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Shorook Na’ara,1,2 Abhishek Mukherjee,3 Salem Billan,2,4 Ziv Gil1,2 1The Laboratory for Applied Cancer Research, Department of Otolaryngology Head and Neck Surgery, Technion-Israel Institute of Technology, Rambam Healthcare Campus, Haifa, Israel; 2The Head and Neck Center, Rambam Healthcare Campus, Clinical Research Institute at Rambam, Rappaport Institute of Medicine and Research, Technion-Israel Institute of Technology, Haifa, Israel; 3Department of Genetics and Developmental Biology, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; 4The Oncology Institute, Rambam Health Care Campus, Haifa, IsraelCorrespondence: Shorook Na’araDepartment of Otolaryngology, Head and Neck Surgery, Rambam Health Care Campus, Haifa, IsraelEmail shorook.n@gmail.comAbstract: Sinonasal mucosal melanoma (SNMM) is a rare tumor, comprising less than 10% of sinonasal malignancies. SNMM most frequently occurs in the nasal cavity (70%) and maxillary sinus (14%), typically as black patches. Overall, SNMM harbors a very poor prognosis; 5-year survival is less than 30%. Nasal cavity tumors confer a better prognosis than sinus melanoma. The primary management for SNMM is surgery, when feasible, followed by adjuvant radiotherapy. Recent studies suggest that immunotherapy may confer survival benefit to patients with advanced disease. The multidisciplinary team approach has been shown to optimize treatment, reduce costs, and minimize adverse events, while maximizing the chances for cure.Keywords: mucosal melanoma, head and neck, multidisciplinary

Today, a growing number of French Jews embrace the far-right French Front National party, which has a long history of anti-Semitism – how did we get here? How is it that Jews turn to the French authorities for protection against so-called Muslim anti-Semitic violence? How is it that we see a similar pattern across Europe: in Belgium, The Netherlands, Denmark, and Britain? This essay addresses these questions by calling attention to the role played by the absent-present Christian West in creating and aggravating tensions between Jews and Muslims while seemingly fulfilling the role of mediation between the two. The essay suggests that current popular images of Jews and Muslims circulating in Western media ironically echo nineteenth-century European depictions of Semites – both Jews and Muslims as devoted monotheistic fanatics controlled by zeal and despotism and in need of external salvation. The bulk of the essay thus focuses on “Semitism” and examines the role of nineteenth-century European philology in disseminating Western perceptions of Jewish and Muslim inferiority. Finally, the essay advocates a re-appropriation of Semitism as an alternative memory, or rather a re-memory which as such is also a re-membering of Jews and Muslims along their shared historical position as radical Others within the hegemonic, Western, Euro-Christian epistemological order.

Study objectiveRoutine ECG testing is recommended in the evaluation of syncope, although the value of such testing in young patients is unclear. For ECG testing, we assess the diagnostic yield (frequency that ECG identified the reason for syncope) and predictive accuracy for 14-day cardiac events after an episode of syncope as a function of age.MethodsAdult patients with syncope or near-syncope were prospectively enrolled for 1 year at a single academic emergency department (ED). A 3-physician panel reviewed ED charts, hospital records, and telephone interview forms to identify predefined cardiac events. The primary outcome included all 14-day, predefined cardiac events including arrhythmia, myocardial ischemia, and structural heart disease.ResultsOf 592 eligible patients, 477 (81%) provided informed consent. Direct telephone contact or admission/outpatient records were successfully obtained for 461 (97%) patients, who comprised the analytic cohort. There were 44 (10%) patients who experienced a 14-day cardiac event. Overall diagnostic yield of ECG testing was 4% (95% confidence interval 2% to 6%). For patients younger than 40 years, ECG testing had a diagnostic yield of 0% (95% confidence interval 0% to 3%) and was associated with a 10% frequency of abnormal findings.ConclusionECG testing in patients younger than 40 years did not reveal a cardiac cause of syncope and was associated with a significant frequency of abnormal ECG findings unrelated to syncope. Although our findings should be verified in larger studies, it may be reasonable to defer ECG testing in younger patients who have a presentation consistent with a benign cause of syncope.

Study objectiveWe externally validate the ability of the San Francisco Syncope Rule to accurately identify syncope patients who will experience a 7-day serious clinical event.MethodsPatients who presented to a single academic emergency department (ED) between 8 am and 10 pm with syncope or near-syncope were prospectively enrolled. Treating physicians recorded the presence or absence of all San Francisco Syncope Rule risk factors. Patients were contacted by telephone at 14 days for a structured interview. A 3-physician panel, blinded to the San Francisco Syncope Rule score, reviewed ED medical records, hospital records, and telephone interview forms to identify predefined serious clinical events. The primary outcome was the ability of the San Francisco Syncope Rule to predict any 7-day serious clinical event. A secondary outcome was the ability of the San Francisco Syncope Rule to predict 7-day serious clinical events that were not identified during the initial ED evaluation.ResultsOf 592 eligible patients, 477 (81%) provided informed consent. Direct telephone contact or admission/outpatient records were successfully obtained for 463 (97%) patients. There were 56 (12%) patients who had a serious 7-day clinical event, including 16 (3%) who received a diagnosis after the initial ED evaluation. Sensitivity and specificity of the San Francisco Syncope Rule for the primary outcome were 89% (95% confidence interval [CI] 81% to 97%) and 42% (95% CI 37% to 48%), respectively, and 69% (95% CI 46% to 92%) and 42% (95% CI 37% to 48%), respectively, for the secondary outcome. Estimates of sensitivity were minimally affected by missing data and most optimistic assumptions for missing follow-up information.ConclusionIn this external validation cohort, the San Francisco Syncope Rule had a lower sensitivity and specificity than in previous reports.

Parenting is a challenging task, especially when parents also work as teachers. In this study, daily hassles experienced by Filipino teacher-parents were studied, particularly during the COVID-19 pandemic. The Parenting Daily Hassles Scale was used to gather responses (N = 371) from teacherparents serving as the primary caregiver of their children under age 14. Data analysis indicated that most teacher-parents experienced parenting hassles at an Average level, with varied intensity or impact. The behavioral challenges experienced also occurred with Average frequency. The findings of this study have significant implications for the parental landscape in the Philippines, and provide promising directions for future research on the role portrayal of control and discipline in improving child behavior. To address the concerns highlighted in the study, the researchers recommended further examination and research on support strategies to manage children's behavior for Filipino teacher-parents amidst their professional responsibilities. This could help in the development of effective interventions and support programs that may assist parents in fulfilling their roles while dealing with daily parenting challenges. The findings highlighted the need to recognize parenting hassles and challenges, particularly during a pandemic, and the importance of supporting parents in their efforts to raise healthy and well-adjusted children. [ABSTRACT FROM AUTHOR]

Summary: The substantia nigra pars reticulata (SNpr), an output structure of the basal ganglia, is hypothesized to gate movement execution. Previous studies in the eye movement system focusing mostly on saccades have reported that SNpr neurons are tonically active and either pause or increase their firing during movements, consistent with the gating role. We recorded activity in the SNpr of two monkeys during smooth pursuit and saccadic eye movements. SNpr neurons exhibited highly diverse reaction patterns during pursuit, including frequent increases and decreases in firing rate, uncorrelated responses in different movement directions and in reward conditions that resulted in the high dimensional activity of single neurons. These diverse temporal patterns surpassed those in other oculomotor areas in the medial-temporal cortex, frontal cortex, basal ganglia, and cerebellum. These findings suggest that temporal properties of the responses enrich the coding capacity of the basal ganglia output beyond gating or permitting movement.