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Background: Infective endocarditis poses many clinical and diagnostic challenge. The diagnosis of infective endocarditis is made by high index of clinical suspicion based on the American Heart Association modified Duke's criteria, and the main imaging modality of choice is echocardiography. Case presentation: Here, we reported a case of recurrent infective endocarditis revealed by FDG PET/CT study despite completion of antibiotics and negative on echocardiography. A 38-year-old female with history of double-valve replacement for aortic stenosis presented with 1-week history of chest pain, dyspnea and intermittent fever. She was treated with 5 weeks of antibiotic with IV Cephalexin for prosthetic valve endocarditis. The repeated blood culture after IV antibiotic was negative for infection. She represented again with episodes of palpitation. Post-treatment blood investigation showed normal leukocyte level with increasing CRP and Troponin T level. The repeated blood culture and transesophageal echo was negative. The F-18 FDG PET/CT showed a mild hypermetabolic focus at the inferior basal myocardial wall adjacent to the prosthetic valve, however not involving the paraaortic region which is likely secondary to ongoing inflamed myocardium. As the fear of another relapse of endocarditis, oral suppression antibiotic therapy was continued for another 6 months. Conclusions: This case report illustrates a patient with a prosthetic valve replacement detected by F-18 FDG PET/CT, which one could have overlooked an endocarditis if one had relied on transesophageal echo (TEE) alone. F-18 FDG PET/CT is a promising adjunctive tool in the diagnostic workup of patients with suspected IE, particularly prosthetic device endocarditis where the TEE sensitivity is lower. In our patient, the positive F-18 FDG PET/CT governs the subsequent therapeutic consequences which include adjustment of antibiotic and length of treatment, and it prevents unnecessary intervention. [ABSTRACT FROM AUTHOR]

The release of ChatGPT in 2022 has generated extensive speculation about how Artificial Intelligence (AI) will impact the capacity of institutions for higher learning to achieve their central missions of promoting learning and certifying knowledge. Our main questions were whether people could identify AI-generated text and whether factors such as expertise or confidence would predict this ability. The present research provides empirical data to inform these speculations through an assessment given to a convenience sample of 140 college instructors and 145 college students (Study 1) as well as to ChatGPT itself (Study 2). The assessment was administered in an online survey and included an AI Identification Test which presented pairs of essays: In each case, one was written by a college student during an in-class exam and the other was generated by ChatGPT. Analyses with binomial tests and linear modeling suggested that the AI Identification Test was challenging: On average, instructors were able to guess which one was written by ChatGPT only 70% of the time (compared to 60% for students and 63% for ChatGPT). Neither experience with ChatGPT nor content expertise improved performance. Even people who were confident in their abilities struggled with the test. ChatGPT responses reflected much more confidence than human participants despite performing just as poorly. ChatGPT responses on an AI Attitude Assessment measure were similar to those reported by instructors and students except that ChatGPT rated several AI uses more favorably and indicated substantially more optimism about the positive educational benefits of AI. The findings highlight challenges for scholars and practitioners to consider as they navigate the integration of AI in education. [ABSTRACT FROM AUTHOR]

In this section of Resonance, we invite readers to pose questions likely to be raised in a classroom situation. We may suggest strategies for dealing with them, or invite responses, or both. "Classroom" is equally a forum for raising broader issues and sharing personal experiences and viewpoints on matters related to teaching and learning science. G Gamow's alpha-decay theory (1928) is somewhat ad hoc for the reason that an alpha-particle inside a radioactive nucleus is supposed to move back and forth, through the dense mass of nucleons (retaining its identity), a number of times before it comes out. This short paper attempts to address this shortcoming via nuclear disintegration. [ABSTRACT FROM AUTHOR]

Background: Budd–Chiari syndrome (BCS) is a rare condition, usually associated with hematological disorders such as thrombotic diathesis and hypercoagulability. Serum CA-125 level is an established tumor marker of ovarian malignancy; however, cases of primary BCS may also show raised CA-125 levels. BCS in a case of ovarian carcinoma is usually primary in nature due to hypercoagulable state, and raised CA-125 levels with tender hepatomegaly in a treated case of ovarian carcinoma usually imply metastatic recurrence in the liver. However, our case demonstrates an atypical secondary cause of BCS in such a patient caused by extrinsic compression of IVC due to recurrent disease. Case presentation: We report an unusual case of a 69-year-old female who presented with nausea and abdominal pain. She had a 7-year-old history of endometrioid carcinoma of the right ovary for which she underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and pelvic lymph node dissection along with adjuvant chemotherapy. Currently, she had right hypochondrium tenderness, deranged liver function tests (LFT) and raised CA-125 levels, which raised suspicion of hepatic metastasis. However, CECT abdomen revealed peripheral mottled enhancement of liver with multifocal extrahepatic tumor deposits, one of them causing compression of inferior vena cava (IVC) implying a diagnosis of secondary Budd–Chiari syndrome. Conclusions: In a background of treated ovarian malignancy with raised CA-125 levels and deranged LFT, primary suspicion is of hepatic tumor recurrence. However, in our case, radiological investigation revealed diagnosis of secondary Budd–Chiari syndrome due to perihepatic metastatic recurrence with the absence of frank intrahepatic lesions. [ABSTRACT FROM AUTHOR]

The objective was, therefore, to evaluate the impact on organic carbon and the formation of soil aggregates in areas of natural vegetation converted into pastures in southern Amazonas. The research was carried out in seven areas in the municipality of Humaitá, Amazonas, Brazil, five of which were pastureland, one native forest, and one natural field. Soil samples were collected at depths of 0–10 and 10–20 cm in the seven study areas and analyzed for aggregate stability, soil density, soil organic carbon, and the calculated soil organic carbon stock. Univariate, bivariate, and multivariate analyses were then carried out. Conversion from forest to pasture had a negative impact on percentage of aggregates >2 mm, soil density, concentration and stock of soil organic carbon. Organic carbon correlates positively with percentage of aggregates >2 mm, geometric mean diameter and weighted mean diameter, and negatively with soil density. Aggregate stability influences carbon sequestration in the pasture and forest areas studied, but has no influence in the natural grassland environment. [ABSTRACT FROM AUTHOR]

Background: The tigerfish (Hydrocynus forskahlii) is an important food fish in different regions of Africa. As such, interest in its performance and nutritional requirements as a potential candidate for aquaculture is increasing. Characterization of the morpho-histological features and functions of the gut provides valuable insights into the feeding physiology and digestive system of fish species. Result: An investigation of the morpho-histological features of the gastrointestinal tract of H. forskahlii captured from Lake Albert was conducted over an eight-month period. The digestive tract of H. forskahlii is characterised by a short oesophagus, well-developed and distensible stomach and moderately long intestine. The oesophagus had a higher abundance of mucous-secreting goblet cells compared to other digestive tract tissues. The stomach had a bag-like shape for swallowing large prey and was distinguishable into the cardiac, fundic and pyloric regions. Both the cardiac and fundic regions of the stomach had numerous gastric glands, whereas the pyloric region had large compound folds consisting of pseudo-stratified columnar epithelium. Many goblet cells were also observed in the mid and posterior regions of the intestine. The relative length of the gut of the H. forskahlii was 1.27 ± 0.03 cm, and it had a total of 20–22 pyloric caeca. The liver was observed to be divided in lobules by a central vein contained within connective sheets. Irregular cords of hepatocytes were also visible throughout the parenchyma. Conclusions: The histological features of the H. forskahlii gut observed in the present study are consistent with those of carnivorous and omnivorous fish. [ABSTRACT FROM AUTHOR]

As known "ecosystem engineers", beavers influence river hydrology, geomorphology, biochemistry, and biological assemblages. However, there is a lack of research regarding the effects of beaver activities on freshwater meiofauna. In this study, we investigated the taxonomic and functional composition of the benthic copepod assemblage of a segment of the Tiber River (Italy) where a beaver dam, created about 7 weeks before our survey, had formed a semi-lentic habitat upstream and a lotic habitat downstream of the dam. We also analyzed the copepod assemblage before and after a flood event that destroyed the beaver dam, providing a unique opportunity to observe changes in a naturally reversing scenario. Our analyses revealed that, while the taxonomic composition and functional traits of the copepod assemblage remained largely unchanged across the recently formed semi-lentic and lotic habitats, substantial differences were evident between the dammed and undammed states. The dammed state showed lower copepod abundances, biomass, and functionality than the undammed one. These results highlight the role of beaver dams in changing the composition and functionality of meiofaunal assemblages offering insights into the dynamic interactions within aquatic ecosystems. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo–18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2–28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3–202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4–13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization. [ABSTRACT FROM AUTHOR]

Endotheliopathy plays a role in the development of acute kidney and lung injury in COVID-19, probably due to inflammation, endothelial permeability, vascular leakage and edema formation. This study examined alterations in the circulation of patients with mild and severe COVID-19 on in vitro endothelial permeability and its relation to the endothelial angiopoietin/Tie2 system, which is involved in the regulation of endothelial permeability. Plasma was obtained from COVID-19 patients admitted to the ward (n = 14) or ICU (n = 20) at admission and after 1 and 2 weeks and healthy controls (n = 5). Human kidney and lung endothelial cells were exposed to patient plasma and treated with recombinant angiopoietin-1. In vitro endothelial barrier function was assessed using electric cell-substrate impedance sensing. Circulating markers of the angiopoietin/Tie2 system, endothelial dysfunction and glycocalyx degradation were measured by ELISA. Plasma from COVID-19 patients reduced endothelial resistance compared to healthy controls, but COVID-19 plasma-induced drop in endothelial resistance did not differ between ward and ICU patients. Circulating angiopoietin-2, soluble Tie2 and soluble Tie1 levels increased over time in ICU patients, whereas levels remained stable in ward patients. The increase in angiopoietin-2 was able to predict 90-day mortality (AUC = 0.914, p < 0.001). Treatment with recombinant angiopoietin-1 did not restore COVID-19 plasma-induced hyperpermeability. In conclusion, these results suggest that indirect effects of the virus represented in the circulation of COVID-19 patients induced endothelial hyperpermeability irrespective of disease severity and changes in the endothelial angiopoietin/Tie2 system. Nonetheless, angiopoietin-2 might be of interest in the context of organ injury and patient outcome in COVID-19. [ABSTRACT FROM AUTHOR]

Background: The usage and implementation of telemedicine by urologists to diagnose, treat, mentor, and prevent diseases have grown worldwide. Numerous clinical, legal, and ethical issues are addressed by this practice. This is a cross-sectional study based on an anonymous online questionnaire, aimed to assess the current urologists' knowledge and attitude towards telemedicine use in Egypt. A total of 108 Egyptian urologists filled out the questionnaire which included sociodemographic data, urologist knowledge, attitude regarding telemedicine, and common concerns and barriers. Results: Out of the total sample, 75.9% of participants did not use telemedicine modalities until COVID-19 pandemic. Nearly 66.7% of participants did not receive formal medicolegal training on using telemedicine. About 62% of participants used personal accounts on social media, and 73.1% of teleconsultations were to assess radiological and laboratory data. Several concerns were highlighted such as possible malpractice risks (79.6%), defamation (72.2%), and keeping patient records (71.3%). Urologists raised many considerable barriers regarding telemedicine, such as lack of patient technology skills (84.3%), absence of regulations or laws (76.9%), insurance reimbursement (57.4%), and lack of administrative support (53.7%). Most of the participants have a positive impression of the advantages of tele-urology. There was a statistically significant difference between the number of cases seen per week and positive total attitude score. Conclusions: Although most participants practiced telemedicine, many obstacles were highlighted through the study. Ignoring legal, ethical, personal, and patient issues may also jeopardize the future of telemedicine. Well-established health policies, formal education, and the implementation of regulated laws of telemedicine are fundamental. [ABSTRACT FROM AUTHOR]

Background: Forensic diatomology is a rapidly progressing domain that involves the examination of microscopic algae known as diatoms for forensic purposes. Diatoms are microscopic, single-celled, eukaryotic algae that exist in diverse aquatic environments such as rivers, lakes, ponds, and oceans. They are characterized by their rigid cell wall made up of silica, which is a unique morphological character, making them useful for forensic investigations. Main body: Diatoms are a type of unicellular microscopic algae that belong to the class Bacillariophyta. They are one of the most common phytoplankton found in all aquatic environments, including marine and freshwater habitats. Diatoms have proven to be valuable evidence in various forensic investigations, particularly in cases involving drowning or bodies recovered from aquatic environments. Conclusion: This comprehensive review provides an in-depth analysis of the principles, methodologies, applications, and challenges associated with the field of forensic diatomology. It emphasizes the importance of diatoms as trace evidence and discusses their potential to establish critical associations between the victim and the surroundings. This review also explores some recent advancements in diatom analysis techniques, including molecular approaches and automated identification methods. Finally, the paper outlines future directions for research and underlines the necessity for standardized protocols and interdisciplinary collaborations to enhance the reliability and validity of forensic diatomology. [ABSTRACT FROM AUTHOR]