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Thyroid abscesses (TA) are a rare clinical entity in adult and pediatric patients. Less than 50 pediatric cases have been described. While inherently resistant to infection, various risk factors may predispose to thyroidal infection and abscess. This report details the incidental discovery of a thyroglossal duct cyst presenting as TA in a child who presented with a 1-week history of worsening pain and swelling of the right neck along with remittent fever. After clinical examination, laboratory examination, and ultrasound, a diagnosis of TA was made. The patient was administered antibiotics and antithyroid medication alongside supportive care. Surgery was considered in case of deterioration or absence of improvement. After two days of treatment, the patient improved and was discharged after two weeks of treatment. This article reports the incidence of TA, which was precipitated by congenital anatomical abnormality. The conservative treatment of TA using antibiotics was also highlighted.

Context: Water kefir is a fermented beverage that is typically made in the home by inoculating a sugar-rich solution with a microbial community (water kefir grains). Several studies on the metabolite content and hepatoprotective effects of water kefir have been published, but carbon tetrachloride (CCl4)-induced acute liver injury has not been studied. Aims: To evaluate the efficacy of water kefir in vivo against hepatoprotective CCl4-induced acute liver injury and to in silico investigate metabolites that play an important role in hepatoprotective mechanisms. Methods: The present study aimed to investigate the hepatoprotective activity of water kefir in an animal model caused by CCl4. Furthermore, using molecular docking, the metabolites found in water kefir were evaluated for their role in the NF-κB and Nrf2 signaling pathways. Results: Water kefir significantly and dose-dependently alleviated acute liver injury caused by CCl4. Water kefir administration at all doses produced results comparable to the positive control (Curcuma extract). Molecular docking simulations showed that, compared to Nrf2, the 25 metabolites were more likely to interact with the NF-kB receptor. Fumaric acid is the strong metabolite that interacts with the NF-κB receptor with a free energy of binding and an inhibition constant of -6.66 kcal/mol and 13.22 µM, respectively. Conclusions: Water kefir administration improved the condition of liver damage, characterized by a decrease in serum levels of AST, ALT, TNF-a, TGF-b, and an improvement in the liver tissue profile. In silico evaluation showed that the metabolites in water kefir were able to interact with target proteins in the NF-kB and Nrf2 pathways. It was concluded that water kefir improves the condition of the liver by reducing the level of necrosis and fibrosis.

Abstract This study provides an overview of the use of lima bean (Phaseolus lunatus L.) flour as a raw material for starch extraction in consecutive steps for the preparation of lima bean protein concentrate. The starch from lima bean flour was extracted at different alkaline pH levels: 7, 8, 9, 10, and 11. The physicochemical, microstructural, crystallinity, pasting, and functional properties of the extracted starch were evaluated. The results showed that the purity of the starch increased with a higher extraction pH. However, a further increase in pH reduced the yield. The alkaline-extracted starch still contained other non-starch compounds. The extraction pH affected the amylose content, presumably due to the interaction of OH- ions with the starch granular components, influencing the yield and amylose level. At lower pH levels, alkali promoted a more orderly granular structure, decreasing starch solubility and resulting in higher yield and amylose content. Meanwhile, at higher pH levels, alkali ions increased protein solubility and starch content. The pH had a slight influence on the starch granule morphology. Lima bean starch exhibited a crystallinity index of 29% to 34% depending on the alkaline extraction pH. All starches showed individual peaks at 2θ values of 15° and 23°, unresolved peaks at 2θ values of 17° and 18°, and a diffracted plane around 5.63°, indicating a C-type starch. After alkali treatment, the starch maintained its C-type structure, indicating no structural transformation in the orthorhombic and hexagonal structures. Increasing the extraction pH to 9 increased starch crystallinity, but a further increase in pH decreased it. Viscosity during pasting was affected by the intensive interaction of water with amylose in the amorphous regions. The extraction pH influenced peak, trough, setback, and final viscosity. The alkaline treatment might disrupt granular regions, altering the functional properties of the starch. Alkaline extraction of starch can be performed on lima bean flour.

Objective: the paper-based OSCE (Pa-OSCE) scoring system has several drawbacks, including significant paper waste and being time-consuming. This study aims to assess examiner satisfaction with the On-OSCE scoring management system, identify and weigh the potential benefits of the innovation, and promote its use., Methods: using a cross-sectional study design, we developed satisfaction inventory consisting of four domains: time-saving, user-friendliness, prospective application, and objectivity. This inventory was used to compare satisfaction scores between two examiner groups (a total of 67 subjects)., Results: the 20-item satisfaction inventory demonstrated high validity and reliability (0.98 and 0.97, respectively). The average scoring time was significantly shorter in the online scoring management system group (p<0.001). Both the total satisfaction score and the scores for each domain were significantly higher in the online scoring management system group compared to the paper-based scoring management system group (p<0.001)., Conclusions: a high proportion of the examiners provided positive feedback on the online scoring management system. The online scoring management system saves the time to score, and is more objective, easier to use, and is recommended for implementation. Online scoring management systems can be implemented in nursing education institutions globally to improve scoring efficiency. Additionally, the 20-item satisfaction inventory can serve as a benchmarking tool to assess educators worldwide.