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Aim: To evaluate the effectiveness of a positive mental health program for adults (PMHP) in the community. Background: Positive mental health (PMH) can be seen as a construct represented by six factors (personal satisfaction, prosocial attitude, self‐control, autonomy, problem resolution, and self‐actualization, and interpersonal relationship skills) according to the Multifactorial Model for PMH. Although there are several interventions in promoting mental health, research on effective promotion of PMH for adults in the community with structured and validated programs of PMH is scarce. Methods: This study protocol describes a randomized controlled trial (RCT) following a wait‐list control design, aimed at evaluating the effectiveness of a PMHP in the community. This study was approved in June 2019 by the Ethics Committee. Participants will be recruited from the school community of teachers. Participants aged ≥ 18 years. The participants will be randomized 1:1 to either (a) an intervention group, which will integrate the PMHP, or (b) the standby control group. Three assessment moments for both groups will take place initial, after the intervention, and a follow‐up of 3–6 months. The evaluation instruments will include a sociodemographic questionnaire, a PMH questionnaire, and a psychological vulnerability scale. Conclusion: The current study provides an innovative approach to PMH. Further, the study may demonstrate new interventions in PMH in the community, based on a program with systematized guidelines and sessions structured according to individual needs. It is expected that at the end of the program, the experimental group will increase the level of PMH. Relevance to clinical practice: To allow future official implementation of the PMH program and the replication of the study in other professional groups as a promotion tool. No patient or public contribution: There was no funding to remunerate a participant for this study. Trial Registration: ClinicalTrials.gov identifier: NCT04600401. Registered on May 15, 2020 [ABSTRACT FROM AUTHOR]

Introduction: Lower gastrointestinal bleeding (LGIB) frequently leads to emergency department (ED) visits and hospitalizations, encompassing a spectrum of outcomes from spontaneous resolution to intrahospital mortality. Aim: The purpose of this study was to validate a scoring system designed to identify cases of low‐risk LGIB, allowing for safe discharge from the ED. Methods: A retrospective analysis of all gastrointestinal bleeding cases presented at three EDs in 2020 was conducted, focusing specifically on patients with LGIB. The SHA2PE score incorporates factors such as systolic blood pressure, hemoglobin levels, use of antiplatelet or anticoagulant medications, pulse rate, and episodes of bright blood per rectum. Results: Out of 1112 patients presenting with LGIB to the ED, 55 were hospitalized, 20 required blood transfusions, 15 underwent colonoscopies, one underwent interventional radiology procedures, and two patients died. Employing a SHA2PE score with a cutoff value of 1 yielded a specificity of 78.5% (95% CI (confidence interval) [75.8–81.0]), sensitivity of 76.8% (95% CI [63.6–87.0]), positive predictive value (PPV) of 17.0% (95% CI [12.6–22.2]), and negative predictive value (NPV) of 98.3% (95% CI [97.2–99.1]) for predicting the need for hospitalization and intrahospital intervention. When considering return visits to the ED within 7 days with the same presentation, the score demonstrated a specificity of 78.8% (95% CI [76.0–81.3]), sensitivity of 68.6% (95% CI [56.4–79.1]), PPV of 19% (95% CI [14.3–24.4]), and NPV of 97.2% (95% CI [95.8–98.2]). Conclusions: The SHA2PE score demonstrates potential in predicting cases of low‐risk LGIB, offering a high NPV for hospitalization, the need for intrahospital intervention, and return visits to the ED. However, these findings should be interpreted cautiously given the low prevalence of interventions and limitations in the study's population and design. [ABSTRACT FROM AUTHOR]

Aim: To investigate the associations of high‐density lipoprotein (HDL) subfractions and apolipoprotein A‐I (apo A‐I) with fat in the pancreas. Methods: A total of 170 individuals were studied. All participants underwent magnetic resonance imaging on a single 3.0‐Tesla scanner to determine the presence/absence of fatty pancreas. HDL subfractions were measured using a commercially available lipoprotein subfractions testing system and classed as large, intermediate and small HDL. Both unadjusted and adjusted (accounting for demographics, anthropometrics, insulin resistance and other covariates) logistic regression models were built. Results: Individuals with fatty pancreas had significantly lower circulating levels of the large HDL class and apo A‐I. Every unit decrease in the large HDL class was associated with a 93% increase in the likelihood of fatty pancreas in the most adjusted model (P <.001). Every unit decrease in apo A‐I was associated with a 45% increase in the likelihood of fatty pancreas in the most adjusted model (P =.012). The intermediate and small HDL classes were not significantly associated with fatty pancreas. Conclusions: Fat in the pancreas is inversely associated with the circulating levels of large HDL particles and apo A‐I. Purposely designed studies are warranted to investigate the potential of fatty pancreas as an indicator of the risk of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have investigated the association between hepatic fat and intrapancreatic fat deposition (IPFD); however, results have been inconclusive. The presence of cardiometabolic factors in certain subpopulations could explain this discrepancy. The aim of the present study was to use moderation analyses to determine the conditions under which hepatic fat is associated with IPFD. Methods: All participants underwent 3T abdominal magnetic resonance imaging (MRI) and spectroscopy. Hepatic fat and IPFD were manually quantified by independent raters. Moderation analyses were performed with adjustment for sex and ethnicity. Results: There were 367 participants included. Adjusted analyses of the overall cohort revealed that age, glycated hemoglobin (HbA1c), low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), and triglycerides were significant moderators (p < 0.05) of the association between hepatic fat and IPFD. Ranges of significance included age < 61 years, HbA1c < 45 mmol/mol, LDL‐C < 157 mg/dL, HDL‐C > 36 mg/dL, and triglycerides < 203 mg/dL. Conclusions: The association between hepatic fat and IPFD is generally present in young and middle‐aged adults with good cardiometabolic health, whereas the link between the two fat depots becomes uncoupled in older adults or individuals with cardiometabolic risk factors. [ABSTRACT FROM AUTHOR]

Since its coinage ca. 1850 AD by Philip Barker Webb, the biogeographical region of Macaronesia, consisting of the North Atlantic volcanic archipelagos of the Azores, Madeira with the tiny Selvagens, the Canaries and Cabo Verde, and for some authors different continental coastal strips, has been under dispute. Herein, after a brief introduction on the terminology and purpose of regionalism, we recover the origins of the Macaronesia name, concept and geographical adscription, as well as its biogeographical implications and how different authors have positioned themselves, using distinct terrestrial or marine floristic and/or faunistic taxa distributions and relationships for accepting or rejecting the existence of this biogeographical region. Four main issues related to Macaronesia are thoroughly discussed: (i) its independence from the Mediterranean phytogeographical region; (ii) discrepancies according to different taxa analysed; (iii) its geographical limits and the role of the continental enclave(s), and, (iv) the validity of the phytogeographical region level. We conclude that Macaronesia has its own identity and a sound phytogeographical foundation, and that this is mainly based on three different floristic components that are shared by the Macaronesian core (Madeira and the Canaries) and the outermost archipelagos (Azores and Cabo Verde). These floristic components are: (i) the Palaeotropical‐Tethyan Geoflora, formerly much more widely distributed in Europe and North Africa and currently restricted to the three northern archipelagos (the Azores, Madeira and the Canaries); (ii) the African Rand Flora, still extant in the coastal margins of Africa and Arabia, and present in the southern archipelagos (Madeira, the Canaries and Cabo Verde), and (iii) the Macaronesian neoendemic floristic component, represented in all the archipelagos, a result of allopatric diversification promoted by isolation of Mediterranean ancestors that manage to colonize Central Macaronesia and, from there, the outer archipelagos. Finally, a differentiating floristic component recently colonized the different archipelagos from the nearest continental coast, providing them with different biogeographic flavours. [ABSTRACT FROM AUTHOR]

We reassess the relationship between robotization and the growth in labor productivity with more recent data. We discover that the effect of robot density in the growth productivity substantially decreased in the post‐2008 period. In this period, the lower positive effect of robot density in the growth of labor productivity is less dependent on the increase in value added. The data analysis dismisses any positive effect of robotization on hours worked. Results are confirmed by several robustness checks, cross‐sectional (and panel‐data) Instrumental Variable and quantile regression analysis. By means of the quantile regression analysis, we learn that the effect of robots on labor productivity is stronger for low productivity sectors and that in the most recent period, the effect of robotization felt significantly throughout the distribution. This highlights one of the possible sources of stagnation in the era of robotization and have implication both for labor market and R&D policies. [ABSTRACT FROM AUTHOR]

Global biodiversity is facing unprecedented pressures, calling into question the effectiveness of existing governance systems aimed at halting extinctions. Renewed hope arose with the recent Conference of the Parties (COP) to the Convention on Biological Diversity (COP15 December 2022) and the Convention on International Trade in Endangered Species (COP19 November 2022). Yet, barriers remain that hamper biodiversity conservation. Identifying and overcoming these barriers is crucial for success. We considered previous lessons learned to show that current barriers to conservation are centered on a multidimensional array of mismatches among legal (law), ecological (science), and sociocultural (human) dimensions across the short, medium, and long term. Focusing on highly migratory marine megafauna (whales, sharks, and turtles), we used the Rubik's cube as a metaphor to conceptualize the multidimensional mismatches and devised a pathway for solutions that is highly dependent on strict alignment across all dimensions. We recommend the continuous cycling across all dimension interfaces to align the use (and update) of regulations and processes in law, improve data and experimentation methods in science, and develop education and engagement actions in the human dimension. This timely alignment across all dimensions is key to achieving biodiversity targets and avoiding further extinctions. [ABSTRACT FROM AUTHOR]

Albinism is a phenotypically and genetically heterogeneous condition characterized by a variable degree of hypopigmentation and by ocular features leading to reduced visual acuity. Whereas numerous genotypic studies have been conducted throughout the world, very little is known about the genotypic spectrum of albinism in Africa and especially in sub‐Saharan Western Africa. Here we report the analysis of all known albinism genes in a series a 23 patients originating from Mali. Four were diagnosed with OCA 1 (oculocutaneous albinism type 1), 17 with OCA 2, and two with OCA 4. OCA2 variant NM_000275.3:c.819_822delinsGGTC was most frequently encountered. Four novel variants were identified (two in TYR, two in OCA2). A deep intronic variant was found to alter splicing of the OCA2 RNA by inclusion of a pseudo exon. Of note, the OCA2 exon 7 deletion commonly found in eastern, central, and southern Africa was absent from this series. African patients with OCA 1 and OCA 4 had only been reported twice and once, respectively, in previous publications. This study constitutes the first report of the genotypic spectrum of albinism in a western sub‐Saharan country. [ABSTRACT FROM AUTHOR]

The analysis of meta‐omics data requires the utilization of several bioinformatics tools and proficiency in informatics. The integration of multiple meta‐omics data is even more challenging, and the outputs of existing bioinformatics solutions are not always easy to interpret. Here, we present a meta‐omics bioinformatics pipeline, Meta‐Omics Software for Community Analysis (MOSCA), which aims to overcome these limitations. MOSCA was initially developed for analysing metagenomics (MG) and metatranscriptomics (MT) data. Now, it also performs MG and metaproteomics (MP) integrated analysis, and MG/MT analysis was upgraded with an additional iterative binning step, metabolic pathways mapping, and several improvements regarding functional annotation and data visualization. MOSCA handles raw sequencing data and mass spectra and performs pre‐processing, assembly, annotation, binning and differential gene/protein expression analysis. MOSCA shows taxonomic and functional analysis in large tables, performs metabolic pathways mapping, generates Krona plots and shows gene/protein expression results in heatmaps, improving omics data visualization. MOSCA is easily run from a single command while also providing a web interface (MOSGUITO). Relevant features include an extensive set of customization options, allowing tailored analyses to suit specific research objectives, and the ability to restart the pipeline from intermediary checkpoints using alternative configurations. Two case studies showcased MOSCA results, giving a complete view of the anaerobic microbial communities from anaerobic digesters and insights on the role of specific microorganisms. MOSCA represents a pivotal advancement in meta‐omics research, offering an intuitive, comprehensive, and versatile solution for researchers seeking to unravel the intricate tapestry of microbial communities. [ABSTRACT FROM AUTHOR]

Adolescent transgender medicine is a growing clinical field. Gender‐affirming medications for transgender youth may include gonadotropin‐releasing hormone (GnRH) agonists, gender‐affirming hormones or both. To evaluate the potential effects of GnRH agonists (puberty suppression) on pharmacokinetic processes for transgender youth, we searched PubMed from inception to May 2024 for publications on the effects of GnRH agonists on drug absorption, distribution, metabolism or excretion for transgender adolescents or effects on hormones (including gonadotropins, adrenal androgens, sex steroids) that are associated with changes in drug metabolism during puberty in the general adolescent population. No publications discussed the effects of GnRH agonist treatment on pharmacokinetic processes for adolescent transgender people. Sixteen publications observed marked decreases in gonadotropins and sex steroids for both adolescent transgender men and adolescent transgender women and slight effects on adrenal androgens. During GnRH agonist treatment, changes in body composition and body shape were greater for adolescent transgender people than for cisgender adolescent people. Further research is needed to better understand the effects of GnRH agonists on drug metabolism and other pharmacokinetic processes for transgender adolescents receiving GnRH agonists and other gender‐affirming medications. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare providers' role in co‐creating health interventions and implementation strategies has evolved significantly, and yet, there is little documentation of this from low‐resource settings. This study aims to share the dilemmas of engaging healthcare providers in co‐creating locally adapted clinical guidelines for maternity facilities in Dar es Salaam, Tanzania, and strategies used to address them. Methods: An ethnographic study explored the co‐creation of locally adapted clinical guidelines for childbirth care within five maternity facilities in Dar es Salaam. Participant observations were conducted during 11 co‐creation workshops. Six in‐depth interviews explored participant experiences. Data were analyzed using Attride‐Stirling's thematic network analysis framework. Results: The analysis revealed four themes representing dilemmas in the co‐creation process and strategies to improve co‐creation: (i) navigating diverse contexts: adapting a single set of guidelines to various, diverse facilities was challenging; this was addressed through engaging in dialogue and flexibility while adjusting care practices. (ii) Competing knowledge systems and sources: differing knowledge sources between researchers and healthcare providers challenged discussions on recommended practices. However, validating scientific recommendations with practical care experience in this context helped bridge this gap. (iii) Fostering meaningful participation: participation was time‐consuming for some. However, early stakeholder engagement and facility‐led participant selection facilitated the meaningful involvement of healthcare providers. (iv) Power imbalances: power dynamics influenced the co‐creation process; involving stakeholders in planning and co‐facilitating workshops helped mitigate these imbalances and encourage more equal participation. Conclusion: Navigating contextual variation, differences in knowledge systems, meaningful participation and power dynamics were key challenges in the co‐creation process. However, reflexivity, open and honest dialogue with stakeholders and early engagement enhanced the co‐creation process. Co‐creating locally adapted clinical guidelines with frontline healthcare workers and scientific experts is essential for feasibility and safety. Further research is needed to explore context specificity, decision‐making and the efficacy of co‐creation in low‐resource settings. Patient or Public Contribution: Healthcare providers and health managers from five maternity facilities who participated in the co‐creation process were actively involved in this study by providing their consent to be interviewed about their experiences of participation. Clinical Trial Registration: This study is a substudy within the PartoMa project. PartoMa is a registered clinical trial with the trial registration number NCT04685668. PartoMa's date of initial trial registration is 28 December 2020. [ABSTRACT FROM AUTHOR]

Oculocutaneous albinism type 2 (OCA2) is the second most frequent form of albinism and represents about 30% of OCA worldwide. As with all types of OCA, patients present with hypopigmentation of hair and skin, as well as severe visual abnormalities. We focused on a subgroup of 29 patients for whom genetic diagnosis was pending because at least one of their identified variants in or around exon 10 of OCA2 is of uncertain significance (VUS). By minigene assay, we investigated the effect of these VUS on exon 10 skipping and showed that not only intronic but also some synonymous variants can result in enhanced exon skipping. We further found that excessive skipping of exon 10 could be detected directly on blood samples of patients and of their one parent with the causal variant, avoiding invasive skin biopsies. Moreover, we show that variants, which result in lack of detectable OCA2 mRNA can be identified from blood samples as well, as shown for the most common OCA2 pathogenic missense variant c.1327G>A/p.(Val443Ile). In conclusion, blood cell RNA analysis allows testing the potential effect of any OCA2 VUS on transcription products. This should help to elucidate yet unsolved OCA2 patients and improve genetic counseling. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to evaluate the epidemiology of seven infections (Chagas disease, strongyloidiasis, schistosomiasis, human immunodeficiency virus, hepatitis B and C virus, and active tuberculosis) in migrant populations attended at primary care facilities in Catalonia, Spain. Methods: This is a cross sectional study conducted from March to December 2018 at eight primary care centres in Catalonia, Spain where health professionals were recommended to systematically screen multiple infections in migrants considering the endemicity of the pathogens in their country of birth. Routine health data were retrospectively extracted from electronic health records of the primary care centres. The proportion of cases among individuals tested for each infection was estimated with its 95% confident interval (CI). Mixed‐effects logistics regression models were conducted to assess any possible association between the exposure variables and the primary outcome. Results: Out of the 15,780 migrants that attended primary care centres, 2410 individuals were tested for at least one infection. Of the 508 (21.1%) migrants diagnosed with at least one condition, a higher proportion originated from Sub‐Saharan Africa (207, 40.7%), followed by South‐East Europe (117, 23.0%) and Latin‐America (88, 17.3%; p value <0.001). The proportion of migrants diagnosed with Chagas disease was 5/122 (4.1%, 95%CI 0.5–7.7), for strongyloidiasis 56/409 (13.7%, 95%CI 10.3–17.0) and for schistosomiasis 2/101 (2.0%, 95%CI 0.0–4.7) with very few cases tested. The estimated proportion for human immunodeficiency virus was 67/1176 (5.7%, 95%CI 4.4–7.0); 377/1478 (25.5%, 95%CI 23.3–27.7) for hepatitis B virus, with 108/1478 (7.3%, 95%CI 6.0–8.6) of them presenting an active infection, while 31/1433 (2.2%, 95%CI 1.4–2.9) were diagnosed with hepatitis C virus. One case of active tuberculosis was diagnosed after testing 172 migrant patients (0.6%, 95%CI 0.0–1.7). Conclusions: We estimated a high proportion of the studied infections in migrants from endemic areas. Country‐specific estimations of the burden of infections in migrants are fundamental for the implementation of preventive interventions. [ABSTRACT FROM AUTHOR]

Annually, approximately 1.5 million tonnes of sediment are dredged from federal navigational channels in Lake Erie. Recognizing the potential influence of Lake sediments on soil compaction, structure, water retention capacity, and aeration, this research assessed the agronomic performance of selected specialty crops under varying sediment ratios in an open‐field production system. The experimental design involved three sediment application rates: 0 tonne (100% farm soil), 0.7 tonne (90% farm soil and 10% sediment), and 7 tonnes per bed (100% sediment). Lettuces (Lactuca sativa L.) were harvested 35 days after planting, with assessments including fresh and dry weights of leaves root biomass and root length measurements. Radishes (Raphanus sativus L.) were evaluated for root length, leaf fresh weight, root fresh weight, and diameter. Tomatoes (Solanum lycopersicum L.) plants were monitored for plant height and stem diameter. Fruit harvest occurred at days 70 and 75 post‐transplant. Metrics such as total number of marketable fruits, total fruit weight, number of US grade‐1 fruits, and polar and equatorial diameters were recorded. The results revealed significant positive effects of the 7‐tonne sediment treatment on lettuce, including increased dry leaf and root biomass, root lengths, and fresh weight. Similarly, radishes exhibited enhanced weight and length when grown in beds with 7 tonnes of sediment. Tomatoes from the 7‐tonne sediment treatment displayed higher values in plant measurements and harvested fruits. Overall, the findings indicate that soils treated with Lake Erie sediment positively influence the development and production of lettuce, radishes, and tomatoes compared to untreated soils. Core Ideas: This study examines Lake Erie sediment's effect on lettuce, radish, and tomato growth.The research presents novel findings showing positive crop responses, which can guide the sustainable use of sediment in agriculture.Applying 7 tonnes of sediment significantly increases biomass, root length, and fruit yield in the studied crops.Lake Erie sediment positively influences the development of lettuce, radish, and tomato plants.The results of this study provide insights into sustainable soil use and can guide improved agricultural practices. [ABSTRACT FROM AUTHOR]

The article delves into the intersection of anthropology and literature, emphasizing how recent theoretical work has enriched the dialogue between these fields by exploring themes such as art, religion, subjectivity, and ethics, while also addressing methodological concerns. It highlights a series of conversations between fiction writer Siddratul Muntaha Jillani and anthropologist Kiran Nazir Ahmed, focusing on the parallels and contrasts between fiction writing and ethnographic writing.

To maintain harbour navigability, significant quantities of sediments are annually dredged and disposed of in the vicinities of Lake Erie. This study aimed to assess the impact of Lake Erie sediment on the productivity of tomatoes, lettuce, and carrots. Using a greenhouse setting, this experiment evaluates different sediment‐farm soil ratios: 100% farm soil (Farm Soil), 100% lake sediment (Sediment), and a blend of 10% dredge sediment and 90% farm soil (Mixture). We evaluated the chemical and physical composition of the treatments and the development of the roots, leaves, and fruit production for each crop. Additionally, Total Organic Carbon (TOC), Total Nitrogen (TN), and Total Phosphorus (TP) were assessed post‐harvest for each crop's roots, leaves, and fruit biomass. The Sediment treatment showed higher pH, Cation Exchange Capacity (CEC), Calcium, and TOC but lower magnesium, phosphate, and potassium compared to Farm Soil. The Sediment and Mixture treatments exhibited higher root and leaf dry weights for lettuce compared to Farm Soil, with the Sediment treatment showing the longest roots. Sediment and Mixture treatments in carrots led to greater root weight and length. Tomatoes submitted to the Sediment treatment excelled in all variables except stem diameter. Lettuce and carrot biomass analysis revealed no statistical differences in TOC and TN among the treatments. Tomato biomass analysis showed no differences among the three treatments. The use of Lake Erie dredged sediment led to increased crop biomass in the greenhouse production of tomatoes, carrots, and lettuce. [ABSTRACT FROM AUTHOR]

This paper presents our contribution to the a posteriori error analysis in 2D and 3D of a semi‐augmented mixed‐primal finite element method previously developed by us to numerically solve double‐diffusive natural convection problem in porous media. The model combines Brinkman‐Navier‐Stokes equations for velocity and pressure coupled to a vector advection‐diffusion equation, representing heat and concentration of a certain substance in a viscous fluid within a porous medium. Strain and pseudo‐stress tensors were introduced to establish scheme solvability and provide a priori error estimates using Raviart‐Thomas elements, piecewise polynomials and Lagrange finite elements. In this work, we derive two reliable residual‐based a posteriori error estimators. The first estimator leverages ellipticity properties, Helmholtz decomposition as well as Clément interpolant and Raviart‐Thomas operator properties for showing reliability; efficiency is guaranteed by inverse inequalities and localization strategies. An alternative estimator is also derived and analyzed for reliability without Helmholtz decomposition. Numerical tests are presented to confirm estimator properties and demonstrate adaptive scheme performance. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship of fat in the pancreas with time spent in different glycaemic ranges. Methods: Abdominal magnetic resonance imaging at 3.0 Tesla was used to quantify fat in the pancreas as both continuous [i.e. intra‐pancreatic fat deposition (IPFD)] and binary (i.e. fatty change of the pancreas vs. normal pancreas) variables. Dexcom G6 devices were used to collect continuous glucose monitoring data every 5 min over a continuous 7‐day period. Time above range (TAR), time in range (TIR) and time below range were computed. Statistical models were built to adjust for age, sex, body composition, and other covariates in linear regression analysis and analysis of covariance. Results: In total, 38 individuals were studied. IPFD was significantly associated with TAR (p =.036) and TIR (p =.042) after adjustment for covariates. For every 1% increase in IPFD, there was a 0.3 unit increase in TAR and a decrease in TIR. Individuals with fatty change of the pancreas, when compared with those with normal pancreas, had significantly higher TAR (p =.034) and lower TIR (p =.047) after adjustment for covariates. Neither IPFD (p =.805) nor fatty change of the pancreas (p =.555) was associated with time below range after adjustment for covariates. Conclusion: Increased fat in the pancreas is associated with excessive glycaemic variability. Fatty change of the pancreas may contribute to heightening the risk of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

This commentary critiques a scientific paper on the fossil flora of the Azores, pointing out inaccuracies and inconsistencies. The authors dispute the claim that there are no fossil plants on certain islands and provide evidence to the contrary. They also highlight errors in geological maps, taxonomic determinations, and descriptions of geological formations. The critique emphasizes the need for more accurate research, including detailed photographic evidence and replication of results. The authors encourage further study but urge improvements in taxonomy, geological descriptions, and evidence presentation. [Extracted from the article]

Purpose: Surgical options for pectoralis major tendon tears include primary repair, though there is no consensus as to which constructs are biomechanically superior for repair. Methods: A systematic review was performed by searching PubMed, the Cochrane library, and Embase using PRISMA guidelines to identify studies that analyzed the biomechanical properties of bone tunnels (BT), cortical buttons (CB) and suture anchors (SA) techniques for pectoralis major tendon repair. The search phrase implemented was 'pectoralis major tendon repair biomechanics'. Studies that did not evaluate biomechanical outcome data, evaluated partial pectoralis major tendon tears, and non-English articles were excluded. Evaluated outcomes included ultimate load to failure (N) and stiffness (N/mm). Results: Six studies met inclusion criteria, including a total of 124 cadaveric specimens, for pectoralis major tendon repair comparing BT with SA and CB. Pooled analysis from four studies reporting on ultimate load to failure between BT and SA failed to reveal a difference between BT and SA (p = 0.489). Pooled analysis from two studies reporting on stiffness failed to reveal a difference in favor of BT compared to SA (p = 0.705). Pooled analysis from four studies reporting on ultimate load to failure between BT and CB failed to reveal a difference between BT and CB (p = 0.567). Pooled analysis from two studies reporting on stiffness failed to reveal a difference in favor of BT compared to CB (p = 0.701). Conclusions: There was no difference in load to failure or stiffness when using BT, CB, or SA in pectoralis major tendon repairs. This review reveals that clinical outcomes may better inform which fixation construct to implement in pectoralis major tendon repairs. Level of evidence: I. [ABSTRACT FROM AUTHOR]

Titin‐dependent stiffening of cardiomyocytes is a significant contributor to left ventricular (LV) diastolic dysfunction in heart failure with preserved LV ejection fraction (HFpEF). Small heat shock proteins (HSPs), such as HSPB5 and HSPB1, protect titin and administration of HSPB5 in vitro lowers cardiomyocyte stiffness in pressure‐overload hypertrophy. In humans, oral treatment with geranylgeranylacetone (GGA) increases myocardial HSP expression, but the functional implications are unknown. Our objective was to investigate whether oral GGA treatment lowers cardiomyocyte stiffness and attenuates LV diastolic dysfunction in a rat model of the cardiometabolic syndrome. Twenty‐one‐week‐old male lean (n = 10) and obese (n = 20) ZSF1 rats were studied, and obese rats were randomized to receive GGA (200 mg/kg/day) or vehicle by oral gavage for 4 weeks. Echocardiography and cardiac catheterization were performed before sacrifice at 25 weeks of age. Titin‐based stiffness (Fpassive) was determined by force measurements in relaxing solution with 100 nM [Ca2+] in permeabilized cardiomyocytes at sarcomere lengths (SL) ranging from 1.8 to 2.4 μm. In obese ZSF1 rats, GGA reduced isovolumic relaxation time of the LV without affecting blood pressure, EF or LV weight. In cardiomyocytes, GGA increased myofilament‐bound HSPB5 and HSPB1 expression. Vehicle‐treated obese rats exhibited higher cardiomyocyte stiffness at all SLs compared to lean rats, while GGA reduced stiffness at SL 2.0 μm. In obese ZSF1 rats, oral GGA treatment improves cardiomyocyte stiffness by increasing myofilament‐bound HSPB1 and HSPB5. GGA could represent a potential novel therapy for the early stage of diastolic dysfunction in the cardiometabolic syndrome. [ABSTRACT FROM AUTHOR]

Aim: To investigate the associations of components of the lipid panel (and its derivatives) with intra‐pancreatic fat deposition (IPFD). Methods: All participants underwent abdominal magnetic resonance imaging on the same 3.0‐Tesla scanner and IPFD was quantified. Blood samples were collected in the fasted state for analysis of lipid panel components. A series of linear regression analyses was conducted, adjusting for age, sex, ethnicity, body mass index, fasting plasma glucose, homeostatic model assessment of insulin resistance, and liver fat deposition. Results: A total of 348 participants were included. Remnant cholesterol (P = 0.010) and triglyceride levels (P = 0.008) were positively, and high‐density lipoprotein cholesterol level (P = 0.001) was negatively, associated with total IPFD in the most adjusted model. Low‐density lipoprotein cholesterol and total cholesterol were not significantly associated with total IPFD. Of the lipid panel components investigated, remnant cholesterol explained the greatest proportion (9.9%) of the variance in total IPFD. Conclusion: Components of the lipid panel have different associations with IPFD. This may open up new opportunities for improving outcomes in people at high risk for cardiovascular diseases (who have normal low‐density lipoprotein cholesterol) by reducing IPFD. [ABSTRACT FROM AUTHOR]

This article discusses a rare autoimmune bullous disease called lichen planus pemphigoides (LPP) that developed in a 50-year-old Caucasian male two weeks after a COVID-19 infection. LPP is characterized by lichenoid and/or bullous skin lesions and the presence of IgG autoantibodies against certain proteins in the skin and mucous membranes. The patient in this case study exhibited the clinical, histopathological, and serological criteria for LPP. The article also mentions the overlap between LPP, bullous lichen planus, and bullous pemphigoid, and highlights the importance of detecting autoantibodies to support the diagnosis. This is the first reported case of LPP after a COVID-19 infection. [Extracted from the article]

Music and language are two fundamental forms of human communication. Many studies examine the development of music‐ and language‐specific knowledge, but few studies compare how listeners know they are listening to music or language. Although we readily differentiate these domains, how we distinguish music and language—and especially speech and song— is not obvious. In two studies, we asked how listeners categorize speech and song. Study 1 used online survey data to illustrate that 4‐ to 17‐year‐olds and adults have verbalizable distinctions for speech and song. At all ages, listeners described speech and song differences based on acoustic features, but compared with older children, 4‐ to 7‐year‐olds more often used volume to describe differences, suggesting that they are still learning to identify the features most useful for differentiating speech from song. Study 2 used a perceptual categorization task to demonstrate that 4–8‐year‐olds and adults readily categorize speech and song, but this ability improves with age especially for identifying song. Despite generally rating song as more speech‐like, 4‐ and 6‐year‐olds rated ambiguous speech–song stimuli as more song‐like than 8‐year‐olds and adults. Four acoustic features predicted song ratings: F0 instability, utterance duration, harmonicity, and spectral flux. However, 4‐ and 6‐year‐olds' song ratings were better predicted by F0 instability than by harmonicity and utterance duration. These studies characterize how children develop conceptual and perceptual understandings of speech and song and suggest that children under age 8 are still learning what features are important for categorizing utterances as speech or song. Research Highlights: Children and adults conceptually and perceptually categorize speech and song from age 4.Listeners use F0 instability, harmonicity, spectral flux, and utterance duration to determine whether vocal stimuli sound like song.Acoustic cue weighting changes with age, becoming adult‐like at age 8 for perceptual categorization and at age 12 for conceptual differentiation.Young children are still learning to categorize speech and song, which leaves open the possibility that music‐ and language‐specific skills are not so domain‐specific. [ABSTRACT FROM AUTHOR]

Sharks are an important attraction for aquaria; however, larger species can rarely be kept indefinitely. To date, there has been little work tracking shark movements post‐release to the wild. The authors used high‐resolution biologgers to monitor a sub‐adult tiger shark's pre‐ and post‐release fine‐scale movements following 2 years of captivity in an aquarium. They also compared its movement with that of a wild shark tagged nearby. Despite the differences in movement between the two sharks, with vertical oscillations notably absent and greater levels of turning seen from the released shark, the captive shark survived the release. These biologgers improve insight into post‐release movements of captive sharks. [ABSTRACT FROM AUTHOR]

Aim: Ureteral obstruction leads to significant changes in kidney renin expression. It is unclear whether those changes are responsible for the progression of kidney damage, repair, or regeneration. In the current study, we aimed to elucidate the contribution of renin‐producing cells (RPCs) and the cells of the renin lineage (CoRL) towards kidney damage and regeneration using a model of partial and reversible unilateral ureteral obstruction (pUUO) in neonatal mice. Methods: Renin cells are progenitors for other renal cell types collectively called CoRL. We labeled the CoRL with green fluorescent protein (GFP) using genetic approaches. We performed lineage tracing to analyze the changes in the distribution of CoRL during and after the release of obstruction. We also ablated the RPCs and CoRL by cell‐specific expression of Diphtheria Toxin Sub‐unit A (DTA). Finally, we evaluated the kidney damage and regeneration during and after the release of obstruction in the absence of CoRL. Results: In the obstructed kidneys, there was a 163% increase in the renin‐positive area and a remarkable increase in the distribution of GFP+ CoRL. Relief of obstruction abrogated these changes. In addition, DTA‐expressing animals did not respond to pUUO with increased RPCs and CoRL. Moreover, reduction in CoRL significantly compromised the kidney's ability to recover from the damage after the release of obstruction. Conclusions: CoRL play a role in the regeneration of the kidneys post‐relief of obstruction. [ABSTRACT FROM AUTHOR]

Graphene is emerging in numerous wearable and biomedical applications. Understanding the impact of graphene‐based nanocomposites over bacterial activity is critical for design appropriate technical solutions. In this work, antibacterial activity of monolayer and few‐layer graphene is tested against Gram‐negative and Gram‐positive model bacteria. Such graphene‐based nanomaterials present different effects on bacteria viability, depending on concentration and shape. The presence of dopant agents can either increase or revert graphene antibacterial effect. Among other bactericidal mechanisms, we also demonstrate that graphene surface polarity is connected to antibacterial properties and can be easily modified by surface charge transfer doping. This electrophilicity tuning offers a novel mechanism for the molecular basis of graphene's antibacterial activity. [ABSTRACT FROM AUTHOR]

Key Clinical Message: There is a high association between umbilical cord hemangiomas or cysts with fetal mortality. However, favorable outcome is possible with proper prenatal monitoring and care Umbilical cord hemangiomas are rare neoplasms of vascular origin, commonly found in the free section of the umbilical cord proximal to placental insertion. They are associated with an increased risk of fetal mortality. We present a rare co‐occurrence of an umbilical cord hemangioma and a pseudocyst managed conservatively, with favorable fetal outcome despite the interval increase in size, decreased caliber of the umbilical arteries, and fetal chest compression. [ABSTRACT FROM AUTHOR]

Introduction: The use of a footstool has been advocated to optimize posture when sitting on the toilet and thus facilitate bowel evacuation. We aimed to assess the alterations in defecatory posture, and the changes in simulated defecation with use of a footstool in patients with constipation. Methods: Forty‐one patients (female 93%, mean 52 year, SD 14 year) with constipation referred to a tertiary neurogastroenterology unit were enrolled. A bowel questionnaire, Hospital Anxiety and Depression Scale, and Rome questionnaire were administered prior to anorectal manometry. Each patient underwent three rectal balloon expulsion tests in randomized order with no footstool, a 7‐inch, and a 9‐inch footstool. Additional assessments included angle between spine and femur, and visual analogue scales assessing ease of evacuation, urge to defecate, and discomfort with expulsion. Key Results: Defecatory posture was significantly altered by footstool use, with progressive narrowing of the angle between the spine and femur as footstool height increased (p < 0.001 for all comparisons). Compared with no footstool, the use of a footstool was not associated with a change in balloon expulsion time and there was no difference between the two footstool heights. Subjectively, no significant change was identified in any of the three perceptions of balloon expulsion between no footstool and footstool use. Conclusions and Inferences: Although the use of a footstool led to changes in defecatory posture, it did not improve subjective or objective measures of simulated defecation in patients with undifferentiated constipation. Therefore, the recommendation for its use during evacuation cannot be applied to all patients with constipation. [ABSTRACT FROM AUTHOR]

Objective: To study the association between high quality of care (QOC) and quality of life (QOL) and nonroutine health care use (HCU) in systemic lupus erythematosus. Methods: Data were derived from 814 participants from the Lupus Outcomes Study sample. Data on sociodemographic information, disease status, medications, and health care variables were collected through annual interviews. QOC was measured at baseline on 13 quality indices amenable to self‐report. Follow‐up QOL was measured using the Short Form 36 health survey (SF‐36) 2 years later. Univariate and multivariate regression analyses assessed the relationship between QOC and SF‐36 scores at baseline, and logistic regression analyses evaluated QOC at baseline as a predictor of minimal clinically important difference (MCID) improvements in SF‐36 scores, emergency room (ER) visits, and hospitalizations at follow‐up. Results: Higher QOC was associated with worse scores on SF‐36 domains on univariate analysis at baseline, which was mediated by comorbidities and high disease activity. QOC and the number of years in high QOC were not predictive of MCID improvements in SF‐36 scores at follow‐up, which were driven by baseline SF‐36 scores, disease activity, and nonroutine HCU. A similar pattern was noted for ER visits and hospitalizations, for which disease activity, damage, and glucocorticoid dose were significant predictors and not QOC. Conclusion: High QOC at baseline and the number of years with high QOC are not associated with MCID improvement in SF‐36 scores and nonroutine HCU on follow‐up. High QOC, as determined by currently defined criteria, serves as a surrogate of greater disease activity, morbidity, and nonroutine HCU. [ABSTRACT FROM AUTHOR]

Purpose: Hormone replacement therapy (HRT) causes a significant increase in the risk of venous thrombosis. The risk of medical and surgery-related complications among women taking HRT following total hip arthroplasty (THA) is poorly understood, and there are currently no guidelines in place regarding venous thromboembolism prophylaxis in this patient population. The purpose of this study was to evaluate the frequency of early medical and surgery-related complications following THA among women taking HRT. Methods: Women aged > 40 years of age who underwent primary THA were identified from a retrospective database review. A control group of non-HRT users was matched using propensity scoring to HRT users. Rates of 90-day medical complications and 1-year surgery-related complications were compared between cohorts using odds ratios. Postoperative anticoagulation regimens were also compared. Results: There were 3,936 patients in the HRT cohort who were matched to 39,360 patients not taking HRT. There were no significant differences in rates of DVT (OR 0.94, p = 0.6601) or PE (OR 0.80, p = 0.4102) between cohorts. Patients on HRT were more likely to sustain a dislocation (OR 1.35, p = 0.0269) or undergo revision surgery (OR 1.23, p = 0.0105). HRT patients were more likely to be prescribed warfarin (OR 1.21, p = 0.0001) or enoxaparin (OR 1.18, p = 0.0022) and less likely to be prescribed rivaroxaban (OR 0.62, p < 0.0001) compared to controls. Conclusions: HRT was not found to be an independent risk factor for thromboembolism following THA. Further research is warranted to better delineate the ideal perioperative medical management of HRT users undergoing THA. [ABSTRACT FROM AUTHOR]

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Papillary thyroid carcinoma (PTC) primarily located in the pyramidal lobe of the thyroid gland is extremely rare, therefore the clinical and pathological features are not well understood. The authors describe a case of PTC of the pyramidal lobe, in a 77‐year‐old woman who underwent en bloc total thyroidectomy with pyramidal lobe, hyoid bone and cervical lymph node excision. In line with the present case, current literature reports a greater presence of worse prognostic factors, namely extrathyroidal extension, advanced T stage or presence of cervical lymph node metastasis. Recently, a new classification has been suggested—Upper Neck Papillary Thyroid Cancer (UPTC)—which encompasses these carcinomas, Delphi ganglion metastases and thyroglossal duct cyst carcinomas, with potential clinical and therapeutic implications, particularly the need for orthotopic thyroidectomy. Also, the complete excision of the pyramidal lobe during thyroidectomy may influence the success of radioactive iodine therapy and the patient's follow‐up surveillance. Pyramidal lobe papillary thyroid carcinoma appears to behave differently from other locations in the thyroid gland in its clinical presentation (proposed a new classification of Papillary Carcinoma of the Upper Neck (UPTC)) and association with more adverse prognostic features. [ABSTRACT FROM AUTHOR]

Aim: How spatial, historical and ecological processes drive diversity patterns remains one of the main foci of island biogeography. We determined how beta diversity varies across spatial scales and among organisms, disentangled the drivers of this variation, and examined how, consequently, biogeographic affinities within and among archipelagos vary among land plants. Location: Macaronesia. Taxon: Bryophytes, pteridophytes, spermatophytes. Methods: Species turnover and nestedness were compared within and among archipelagos across taxonomic groups. The relationship between species turnover and nestedness, climatic, geological and geographic factors was analysed using generalized dissimilarity models. Results: Species turnover, but not nestedness, increased with the geographic scale. This increment decreased from spermatophytes, pteridophytes and bryophytes, wherein the median turnover was less than half that in spermatophytes. Bryophytes exhibited a significantly higher nestedness and lower turnover than spermatophytes. Extant climatic conditions and island age contributed the most to all models but the importance of island age for bryophyte and pteridophyte turnover was marginal. Spermatophyte floras clustered by archipelago, whereas the clustering patterns in pteridophyte and bryophyte floras reflected macroclimatic conditions. Main Conclusions: The lower increment of species turnover with spatial scale and the higher nestedness in bryophytes and pteridophytes than in spermatophytes reflect the variation in dispersal capacities and distribution ranges among land plants. Accordingly, extant climatic conditions contributed more to explain turnover in bryophytes and pteridophytes than in spermatophytes, whereas factors associated with dispersal limitations, including island age, geographic distance and archipelago structure, exhibited the reverse trend. The differences in beta diversity patterns, caused by different responses of Macaronesian land plant lineages to the main factors shaping their community composition, explain their different biogeographic affinities. These differences reflect a distinct origin and different mechanisms of speciation among Macaronesian land plant lineages and archipelagos. [ABSTRACT FROM AUTHOR]

Palaearctic Erica sect. Chlorocodon, known as the wind‐pollinated besom heaths (WPBH), includes the Macaronesian E. azorica, E. platycodon subsp. platycodon and E. platycodon subsp. maderincola together with the Mediterranean and North African E. scoparia. Despite the broad extant distribution, the mainland fossil record of this section is scarce and poorly preserved and dated, and Macaronesian fossils were so far unknown. Here we discuss the systematic affinities of the first fossils of a WPBH found in Macaronesia, within a 1.3 Ma (Pleistocene, Calabrian stage) Madeira Island fossiliferous deposit. One flower and dissociated seed fossils were found in the same sediment layer, being preserved as coalified compressions with cuticular preservation. Both the flower and seed fossils present unique WPBH characters. The flower fossil is characterised by an exserted, peltate and discoid stigma – an unequivocal adaptation to anemophily, unique within Palaearctic Erica taxa. The seed fossils are of small size, presenting a testa with channelled anticlinal cell‐walls, a characteristic only found in the extant Macaronesian WPBH. Morphological, anatomical, and biometric comparisons of the fossils to extant flowers and seeds suggest that the fossils are related to the Palaearctic E. sect. Chlorocodon, being morphologically close to E. azorica. Here we assign them to E. aff. azorica. These findings suggest a colonisation to Madeira Island prior to 1.3 Ma, corresponding to the oldest and unambiguous WPBH fossils, at least 0.90–1.2 Ma older than the oldest known record. The fossil flower also indicates the presence of anemophilous traits since at least the early Pleistocene. Finally, the presence of a WPBH could suggest the same ecological role in seral communities, important to the establishment of the Madeiran temperate stink‐laurel forest. [ABSTRACT FROM AUTHOR]

Angiosperms present an astonishing diversity of genome sizes that can vary intra‐ or interspecifically. The remarkable new cytogenomic data shed some light on our understanding of evolution, but few studies were performed with insular and mainland populations to test possible correlations with dispersal, speciation, and adaptations to insular environments. Here, patterns of cytogenomic diversity were assessed among geographic samples (ca. 114) of Crithmum maritimum (Apiaceae), collected across the Azores and Madeira archipelagos, as well as in adjacent continental areas of Portugal. Using flow cytometry, the results indicated a significant intraspecific genome size variation, spanning from reduced sizes in the insular populations to larger ones in the mainland populations. Moreover, there was a tendency for an increase in genome size along the mainland populations, associated with lower temperatures, higher precipitation, and lower precipitation seasonality. However, this gradient might be the result of historic phylogeographical events associated with previous dispersal and extinction of local populations. Overall, our findings provided evidence that smaller genome sizes might play a critical role in the colonization of islands, corroborating other studies that argue that organisms with smaller genomes use fewer resources, having a selective advantage under insular environments. Although further studies are needed to improve our understanding of the mechanisms underlying genome size evolution on islands, conservation strategies must be promoted to protect the rich cytogenomic diversity found among C. maritimum populations, which occur in coastal areas that are particularly threatened by human activity, pollution, invasive species, and climate changes. [ABSTRACT FROM AUTHOR]

Background: Recent community‐based studies have demonstrated that experiencing multiple concurrent functional gastrointestinal disorders (FGIDs) is associated with increased somatization, worse quality of life (QoL), and greater health care utilization. However, the presence of multiple overlapping FGIDs is unstudied specifically in chronic constipation and functional defecation disorders (FDD). We investigated the prevalence and impact of additional nonconstipation FGIDs on constipation severity, anorectal physiology, anxiety and depression, and QoL, in patients with chronic constipation and FDD. Methods: One‐hundred and forty‐six consecutive patients with functional constipation or irritable bowel syndrome (IBS‐C/IBS‐M) presenting to a tertiary referral Neurogastroenterology Clinic were studied. In addition, 90/146 (62%) qualified for FDD due to abnormal defecatory physiology. Patients underwent comprehensive baseline assessment comprising anorectal physiology, Bristol Stool Chart, Rome questionnaire, Knowles‐Eccersley‐Scott‐Symptom (KESS) constipation score, Hospital Anxiety, and Depression Scale, and modified 36‐Item Short Form Health Survey (SF‐36) for QoL. Additional FGIDs were diagnosed using Rome III criteria. Key Results: Additional nonconstipation FGIDs occurred in 85% of patients, with a mean of 2.1 (SD 1.6) additional FGIDs. Patients with four or more additional FGIDs experienced greater constipation severity compared to those with no additional FGIDs (p = 0.004). Comorbid FGIDs were associated with worse SF‐36 scores for physical functioning (p < 0.001), role‐physical (p = 0.005), bodily pain (p < 0.001), vitality (p = 0.008), social functioning (p = 0.004), and mental health index (p = 0.031). Conclusions and Inferences: Functional gastrointestinal disorders comorbidity is highly prevalent in chronic constipation and defecatory disorders, and this is associated with greater symptom severity and worse QoL. Multimodal treatments targeting comorbid FGIDs may lead to superior outcomes. [ABSTRACT FROM AUTHOR]

Whole‐room indirect calorimeters (WRICs) provide accurate instruments for the measurement of respiratory exchange, energy expenditure, and macronutrient oxidation. Here, we aimed to determine the validity and reproducibility of a 7500 L WRIC for the measurement of ventilation rates and resting metabolic rate (RMR). Technical validation was performed with propane combustion tests (n = 10) whereas biological reproducibility was tested in healthy subjects (13 women, 6 men, mean ± SD age 39.6 ± 15.3) in two 60 min measurements separated by 24 h. Subjects followed a run‐in protocol prior to measurements. The coefficient of variation (CV) and intraclass correlation coefficient (ICC) were calculated for ventilation rates of O2 (VO2), CO2 (VCO2), the respiratory quotient (RQ; VCO2/VO2), and RMR. Technical validation showed good validity with CVs ranging from 0.67% for VO2 to 1.00% for energy expenditure. For biological reproducibility, CVs were 2.89% for VO2; 2.67% for VCO2; 1.95% for RQ; and 2.68% for RMR. With the exception of RQ (74%), ICCs were excellent for VO2 (94%), VCO2 (96%) and RMR (95%). Excluding participants that deviated from the run‐in protocol did not alter results. In conclusion, the 7500 L WRIC is technically valid and reproducible for ventilation rates and RMR. [ABSTRACT FROM AUTHOR]

Purpose: Robotic total knee arthroplasty (TKA) has seen a rapid increase in utilization with recent literature suggesting that implant accuracy and resection are better optimized than in conventional TKA. The purpose of this study was to evaluate the biomechanical properties of robotic-assisted versus conventional TKA in minimizing biplanar femoral and tibial resection error in cadaveric specimens. Methods: A systematic review and meta-analysis was performed by searching through PubMed, Cochrane library, and Embase to identify studies that analyzed the biomechanical properties of robotic assisted and conventional TKA, according to standard PRISMA guidelines. Evaluated outcomes included femoral coronal resection error (deg), femoral sagittal resection error (deg), tibial coronal resection error (deg), and tibial sagittal resection error (deg). Results: Seven studies met inclusion criteria, including a total of 140 cadaveric specimens (robotic: 70, conventional: 70), for resection accuracy between robotic and conventional TKA. Pooled analysis from seven studies revealed a significant difference in femoral coronal and sagittal resection error in favor of robotic systems compared to conventional systems (p < 0.001 & p < 0.001, respectively). The pooled analysis from seven studies revealed a significant difference in tibial sagittal resection error in favor of robotic systems compared to conventional systems following TKA (p = 0.012). Posthoc power analysis revealed a power of 87.2%. Conclusion: The use of robotic TKA is associated with lower femoral coronal, lower femoral sagittal and tibial sagittal resection error compared to conventional TKA. It should be noted that these findings are purely biomechanical – surgeons should interpret these findings along with clinical differences between conventional and robotic systems to determine which system is best for each patient. [ABSTRACT FROM AUTHOR]

Background: Chronic urticaria (CU) is defined as the occurrence of wheals/angioedema for ≥6 consecutive weeks. Until now, guidelines and publications addressing CU have focused mainly on adults. As a result, evidence and guidance in the pediatric population are scarce. Methods: This study aims to describe clinical and laboratory findings in pediatric CU and to determine factors associated with remission. Results: 185 patients, 54% female, median age at onset of 8.8 years. Angioedema was present in almost half. The most common type of CU was chronic spontaneous urticaria (CSU) in 74%. At least one atopic comorbidity was found in almost a third (35%). In addition, 8% had an autoimmune disorder (exclusively in CSU) and 9% had a psychiatric condition. Basopenia was found in 67% and was more frequently associated with CSU. The basophil activation test (BAT) was positive in 40%. With regard to remission, being of male sex, angioedema absence, the absence of physical triggers, and eosinophil counts >0.51 × 109/L were associated with shorter CU duration. Conclusion: Atopy is a common condition in pediatric CU. CSU is the most common type. Autoimmune comorbidities and basopenia were significantly more common in CSU. In addition, ours is one of the few studies, assessing BAT utility in the pediatric population, being positive in a relevant percentage (40%). BAT positivity was more frequent in CSU. Our results suggest that the absence of angioedema and physical triggers, male sex, and eosinophil counts >0.51 × 109/L appear to be associated with a better prognosis in terms of remission. [ABSTRACT FROM AUTHOR]

Aim: To assess the accuracy of metastasis in cervical nodes using preoperative palpation method, ultrasonography with colour doppler (USG) and computed tomography (CT) in oral squamous cell carcinoma. Methodology: Thirty‐one biopsy‐proven patients with OSCC who fulfilled the inclusion and exclusion criteria were included in the study. The nodal status of each was assessed by clinical palpation, USG and CT and compared with the post‐operative histopathological result. The results were evaluated statistically for sensitivity, specificity, positive predictive value and negative predictive value and accuracy. Results: The accuracy of clinical palpation, USG and CT in diagnosing a node as metastatic was 70.9%, 100% and 87%, respectively, showing ultrasonography to be better than CT, followed by CT and clinical palpation. Conclusion: The accuracy and sensitivity of USG in the detection of cervical lymph node metastases make it a potentially promising and cheap preoperative tool for staging neck node metastases. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This rare diagnosis highlights the importance of anatomical and embryological knowledge in the differential diagnosis of neck masses. A 41‐year‐old woman was referred to the head and neck surgery department because of a large midline neck mass at the level of the hyoid bone that was diagnostic for functioning thyroid tissue in a totally ectopic location. [ABSTRACT FROM AUTHOR]

Background: Poor sleep and anxiety disorders are highly comorbid in youth, and each predicts altered ventral striatum (VS) response to rewards, which may impact mental health risk. Contrasting evidence suggests previously reported negative associations between sleep health and VS response may be stronger or weaker in youth with anxiety, indicating sensitivity to win/loss information or blunted reward processing, respectively. We cross‐sectionally examined the role of sleep in VS response to rewards among youth with anxiety versus a no‐psychiatric‐diagnosis comparison (ND) group. We expected a group*sleep interaction on VS response to rewards but did not hypothesize directionality. Methods: As part of the pretreatment battery for a randomized clinical trial, 74 youth with anxiety and 31 ND youth (ages 9–14 years; n = 55 female) completed a monetary reward task during fMRI. During the same pretreatment window, actigraphy and diary‐estimated sleep were collected over 5 days, and participants and their parents each reported participants' total sleep problems. We examined group*sleep interactions on VS response to monetary rewards versus losses via three mixed linear models corresponding to actigraphy, diary, and questionnaires, respectively. Results: Each model indicated group*sleep interactions on VS response to rewards. Actigraphy and diary‐estimated time awake after sleep onset predicted reduced VS response in youth with anxiety but not ND youth. Parent‐reported sleep problems similarly interacted with group, but simple slopes were nonsignificant. Conclusions: Wake after sleep onset was associated with blunted reward response in youth with anxiety. These data suggest a potential pathway through which sleep could contribute to perturbed reward function and reward‐related psychopathology (e.g., depression) in youth with anxiety. [ABSTRACT FROM AUTHOR]

Since mid‐March 2020, a state of emergency was decreed in Portugal due to the COVID‐19 pandemic and, consequently, measures were implemented to protect public health, such as social isolation, which will certainly have a notable impact on the mental health of the population, especially in the most vulnerable groups. Positive Mental Health (PMH) is essential to deal with adversity, in this case with the pandemic, and to live better and with greater satisfaction. We consider it relevant to investigate how PMH was used as a resource to deal with the pandemic, depending on the level of vulnerability and sex. A, cross‐sectional study was carried out whose the aim was to evaluate the levels of PMH and psychological vulnerability in people with COVOD‐19 infection and analyze the association between PMH and psychological vulnerability among men and women. Methods: The instruments used were a sociodemographic characterization questionnaire, the Positive Mental Health Questionnaire, and the Psychological Vulnerability Scale (PVS), that were sent and filled out online. A quantitative, cross‐sectional, descriptive, and correlational study was carried out. Results: After analyzing the results, it was found that approximately 50.4% of the respondents (n = 387) had global PMH values that place them in quartile 50. There was also a statistically significant difference between female and male PMH, with women showing greater psychological vulnerability and lower overall PMH. Conclusions: We conclude that the women present a greater psychological vulnerability and a lower level of PMH when compared to men. Relevance to clinical practice: Considering the study's statistically significant results, when we talk about mental health, we should always consider the sex variable as a vulnerability factor, in a pandemic or non‐pandemic phase. [ABSTRACT FROM AUTHOR]

Purpose: Implants placed at variable depths may vary the amount of visible scannable surface of a scan body. Intraoral scanner technology uses advanced optical principles to record the surface of the scan body to accurately capture the implant position. The purpose of this study is to investigate the effect implant placement depth has on the accuracy of digital implant impressions using an intraoral scanner. Materials and methods: A partially edentulous gypsum master model was fabricated to allow the positioning of a single implant analog at different depths. Four groups were created based on the planned implant depths of 7, 6, 3, and 0 mm and corresponding visibility of the scan body at 2, 3, 6, and 9 mm. The model was digitized with a laboratory scanner for the reference scan and with an intraoral scanner to generate 15 test scans per group, with a total of 60 scans. The test scans were superimposed onto the reference scan using the best fit algorithm to analyze and measure the positional (dXYZ) and angular deviation (d⍬) of the scan body using three‐dimensional metrology software. Statistical analysis was performed using a one‐way ANOVA and pairwise comparison was done with a Tukey‐Kramer HSD test (α = 0.05). Results: The one‐way ANOVA of the groups for the dXYZ and dθ parameters was statistically significant (F3,56 = 11.45, p < 0.001, F3,56 = 24.04, p < 0.001). Group D (9 mm) showed the least positional deviation at 38.41 μm (95% CI 30.26; 46.56) and the least angular deviation of 0.17° (95% CI 0.12; 0.21). Group A (2 mm) showed the greatest positional deviation of 77.17 μm (95% CI 65.23; 89.11) and greatest angular deviation of 0.84° (95% CI 0.65; 1.03). The positional and angular deviation increased with increased implant depth. Conclusions: The accuracy of digital impressions is influenced by the implant depth and the amount of visibility of the scan body. The trueness and precision are highest when the implant is placed at 0 mm depth with complete visibility of the scan body and decreases with subgingival implant placement. [ABSTRACT FROM AUTHOR]