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An uncommon congenital abnormality known as crossed testicular ectopia (CTE) or transverse testicular ectopia (TTE) occurs when both testes migrate into the same hemiscrotum. Inguinal hernia and persistent Müllerian duct syndrome are frequently associated with it. We present a case of “TTE” in a 1-year-old boy with an empty right hemiscrotum and left inguinal hernia. TTE, first described by Von Lenhossek, can be diagnosed via ultrasound, with over 100 cases reported. Theories of its origin include developmental anomalies of the genital ridge and Wolffian duct fusion. Accurate diagnosis is crucial due to increased malignancy risks and complications in management.

Resting-state functional magnetic resonance imaging (rsfMRI) is a powerful tool for investigating the relationship between brain function and cognitive processes as it allows for the functional organization of the brain to be captured without relying on a specific task or stimuli. In this paper, we present a novel modeling architecture called BrainRGIN for predicting intelligence (fluid, crystallized and total intelligence) using graph neural networks on rsfMRI derived static functional network connectivity matrices. Extending from the existing graph convolution networks, our approach incorporates a clustering-based embedding and graph isomorphism network in the graph convolutional layer to reflect the nature of the brain sub-network organization and efficient network expression, in combination with TopK pooling and attention-based readout functions. We evaluated our proposed architecture on a large dataset, specifically the Adolescent Brain Cognitive Development Dataset, and demonstrated its effectiveness in predicting individual differences in intelligence. Our model achieved lower mean squared errors, and higher correlation scores than existing relevant graph architectures and other traditional machine learning models for all of the intelligence prediction tasks. The middle frontal gyrus exhibited a significant contribution to both fluid and crystallized intelligence, suggesting their pivotal role in these cognitive processes. Total composite scores identified a diverse set of brain regions to be relevant which underscores the complex nature of total intelligence., Competing Interests: Financial Disclosures Section All authors declare that they have no conflicts of interest.

Objectives: The aims of the study were to (1) describe types of pain in cancer patients, (2) examine the predictors and consequences of pain, (3) investigate the association between type of pain and survival, and (4) examine potential biological mediators of pain and survival., Methods: This was a secondary analysis of baseline data from patients diagnosed with cancer. Patients answered questionnaires that assessed sociodemographic characteristics, pain, depression, sleep, and fatigue. Blood was collected and cytokine assays were performed. Analysis of variance, Kaplan-Meier, and Cox regression survival analyses were used to test the aims., Results: Of the 779 patients diagnosed with cancer, the mean age was 63.5 years, 57.8% male, and 90.6% White. Of those who reported pain (total 70.3%), 46.5% stated their pain was cancer-related while 53.5% stated their pain was non-cancer-related. While both cancer and non-cancer-related pain was associated with depressive symptoms, fatigue, and sleep duration, those with cancer-related pain had significantly higher rates of depressive symptoms (F(1,516) = 21.217, p < 0.001) and fatigue (F(1,516) = 30.973, p < 0.001) but not poorer sleep (F(1,497) = 0.597, p = 0.440). After adjusting for sociodemographic, disease-related characteristics, depression, sleep duration, and morphine milligram equivalent, patient reports of cancer-related pain were significantly associated with poorer survival (HR = 0.646, 95% CI = 0.459-0.910, p = 0.012) compared to those with non-cancer-related pain, which was not associated with survival (HR = 1.022, 95% CI = 0.737-1.418, p = 0.896). Cytokines did not significantly mediate the link between pain and survival., Conclusion: While nearly half of the pain reported was cancer-related, both types of pain resulted in greater symptom burden, but only cancer-related pain was associated with survival.

Cholecystectomy is a common surgical procedure performed worldwide for acute cholecystitis. Acute cholecystitis occurs when the cystic duct is obstructed by a gallstone, which causes gallbladder distension and subsequent inflammation of the gallbladder. Acute cholecystitis is characterized by pain in the right upper quadrant, anorexia, nausea, fever, and vomiting. Cholecystectomy is the treatment of choice for acute cholecystitis. The two commonly performed types of cholecystectomies are open cholecystectomy and laparoscopic cholecystectomy. However, the approach of choice widely fluctuates with regard to various factors such as patient history and surgeon preference. It is imperative to understand the variations in outcomes of different approaches and how best they fit an individual patient when deciding the technique to be undertaken. This article reviews several studies and compares the two techniques in terms of procedure, mortality rate, complication rate, bile leak/injury rate, conversion rate, and bleeding rate., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mannam et al.)

Irritable bowel syndrome (IBS) plagues nearly a fifth of the general population. It is a chronic illness that can significantly lower quality of life (QoL) and work productivity. The relationship between diet and the functional gastrointestinal (GI) symptoms present in IBS is gaining more and more attention. In addition to being a factor in the pathophysiology of IBS, diet also has a significant impact on symptoms and overall well-being. Recent research has also shown that short-chain fermentable carbohydrates increase colonic gas production and small intestine water volume, which in turn causes functional GI symptoms in those with visceral hypersensitivity. This review article has consolidated various studies highlighting the association between certain foods and the pathophysiology of IBS. It has also talked about how restricting certain food items from the diet of affected individuals can relieve symptoms and in some cases can be more effective than pharmacotherapy. Although the low reduced fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet (LFD) is a well-known method of treating IBS symptoms, over a third of individuals do not benefit from it. This article has also discussed the effectiveness and applicability of the LFD compared to other dietary therapies for the long-term management of IBS., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sarvepalli et al.)

Non-alcoholic fatty liver disease (NAFLD) encompasses a range of conditions, from fatty liver to cirrhosis. In response to evolving research and to better reflect the complex metabolic underpinnings, the term metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed. The aim of this meta-analysis was to compare cardiovascular events and all-cause mortality between NAFLD and MAFLD patients. The present study was conducted following the Preferred Reporting of Systematic Review and Meta-analysis (PRISMA) guidelines. We systematically searched PubMed, EMBASE, and the Web of Science to identify studies that compared cardiovascular outcomes in MAFLD and NAFLD from inception to July 31, 2023. Outcomes assessed in this meta-analysis included all-cause mortality, cardiovascular mortality, and cardiovascular events. A total of 11 studies were included in this meta-analysis. The risk of cardiovascular mortality was significantly higher in patients with MAFLD patients compared to NAFLD patients (risk ratio (RR): 1.48, 95% confidence interval (CI): 1.11 to 1.98). The risk of all-cause mortality was higher in MAFLD patients compared to NAFLD, and the difference was statistically significant (RR: 2.80, 95% CI: 2.39 to 3.28). The risk of cardiovascular events was significantly higher in MAFLD patients compared to NAFLD (RR: 1.18, 95% CI: 0.86 to 1.61). The key findings underscore that individuals diagnosed with MAFLD face a notably higher risk of all-cause mortality, cardiovascular mortality, and cardiovascular events when compared to those with NAFLD., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Virk et al.)

The aim of this study was to compare outcomes between dexmedetomidine and propofol for sedation after cardiac surgery in patients requiring mechanical ventilation. This meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Online databases, including EMBASE, PubMed, and the Cochrane Library, were comprehensively searched to identify relevant randomized controlled trials (RCTs) comparing the safety and efficacy of dexmedetomidine and propofol in patients undergoing cardiac surgery and requiring mechanical ventilation. The examined outcomes included the mean length of intensive care unit (ICU) stay in hours, duration of mechanical ventilation in hours, length of hospital stay in days, and number of patients diagnosed with delirium. A total of 14 studies were included in the present meta-analysis while 1360 patients undergoing cardiac surgery were involved in these studies. Pooled results showed that the duration of mechanical ventilation was lower in the dexmedetomidine group compared to the propofol group (mean difference (MD): 0.75, 95% confidence interval (CI): 0.06-1.44, p-value: 0.03). We also found a significantly low length of stay in ICU in the dexmedetomidine group compared to the propofol (MD: 0.89, 95% CI: 0.04-1.74, p-value: 0.04). The length of hospital stay was also significantly lower in patients receiving dexmedetomidine as compared to the propofol group (MD: 0.51, 95% CI: 0.32-0.70, p-value<0.001). Risk of delirium was significantly higher in patients receiving propofol compared to patients receiving dexmedetomidine (RR: 2.02, 95% CI: 1.48-2.74, p-value<0.001). In conclusion, our meta-analysis provides evidence of the beneficial impacts of dexmedetomidine on clinical outcomes in patients undergoing cardiac surgery. Dexmedetomidine was associated with a significant reduction in the duration of mechanical ventilation, length of stay in the intensive care unit (ICU) and hospital, and the risk of delirium., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sattar et al.)

Diabetes mellitus (DM) is one of the most prevalent metabolic disorders in the world and is characterized by excessive blood glucose levels, which lead to deranged carbohydrate, protein, and lipid metabolisms. At its core, DM is an impairment of insulin metabolism, leading to a plethora of clinical features. The thyroid gland is another vital cog in the wheel of the endocrine system, and the hormones synthesized by it are heavily involved in the control of the body's metabolism. Hypothyroidism is a state in which thyroid hormones are deficient due to various factors and is characterized by a metabolically hypoactive state. Together, insulin, implicated in DM, and thyroid hormones engage in an intricate dance and serve to regulate the body's metabolism. It is imperative to explore the relationship between these two common endocrine disorders to understand their clinical association and mold treatments specific to patients in which they coexist. Both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) have been shown to have an increased association with hypothyroidism, especially in patients with risk factors including female sex, hyperlipidemia, obesity, and anemia. This review also explores DM's macrovascular and microvascular complications and their association with hypothyroidism. It is of great use to screen for hypothyroidism in diabetic patients. Specific protocols, especially for patients at an elevated risk, provide improved quality of life to patients affected by this highly prevalent disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Vemula et al.)

An abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta above 3 cm or 50% greater than the segment above. It is a dangerous condition accounting for a substantial number of deaths per year and increasing at an alarming rate. Various factors come into play in the development of AAAs, which this study has elaborated on, including smoking and old age, demographics, and comorbid conditions. Endovascular aneurysm repair (EVAR) is a newer treatment modality used for AAAs in which an endograft device is placed into the aorta, thereby creating a bypass tract from the aneurysm and generating flow mimicking that of the natural aorta. It is minimally invasive and associated with less postoperative mortality and reduced hospital stay. However, EVAR is also associated with significant postoperative complications, including endoleaks, which were reviewed in depth. Endoleaks are postprocedural leaks into the aneurysm sac that are usually identified immediately after graft placement and indicate treatment failure. They are of five subtypes, categorized according to their mechanism of development. The most common type is type II endoleaks, and the most dangerous is type I endoleaks. Each subtype has multiple management options with varying rates of success. Prompt identification along with appropriate treatment of endoleaks can lead to better postoperative outcomes and improved quality of life for patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Yanamaladoddi et al.)

Tuberculosis  is a transmissible disease caused by the bacteria Mycobacterium tuberculosis, which is a cause of significant morbidity and mortality all over the world. Tuberculosis has a number of risk factors, such as living in a developing country, poor ventilation, smoking, male sex, etc., which not only increase the chance of infection but may be independent factors for impairment in pulmonary function as well. In this review article, we have compiled several studies to learn how tuberculosis causes impaired lung function and further explored the long-term effects of tuberculosis on the same. We studied tuberculosis's effect on the lungs even after appropriate treatment and its relationship with obstructive and restrictive lung disorders. A significant relationship exists between chronic respiratory disorders and tuberculosis even after treatment; hence, we believe prevention is far superior to cure., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Bansal et al.)

Alzheimer's disease (AD) is the most common cause of dementia in the elderly, affecting roughly half of those over the age of 85. We briefly discussed the risk factors, epidemiology, and treatment options for AD. The development of therapeutic therapies operating very early in the disease cascade has been spurred by the realization that the disease process begins at least a decade or more before the manifestation of symptoms. Thus, the clinical significance of early diagnosis was emphasized. Using various keywords, a literature search was carried out using PubMed and other databases. For inclusion, pertinent articles were chosen and reviewed. This article has reviewed different neuroimaging techniques that are considered advanced tools to aid in establishing a diagnosis and highlighted the advantages as well as disadvantages of those techniques. Besides, the prevalence of several in vivo biomarkers aided in discriminating affected individuals from healthy controls in the early stages of the disease. Each imaging method has its advantages and disadvantages, hence no single imaging approach can be the optimum modality for diagnosis. This article also commented on a better approach to using these techniques to increase the likelihood of an early diagnosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Aramadaka et al.)

Obstructive sleep apnea (OSA) is identified by apnea or hypopnea of the upper respiratory tract, which is associated with decreased oxygen saturation or awakening from sleep. A severe and prevalent association with OSA is atrial fibrillation (AF). This review article outlined numerous studies to understand the pathogenic pathways linked with developing OSA-associated AF and the therapeutic and preventive options available to reduce AF. The article looked for multiple risk factors common to OSA and AF. In addition, it has reviewed several therapeutic modalities such as continuous positive air pressure (CPAP), weight loss, upper airway stimulation (UAS), and other novel treatment options to find their efficiency in decreasing the outcome of AF in OSA patients. Since OSA often goes undiagnosed, this article emphasizes the importance of early screening in patients with AF and other comorbid conditions such as obesity, advanced age, diabetes, hypertension, and many more. The article focuses on the importance of preventive approaches that can be easily implemented, such as behavioral modifications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sankaranarayanan et al.)

Introduction: Stroke is the second-leading cause of mortality in the world and ranks fifth in terms of causes of death in the United States. "Time is brain" when it comes to the detection and treatment of a stroke as it can reduce morbidity and disability in the long run. May is recognized as Stroke Awareness Month to involve the concerned stakeholders. The goal of this month is to raise public awareness of the risk factors for stroke and to minimize its occurrence. We, for the first time, evaluated the actual impact of this awareness campaign to formulate evidence-based recommendations to promote stroke awareness., Methods: The total number of tweets posted in the month of May from 2014 to 2022 were extracted. The search queries used were "stroke awareness month OR stroke month OR #strokemonth OR #strokewarenessmonth" and "stroke OR #stroke". Social network analysis of the tweets was done to understand the context of posts. Network analysis provides the capacity to estimate complex patterns of relationships and gives insights into useful information about impact, reach, and interactions in an environment. The top 100 related hashtags, influencers, and keywords were extracted. Beyond social media usage, Google Trends web search analysis was done for the search term 'stroke awareness month' for interest by region of the last five years to get an overall idea of the internet search trends globally., Results: Out of the total 989,935 tweets about stroke posted in May 2022, only 1.07% of the tweets were specific to Stroke Awareness Month. The mean and standard deviation of the percentage of targeted action from 2014 to 2022 have been 3.14% and 1.35%, respectively. Forty-five percent of the top users never collaborated with each other. On Google Trends analysis, the event had primary involvement from the United States and the United Kingdom. The event had very limited reach in other continents, especially in Asian and African countries., Conclusion: Our estimates highlight the limited digital impact of Stroke Awareness Month globally. The use of social media should be promoted, particularly in developing countries, to provide reliable information and generate user involvement on a global scale. Findings from this study can be leveraged to inform future policies for stroke awareness campaigns that improve public and global health., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Goyal et al.)

In the initial assessment of the headache patient, the emergency physician must consider several dangerous secondary causes of headache. A thorough history and physical examination, along with consideration of a comprehensive differential diagnosis may alert the emergency physician to the diagnosis of a secondary headache particularly when the history is accompanied by any of the following clinical features: sudden/severe onset, focal neurologic deficits, altered mental status, advanced age, active or recent pregnancy, coagulopathy, malignancy, fever, visual deficits, and/or loss of consciousness., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Long-term follow-up is needed to evaluate the impact of short-term cancer research programs on the career trajectories of medical and graduate students. Participation in these programs may be crucial in fostering the next generation of cancer research scientists. This report presents the career outcomes and research productivity of 77 medical and public health students with 25 years of tracking data following their participation in a summer cancer research training program at the University of Alabama at Birmingham (UAB) in 1990-1998. Of 64 summer trainees with contact information, complete survey responses were received from 55 (86.0%) individuals. Over half reported clinical care of cancer patients and 18.2% stated that they were engaged in cancer research. Literature searches confirmed that 23.4% (18/77) of trainees have published cancer research papers. Future studies should explore the optimal timing of short-term post-baccalaureate academic cancer training experiences to identify participant characteristics and institutional factors that influence career choices and determine research productivity.

The ability of the internal states of a working fluid to be in a coherent superposition is one of the basic properties of a quantum heat engine. It was recently predicted that in the regime of small engine action, this ability can enable a quantum heat engine to produce more power than any equivalent classical heat engine. It was also predicted that in the same regime, the presence of such internal coherence causes different types of quantum heat engines to become thermodynamically equivalent. Here, we use an ensemble of nitrogen vacancy centers in diamond for implementing two types of quantum heat engines, and experimentally observe both effects.

In this study Si-alloy/graphite composite electrodes are manufactured using water-soluble poly-acrylic acid (PAA) binder of different molecular weights (250, 450 and 1250 kg mol -1 ). The study aims to assess the behavior of the different binders across all the steps needed for electrodes preparation and on their influence on the electrodes electrochemical behavior. At first, rheological properties of the water-based slurries containing Si-alloy, graphite, conductive carbon and PAA are studied. After coating, the adhesion strength and electronic conductivity of the manufactured electrodes are evaluated and compared. Finally, the electrochemical behavior of the composite anodes is evaluated. The electrodes show high gravimetric as well as high areal capacity (∼750 mAh/g; ∼3 mAh/cm 2 ). The influence of the binder on the first cycle irreversible loss is considered as well as its effectiveness in minimizing the electrode volume variation upon lithiation/de-lithiation. It is finally demonstrated that the use of 8 wt.% of PAA-250k in the electrode formulation leads to the best performance in terms of high rate performance and long term stability.

The Clausius inequality form of the second law of thermodynamics relates information changes (entropy) to changes in the first moment of the energy (heat and indirectly also work). Are there similar relations between other moments of the energy distribution, and other information measures, or is the Clausius inequality a one of a kind instance of the energy-information paradigm? If there are additional relations, can they be used to make predictions on measurable quantities? Changes in the energy distribution beyond the first moment (average heat or work) are especially important in small systems which are often very far from thermal equilibrium. The additional energy-information relations (AEIR's), here derived, provide positive answers to the two questions above and add another layer to the fundamental connection between energy and information. To illustrate the utility of the new AEIR's, we find scenarios where the AEIR's yield tighter constraints on performance (e.g., in thermal machines) compared to the second law. To obtain the AEIR's we use the Bregman divergence-a mathematical tool found to be highly suitable for energy-information studies. The quantum version of the AEIR's provides a thermodynamic meaning to various quantum coherence measures. It is intriguing to fully map the regime of validity of the AEIR's and extend the present results to more general scenarios including continuous systems and particles exchange with the baths.