Betel Quid Use and Tuberculosis Transmission: A Neglected Focus Area for Tuberculosis Control in Low- and Middle-Income Countries.

Habitual betel quid consumption and spitting contribute to tuberculosis (TB) transmission due to direct exposure to pathogens, immunosuppression, and social contact. Despite betel quid being classified as a group 1 human carcinogen and a high prevalence of betel quid consumption in patients with TB, there exists a knowledge gap in the relationship between quid use and TB, which presents as a neglected opportunity to address the global burden of TB in low- and middle-income countries. Understanding such a knowledge gap is crucial when taking measures at various levels, including research prioritization, behavior change communication, and legislation to address the availability and access of quid products, coupled with community-based interventional strategies.

A case study of the development of a valid and pragmatic implementation science measure: the Barriers and Facilitators in Implementation of Task-Sharing Mental Health interventions (BeFITS-MH) measure.

Background: Few implementation science (IS) measures have been evaluated for validity, reliability and utility - the latter referring to whether a measure captures meaningful aspects of implementation contexts. We present a real-world case study of rigorous measure development in IS that assesses Barriers and Facilitators in Implementation of Task-Sharing in Mental Health services (BeFITS-MH), with the objective of offering lessons-learned and a framework to enhance measurement utility.

Methods: We summarize conceptual and empirical work that informed the development of the BeFITS-MH measure, including a description of the Delphi process, detailed translation and local adaptation procedures, and concurrent pilot testing.

Androgen receptor expression in recurrent granulosa cell tumor of the ovary: Clinical considerations of treatment and surveillance in a transgender male.

Granulosa cell tumors (GCT) represent a rare subtype of ovarian cancers. A majority of these tumors express androgen receptor (AR), making them hormonally sensitive. AR positivity not only suggests a potential role of anti-androgen therapy in treating these tumors but also poses a cause for concern: female to male (FTM) transgender patients undergoing exogenous testosterone therapy may be at risk for recurrence, progression, or even incidence of this type of cancer.

Cellular Profile of Subfornical Organ Insulin Receptors in Mice.

Brain insulin receptor signaling is strongly implicated in cardiovascular and metabolic physiological regulation. In particular, we recently demonstrated that insulin receptors within the subfornical organ (SFO) play a tonic role in cardiovascular and metabolic regulation in mice. The SFO is a forebrain sensory circumventricular organ that regulates cardiometabolic homeostasis due to its direct exposure to the circulation and thus its ability to sense circulating factors, such as insulin.

Dual-energy subtraction radiography (DESR): a systematic review and meta-analysis of pulmonary nodule detection.

Purpose: This study examined the literature to compare the accuracy, sensitivity, and specificity of dual-energy subtraction radiography (DESR) with conventional radiography (CR) in the detection of pulmonary nodules. To our knowledge, no meta-analysis has been conducted to compare DESR with CR.

Material And Methods: The authors searched Pubmed using the terms "Dual-energy subtraction radiography," and "Dual-Energy Chest Radiography.

Implementation of Antigen-Based Diagnostic Assays for Detection of Histoplasmosis and Cryptococcosis among Patients with Advanced HIV in Trinidad and Tobago: A Cross-Sectional Study.

The Caribbean continues to have high HIV prevalence globally with concurrently high mortality rates due to opportunistic Infections. This study addresses the prevalence of histoplasmosis and cryptococcosis among patients living with advanced HIV disease (AHD) in Trinidad and Tobago, focusing on the implementation of antigen-based diagnostic assays. Conducted as a cross-sectional survey across five HIV treatment sites, 199 participants with advanced HIV disease were enrolled between July 2022 and September 2023.

The opioid industry's use of scientific evidence to advance claims about prescription opioid safety and effectiveness.

It is widely recognized that pharmaceutical marketing contributed to the ongoing US opioid epidemic, but less is understood about how the opioid industry used scientific evidence to generate product demand, shape opioid regulation, and change clinician behavior. In this qualitative study, we characterize select scientific articles used by industry to support safety and effectiveness claims and use a novel database, the Opioid Industry Documents Archive, to determine notable elements of industry and non-industry documents citing the scientific articles to advance each claim. We found that 15 scientific articles were collectively mentioned in 3666 documents supporting 5 common, inaccurate claims: opioids are effective for treatment of chronic, non-cancer pain; opioids are "rarely" addictive; "pseudo-addiction" is due to inadequate pain management; no opioid dose is too high; and screening tools can identify those at risk of developing addiction.

Atypical Multifocal Granular Cell Tumor with FLT3 Y842C Somatic Mutation: A case report and a review of the literature.

Introduction: Granular cell tumors (GCT) are predominantly benign neoplasms composed by cells with abundant eosinophilic granular cytoplasm. Although the majority of GCTs exhibit a benign clinical course, a minority display cytological atypia and may exhibit aggressive, cancer-like behavior. Definitive evidence of malignancy in GCTs is reliably established only through the presence of metastasis.

Increased fatigability and impaired skeletal muscle microvascular reactivity in adults with obstructive sleep apnea: a cross-sectional study.

Background: Sympathetic nervous system hyperactivity and chronic intermittent nocturnal hypoxia in individuals with obstructive sleep apnea (OSA) predispose them to microvascular impairment, which may contribute to increased daytime muscle fatigue. This study aimed to assess microvascular reactivity of the skeletal muscle, examine fatigability, and determine the relationship between fatigability and microvascular reactivity in adults with OSA.

Methods: Twenty-six participants were allocated into two groups-those with OSA and those without i.

Impact of Comorbid Polycystic Ovary Syndrome on Clinical and Laboratory Parameters in Female Adolescents with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Cross-Sectional Study.

: Metabolic dysfunction-associated steatotic liver disease (MASLD) and polycystic ovary syndrome (PCOS) share several pathophysiological mechanisms. While the prevalence of MASLD has been extensively studied in PCOS populations, the occurrence of PCOS among female adolescents with transient elastography (TE)-confirmed MASLD in pediatric hepatology settings remains poorly characterized. This cross-sectional study aims to address this knowledge gap and elucidate potential clinical and biochemical differences between female adolescents with MASLD and comorbid PCOS compared to those without PCOS.

Comparative analysis of personal protective equipment nonadherence detection: computer vision versus human observers.

Objectives: Human monitoring of personal protective equipment (PPE) adherence among healthcare providers has several limitations, including the need for additional personnel during staff shortages and decreased vigilance during prolonged tasks. To address these challenges, we developed an automated computer vision system for monitoring PPE adherence in healthcare settings. We assessed the system performance against human observers detecting nonadherence in a video surveillance experiment.

The Global Dam Watch database of river barrier and reservoir information for large-scale applications.

There are millions of river barriers worldwide, ranging from wooden locks to concrete dams, many of which form associated impoundments to store water in small ponds or large reservoirs. Besides their benefits, there is growing recognition of important environmental and social trade-offs related to these artificial structures. However, global datasets describing their characteristics and geographical distribution are often biased towards particular regions or specific applications, such as hydropower dams affecting fish migration, and are thus not globally consistent.

Gut-Brain Nexus: Mapping Multi-Modal Links to Neurodegeneration at Biobank Scale.

Alzheimer's disease (AD) and Parkinson's disease (PD) are influenced by genetic and environmental factors. Using data from UK Biobank, SAIL Biobank, and FinnGen, we conducted an unbiased, population-scale study to: 1) Investigate how 155 endocrine, nutritional, metabolic, and digestive system disorders are associated with AD and PD risk prior to their diagnosis, considering known genetic influences; 2) Assess plasma biomarkers' specificity for AD or PD in individuals with these conditions; 3) Develop a multi-modal classification model integrating genetics, proteomics, and clinical data relevant to conditions affecting the gut-brain axis. Our findings show that certain disorders elevate AD and PD risk before AD and PD diagnosis including: insulin and non-insulin dependent diabetes mellitus, noninfective gastro-enteritis and colitis, functional intestinal disorders, and bacterial intestinal infections, among others.

Antibiotic Prophylaxis for Genitourinary Procedures in Patients with Artificial Joint Replacement and Artificial Heart Valves.

Prosthetic joint infection (PJI) and prosthetic valve endocarditis (PVE) are uncommon but serious complications. According to current best practice statements, prior to a genitourinary procedure, patients with prosthetic joints should receive antibiotic prophylaxis if they are within 2 years of arthroplasty, if they are high risk for infection due to their individual comorbidities, or if the procedure poses a high risk for bacteremia. Patients with prosthetic valves should not receive antibiotic prophylaxis for the sole purpose of prevention of endocarditis.

Advances in Bowel Preparation and Antimicrobial Prophylaxis for Open and Laparoscopic Urologic Surgery.

Surgical site infections (SSIs) represent a major source of postoperative complications adversely impacting morbidity and mortality indices in surgical care. The discovery of antibiotics in the mid-20th century, and their ensuing use for preoperative antimicrobial bowel preparation and prophylaxis, drastically reduced the occurrence of SSIs providing a major tool to surgeons of various specialties, including urology. Because, the appropriate use of these antimicrobials is critical for their continued safety and efficacy, an understanding of the recommendations guiding their application is essential for all surgeons.