, DLPFC metabolite changes suggest altered mitochondrial function in AD. NAA/mI ratio shows good specificity in distinguishing AD from HC, suggesting its role in complementing other biomarkers. Future studies should evaluate NAA/mI ratio with other disease specific biomarkers., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Competing Interests: This work was supported by the Foundation for Innovative New Diagnostics, Geneva. RK and MA from FIND were involved in writing this Comment. No industry or pharma company was involved in writing this article and nobody was paid to write the article. RK and MA are employees of FIND, a non-profit, grant and donor funded non-profit organization that supports the development, evaluation, and implementation of several diagnostics. FIND has product evaluation agreements with several private sector companies that design diagnostics for global health. These agreements strictly define FIND’s independence and neutrality regarding the companies whose products get evaluated and describe roles and responsibilities. No funder of FIND had any role in the conceptualization or writing of the manuscript or in the decision to submit it for publication. JB declares consulting income from Stop TB Partnership’s New Diagnostics Working Group and FIND for unrelated projects. LA is managing director of Healthier Systems Ltd, a global public health consulting company, and has consultancy services for unrelated work with WHO and World Bank. He also declares a grant for unrelated work from the Peek Vision Foundation. MP serves as an advisor to non-profits, namely the World Health Organization, Stop TB Partnership, Bill & Melinda Gates Foundation, and Foundation for Innovative New Diagnostics. SV is employed by Qure.ai, Mumbai, India.

Breast cancer (BC) is the most commonly diagnosed cancer and the predominant cause of death in women. BC is a complex disorder, and the exploration of several types of BC omic data, highlighting genes, perturbations, signaling and cellular mechanisms, is needed. We collected mutational data from 9,555 BC samples using cBioPortal. We classified 1174 BC genes (mutated ≥ 40 samples) into five tiers (BCtier_I-V) and subjected them to pathway and protein‒protein network analyses using EnrichR and STRING 11, respectively. BCtier_I possesses 12 BC genes with mutational frequencies > 5%, with only 5 genes possessing > 10% frequencies, namely, PIK3CA (35.7%), TP53 (34.3%), GATA3 (11.5%), CDH1 (11.4%) and MUC16 (11%), and the next seven BC genes are KMT2C (8.8%), TTN (8%), MAP3K1 (8%), SYNE1 (7.2%), AHNAK2 (7%), USH2A (5.5%), and RYR2 (5.4%). Our pathway analyses revealed that the five top BC pathways were the PI3K-AKT, TP53, NOTCH, HIPPO, and RAS pathways. We found that BC panels share only seven genes. These findings show that BC arises from genetic disruptions evident in BC signaling and protein networks., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

The membrane bioreactor (MBR) process synergistically combines biological treatment with membrane filtration, offering a compact design and enhanced operational flexibility. However, membrane fouling remains a critical bottleneck, limiting its widespread application, particularly in treating high-strength wastewater. Recent advances have demonstrated that integrating MBR systems with auxiliary processes such as adsorption, electrochemical treatments, algal-assisted systems, and others can significantly mitigate fouling and enhance treatment efficacy. This paper critically reviews various MBR hybrid configurations, examining their mechanisms, advantages, and limitations in terms of treatment performance and fouling control, while highlighting their potential to extend conventional MBR's applicability to challenging wastewaters and addressing operational challenges like economic viability and sustainability. Elaborated tables incorporating a wide variety of research studies within the realm of synchronization have been meticulously compiled to generate a comprehensive literature review., Competing Interests: Declarations. Ethical approval: As this review article synthesizes previously published research, all included research was presumed to have obtained appropriate ethical approval from their respective institutions or ethics committees However, the inclusion of studies follows established ethical guidelines. Consent to participate: In compliance with ethical standards, this review article did not involve the direct participation of human subjects. Consent to publication: Consent to publish was obtained from the authors for this review article, all included studies are assumed to have obtained appropriate consent for publication. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Evidence of racism's health harms among children and youth is rapidly increasing, though attention to impacts on physical health and biomarker outcomes is more emergent. We performed a systematic review of recent publications to examine the association between racism and health among children and youth, with a meta-analysis of the specific relationships between racism and physical health and biomarkers., Methods: We conducted a systematic literature search using four databases: Medline, PsycINFO, PubMed, and ERIC. Four inclusion criteria were used to identify eligible studies: (1) exposure was experiences of racism, (2) outcome was health and wellbeing, (3) quantitative methods were used to estimate the association between racism and health outcomes, and (4) the effect size of associations between racism and health and wellbeing was reported for participants aged 0-24 years. Correlation coefficients were used to report the pooled effect size for each outcome indicator., Results: There were 463 eligible studies included in the screening process, with 42 studies focusing on physical health or biomarker outcomes. Random-effects meta-analysis found minimal to moderate positive associations between racism and C-reactive protein, Interleukin 6, body mass index (BMI), obesity, systolic blood pressure, salivary cortisol, asthma, and somatic symptoms. There were marginal positive associations between racism and Tumour Necrosis Factor-α, cortisol collected via saliva, urine and hair, BMI-z score, and diastolic blood pressure, with imprecise estimates and wide confidence intervals., Conclusions: Racism is associated with negative physical health and biomarker outcomes that relate to multiple physiological systems and biological processes in childhood and adolescence. This has implications for health and wellbeing during childhood and adolescence and future chronic disease risk. Collective and structural changes to eliminate racism and create a healthy and equitable future for all children and youth are urgently required., (Copyright © 2024. Published by Elsevier Ltd.)

Background: The ACR in 2021 and the EULAR in 2022 published recommendations for management of ANCA-associated vasculitis. Given the differences in the demographic, clinical profiles, and the socio-economic realities between various countries, there is a need for development of guidelines for the management of AAV for less economically developed regions of the world., Methods: These guidelines were made following the GRADE methodology. After the systematic literature review, recommendations were formulated and opinion was sought from the 18-member expert panel consisting of 17 clinicians and one patient representative., Results: Twenty recommendations were formulated. We recommend ANCA testing by ELISA over IIF. For remission induction in active GPA or MPA, we recommend use of intravenous cyclophosphamide or rituximab in combination with glucocorticoids. We conditionally recommend the use of reduced dose glucocorticoids over standard dose glucocorticoids for remission induction in active GPA or MPA. For remission maintenance in patients with GPA or MPA, we recommend the use of rituximab over azathioprine for at least 48 months from diagnosis. We conditionally recommend the use of plasma exchange in patients with severe renal vasculitis. For remission induction in EGPA, we recommend use of cyclophosphamide or rituximab in severe disease and mepolizumab or azathioprine or methotrexate or mycophenolate mofetil in non-severe disease., Conclusions: These are the first ever Indian recommendations for the management of AAV. Despite our effort to formulate these recommendations based on high quality evidence, some recommendations were still based on low quality evidence but with high rate of agreement among expert panel members., Competing Interests: Declaration of competing interest Nil., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Pure intertubular seminoma (PITS) of the testis is described as the presence of seminoma cells within the interstitium of testis without any evidence of diffuse growth pattern or mass lesion of classical seminoma. These tumors are clinically and grossly inconspicuous and are diagnosed incidentally or during investigations for testicular pain, infertility or other symptoms. Rarely metastasis is the first presentation. Microscopic identification can be difficult and poses a diagnostic challenge in the absence of a mass lesion. Seminomas with exclusive intertubular growth patterns were gathered in an international cohort. Diagnoses were confirmed by fellowship-trained or specialized urologic pathologists. Cases with the presence of a classical diffuse or nested pattern of seminoma or any other germ cell tumor component were excluded. The patient's age, tumor characteristics and additional clinicopathologic features were recorded and analyzed. 15 patients of pure intertubular seminoma (PITS) were collated. The mean age of presentation was 29 years. Patients presented with variable symptoms, including undescended testis (26%, n = 4/15), testicular heaviness/pain (20%, n = 3/15) infertility (20%, n = 3/15) and metastasis (6%, n = 1/15); presentation was unknown in 4 patients. Of note, none of the patients presented because of testicular mass. Serum markers were within normal limits in most patients (93%, n = 14/15) with available data. No tumors were identified macroscopically; however, an ill-defined, grey-white, firm area was noted in one orchiectomy specimen. Microscopically, tumor cells were seen in intertubular spaces as dispersed individual cells or small clusters. Tumor cells were round to polygonal with large nuclei and prominent nucleoli. Mild to moderate lymphocytic infiltrates were seen admixed with tumor cells in 40% (n = 6/15) of the tumors. GCNIS was present in association with most PITS (73%, n = 11/15). Tubular atrophy with thickening of the basement membrane and Leydig cell hyperplasia was observed in one tumor. Thirty-three percent (n = 5/15) of the tumors showed pagetoid involvement of rete testis, including the tumor with metastasis. All tumors showed the classical immunohistochemical profile of seminoma, with PLAP, c-KIT, OCT3/4, D2-40 and SALL4 positivity. PITS can be clinically & pathologically inconspicuous, difficult to stage and liable to be misdiagnosed especially if presented with metastasis. Despite the inconspicuousness, PITS may represent an aggressive growth pattern of seminoma with the propensity for rete testis invasion., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Mir Hashim Rasool reports was provided by Islamic University of Science and Technology. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Oncocytic renal neoplasms are a major source of diagnostic challenge in genitourinary pathology; however, they are typically nonaggressive in general, raising the question of whether distinguishing different subtypes, including emerging entities, is necessary. Emerging entities recently described include eosinophilic solid and cystic renal cell carcinoma (ESC RCC), low-grade oncocytic tumor (LOT), eosinophilic vacuolated tumor (EVT), and papillary renal neoplasm with reverse polarity (PRNRP). A survey was shared among 65 urologic pathologists using SurveyMonkey.com (Survey Monkey, Santa Clara, CA, USA). De-identified and anonymized respondent data were analyzed. Sixty-three participants completed the survey and contributed to the study. Participants were from Asia (n = 21; 35%), North America (n = 31; 52%), Europe (n = 6; 10%), and Australia (n = 2; 3%). Half encounter oncocytic renal neoplasms that are difficult to classify monthly or more frequently. Most (70%) indicated that there is enough evidence to consider ESC RCC as a distinct entity now, whereas there was less certainty for LOT (27%), EVT (29%), and PRNRP (37%). However, when combining the responses for sufficient evidence currently and likely in the future, LOT and EVT yielded > 70% and > 60% for PRNRP. Most (60%) would not render an outright diagnosis of oncocytoma on needle core biopsy. There was a dichotomy in the routine use of immunohistochemistry (IHC) in the evaluation of oncocytoma (yes = 52%; no = 48%). The most utilized IHC markers included keratin 7 and 20, KIT, AMACR, PAX8, CA9, melan A, succinate dehydrogenase (SDH)B, and fumarate hydratase (FH). Genetic techniques used included TSC1/TSC2/MTOR (67%) or TFE3 (74%) genes and pathways; however, the majority reported using these very rarely. Only 40% have encountered low-grade oncocytic renal neoplasms that are deficient for FH. Increasing experience with the spectrum of oncocytic renal neoplasms will likely yield further insights into the most appropriate work-up, classification, and clinical management for these entities., Competing Interests: Declarations Conflict of interest The authors declare no competing interests., (© 2024. The Author(s).)

2,4-Thiazolidinedione derivatives represent nitrogen-containing heterocyclic compounds utilized in type 2 diabetes mellitus management. Recent advances in medicinal chemistry have unveiled diverse therapeutic potentials and structural modifications of these derivatives. This review delves into novel TZD derivatives, encompassing their synthesis, structure-activity relationships, and pharmacokinetic profiles. Various therapeutic potentials of TZDs are explored, including anticancer, antimicrobial, anti-inflammatory, antioxidant, anticonvulsant, antihyperlipidemic, anticorrosive, and antitubercular activities. Additionally, it addresses mitigating side effects associated with marketed TZD derivatives such as weight gain, oedema, fractures, and congestive heart failure in type 2 diabetes mellitus management. The review elaborates on in vivo, in vitro, and ex vivo studies supporting different biological activities, alongside predicting ADME and drug-likeness properties of TZDs. Computational studies are also integrated to elucidate binding modes and affinities of novel TZD derivatives. Furthermore, a plethora of novel TZD derivatives with varied and enhanced therapeutic potentials are presented, warranting further evaluation of their biological activities., (© 2024 The Authors. ChemistryOpen published by Wiley-VCH GmbH.)

Aims: Urothelial carcinoma (UC) demonstrates significant molecular and histologic heterogeneity. The WHO 2022 classification has hinted at adding molecular signatures to the morphologic diagnosis. As morphology and associated molecular repertoire may potentially translate to choices of and response to therapy and relapse rate, broader acceptability of recognizing these key features among uropathologists is needed. This prompted an international survey to ascertain the practice patterns in classical/subtype UC among uropathologists across the globe., Methods and Results: A survey instrument was shared among 98 uropathologists using SurveyMonkey software. Anonymized respondent data were analysed. The response rate was 85%. A majority were in concordance with the profiles of luminal (93%) and basal (82%) types. Opinion on the FGFR3 testing platform was variable. While 95% concurred that TERT promoter mutation is the key driver in UC, 72% had the opinion that APOBEC mutagenesis is the main signature in muscle invasive bladder cancer (MIBC). Uropathologists have divergent opinions on MIBC and ERCC2 mutations. Among the participants, 94% would quantify aggressive micropapillary and sarcomatoid histology, while 88% would reevaluate another transurethral resection of the bladder tumour specimen in nonmuscle invasive tumour with micropapillary, small cell, or sarcomatoid histology. A leading number agreed to specific molecular signatures of micropapillary (93%), plasmacytoid (97%), and small cell (86%) subtypes. Ninety-six percent of participants agreed that a small-cell component portends a more aggressive course and should be treated with neoadjuvant chemotherapy and 63% would perform HER2/neu testing only on oncologist's request in advanced tumours. Ninety percent agreed that microsatellite instability testing, although not a standard protocol, should be considered in young patients with upper tract UC. Eighty-six percent agreed that UC with high tumour mutational burden would be a better candidate for immunotherapy., Conclusion: In the era of precision medicine, enhanced understanding of molecular heterogeneity of UC will contribute to better therapeutic options, novel biomarker discovery, innovative management protocols, and outcomes. Our survey provides a broad perspective of pathologists' perceptions and experience regarding incorporation of histomolecular approaches to "personalize" therapy. Due to variable clinical adoption, there is a need for additional data using uniform study criteria. This will drive generation of best practice guidelines in this area for widespread and consistent clinical utility., (© 2024 John Wiley & Sons Ltd.)

In this paper, a new synthetic route is introduced for the synthesis of high-luminescent greenish-yellow fluorescent copper nanoclusters (PVP@A. senna-Cu NCs) using Avaram senna (A. senna) and polyvinylpyrrolidone (PVP) as templates. A. senna plant extract mainly contains variety of phytochemicals including glycosides, sugars, saponins, phenols, and terpenoids that show good pharmacological activities such as anti-inflammatory, antioxidant, and antidiabetic. PVP is a stable and biocompatible polymer that is used as a stabilizing agent for the synthesis of PVP@A. senna-Cu NCs. The size, surface functionality, and element composition of the fabricated Cu NCs were confirmed by various analytical techniques. The as-prepared greenish-yellow fluorescent Cu NCs exhibit significant selectivity towards fipronil, thereby favoring to assay fipronil pesticide with good linearity in the range of 3.0-30 μM with a detection limit of 65.19 nM. More importantly, PVP@A. senna-Cu NCs are successfully applied to assay fipronil in vegetable and grain samples., Competing Interests: Declarations. Ethical Approval: There are no ethical approvals required for this research work. Consent for Publication: Not Applicable. Competing Interests: The authors declare no competing interests., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Triple-negative breast cancer (TNBC) is difficult to treat breast cancer subtype due to lack or insignificant expressions of targetable estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2). Therefore, finding a targetable protein or signaling pathway in TNBC would impact patient care. Here, we report that a member of the Mixed Lineage Kinase (MLK) family, MLK3, is an effector of G-protein-coupled protease-activated receptors 1 (PAR1) and targeting MLK3 by a small-molecule inhibitor prevented PAR1-mediated TNBC tumorigenesis. In silico and immunohistochemistry analysis of human breast tumors showed overexpression of PAR1 and MLK3 in TNBC tumors. Treating α-thrombin and PAR1 agonist increased MLK3 and JNK activities and induced cell migration in TNBC cells. The PAR1 positive/high (PAR1 +/hi ) population of TNBC cells showed aggressive tumor phenotype with increased MLK3 signaling. Moreover, combined inhibition of the PAR1 and MLK3 mitigated the TNBC tumor burden in preclinical TNBC models. Our data suggests that activation of the PAR1-MLK3 axis promotes TNBC tumorigenesis. Therefore, combinatorial therapy targeting MLK3 and PAR1 could effectively reduce TNBC tumor burden., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background The peak expiratory flow rate (PEFR) is the maximum flow rate (expressed as L/s) generated during a forceful exhalation, starting from full inspiration. It is an effort-dependent parameter and reflects large airway flow. It depends on lung recoil, muscular strength of patients, and voluntary effort. The PEFR is a simple and easy way to detect early changes in lung function. The PEFR can be measured by a peak flow meter or a spirometer; however, a spirometer is more accurate than a peak flow meter. The PEFR is known to vary according to age, gender, and anthropometric parameters like height, weight, BMI, ethnicity, and altitude. PEFR values for different populations are needed because they help to determine the variable expiratory flow limitation in asthma. There is no study done to find out the normal PEFR in children in Jharkhand. Hence, this study aimed to establish the reference values of the PEFR of children in Jharkhand. Methodology Three hundred and sixteen healthy children belonging to the age group of 6-18 years attending the OPD of Rajendra Institute of Medical Sciences, Ranchi were studied. All the children were asked to perform spirometry, and the PEFR was recorded. Patient demographic details like age, sex, height, weight, BMI, and ethnicity were documented. These factors were selected to see how the PEFR of children in Jharkhand correlated with them and compare it with the values obtained from similar studies conducted in different parts of India. Results Three hundred and sixteen children were studied, consisting of 194 male participants and 122 female participants. The mean PEFR for male participants was 3.90±1.58L/s and for female participants, it was 4.04±1.49L/s. The correlation coefficient of the PEFR with height was 0.792, that of the PEFR with weight was 0.713 and that of the PEFR with BMI was 0.364. Hence, height is the best predictor of PEFR. The lowest correlation of BMI with PEFR shows that the recent rise in obesity in the paediatric population should not be expected to affect the lung function significantly. Conclusion The mean PEFR of children in Jharkhand is lower than that of children in northern (mean PEFR of male participants =4.41 ± 1.54 L/s, mean PEFR of female participants = 4.17 ± 1.17 L/s) and southern India (mean PEFR of male participants = 4.88±1.29 L/s, mean PEFR of female participants = 4.25±1.29 L/s). Compared to neighbouring states in eastern India, the mean PEFR of children in Jharkhand is lower., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, Rajendra Institute of Medical Sciences, Ranchi issued approval 201. This is to certify that the Institutional Ethics Committee of Rajendra Institute of Medical Sciences approves and grants the permission to conduct the scientific work on the project entitled "Assessment of normal values of Peak Expiratory Flow Rates in children between 6 to 18 years of age in a tertiary care centre in Jharkhand: A Cross Sectional Study" done by Dr Shambhavi Datta, postgraduate resident, Paediatrics, Batch 2021-2024, under the guidance of Dr Sunanda Jha, Associate Professor, Department of Paediatrics, RIMS, Ranchi. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Datta et al.)

Background: ST-elevation myocardial infarction (STEMI) and Takotsubo syndrome (TS) are two distinct cardiac conditions that both result in sudden loss of cardiac dysfunction and that are difficult to distinguish clinically. This study compared plasma protein changes in 24 women with STEMI and 12 women with TS in the acute phase (days 0-3 post symptom onset) and the stabilization phase (days 7, 14, and 30) to examine the molecular differences between these conditions., Methods: Plasma proteins from STEMI and TS patients were extracted during the acute and stabilization phases and analyzed via quantitative proteomics. Differential expression and functional significance were assessed. Data are accessible on ProteomeXchange, ID PXD051367., Results: During the acute phase, STEMI patients showed higher levels of myocardial inflammation and tissue damage proteins compared to TS patients, along with reduced tissue repair and anti-inflammatory proteins. In the stabilization phase, STEMI patients exhibited ongoing inflammation and disrupted lipid metabolism. Notably, ADIPOQ was consistently downregulated in STEMI patients in both phases. When comparing the acute to the stabilization phase, STEMI patients showed increased inflammatory proteins and decreased structural proteins. Conversely, TS patients showed increased proteins involved in inflammation and the regulatory response to counter excessive inflammation. Consistent protein changes between the acute and stabilization phases in both conditions, such as SAA2, CRP, SAA1, LBP, FGL1, AGT, MAN1A1, APOA4, COMP, and PCOLCE, suggest shared underlying pathophysiological mechanisms., Conclusions: This study presents protein changes in women with STEMI or TS and identifies ADIPOQ, SAA2, CRP, SAA1, LBP, FGL1, AGT, MAN1A1, APOA4, COMP, and PCOLCE as candidates for further exploration in both therapeutic and diagnostic contexts.

Background: India aims to eliminate rubella and congenital rubella syndrome (CRS) by 2023. We conducted serosurveys among pregnant women to monitor the trend of rubella immunity and estimate the CRS burden in India following a nationwide measles and rubella vaccination campaign., Methods: We surveyed pregnant women at 13 sentinel sites across India from Aug to Oct 2022 to estimate seroprevalence of rubella IgG antibodies. Using age-specific seroprevalence data from serosurveys conducted during 2017/2019 (prior to and during the vaccination campaign) and 2022 surveys (after the vaccination campaign), we developed force of infection (FOI) models and estimated incidence and burden of CRS., Results: In 2022, rubella seroprevalence was 85.2% (95% CI: 84.0, 86.2). Among 10 sites which participated in both rounds of serosurveys, the seroprevalence was not different between the two periods (pooled prevalence during 2017/2019: 83.5%, 95% CI: 82.1, 84.8; prevalence during 2022: 85.1%, 95% CI: 83.8, 86.3). The estimated annual incidence of CRS during 2017/2019 in India was 218.3 (95% CI: 209.7, 226.5) per 100, 000 livebirths, resulting in 47,120 (95% CI: 45,260, 48,875) cases of CRS every year. After measles-rubella (MR) vaccination campaign, the estimated incidence of CRS declined to 5.3 (95% CI: 0, 21.2) per 100,000 livebirths, resulting in 1141 (95% CI: 0, 4,569) cases of CRS during the post MR-vaccination campaign period., Conclusion: The incidence of CRS in India has substantially decreased following the nationwide MR vaccination campaign. About 15% of women in childbearing age in India lack immunity to rubella and hence susceptible to rubella infection. Since there are no routine rubella vaccination opportunities for this age group under the national immunization program, it is imperative to maintain high rates of rubella vaccination among children to prevent rubella virus exposure among women of childbearing age susceptible for rubella., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Highly pathogenic Burkholderia pseudomallei is the causative agent of melioidosis, a neglected tropical disease endemic in Southeast Asian tropical region. This bacterium encompasses diverse virulence factors which further undergo dynamic gene-expression flux as it transits through distinct environmental niches within the host which may lead to manifestation of differential clinical symptoms. B. pseudomallei, is classified as a Tier 1 select agent in the United States and regarded as a risk group 3 organism in India with the potential to be used as bioweapon. Considering these facts, it is vital to uncover both physiological and genetic heterogeneity of B. pseudomallei, particularly to identify any novel virulence factors that may contribute to pathogenicity. B. pseudomallei strain CM000113 was isolated from a clinical case in India, characterized it for its physiological, biochemical, and prominently genetic traits through WGS. It has a type 2 morphotype with faster doubling time and high biofilm producing capacity as compared to Pseudomonas aeruginosa. The genome size is 7.3 Mbp and it is phylogenetically close to B. pseudomallei strain Mahidol 1106a and Burkholderia mallei Turkey 2. We observed genetic heterogeneity, as key virulence factors that were identified shows sequence dissimilarity with reference strains. Additionally, presence of genomic islands, harbouring two virulence factors, GmhA and GmhB2, associated with pathogenesis indicates possibility of horizontal gene transfer. These results emphasize the need for an extensive study focusing the genome of B. pseudomallei and its associated heterogeneity, to identify molecular biomarkers aiding to develop point-of-care diagnostic kits for early diagnosis of melioidosis., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background Auto-polymerizing acrylic resins, composed primarily of poly(methyl methacrylate) and methyl methacrylate, are crucial in prosthetic dentistry due to their ease of use, cost-effectiveness, and acceptable aesthetics, polymerizing at room temperature to form solid polymer networks. One of the most important mechanical properties of these resins is flexural strength, which is essential for their performance under continuous masticatory forces. In clinical applications, prosthetic materials endure repetitive stress from chewing, and resins with higher flexural strength are better equipped to resist deformation and fractures. This property is vital for ensuring the long-term integrity of prostheses, minimizing the risk of material failure, and enhancing prosthetic longevity, thus contributing to better clinical outcomes and patient satisfaction. Objective Resins with superior flexural strength, such as DPI, provide better clinical outcomes. High flexural strength minimizes the risk of material failure in high-stress areas, especially in extensive restorations like temporary bridges or denture repairs. For clinicians, using materials with greater strength reduces the likelihood of restoration failure, ensuring more reliable performance and fewer interventions for repair or replacement. This study aims to evaluate and compare the flexural strength of three commercially available auto-polymerizing acrylic resins, Pyrax (Pyrax International, Uttarakhand, India), DPI (Dental Products of India, Mumbai, India), and Quick Ashvin (National Dental Supply Company, Delhi, India), to determine their suitability for various dental applications. Methodology Following American Dental Association specifications, 20 rectangular bar-shaped specimens (25 mm x 2 mm x 2 mm) of each resin type were prepared. The resins were mixed according to manufacturer instructions, poured into molds, and allowed to auto-polymerize at room temperature. Post-polymerization, specimens were immersed in artificial saliva at 37°C for 10 days to simulate oral conditions. Flexural strength was assessed using a three-point bending test on a universal testing machine, and results were analyzed using ANOVA and post-hoc Bonferroni tests. Results The flexural strength of DPI resin bars (mean=482.10 MPa, SD=17.28) was significantly higher compared to both Pyrax (mean=467.82 MPa, SD=15.01) and Quick Ashvin (mean=470.17 MPa, SD=8.18). ANOVA revealed a significant difference among the resins (F=5.956, p=0.004). Post-hoc Bonferroni comparisons showed a statistically highly significant difference between DPI and Pyrax (p=0.006) and a significant difference between DPI and Quick Ashvin (p=0.028). No significant difference was observed between Pyrax and Quick Ashvin (p=1.000). Conclusion DPI resin, with its superior flexural strength, is the best choice for high-stress dental applications, while Quick Ashvin offers balanced performance for interim uses such as temporary crowns. Pyrax, being more cost-effective, is suitable for less demanding cases. This study underscores the importance of selecting materials based on mechanical properties and calls for further research to enhance resin durability. For dental practitioners, DPI is ideal for long-lasting restorations, Quick Ashvin for temporary solutions, and Pyrax for budget-conscious cases., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Banerjee et al.)

Nitrate ion-based chemical ionization mass spectrometry (NO 3 - -CIMS) is widely used for detection of highly oxygenated organic molecules (HOMs). HOMs are known to participate in molecular clustering and new particle formation and growth, and hence understanding the formation pathways and amounts of these compounds in the atmosphere is essential. However, the absence of analytical standards prevents robust quantification of HOM concentrations. In addition, nitrate-based ionization is usually very selective towards the most oxygenated molecules and blind to less oxygenated compounds hindering the investigation of molecular formation pathways. Here, we explore varying concentrations of nitric acid reagent gas in the sheath flow of a chemical ionization inlet as a method for detecting a wider range of oxidation products in laboratory-simulated oxidation of benzene and naphthalene. When the concentration of reagent nitric acid is reduced, we observe an increase in signals of many oxidation products for both precursors suggesting that they are not detected at the collision limit. The sensitivity of naphthalene oxidation products is enhanced to a larger extent than that of benzene products. This enhancement in sensitivity has a negative relationship with molecular oxygen content, the oxygen-to-carbon ratio, the oxidation state of carbon, and lowered volatility. In addition, the sensitivity enhancement is lower for species that contain more exchangeable H-atoms, particularly for accretion products. While more experimental investigations are needed for providing the relationship between enhancement ratios and instrumental sensitivities, we suggest this method as a tool for routine check of collision-limited sensitivities and enhanced detection of lower-oxygenated species., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: Gastritis is a very common disorder that is widely distributed worldwide, representing one of the most prevalent pathological entities in gastroenterology and digestive endoscopy. This study aims to analyse the correlation between the endoscopic findings and the symptoms of gastritis. Upper gastro-intestinal (UGI) endoscopy is a widely used investigation for a variety of UGI symptoms namely dysphagia, dyspepsia, abdominal pain, etc., and when combined with biopsy, its diagnostic accuracy get increased manifold., Materials and Methods: This is a study with 70 patients with symptoms of gastritis underwent UGI endoscopy and biopsy included in study. Biopsy was taken from gastric/duodenal mucosa and was sent for histopathology examination. Data of patient's age, gender, food habits, oral hygiene, etc., were then taken into consideration and findings of UGI endoscopy were correlated with these data and also correlated with histopathological report., Results: Gastritis significantly affects the lifestyle of the majority of our participants as out of 70, 65 (95%) had gastritis in our study. Helicobacter pylori was present among 41.5 % of study participants. Other less common findings were esophagitis in 20 % and duodenitis in 7% of study participants. The mean age of participants were 46.76 ± 16.25 years., Conclusion: Histopathology plays a major role in diagnosing H. pylori infection. So, histological examination as an adjunct to UGI endoscopy should be considered as best diagnostic tool rather than UGI endoscopy alone or clinical examination or radiological examination alone. It helps to treat the gastritis patients by diagnosing the underlying cause and management accordingly., Competing Interests: Nil., (Copyright: © 2024 Journal of the West African College of Surgeons.)

Introduction and Hypothesis: Coital incontinence (CI) is common, with a significant impact on quality of life and sexual function. This multicentre study was aimed at measuring the association between overactive bladder (OAB), stress urinary incontinence (SUI) and different aspects of CI including orgasm and penetration incontinence., Methods: Following ethical approval, data from the electronic Personal Assessment Questionnaire-Pelvic Floor patient-reported outcome measure was collated for Urogynaecology outpatients from seven participating UK Hospitals between April 2018 and January 2022. Data were anonymised and analysed centrally using Excel., Results: A total of 12,877 responses were obtained, of which 4,843 were valid for inclusion. 79.3% of women presented with urinary incontinence of whom 41.6% also reported CI. 96.8% of women with CI reported mixed OAB and SUI, with 2.1% and 1.1% reporting pure OAB and SUI respectively. There was a small subset (2.4%) with no overt urinary incontinence who occasionally experienced CI. Spearman's rank-order correlation demonstrated a statistically significant association between CI symptom score with both SUI (R = 0.57, p < 0.001) and OAB (R = 0.40, p < 0.001); orgasm incontinence with SUI (R = 0.49, p < 0.001) and OAB (R = 0.36, P < 0.001); penetration incontinence with SUI (R = 0.48, p < 0.001) and OAB (R = 0.35, p < 0.001)., Conclusions: Coital incontinence is experienced by 42% of women with urinary incontinence. There is a statistically significant association between both SUI and OAB with orgasm incontinence and penetration incontinence, suggesting (a) common underlying mechanism(s). Limitations of this study include the large amount of missing data and the NHS outpatient setting that limit the conclusions that can be drawn from the data., (© 2024. The International Urogynecological Association.)

This paper presents all-atom molecular dynamics to understand the separation behavior of 5-hydroxymethylfurfural (5-HMF) from 1-butyl-3-methylimidazolium tetrafluoroborate [BMIM] + [BF 4 ] - using alkylated phenols as extractants. We have utilized four solvents such as 4-methyl phenol (4-MP), 4-ethyl phenol (4-EP), 4-propyl phenol (4-PP), and 4-butyl phenol (4-BP). We perform structural, dynamic, and rigorous thermodynamic analyses of 5-HMF in the mixture of ILs and solvents. The [BMIM] + [BF 4 ] - show a strong interaction with phenols. The self-diffusion coefficient of 5-HMF shows a 3-fold increase with a decrease in the methyl group on the phenol. The solvation-free energy (ΔG solvation ) of 5-HMF shows favorably in phenols. On the other hand, the transfer free energy (ΔG transfer ) of 5-HMF presents favorable from ILs to phenols. The partition coefficient (log P) values show favorability for separation of 5-HMF using phenols. Overall, the molecular level analysis provides the role of the alkyl group effect on the phenols for extracting 5-HMF from the ILs., (© 2024 Wiley-VCH GmbH.)

Background: An abnormal EEG is pivotal in diagnosis, exclusion of mimickers and prognosticating epilepsy in Autoimmune Encephalitis (AE). However, little is known about the short and long term electroencephalographic outcomes and predictors of epilepsy in AE. This study aims to describe the seizure characteristics and electrophysiological markers of various AE subtypes and assess the clinical and electrophysiological predictors of autoimmune epilepsy., Methods: Clinical features and EEGs in 74 patients (acute phase=39 and post-acute phase defined after a minimum eight weeks after acute phase=35) of AE fulfilling the proposed criteria were reviewed in their respective acute phases and at six months follow-up., Results: The mean age of presentation (N = 74, 45 females) was 21.8 (21.8 ± 17.0) years. 38 (51 %) patients were <18 years. Seizures were present in 55 (74 %) patients with poor response to ASMs (p = 0.039). 39 (52.7 %) EEGs were abnormal in acute phase. Anti-NMDAR AE had most frequently abnormal EEG (63.4 %). Poor background reactivity and theta range slowing were most common abnormalities. FIRDA, EDB and delta range slowing were seen in seropositive AE (P = 0.003). Mutism, psychiatric features and incontinence correlated with abnormal EEG (p = 0.013, p = 0.028 and p = 0.025). Background slowing and epileptiform discharges predicted worse cognitive scores at follow-up (p = 0.012). Eight (11.9 %) patients developed epilepsy. Status epilepticus at presentation (p = 0.009), seronegative status (p = 0.0020), delayed initiation of immunotherapy (p = 0.012), abnormal MRI (p = 0.003) and abnormal EEG (p = 0.004) at onset indicate development of autoimmune epilepsy CONCLUSIONS: FIRDA, EDB and delta range slowing with refractory seizures suggest AE. Epileptiform abnormalities, status epilepticus and seronegativity predict autoimmune epilepsy., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

L-thyroxine serves as a primary biomarker for diagnosing hypothyroidism and it is also utilized in hormone replacement therapy. Regular assessment of thyroxine levels is crucial for preventing health issues in hypothyroid patients, suggesting the requirement of a facile analytical tool for the detection of L-thyroxine. In this work, a straightforward and efficient synthetic method is introduced for in-situ preparation of Mn 2+ -doped boron quantum dots (Mn 2+ @B-QDs) derived from boron powder through a solvothermal reaction. The introduction of Mn 2+ ion into B-QDs not only enhances fluorescence efficiency but also provides favorable sites within the QDs, expanding their potential applications in analytical chemistry. The blue fluorescent Mn 2+ @B-QDs exhibited excellent performance for the selective recognition of L-thyroxine via a dynamic quenching mechanism. Under ideal conditions, a good linear relation was observed between the fluorescence emission intensity ratio of Mn 2+ @B-QDs and the concentration of L-thyroxine in the range of 0.125-5 μM, with a lower detection limit of 59.86 nM. The Mn 2+ @B-QDs exhibited the negligible cytotoxicity against A549 lung cancer cell lines and demonstrated good biocompatibility toward Saccharomyces cerevisiae cells., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Synovial sarcoma (SS) is a rare genitourinary malignancy with a specific SS18::SSX 1/2 gene fusion in majority of the instances. The paratesticular location of this neoplasm is extremely rare and only 4 cases are reported in the literature. Herein, we describe the clinicopathologic features and molecular profile of paratesticular SS in the largest case series to date and to the best of our knowledge, and the only series to use novel SS18-SSX antibody for immunohistochemistry. Clinicopathologic, immunohistochemical (IHC), molecular, treatment, and follow-up data of the patients were analyzed. There were 14 patients, ranging from 15 to 47 years (mean: 30 y). The tumor size ranged from 4​​​​​​ to 15 cm. The tumors were unilateral, solid, and homogeneous tan-white with monomorphic spindle cell histology. All 14 tumors expressed SS18-SSX and TLE1 IHC and harbored SS18 rearrangement. In addition, the tumor with multifocal SS18-SSX expression had lower break-apart signals in the FISH assay (38% of the tumor cells; range: 29% to 85%). Radical orchiectomy was performed in all 14 patients and adjuvant chemotherapy was administered in 9 patients. Follow-up was available in 9 patients. The follow-up duration ranged from 5 to 24 months (median=10 mo). Four patients died of metastatic disease (range: 5 to 16 mo) and 2 patients who are alive had metastatic disease at the last follow-up. Based on our experience with the largest series to date and aggregate of the published data, paratesticular SS has a poor prognosis despite aggressive therapy. Owing to its rarity, the differential diagnosis is wide and requires a systematic approach for ruling out key morphologic mimics aided with SS18-SSX IHC and molecular confirmation because this distinction carries important therapeutic and prognostic implications. Due to the excellent concordance of SS18-SSX IHC results with FISH results as observed in our study, we would like to suggest inclusion of SS18-SSX in the diagnostic immunohistochemistry panel of all spindle cell sarcomas where synovial sarcoma is considered as a morphologic differential. SS18-SSX-positive staining may be used as a surrogate for FISH assay in a resource-limited setting where molecular assay is not available. Furthermore, IHC has a fairly shorter turn-around-time, is less complex, and of low cost., Competing Interests: Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Posttraumatic stress disorder (PTSD) is associated with mortality and increased risk of diseases of aging, but underlying mechanisms remain unclear. We examine associations of PTSD with one potential pathway, accelerated epigenetic aging. In a longitudinal cohort of trauma-exposed middle-aged women (n = 831, n observations = 1,516), we examined cross-sectional and longitudinal associations between PTSD, with and without comorbid depression, and epigenetic aging measured by six clocks at two time points approximately 13.5 years apart: Hannum, Horvath, PhenoAge, GrimAge, DunedinPoAM, and DunedinPACE. We further examined associations of 3 well-established predictors of aging and mortality also linked with PTSD, namely, body mass index (BMI), diet quality, and physical activity, with epigenetic aging. Cross-sectionally, across all six clocks, epigenetic aging in women with PTSD alone, depression alone, and co-occurring depression and PTSD did not differ from the reference group of women without PTSD or depression in analyses adjusted for age, self-reported race, cell proportions, and ancestry principal components. In longitudinal analyses, we similarly did not find any difference in change in epigenetic age over time by PTSD and depression status at baseline. Among the health factors, in cross-sectional analyses, higher BMI was significantly and consistently associated with greater epigenetic aging measured by the PhenoAge, GrimAge, DunedinPoAM, and DunedinPACE clocks, but not measured by the Hannum or Horvath clocks. Physical activity was not consistently associated with epigenetic aging measured by Hannum, Horvath, PhenoAge, or GrimAge. In analyses with the DunedinPoAm and DunedinPACE clocks, women who reported exercise equivalent to 1 or more hours/week walking had slower epigenetic aging than women with less exercise. Diet quality was not consistently associated with epigenetic aging measured by any of the clocks. Our data do not provide evidence that biological aging, as measured by any of the six epigenetic clocks, is a pathway linking PTSD with mortality and diseases of aging., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Rudimentary uterine horn pregnancy is rare, with a reported incidence of 1 in 76,000 to 1 in 150,000. This report aims to advance knowledge regarding this rare condition, importance of MRI imaging in characterizing congenital uterine anomalies and the feasibility of a total laparoscopic management approach. A 26 year old female presented with new onset abdominal pain at 6 weeks gestation. Ultrasound imaging initially suggested that the pregnancy was located within a unicornuate uterus. However further imaging (ultrasound and MRI) instead located the pregnancy within a noncommunicating right-sided rudimentary uterine horn, with a left-sided unicornuate uterus. This uterine anomaly was newly diagnosed in early pregnancy and required a multidisciplinary approach to determine optimal management. A total laparoscopic approach was successfully used to excise the right uterine horn and fallopian tube to prevent recurrence and future complications including tubal ectopic pregnancy., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

A hydrothermal synthetic method is established to produce blue fluorescent Eu 3+ -doped niobium carbide MXene quantum dots (Eu 3+ -Nb 2 C MQDs). The synthesized Eu 3+ -Nb 2 C MQDs demonstrated a quantum yield of 20.61% and a maximum emission intensity at 405 nm. The as-prepared Eu 3+ -Nb 2 C MQDs acted as a sensor for the rapid and sensitive detection of hypoxanthine through fluorescence quenching, and of fluoxetine through fluorescence enhancement mechanisms. The emission peak of Eu 3+ -Nb 2 C MQDs at 405 nm exhibited a linear response for hypoxanthine and fluoxetine in the ranges of 0.5-25 µM and 0.125-2.5 µM, with detection limits of 15.0 and 3.7 nM, respectively. The newly developed probe was effectively used for the selective detection of hypoxanthine and fluoxetine in biofluids and pharmaceutical samples. Remarkably, the Eu 3+ -Nb 2 C MQDs exhibited minimal cytotoxicity towards A549 lung cancer cells and showed great potential as imaging agent for imaging of Saccharomyces cerevisiae cells., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Water contamination is a major environmental issue, especially in rapidly growing industrialized areas like Singrauli. This study addresses research gaps regarding the hydrochemical characterization, health risk assessment, and source identification of contaminants. Hydrochemistry shows the concentrations of Na + , Ca 2+ , F - , Mn, As, Mo, Sr, and Ni were above the permissible limit for drinking usage. Water quality index (WQI), heavy metal pollution (HMPI), and evaluation indices (HMEI) revealed As, Mn, Cd, Mo, Co, and Ni were the key heavy elements contributing towards aqueous media pollution in the Singrauli area. Additionally, F was also considered one of the major contaminants. In health risk assessment, the higher values of hazard quotient (HQ) for non-carcinogens were associated with Mn, As, Mo, and F; and hazard index (HI) values > 1 were found in 70% and 55% of samples for children and adults, respectively. Carcinogenic risk (CR) for human health was associated with As. CR values in 56.7% (for adults) and 61.7% (for children) of the total samples exceeded 1 × 10 -4 . Monte Carlo simulation was applied and highlighted the significant risk factors responsible for both carcinogenic and non-carcinogenic health impacts. 19.2%, 7.3%, and 6.9% of the simulated HQ values for adults and 30.1%, 16.9%, and 10.6% for children were above the safe limit for F, As, and Mn, respectively. Additionally, only 43.8% and 24.8% of the simulated HI for adults and children were within the safe limit. Irrespective of age groups, all the simulated values of As in CR were above 1 × 10 -6 ; and 60% (for adults) and 77.1% (for children) of the values were above 1 × 10 -4 . This outcome emphasizes the urgency of pollution control measures, especially for As, F, and Mn, to safeguard public health. Moreover, a multivariate statistical approach revealed that both geogenic and anthropogenic sources were responsible for contamination. Therefore, regular monitoring, filtration, and purification are mandatory to ensure safe drinking water for human consumption., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Radiology began as a translation of quantum physics to clinical medicine. Advances in computing and engineering enabled the differentiation of the field into diagnostic radiology, interventional radiology, and radiation oncology as practical responses to rapidly proliferating medical knowledge. Radiology has itself transformed modern medicine, helping clinicians identify, track, and intervene on multiple once deadly diseases. It is practiced in academic departments and hospital based, outpatient center based, or fully remote private groups of varying sizes, often with direct physicist support to optimize the use of complicated equipment. Importantly, radiology was guided to its current form not just by scientific advances, but by the interplay of cultural and governmental forces, as well as hard lessons, the results of constantly shifting balances of competing interests as follows: insurance, pharmaceutical, medical device, hospital, physician, physician extender, and patient. The purpose of this review is to describe the historical legal landscape of diagnostic radiology in the context of ethics, public health initiatives, and patient protections. For clarity, the review is divided into two parts., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)