Maintaining task-relevant information in working memory (WM) while preventing distraction from task-irrelevant information is essential for adaptive behavior. However, whether the task-irrelevant information is removed or retained in WM remains debated. This study addressed this controversy across two experiments employing a retrospectively cueing (retro-cue) paradigm that examined simultaneous influence from endogenous and exogenous factors on internal representations. Behavioral results showed that retro-cues aligning endogenous and exogenous factors enhanced the retention for task-relevant information but negatively impacted memory for task-irrelevant information. Conversely, retro-cues that created conflicts between the two factors improved memory performance for task-irrelevant information whereas sacrificed memory for task-relevant information, in a way similar with retro-cues that merely involved exogenous factors. Results of event-related potentials (ERPs) provided direct evidence for the fate of task-irrelevant WM information via the component of contralateral delayed activity (CDA). ERP results of CDA suggested that task-irrelevant information was dropped out of WM when endogenous and exogenous factors were aligned, but was maintained in WM either when the two factors were in conflicts, or when there was only the exogenous influence. To conclude, this study suggested that task-irrelevant information was saved from being removed out of WM when there were conflicts between endogenous and exogenous factors, in a way similar with that when there was only exogenous influence.

Renal transplant recipients are at higher risk of COVID-19 infection due to chronic comorbidities and immunocompromised state. Limited information is available on the course and outcome of this infection in organ transplantation patients, especially in Nepal. This study aims to find out the impact of COVID-19 on renal transplant recipients. Methods: A retrospective cross-sectional study was conducted using census sampling technique on 601 patients who underwent renal transplant surgery at Shahid Dharmabhakta National Transplant Center (SDNTC), Bhaktapur. Both living as well as deceased donor renal transplant patients, who were COVID-19 confirmed through PCR test were included in the study. A self-developed, semi-structured telephone interview schedule was utilized for data collection. Results: Among the 601 patients that responded to our telephone calls, 37.9% were diagnosed as COVID-19 positive. The overall mortality among total respondent patient was nominal (5.7%) and 14.9% among COVID-19 positive patients. Most of the COVID-19 positive patients (79.8%) were male and residing in province 3 (Bagmati province). Among the expired patients, most of them (41.17%) were more than 45 years of age and employed (64.7%). Hypertension and diabetes mellitus were the top two comorbid condition. While, the most common presenting feature was fever followed by cough. Interestingly, 23.7 % of COVID-19 positive patient were hospitalized and among them 72.2% were admitted for more than 2 days. Notably, 65.8% of the COVID-19 patients were not vaccinated and among the vaccinated ones 73.1% had only single dose. The most common vaccine among patient was Vero Cell. Conclusion: This study highlights the heightened vulnerability of renal transplant recipients to COVID-19 as significant portion of the studied patients tested positive for COVID-19, with a notable mortality rate among these patients. The findings underscore the critical role of vaccination, as a considerable number of the COVID-19 positive patients were unvaccinated or partially vaccinated.

A new thermodynamic limit for the open circuit voltage of solar cells that includes thermalization is obtained in terms of photon entropy. A simple graphical construction makes it possible to link this limit to the existing limits for single junction cells due to Trivich and Flinn, Shockley and Queisser and Würfel, and the thermodynamic Carnot-type limit for hot-carrier solar cell. At the fundamental level, this limit points to similarity between photovoltaic and thermoelectric energy conversion.

Ten years after the six International Society of Paediatric Oncology (SIOP) Baseline Standards for Nursing Care in Low- and Middle-Income Countries (LMIC) were published (2014), multiple LMIC nurses have used the standards for practice assessment and change. The WHO Global Initiative for Childhood Cancer has galvanized LMIC member states to prioritize childhood cancer and save one million lives by 2030. The CureALL framework highlights critical nursing practice actions aligned with the nursing standards to meet this goal. SIOP Nursing Network’s Baseline Standards special interest group has a 5-year strategic plan for advocacy, research, and standards implementation through global multidisciplinary collaboration.

We present and analyze a second order numerical scheme with variable time steps for a liquid thin film coarsening model, which is a Cahn-Hilliard-type equation with a singular Leonard-Jones energy potential. The fully discrete scheme is mainly based on the Backward differentiation formula (BDF) method in time derivation combined with the finite difference method in spacial discretization. A second order viscous regularization term is added at the discrete level to guarantee the energy dissipation property under the condition that r ≤ r max . The uniquely solvable and positivity-preserving properties of the numerical solution are established at a theoretical level. In addition, based on the strict separation property of the numerical solution obtained by using the technique of combining the rough and refined error estimates, the optimal rate convergence analysis in ℓ ∞ ( 0 , T ; H h − 1 ) norm is established when τ≤ Ch by using the technique of the discrete orthogonal convolution(DOC) kernels. Finally, several numerical experiments are carried out to validate the theoretical results.

Background/Objective: Osteosarcoma treatment incorporates chemotherapy and surgery. Resection of the primary tumor usually occurs after induction chemotherapy. Occasionally, scheduling challenges and medical complications result in delay. The goal of this study is to determine if an increased interval between completion of neoadjuvant therapy and surgical resection correlates with decreased tumor necrosis and inferior outcomes in children and young adults with osteosarcoma. Design/Method: We conducted a retrospective chart review of 121 patients age less than 40 years diagnosed with osteosarcoma treated at a single tertiary medical center between 2000-2022. Inclusion criteria included receipt of two cycles of neoadjuvant methotrexate, cisplatin, and doxorubicin. Association of the interval from completion of induction chemotherapy to resection with tumor necrosis (Spearman’s correlation) and outcomes (multivariable Cox hazard regression) were analyzed. Results: There was no significant correlation between interval length and tumor necrosis. However, patients with an interval greater than 16 days had lower 5-year event free survival (p=0.019). Multivariable adjusted analysis of patients with initially localized disease revealed that each day increase in interval length corresponds with a 1.1 times greater hazard of having an event (95% CI: 1.02 to 1.19; p=0.016). Conclusion: Delays in local control were not associated with tumor necrosis. This is consistent with the hypothesis that tumor necrosis is a biologic marker of a tumor’s sensitivity to chemotherapy and may not be affected by minor regimen aberrations. However, surgical delay from completion of induction chemotherapy may confer worse outcomes. Longer intervals generally confer worse outcomes in patients with initially localized disease.

We show that any bounded smooth helically symmetric solution ( u , h ) in R 3 must be constant vectors. This is an extension of previous result[17, Theorem 1.1] from Navier-Stokes system to MHD system. The proof relies on establishing a Saint-Venant type estimate to characterize the growth of Dirichlet integral of nontrivial solutions.

Xanthogranulomatous Epithelial Tumor: A Case Report with One-Year Follow-UpMuna AbuHejleh1, Ahmed Mounir ElSayed2, Renan Elsadeg Ibrahem3, Asmaa Elhassan Mohamed4, Adham Ammar11Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar; [email protected], [email protected] of Orthopedics Surgery, Hamad Medical Corporation Doha Qatar; [email protected] of Clinical Imaging, Hamad Medical Corporation, Doha Qatar; [email protected] Hematology Department, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar; [email protected]

Aims: Research on family functioning in psychosis has typically focused on specific family-related factors and their impact on symptomatology, finding strong associations between high expressed emotion and poor outcomes, especially in those with long-term illness. The objective of this review is to examine the impact of a broad range of family-related factors and their relationship with clinical, social, occupational, and relational outcomes in first-episode psychosis (FEP). Method: A systematic search of databases PsycInfo, Pubmed, Embase and CINHAL between 1990 and August 2023 was completed. In total, 1408 articles were screened, and study quality was assessed using the JBI Critical Appraisal Checklists for Analytical Cross-Sectional Studies and Cohort Studies. A narrative synthesis approach was used to analyse the data. Results: Of the 1408 identified articles, 80 full-text articles were screened. Fifteen studies were included for data extraction. The objectives and scope of the selected studies varied considerably. Studies consisted of cross-sectional and prospective cohort designs. Participants consisted of FEP patients and family members, with the patient age range varying from 15.9 to 30.8 (MD=24.5). Significant associations were identified between family factors (high EE, family environment and carer burden) and symptom and social outcomes. Discussion: While findings emphasised the significant impact of family factors on symptomatic and social outcomes, the literature had significant limitations due to the absence of underlying theoretical models and understanding of the dynamics of distress in families within FEP. Future research should seek to develop a model accounting for such processes.

A document by Xiaolong Li. Click on the document to view its contents.

A document by Bishnu Prasad Kandel. Click on the document to view its contents.

Introduction:Beginning in 1940s Dapsone (diaminodiphenyl sulfone or DDS) was used to treat leprosy1.  In early 1950 Lowe reported Dapsone hypersensitivity reaction and it was named by Allday and Barnes2. Dose dependent (pharmacological) adverse effects which includes hemolytic anemia and methemoglobinemia and dose independent (idiosyncratic) adverse effects that includes dapsone hypersensitivity syndrome (DHS) are two types of adverse effects caused by dapsone2. Fever, rash, lymphadenopathy, hepatitis, splenomegaly, hemolytic anemia, atypical lymphocytosis are some features of dapsone hypersensitivity syndrome and they generally occur after patients receive DDS for 5 to 6 weeks2,3.  If DHS is not detected early and managed it can lead to irreversible organ damage and death4. The prevalence of DHS is estimated to be 1.4 % with a fatality rate of 9.9 % 3. We present a case of Dapsone hypersensitivity syndrome who presented to emergency with fever, jaundice, maculopapular rash, deranged LFT and methemoglobinemia following use of dapsone for 5 weeks duration.

not-yet-known not-yet-known not-yet-known unknown Animals that acquire beneficial microbial symbionts from their environment run the risk of acquiring a sub-optimal partner, or no partner at all. The leaffooted bug Leptoglossus zonatus (Coreidae) acquires its Caballeronia (Burkholderiaceae) bacterial symbiont from the environment, presumably from local soil. Despite large contributions to the bug’s fitness, young nymphs must re-acquire the symbiont every generation. To understand how the environmental reservoir of symbiont lineages shapes the insect’s biology, we examined the role of space and time in the distribution of Burkholderia sensu lato (including Caballeronia) strains in the bug and the soil. We compared samples within trees, within plots, within cities and among different cities in the Southwest USA. We also sampled Caballeronia in L. zonatus within a pomegranate orchard over two years. We found high Caballeronia diversity both in soils (29 lineages) and in bugs (26 lineages). Caballeronia lineages were spatially structured among soils and bugs, with fewer shared as distance between samples increased. Where a bug develops, therefore, influences the symbiont strain it acquires, consistent with a process of passive spatial turnover. Also, while some Caballeronia subclade frequencies in bugs approximated frequencies in soils, the coreoid subclade of Caballeronia appeared to be enriched in bugs. Turnover of strains between timepoints remained relatively constant, suggesting that the community composition of hosted Caballeronia is not undergoing directional change over time. Ultimately, understanding how symbiont strains of varying local benefit are distributed in space and time will help us predict how geography and seasonality are related to host fitness in environmentally acquired symbioses.

Objectives HPV-positive Oropharyngeal squamous cell carcinoma (OPSCC) and Head and neck carcinoma of unknown primary (HNCUP) is increasing. Despite good prognosis, recurrence rates range from 10- to 25%. Surveillance with clinical controls and imaging are not always reliable. Circulating tumour human papillomavirus DNA (ctHPV-DNA) has emerged as a potential biomarker for treatment evaluation and detection of recurrence. We aimed to investigate the correlation between ctHPV-DNA in HPV+ OPSCC/HNCUP and radiologic tumour burden. Additionally, we sought to assess whether ctHPV-DNA could serve as a tool in treatment evaluation. Design A prospective observational cohort study. Setting This multicenter study involved three otolaryngology units located in central Sweden. We utilised HPV genotype-specific assays for droplet digital PCR (ddPCR) to detect ctHPV-DNA in plasma at diagnosis and follow-up. ctHPV-DNA levels were correlated to radiological tumour burden and radiological response using Kendall Rank correlation coefficient and Kruskal Wallis test. Participants Patients with HPV+ OPSCC/HNCUP undergoing definitive (chemo)radiotherapy. Results Out of 54 patients, 51 were eligible for analyses. At baseline, ctHPV-DNA was detectable in 88%. The majority of patients with a favourable radiological evaluation according to RECIST, had a corresponding undetectable ctHPV-DNA at follow-up. The levels of ctHPV-DNA at baseline correlated with Total Tumour Volume and Nodal Volume (r τ = 0.39, p<0.01, respectively r τ =0.26, p<0.01). Conclusion ctHPV-DNA shows correlation with tumour burden. This study strengthens the role of ctHPV-DNA as a promising biomarker for diagnosing and monitoring HPV-related OPC/HNCUP. With further research on serial plasma sampling, ctHPV-DNA could complement radiological treatment evaluation in HPV+ OPSCC/HNCUP.

The scale of influence of hydrological and thermal conditions on plant disease remains uncertain for most natural plant pathosystems, restricting our ability to predict the potential impacts of climate change. Analysis of the spatiotemporal spread of a fungal rust pathogen across four naturally occurring flax populations over the course of five growing seasons reveals both expected relationships with snow cover, relative humidity and temperature, and a novel footprint of severe drought. This indicates that climate change may have substantial drought-mediated impacts on the spread of plant disease, and points to a need for further research integrating population-level epidemiological studies with mechanistic environmental studies to explore the effects of drought on natural plant epidemics.

Theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (TMS), is capable of non-invasively modulating cortical excitability. TBS is gaining popularity as a therapeutic tool for psychiatric disorders such as depression, in which the dorsolateral prefrontal cortex (DLPFC) is the main therapeutic target. However, the neuromodulatory effects of TBS on prefrontal regions remain unclear. Concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) can assess neuromodulation in non-motor regions using TMS-evoked potentials (TEPs) and event-related synchronisation/desynchronisation (ERS/D). We assessed twenty-four healthy participants (13 males, mean age 25.2±9.9 years) in a single-blinded crossover study design, following intermittent TBS, continuous TBS, and sham applied to the left DLPFC. TEPs and ERS/ERD were obtained at baseline and 2-, 15-, and 30-min post-stimulation. Four TEP components (N40, P60, N100 and P200) and two frequency bands (theta and gamma) were analysed using mixed effects repeated measures models (MRMM). Results indicated no significant effects for any assessed components or frequency bands. Relative to sham, the largest TEP effect size was obtained for the N100 component at 15 minutes post-iTBS (d = -0.50), and the largest frequency effect was obtained for gamma ERS at 15 minutes post-cTBS (d = 0.53). These results were in the same direction but smaller than found in previous studies, suggesting that effect sizes of the neuromodulatory effects of TBS may be lower than previously reported.

Introduction:Ingestion of honey that has a toxin called as grayanotoxin causes wild or mad honey poisoning. This toxin is also known as rhodotoxin as it is found in nectar of some rhododendron species mainly found in the mountains of Bhutan, India, Nepal and Turkey. (1) It acts on sodium channel and increases parasympathetic effect. (2) This can lead to nausea, vomiting, dizziness, sweating, altered consciousness, hypotension, bradycardia, cardiac rhythm abnormalities like first-, second-, and third -degree AV block, asystole and sinus bradycardia. (3,4) Wild honey is being used as alternative medicine to treat hypertension, diabetes, peptic ulcer disease, bower disorder, arthritis, flu and as sexual stimulant. (5) We present a case report of wild honey poisoning who presented to emergency with bradycardia and hypotension.

Case report of Sensory Changes Following Labor Epidural Analgesia Sara Gier, BS,a Jose L Diz Ferre, MD,b Sabry Ayad, MD MBAb aOhio University Heritage College of Osteopathic MedicinebCleveland Clinic Foundation, Outcomes Research, Anesthesiology Department, Cleveland, Ohio Corresponding Author   Sabry Ayad, MD, MBA Department of Anesthesiology  18101 Lorain Ave, Cleveland, OH 44111 Phone: 216 476-7052 Email: [email protected] Abstract Epidural analgesia represents a pivotal advancement in the management of labor pain, offering significant benefits in terms of pain relief and patient satisfaction. While its safety and efficacy are well-documented, practitioners must remain cognizant of the potential for rare neurological complications. These complications can range from mild sensory disturbances to severe adverse events necessitating immediate intervention. The occurrence of transient paresthesia, although infrequent, points out the potential neurological impacts associated with the epidural procedures. We present the case of a 31-year-old female, who requested epidural analgesia for labor and inadvertently developed this complication.Key clinical message Understanding neurological adverse events is central not only for diagnosing and anticipating complications but also for informing patients accurately about the risks and benefits of epidural analgesia.Keywords: anesthesia, obstetrics/gynecologyConsent statement: Written informed consent was obtained from the patient.IntroductionEpidural analgesia is a cornerstone in labor pain management, offering targeted pain relief that greatly enhances patient satisfaction and the overall childbirth experience. While its safety and efficacy are well-documented, the potential for rare but serious neurological complications requires careful consideration. Instances of transient or persistent paresthesia, though infrequent, underscore the necessity for a thorough understanding of the neurological impacts associated with epidural procedures.Neurological adverse effects, occurring at rates between 0.03 to 0.1%, can stem from various factors, such as direct needle trauma, ischemic events, or inadvertent administration of neurotoxic agents1. Other complications are unintended intravascular or intrathecal injections of local anesthetics, local anesthetic systemic toxicity, total spinal anesthesia, and high spinal block. This case report examines the occurrence of transient bilateral lower facial and oral sensory changes during labor epidural analgesia, underlining the importance of vigilant monitoring to ensure patient safety.