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AIMS: We aimed to investigate the effect of denosumab on pedal bone health and clinical resolution in active Charcot foot (CN). METHODS: This multicentre open-label phase 2 randomised controlled trial recruited adults with diabetes mellitus and active CN within 3 months of onset. Participants were randomised to standard care alone, or with denosumab 60 mg subcutaneously. Denosumab was administered at baseline and again at 6 months, unless foot temperature had normalised (i...

The skull most commonly symbolizes death, mortality, and the unachievable nature of immortality. However, in Korean Buddhist art, skulls are rarely found. The aim of this study was to explore the image and meaning of the skull in the Joseon dynasty (1392 to 1910) of Korea. The terms [Buddhist] and [painting] and [Korea] were used to search Google (www.google.com), and the Research Information Sharing Service of Korea (https://www-riss-kr-ssl.openlink), was also searched for [Buddhism] () and [art] () and [skull] ()...

Clinical decision making by psychiatrists and informed consent by patients require knowledge of evidence-based psychotherapies (EBPs) and their indications. However, many mental health professionals are not versed in the empirical literature on EBPs or the consensus guideline recommendations derived from this literature. The authors compared rigorous national consensus guidelines for EBP treatment of DSM -defined adult psychiatric disorders-derived from well-conducted randomized controlled trials and meta-analyses and from expert opinions from the United States, United Kingdom, and Canada-to create the Psychotherapies-at-a-Glance tool...

This research introduces the Multi-Objective Liver Cancer Algorithm (MOLCA), a novel approach inspired by the growth and proliferation patterns of liver tumors. MOLCA emulates the evolutionary tendencies of liver tumors, leveraging their expansion dynamics as a model for solving multi-objective optimization problems in engineering design. The algorithm uniquely combines genetic operators with the Random Opposition-Based Learning (ROBL) strategy, optimizing both local and global search capabilities. Further enhancement is achieved through the integration of elitist non-dominated sorting (NDS), information feedback mechanism (IFM) and Crowding Distance (CD) selection method, which collectively aim to efficiently identify the Pareto optimal front...

Dysphagia is a common symptom in patients with head and neck cancer that can significantly impact health outcomes and quality of life. The origin of dysphagia in these patients is often multifactorial, making diagnosis and management especially complex. The evaluating otolaryngologist should be well versed with the patient's neoplasm, comorbidities, and treatment history alongside dysphagia-specific imaging modalities. Management is often dynamic, requiring frequent monitoring, interprofessional collaboration, and a variety of supportive and invasive measures to achieve optimal outcomes...

Temporary pacing wires are often used following cardiac surgery to optimise the heart rhythm. Although setting and checking temporary pacemakers is typically undertaken by anaesthetists, intensivists, and nursing staff who care for post-cardiac surgical patients, almost all patients with temporary pacing wires are transferred to the ward with the pacing wires left in situ, where surgical, often junior, staff become responsible for temporary pacing wire management. Thus, knowledge is required not only of temporary pacing wire indications, types, and positioning at surgery, but also of practical skills in performing a pacing check, setting the pacemaker, and troubleshooting common problems...

Three links between poetry and psychoanalysis are highlighted in this paper. These refer to the presence, in the clinical hour, of (i) poetic sentiment, (ii) poetic speech, and (iii) poetic specimen. Each is elucidated in detail and with the help of socio-clinical vignettes. The aim of the paper is to demonstrate that, through the affirmative holding and partial unmasking of the instinctual-epistemic conflation in verse and free-association, both poetry and psychoanalysis seek to transform the private into shared, the hideous into elegant, and the unfathomable into accessible...

BACKGROUND: Concomitant use of efavirenz-based antiretroviral therapy and a standard-dose etonogestrel contraceptive implant resulted in 82% lower etonogestrel exposure compared to women not receiving antiretroviral therapy. The clinical impact of this reduced exposure is supported by retrospective cohort evaluations which demonstrated higher rates of unintended pregnancies when contraceptive implants were combined with efavirenz. We hypothesized that placement of two etonogestrel implants in those taking efavirenz-based antiretroviral therapy could increase etonogestrel exposure and improve measures of contraceptive efficacy...

While emergent pedagogies offer potentially high impact, the risks in using such pedagogies can be significant when not handled carefully. This article explores the cautions and limitations of emergent-based pedagogies such as case-in-point, intentional emergence, and group relations. Leadership educators who use emergent-based approaches need to be well-versed in how to hold the heat in the classroom, even when the heat may be directed at them. The learning and impact from the pedagogy may sometimes take months or even years to be felt...

INTRODUCTION: The aging global population presents an increasing challenge for spine surgeons. Advancements in spine surgery, including minimally invasive techniques, have broadened treatment options, potentially benefiting older patients. This study aims to explore the clinical outcomes of spine surgery in septuagenarians and octogenarians. METHODS: This retrospective analysis, conducted at a US tertiary center, included patients aged 70 and older who underwent elective spine surgery for degenerative conditions...

Introduction Cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC) belong to the group of keratinocyte carcinomas (KC). Actinic keratosis (AK) is a precursor lesion of cSCC. The incidences of cSCC, BCC and AK are currently strongly increasing. Different standard therapies exist for these conditions but are not always applicable or successful. Hydrophilic Viscum album extracts have been used in anthroposophic cancer therapy since 1917. Viscum album Lipophilic Extract (VALE) is prepared by means of supercritical CO2 extraction...

Twenty years after the concept of open innovation was first proposed, entrepreneurship and horizontal division of labor have become popular in Japan, following the global trend. However, in the life science field, the foundation for open innovation is still in its infancy due to the high degree of specialization, large scale of required investment, and low probability of success. For the five years since its opening in 2018, Shonan Health Innovation Park (Shonan iPark) has taken on the challenge of building an ecosystem to create a place where a diverse range of players can realize open innovation...

Many pregnant people learn of fetal anomalies in the second trimester and subsequently present to prenatal genetic counselors (PGCs) for counseling, including but not limited to a nuanced discussion about whether to continue or terminate pregnancy. In those who choose to terminate, the decision between dilation and evacuation (D&E) or induction is often one of patient preference and as such, is heavily influenced by the quality of counseling received. PGCs are expertly trained to provide values-based counseling, yet little is known about their termination counseling practices, referral practice patterns, and perceived responsibilities in caring for this group of pregnant people...

This article discusses the diagnostic criteria for autism spectrum disorder (ASD), as well as other neurodevelopmental disorders that may be confused with or co-occur with ASD. Practitioners involved in diagnostic assessment of ASD must be well versed in the features that differentiate ASD from other conditions and be familiar with how co-occurring conditions may manifest in the context of ASD. ASD symptoms present differently across development, underscoring the need for training about typical developmental expectations for youth...

BACKGROUND: Lupus nephritis (LN) is a common disease with diverse clinical and pathological manifestations. A major challenge in the management of LN is the inability to predict its treatment response at an early stage. The objective of this study was to determine whether the density of tubulointerstitial macrophage infiltration can be used to predict treatment response in LN and whether its addition to clinicopathological data at the time of biopsy would improve risk prediction. METHODS: In this retrospective cohort study, 430 patients with LN in our hospital from January 2010 to December 2017 were included...

Simulation can be an excellent teaching and learning method if the scenarios are created appropriately. It starts with assessing the learner's needs and is followed by laying down objectives embracing the SMART principles. While creating a scenario, it is essential to consider the different aspects of realism, such as physical, contextual and psychological aspects. Using moulages and props helps in creating physical realism. The simulation expert should also be aware of the learner's experience and decide the SimZones for their learners based on their level of clinical expertise...

Polycystic ovary syndrome (PCOS) manifests a multifactorial pathology characterized by polycystic ovaries, menstrual cycle disorders, varying degrees of hyperandrogenism, and an ad-verse metabolic risk profile. The position of hyperandrogenism in this syndrome has been extensively studied. A multitude of mechanisms place it in the position of cause but also of consequence; therefore, ongoing research efforts are focused on identifying medications that can effectively reduce levels of androgens in women with PCOS...

Masu salmon, Oncorhynchus masou (Brevoort 1856), a commercially important fish species endemic to the North Pacific Ocean, attained national second-level protected animal status in China in 2021. Despite this recognition, knowledge about the trophic ecology of this fish remains limited. This study investigated the diet diversity of fluviatile Masu salmon in the Mijiang River, China, utilizing the gastrointestinal tract environmental DNA (GITeDNA) metabarcoding and morphological identification. The results revealed a diverse prey composition, ranging from terrestrial and aquatic invertebrates to small fishes...

BACKGROUND: The Coronavirus Anxiety Scale (CAS) was developed in April 2020 as an instrument to gauge the symptoms of stress and anxiety occurring secondary to the COVID-19 pandemic. It was constructed using the English language due to which its application to a multi-linguistic country like India became a hindrance. AIM: To establish psychometric validity and reliability of the Bengali translation of CAS. MATERIALS AND METHODS: Experts well-versed in the English and Bengali languages translated CAS from English to Bengali...