F1000Research

Endometriosis is a benign, estrogen-dependent, persistent chronic inflammatory heterogeneous condition that features fibrotic adhesions caused by periodic bleeding. The characteristic ectopic lesions are marked by a widely spread dense fibrotic interstitium comprising of fibroblasts, myofibroblasts, collagen fibers, extracellular proteins, inflammatory cells, and active angiogenesis. Fibrosis is now recognized as a critical component of endometriosis because of which current treatments, such as hormonal therapy and surgical excision of lesions are largely ineffective with severe side effects, high recurrence rates, and significant morbidity. The symptoms include dysmenorrhea (cyclic or noncyclic), dyspareunia, abdominal discomfort, and infertility. The significant lack of knowledge regarding the underlying root causes, etiology, and complex pathogenesis of this debilitating condition, hinders early diagnosis and implement effective therapeutic approaches with minimal side effects presenting substantial hurdles in endometriosis management. Emerging research offer a close relationship between endometriosis and fibrosis, which is believed to be tightly linked to pain, a primary contributor to the deterioration of the patient’s quality of life. However, the underlying pathophysiological cellular and molecular signaling pathways behind endometriosis-associated fibrosis are poorly addressed. The available experimental disease models have tremendous challenges in reproducing the human characteristics of the disease limiting the treatment effectiveness. Future translational research on the topic has been hindered by the lack of an adequate fibrotic model of endometriosis emphasizing the necessity of etiological exploration. This review article focuses on recent developments in the field and highlight the necessity for novel fibrotic models for early diagnosis, a better understanding the disease’s etiology and develop effective anti-fibrotic treatments. By addressing these knowledge gaps, we want to open fresh avenues for a thorough investigation and extended research in the field of endometriosis.

Background The COVID-19 pandemic has generated significant impacts on the forestry sector. Employment layoffs have led to an increase in return migration, resulting in additional labor supply and heightened family economic burdens. This research employs the Theory of Planned Behaviour (TPB) framework to examine and predict sustainable forest management practices among families managing customary forests and village forests in Bali. Methods Purposive sampling was used to collect data from 71 managers of customary forests and village forests in Tenganan and Wanagiri. Partial least square-structural equation modelling (PLS-SEM) was used to analyze the acquired data. Results The findings demonstrated that TPB can explain the sustainable forest management. The incorporation of an additional construct, Tri Hita Karana (THK), enhanced the model’s predictive power for both managerial intentions and behaviors in sustainable forest management. Specifically, THK influences management intentions through the mediation of attitudes, subjective norms, and perceived behavioral control. Conclusions This study established that THK , a fundamental value system in Balinese society, serves an antecedent predictor of behavioral intentions toward sustainable forest management. The relationship between THK and sustainable forest management intentions is mediated by attitudes, subjective norms, and perceived behavioral control. This research makes significant theoretical and managerial contributions. First, it validates the established TPB framework within the context of COVID-19’s impact in Bali. Additionally, it provides scholars with insights for identifying other potential constructs that may influence forest land managers’ behavior.

Background Prosthodontics significantly impacts oral health-related quality of life, especially oral comfort, functions, aesthetics, and overall well-being. This discipline is grounded in a solid academic and evidence-based understanding of fundamental principles for managing dental diseases and aims to restore the health of teeth and supporting tissues and compensate missing ones. Dental education is evolving quickly with the rise of digital dentistry, especially in prosthodontics. Integrating augmented reality simulations and haptic feedback has significantly advanced this transformation. This systematic review protocol intends to determine the effectiveness of haptic simulators in prosthodontics training during preclinical dental education. Methods An exhaustive search strategy will be employed, exploring PubMed, Scopus, EBSCO, Web of Science and Cochrane Central to select relevant studies, thereby enhancing the robustness of the review findings. Boolean operators (AND,OR) were utilized to assemble MeSH terms and relevant keywords. Titles and abstracts screening to identify studies that satisfy the eligibility criteria was followed by the quality and risk of bias assessment for the selected studies, via the Cochrane Collaboration’s tool and the Newcastle-Ottawa Scale (NOS). Data will be collected via standard form. Reviewers disagreement will be solved throughout debate, or by referring to a third opinion. This protocol will adhere the recommendations appointed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Discussion The outcomes of this systematic review are highly significant for dental education exploring the importance of enhancing haptic simulation during preclinic prosthetic training. Recognizing the strengths and weaknesses of virtual reality (VR) in relation to traditional preclinical training methods is crucial for developing effective educational strategies. This understanding can lead to enhanced training outcomes and increased student satisfaction, which in turn contributes to improved quality of clinical prosthetic services. Systematic review registration PROSPERO: CRD42024603681 (Registered on 30/10/2024).

Background Livelihood diversification involves households earning through various economic activities, such as non-farm businesses, entrepreneurship, and off-farm jobs, improving sustainability, resilience, risk sharing, employment opportunities, and reducing poverty and food insecurity. However, little research has been done on the status, factors and relation of livelihood diversification and food security. This study explores the relationship between food security and livelihood diversification in the Chencha district of southern Ethiopia, focusing on determinants and their connection with household food security. Methods Quantitative and qualitative data were collected from 303 randomly selected households using surveys, key informant interviews, focus group discussions, and observations. Data were analyzed by using descriptive statistics, Herfindahl-Hirschman Index, Ordered probit regression and Pearson’s correlation coefficient. Results The result revealed that subsistence farming (52.1%) and weaving (38.6%) activities were reported as the primary and secondary main income sources of households. A majority of households (90.7%) diversified their livelihood. Based on income share, non-farm, on-farm, and off-farm income sources contributed, 72.96%, 25.3%, and 1.74% of total household income, respectively. Formal employment, weaving, barber/hairdresser, cattle production and sale, cereal production, and vegetable production (Potato) were highly paying livelihood activities in order. Households who combined on-farm, off-farm, and non-farm have gained far larger mean income followed by on-farm and non-farm strategies. Ordered Probit model results showed that landholding size, livestock holding size, and access to farmer training center (FTC) have positively affected the extent of livelihood diversification. Positive association was found between livelihood diversification and the food security status of households. Conclusion thus, the majority of weaving-based livelihood groups diversify their livelihood activities to on-farm, off-farm, and non-farm activities. Hence, supporting the weaving activity and motivating females’ participation, increasing other livelihood options, and modernizing the system with appropriate training, education, and market linkage seems inevitable.

Background The emergence of artificial intelligence presents both potential for growth and challenges for the financial industry. This study examines the impact of artificial intelligence (AI) on the South African fintech industry, focusing on its transformative nature. Method A purposive sampling technique was used to select 76 participants from the banking sector. Furthermore, the participants were divided into focus groups and interviewed. The thematic analysis conducted in this study revealed eight critical themes that encapsulated the myriad challenges and opportunities faced by industry professionals. From navigating the ever-changing regulatory environment to embracing technological advancements, addressing shifting customer expectations, and cultivating organisational agility and resilience, the financial industry grapples with a complex interplay of factors that demand strategic foresight, adaptability, and a commitment to continuous learning and innovation. Conclusions The results demonstrate that AI is propelling innovation, improving operational efficiency, and transforming customer experience in the finance industry. Nevertheless, substantial impediments have arisen in the form of issues over data protection, talent recruiting, and regulatory ambiguity.

Background Several scholars defined the concepts of fuzzy soft set theory and their application on decision-making problem. Based on this concept, researchers defined the generalised fuzzy soft set and its applications. However, to the best of the author’s knowledge, the generalised fuzzy soft set has not been dealing with in the generalised fuzzy soft code set. In this paper, we introduce the notion of generalised fuzzy soft code set and its application. Methods The theory of fuzzy soft sets and its application, generalised fuzzy soft sets and fuzzy codes in different years were studied with various researchers. To derive a generalised fuzzy soft code set, we apply the concepts of generalised fuzzy soft set and a new view of fuzzy codes and its application. A new aspect of this paper is to introduce the definition of generalised fuzzy soft code sets and its application on medical diagnosis and decision-makings. Results Generalised fuzzy soft code is the most powerful and effective extension of fuzzy soft sets that deal with the choice’s parameterized values. It is an extended model of fuzzy soft sets and a new mathematical tool with significant advantages for handling uncertain information and is proposed by combining the concept of fuzzy soft sets and fuzzy code sets. This paper introduces the concept of generalised fuzzy soft code and its properties. Conclusions In this study, we combine generalised fuzzy soft set and a different approach to coding theory to introduce generalisation of fuzzy soft codes. The paper also considers the relation between generalised fuzzy soft code and its application. We discussed the matrix representation of generalised fuzzy soft code. Furthermore, a demonstration example illustrates how the strategy could be effectively applied to various problems.

Background To supplement the extant literature on the economics of employing persons of disability, the present study explores the challenges and opportunities companies face with the employment of people with disabilities. Despite legal frameworks and growing awareness, individuals with disabilities often face significant barriers to securing meaningful employment. Misconceptions about their capabilities and concerns over potential costs persist, overshadowing evidence of economic and social benefits. This study explores these dynamics, emphasizing the potential advantages of inclusive hiring practices for organizations. Methods Semi-structured expert interviews were conducted with HR managers from five South Tyrolean companies across diverse industries. Participants were selected based on criteria such as company size (minimum 35 employees) and HR management experience (at least 3 years). Interviews focused on exploring workplace adjustments, employment motivations, challenges, and barriers, generating qualitative insights into inclusion practices. Results The study identified several advantages of employing individuals with disabilities, including low turnover rates, increased employee motivation, and a positive workplace atmosphere. Most companies incurred minimal costs for workplace adjustments. Challenges included insufficient understanding among staff, difficulty matching job roles with capabilities, and bureaucratic obstacles. The experts also noted a lack of job applications from individuals with disabilities, potentially due to low confidence or family overprotection. Conclusions Employing people with disabilities can be economically profitable and is not limited to social aspects alone. Existing barriers can often be dismantled without significant financial or time investment, with obstacles being readily overcome. This article contributes to a better understanding of challenges and opportunities of employing staff with disabilities and demonstrates the conditions under which economic benefits emerge for companies. The findings are discussed from an economical and social/cultural perspective with practical implications for human resource practice and operation management.

Background The purpose of the study was to assess the obstacles faced by diabetes patients in their self-care and determine the factors associated with these obstacles. The management of diabetes mellitus (DM) extends beyond the clinician’s efforts, with the responsibility of the care also being shared by the patient to achieve better treatment outcomes and prevent complications. Self-care management is the most important part of DM treatment, which includes diet, regular exercise, blood glucose monitoring, medication and foot care. Methods A facility-based cross-sectional study was conducted among 107 type 2 DM patients aged >18 years using the Diabetes Obstacles Questionnaire-30. Patients scoring a mean response score >3 were considered to have an obstacle. We included age, gender, socioeconomic status (SES), duration of DM and blood glucose levels as factors for regression analysis and a P value <0.05 was considered to be statistically significant. Results A large majority (64.5%, n = 69) of our participants were aged above 55 years and belonged to lower socio-economic status (65.4%, n = 70). Family history of DM was present in 41% (n=44) of the participants. The median duration of DM among the participant was 10 (4 – 7) years. In our study, the participants faced obstacles for two items in the domains: Support from Friends & Family (mean score: 3.73) and Knowledge of the Disease (mean score: 3.58). A multinominal regression analysis revealed SES was predictive of participants who could not understand information from literature with a P. value of 0.002 (OR: 3.65, CI: 1.60-8.338). Conclusion The two major obstacles to self-management practices that were identified were in the domains of Support from Friends and Family, and Knowledge of the Disease. Socioeconomic status was identified to be a predictive factor associated with the participants who are not able to understand information from the literature.

Backround/Objectives We investigated a technique that facilitates the coiling of a regular straight catheter (with integral stylet) behind the sciatic nerve in an ultrasound (US) regional anaesthesia simulator, and then applied our findings to a series of orthopedic-trauma patients. Methods We conducted a randomized study of two methods of perineural catheter advancement in a sciatic nerve block Blue Phantom simulator. Two groups of twenty catheters each (method A and method B) were evaluated under real-time ultrasound imaging. The needle in-plane/nerve in-short-axis technique was applied. In method A the catheter was advanced beyond the needle tip with the integral stylet extending along its entire length; in method B the catheter was advanced after its integral stylet was retracted by 6 cm, thus providing flexibility to the catheter’s distal end. Additionally, to assess the procedural effectiveness of method B coiling technique, a pilot study was conducted examining 25 perineural catheters coiled underneath the sciatic nerve in trauma-orthopaedic patients to document any catheter tip displacement from their initial position (for 36 hours postoperatively). Results In the simulation study, method B led to a significantly higher percentage (18/20:90%) of coiled catheters than method A (3/20:15%). Two coiled catheters of method B were found kinked/obstructed. In our patients, after catheter insertion, the distal end of 2/25 (8%) coiled catheters was obstructed. One perineural catheter was dislodged. For the remaining 22 (88%) catheters, ultrasound imaging demonstrated that local anaesthetic infusion made contact with the sciatic nerve, indicating no displacement of the catheter’s distal end postoperatively. Conclusion Regular straight perineural catheters can be coiled if their integral stylet is partially retracted. This coiling method offers extra catheter length adjacent to the nerve structure which potentially mitigates catheter tip displacement. Trial registration clinicaltrials.gov, registration No: NCT06568510, 23/08/2024, registration URL: https://clinicaltrials.gov/study/NCT06568510?intr=coiling%20of%20echogenic%20sciatic%20nerve&rank=1#study-overview

Background Stroke survivors, especially working-age adults, face an increased risk of recurrent stroke within one to five years after the initial occurrence, primarily due to suboptimal risk factor management. This study aims to investigate the contributing factors associated with the risk of recurrent stroke in this demographic. Methods This case-control study matched participants with recurrent stroke to those without recurrent stroke by age and gender. Multivariate logistic regression analyses were conducted to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to identify significant factors associated with recurrent stroke. The study included 100 patients with recurrent stroke and 200 control participants recruited from the hospital database. Results Significant factors associated with recurrent stroke were gender (OR, 1.83; 95% CI, 1.10 to 3.29), high fasting blood sugar (OR, 3.70; 95% CI, 1.10 to 3.29), drinking status (OR, 3.63; 95% CI, 3.01 to 6.54), sedentary lifestyle (OR, 2.77; 95% CI, 1.50 to 5.13), and lack of workplace support for health (OR, 2.02; 95% CI, 1.13 to 3.63). The association of female gender, marital status, smoking status, sedentary lifestyle, interpersonal relationships at the workplace, and workplace support for health with recurrent stroke differed by age group. Conclusions This study highlights the importance of addressing lifestyle-related and occupational factors to reduce recurrent stroke risk among working-age adults. Tailoring age-specific stroke prevention strategies, promoting healthier lifestyles, and implementing evidence-based interventions can lead to improved stroke outcomes and enhance the quality of life for this vulnerable population.

Background Research software is increasingly recognized as critical infrastructure in contemporary science. It spans a broad spectrum, including source code files, algorithms, scripts, computational workflows, and executables, all created for or during research. While research funders have developed programs, initiatives, and policies to bolster research software’s role, there has been no empirical study of how these funders prioritize support for research software. Understanding their priorities is essential to clarify where current support is concentrated and to identify strategic gaps. Methods We conducted an online mixed methods survey of international research funders (n=36) to explore their priorities in supporting research software. The survey gathered data on the specific outcomes funders emphasize in their programs and initiatives for research software. Results The survey revealed that funders place strong emphasis on developing skills, promoting software sustainability, embedding open science practices, building community and collaboration, advancing research software funding mechanisms, increasing software visibility and use, fostering innovation, and ensuring security. Conclusions The findings highlight opportunities to enhance research software’s role through increased funder attention on professional recognition for software contributions and the non-technical, social aspects of research software sustainability. Addressing these areas could lead to more effective support and development of research software, ultimately benefitting the entire research ecosystem.

In Peru, insect consumption, as a nutritional complement or as the main source in the diet, is limited to the regions of our the central jungle where Atta sexdens ants are consumed. An energy bar based on Andean grains with Atta sexdens ant flour was formulated. The ants were obtained from the department of San Martin, district of Rioja, province of Rioja. Four different formulations were prepared with different Atta sexdens ant flour concentrations: 15%, 20%, 25%, and 30%. Moisture, total fat, ash, proteins, fiber, carbohydrates, instrumental texture, and organoleptic analysis (taste, texture, and color) were performed. The developed cereal energy bar presented a 10 g protein content in 100 g of the final product. Acceptability was evaluated in adolescents and young adult populations. The developed cereal bars presented a high protein content, adequate organoleptic properties and high acceptability. However, this must be considered in the context of the rising cost of protein-rich foods.

Background Pathological response of liver metastases (LM) from colorectal carcinoma (CRC) to neoadjuvant therapy is a known prognostic factor associated with recurrence and survival. The aim of this study was to compare the performance of two prognostic scores in patients who underwent surgery for colorectal cancer liver metastases (CRCLM), specifically in stage IV disease. Methods We conducted a study on patients with stage IV colorectal cancer who received preoperative chemotherapy (CT) followed by liver metastasis (LM) resection between 2015 and 2021. Among these patients, 57% had synchronous metastases (diagnosed at the same time as the primary tumor), while the remaining cases were metachronous (diagnosed after the primary tumor). Pathological response was evaluated using both the Rubbia-Brandt tumor regression grade (TRG) and the Blazer scoring system. We then assessed the performance of these two prognostic scores based on homogeneity (using the likelihood ratio, LR+), monotonicity, and discriminative ability (using the area under the receiver operating characteristic [ROC] curve, AUC). Results 70 cases were included in the study. Mean age was 56 years. The sex ratio (males/females) was 2.2. Forty patients were stage IV (57%) with synchronous all CRCLMs. The overall survival, all stages combined, was 85.5% at 12 months, 41.7% at 24 months and 19.3% at 36 months. The median survival was better in case of major response (TRG1/TRG2) evaluated at 40.1 and 41.1 months after diagnosis. In cases of partial response (TRG3), the median survival was 32.1 months. In cases with no response (TRG4/TRG5), survival was estimated at 29.9 and 18.5 months. The Rubbia-Brandt TRG had the highest LR+ (10.95). The LR+ of the Rubbia-Brandt score was greater than 10, so it was a test with very strong contribution. The LR+ of the Blazer score was between 5 and 10, it was a test with strong contribution. The Rubbia-Brandt TRG had the highest linearity value (10.73). With a higher AUC of the ROC curve (0.8), the Rubbia-Brandt TRG was better at predicting survival than the Blazer score. Conclusion Surgical resection is the gold standard for CRCLM, with improved prognosis from neoadjuvant chemotherapy. Pathological response to CT is a key prognostic factor, and the Rubbia Brandt TRG system enhances survival predictivity when combined with ypTN stage.

Backgrounds The retention of the maxillary complete denture may be influenced by adequate recording in the patient’s mouth, marking, and carving of the post-dam on the maxillary cast. Failure to do so may lead to loss of retention. Successful denture construction with patient’s comfort could be achieved by effective methods of recording, marking, and carving of the post-dam. The aim of the study was to assess Iraqi dentists in their knowledge and application of the post-dam in maxillary complete dentures. Methods Questionnaires were distributed randomly through online Google Forms and 118 Iraqi dentists with different academic degree participated in the study. A multinomial logistic regression model was also used to assess the nominal outcome variables. Results A High percentage of 90.7% of Iraqi dentists with different academic degree stated that they had the knowledge about the vibrating lines and their location and 84.7% stated that they mark the post-dam on the master cast, while 15.3% stated that the dental technician marks it. More the half (52.5%) of the participants carved the post-dam, while 47.5% of the participants stated that the dental technician did it. For participants not marking the post-dam, 30.5% of the participants stated they depend on the dental technician in marking and/or carve the post-dam, while the fear of denture failure and loss of retention was observed in 25.4% of the participants, followed by 24.6% of participants forgetting to carve, 10.2% of participants had no information about carving, and 9.3% participants found it was difficult to carve. Conclusions Within the limitations of the study, most Iraqi dentists with different academic degree stated that they had the knowledge on the location of vibrating lines. However, recording and carving the post-dam was influenced by the dentist’s personal preference and their dependency on the dental technician.

Decades of research have illuminated the consequences of early adverse rearing experiences in laboratory macaque populations. However, knowledge of the impact of traumatic episodes in non-laboratory settings remains limited. This study investigates the socio-emotional and behavioural impacts of illegal trade on five macaque species, all victims of poaching. We studied 53 focal subjects residing at the Lao Conservation Trust for Wildlife (LCTW), a former zoo converted into a rescue and rehabilitation centre. We categorised their past experiences into seven aspects, encompassing maternal care and interactions with conspecifics. We assessed social engagement and cooperation by analysing social behaviours and employing the Social Responsiveness Scale. Emotional resilience was evaluated by measuring anxiety levels and the occurrence of abnormal behaviours, supported by a welfare questionnaire. Additionally, the introduction of Cattell’s 16PF questionnaire in macaques for the first time aimed to reveal the influence of traumatic experiences on their personality traits. Our findings underscore the significance of early social exposure to conspecifics. Macaques deprived of juvenile social contact show reduced social behaviours and a tendency towards social avoidance in adulthood. Human-reared macaques display increased abnormal behaviours in social contexts, which compromises welfare. Social deprivation with conspecifics during infancy negatively affects psychological stimulation and overall welfare, with prolonged time in illegal trade correlating with increased anxiety levels. Personality traits, such as ‘Calmness’ and ‘Unfriendliness’, are shaped by rearing conditions, with macaques deprived of social interaction showing higher levels of introversion. In summary, the more time macaques spend in human care with minimal exposure to conspecifics, the more pronounced the impacts on anxiety, abnormal social behaviours, and personality traits, highlighting the significant long-term effects of early rearing conditions on their socio-emotional development.

Objectives Good oral hygiene measures are important for successful orthodontic treatment. They involve various types of mouthwashes which have been reported to cause alteration of mechanical properties of archwires. This study aimed to evaluate the effects of a new kind of chlorine-dioxide-containing mouthwash on the mechanical properties and surface morphology of stainless steel orthodontic archwires against the already prevalent chlorhexidine mouthwash in the market. Method Group A – Chlorhexidine mouthwash 0.2% (study), Group B – Chlorine Dioxide mouthwash (study), and Group C – Artificial Saliva (control). 42 specimens of 5 cm long 19x25 inch SS archwires were immersed in each group equally. Post immersion, the frictional force was analyzed in the universal testing machine for each group using custom-made acrylic jigs for 10 specimens. The remaining 4 specimens from each group were sent for surface morphology evaluation using an atomic force microscope. Results Friction resistance evaluation for the archwires revealed a mean friction of 0.011 ± 0.0056 in Group A, 0.015 ± 0.0052 in Group B, and 0.010 ± 0.0067 in Group C. Results suggested that the static friction of Group C (control group) was found to be the least when compared with the experimental groups, although not producing statistically significant values. Surface roughness of archwires compared at a 10μm range revealed a mean roughness of 19.38 ± 0.82 in Group A, 25.39 ± 7.01 in Group B, and 16.65 ± 3.07 in Group C which shows there wasn’t any statistically significant difference in the mean roughness midst the three sets. Conclusion Chlorine dioxide and Chlorhexidine mouthwashes caused an increase in the frictional resistance of the archwires when compared to the control group. This increase was statistically insignificant. When measured at a range of 10μm the mean surface roughness did not statistically differ across the control and the experimental groups.

Background Cerebral palsy (CP) is a neurological disorder that can affect motor skills and psychophysiological well-being. Virtual Reality Exercise (VRE) improves cognitive and physical outcomes in patients with CP. Therefore, this study aimed to investigate the effects of VRE on attention, vigor, and decision-making abilities in adolescents with CP. Methods A randomized controlled trial was conducted. The intervention consisted of a single 40-minute session of VRE compared to TE conducted in a controlled laboratory environment. Results Fourteen participants (42.9 % female) were included in this analysis. The results indicated that VRE had a statistically significant positive effect on attention and vigor compared to TE. While participants in the VRE group exhibited enhanced attention levels and reported elevated levels of vigor subsequent to the exercise sessions, the memory results did not reach statistical significance. Conclusions The findings suggest that VRE is an effective intervention for improving attention and vigor in adolescents with CP. Registration Pan African Clinical Trial Registry (PACTR202308598603482; 31/08/2023). The trial was reported in accordance with the CONSORT reporting guidelines.

Macrophage Activation Syndrome (MAS) is a serious and life-threatening complication defined by excessive immune activation. While it’s commonly associated with rheumatic diseases, infections can also trigger MAS, with tuberculosis being a rare but significant cause. This case report discusses a rare occurrence of Macrophage Activation Syndrome (MAS) caused by multifocal tuberculosis in an immunocompromised patient with Crohn’s disease receiving immunosuppressive treatment. The patient is a 26-year-old woman with Crohn’s disease who is being treated with azathioprine. She arrived at the hospital battling persistent abdominal pain, overwhelming fatigue, and fever. Upon examination, splenomegaly and ascites were noted. A chest X-ray revealed bilateral pleural effusion consistent with tuberculosis. A CT scan confirmed the presence of pleural, pericardial, and intraperitoneal fluid. Blood tests indicated pancytopenia, hyperferritinemia, and hypofibrinogenemia. The analysis of ascitic fluid suggested an exudate. The PCR test of the bone marrow aspirate was positive for tuberculosis without rifampicin resistance, and the smear showed hemophagocytosis images. The patient was diagnosed with Macrophage Activation Syndrome secondary to multifocal tuberculosis. This report delves into the complex relationship between MAS and tuberculosis, emphasizing the challenges in diagnosing MAS in such cases and the potential link to tuberculosis. The complex diagnostic landscape of multifocal tuberculosis, which can often mimic malignancies, underscores the importance of promptly detecting and starting anti-tuberculosis interventions for improved clinical outcomes and the prevention of associated complications.

Background Formaldehyde a commonly used embalming fluid for the preservation of cadavers, produces numerous short and long-term side effects on the students and staff working with it. Indoor plants have been shown to reduce atmospheric formaldehyde levels. The purpose of the study was to compare the efficacy of indoor plants in reducing formaldehyde levels in ambient air to levels deemed safe by WHO standards Methods The study was conducted in the storage room of the Anatomical dissection hall. 7 potted plants of one variety were kept in the storage room for 14 days and the Formaldehyde reading was measured using a VOC (Volatile Organic Compound) monitor. Then the same was done with no plant. This cycle was repeated 2 more times, with two different plant species. The three spieces of plants used for this study were as follows: Dracaena trifasciata , Epipremnum aureum , Spathiphyllum. Results The results were analysed and compared and it was determined that the effect of having a plant present versus having no plant present on the Formaldehyde concentration in the air was inconclusive as Dracaena trifasciata failed to reject the null hypothesis altogether (p-value>0.05), while Epipremnum aureum and Spathiphyllum rejected the null hypothesis (p-value<0.05), however they both had a weak positive correlation with formaldehyde concentration. Conclusion The efficacy of indoor plants in reducing formaldehyde levels in ambient air needs to be further explored and validated since all the prior studies conducted were in controlled environment and should be done in a real time scenario for its practical and beneficial uses.

This work is an application of experimental temperature data previously collected in a residential building in Douala, Cameroon, in order to analyze thermal discomfort. The data was collected according to three occupancy scenarios over 12 month period using thermohygrometer sensors. The temperature data are analysed in comparison with the comfortable temperature range from 24°C to 28°C. The degree hour (DH) method was used to assess the severity of thermal discomfort in a hot and humid climate. The results reveal that the open C1, closed C2 and inhabited C3 rooms corresponding to scenarios C1, C2 and C3 respectively, have 7270.6°H, 9063.9°H and 10023°H. The inhabited room C3 has the largest DH and although the room C1 has the smallest DH, the latter largely exceeded the tolerable limit value of 1250°H set by the RE2020 Environmental Regulations. Results from this work can serve in building modelling for researchers and architects to act for the alleviation of thermal discomfort in regions with hot and humid climate.

Background At the international level, the survival of exporting companies represents a critical issue in a context of heightened uncertainty and intensified competition within the framework of the country’s commercial opening. This is a context in which different companies are born and die as a result of the interaction between the market and other factors. The objective of this research was to analysis of the survival of exporting agricultural companies in Peru, 2009-2019. To this end, data from the Commission for the Promotion of Peru for Exports and Tourism (Promperu) was utilised. Methods The methodological contribution of the research is based on the quantitative approach, of basic type with a descriptive elk; being the population that involves a total of data of the agricultural exporting companies of Peru in the period 2009-2019 and the sample is census and the non-parametric statistical technique used was the Kaplan Meier estimate for the estimation of the survival rate. Results Exports of Peru’s non-traditional agricultural sector in FOB value have had an average annual growth of 12% in terms of FOB value and 9% in terms of volume exported; the entry rate of new agro-exporting agricultural companies reached an average growth of 2.3% and the exit rate reached an average of 2.2% in the period 2009-2019. Conclusions The survival of exporting companies in the non-traditional agricultural sector is critical, where 89% of them survive only one year, while in the second year only 75% survive and in the sixth year only 33% survive.

Background Tuberculosis (TB) is a leading cause of death worldwide with over 90% of reported cases occurring in low- and middle-income countries (LMICs). Pre-treatment loss to follow-up (PTLFU) is a key contributor to TB mortality and infection transmission. Objectives We performed a scoping review to map available evidence on interventions to reduce PTLFU in adults with pulmonary TB, identify gaps in existing knowledge, and develop a conceptual framework to guide intervention implementation. Methods We searched eight electronic databases up to February 6 2024, medRxiv for pre-prints, and reference lists of included studies. Two review authors independently selected studies and extracted data using a predesigned form. We analysed data descriptively, presented findings in a narrative summary and developed a conceptual framework based on the Practical, Robust Implementation, and Sustainability Model to map the factors for effective intervention implementation. Results We reviewed 1262 records and included 17 studies. Most studies were randomized controlled trials (8/17, 47%). Intervention barriers included stigma and inadequate resources; enablers included mobile phones and TB testing and results on the same day. We identified eight interventions that reduced PTLFU: treatment support groups; mobile notifications; community health workers; integrated HIV/TB services; Xpert MTB/RIF as the initial diagnostic test; computer-aided detection with chest radiography screening; active linkage to care; and multi-component strategies. Conclusion Given the variation of healthcare settings, TB programs should consider contextual factors such as user acceptability, political commitment, resources, and infrastructure before adopting an intervention. Future research should utilize qualitative study designs, be people-centred, and include social and economic factors affecting PTLFU.

Electrocardiograms (ECGs) can be affected by various factors and technical problems. It is rare for an artefact to be the cause of ST-segment elevation, especially in asymptomatic patients. An important distinction between true ST segment elevation caused by myocardial infarction and an artefact is that the baseline elevation in an artefact may begin before or after the appearance of the QRS complex. When confronted with an abnormal ECG with suspicious waveform contours and possibly only one completely normal limb leads, the diagnosis of arterial pulse artefact should be considered. It is important to exclude subjective assessments unless they are clearly labelled as such.

This case report presents a complex case of a 65-year-old female with a history of hypertension and a family history of polycystic kidney disease and Fabry disease presented with acute pancreatitis and subsequent renal insufficiency. Despite initial corticosteroid therapy for immuno-allergic nephropathy, the patient’s condition deteriorated with the development of a skin rash, uremic syndrome, and neurological symptoms. A renal biopsy revealed cellular crescents and cytoplasmic vacuolization in podocytes and tubular cells. Genetic testing confirmed a GLA gene mutation, consistent with Fabry disease. While undergoing treatment with cyclophosphamide, the patient experienced severe allergic reactions, ultimately leading to acute respiratory distress syndrome and fatal outcome. Despite the Fabry disease variant being primarily associated with cardiac involvement, renal involvement was evident. This case highlights the rarity of this co-occurrence, the diagnostic challenges, the importance of genetic factors in autoimmune kidney diseases, and the impact of drug allergies on patient management.

Introduction Targeted Muscle Reinnervation (TMR) is an innovative surgical procedure initially designed for upper-limb amputations, which has shown growing potential for improving functional outcomes in below-knee amputees. TMR involves redirecting severed nerves from the amputated limb to nearby residual muscles, allowing these muscles to act as amplifiers for nerve signals, thereby improving prosthetic control. Recent advancements in TMR for below-knee amputations have highlighted its ability to reduce post-amputation complications, such as neuroma pain and phantom limb pain, while offering enhanced control over prosthetic limbs, thus improving mobility and quality of life. Methods Following PRISMA guidelines, a systematic review was conducted, sourcing studies up to May 2024 from PubMed, Cochrane Library, Scopus, Springer, and Epistemonikos. The analysis included randomized controlled trials (RCTs) and clinical trials. A meta-analysis was performed to assess phantom limb pain reduction, while study quality was evaluated using RoB 2.0, ROBINS-I, and ROBINS-E. Meta-regression examined the influence of variables such as age and sex on pain outcomes. Results Seven studies, including 363 patients, were analyzed. The meta-analysis showed that TMR significantly reduced phantom limb pain (MD: -1.74; 95% CI: -2.46 to -1.02; P<0.00001; I2=0%). However, the pooled risk ratio for phantom pain incidence (RR: 1.58; 95% CI: 0.61 to 4.11; P=0.35; I2=93%) indicated variable outcomes. Conclusion TMR significantly reduces phantom limb pain and improves prosthetic control, particularly for patients with SCC of the foot, ultimately enhancing their quality of life.