From Cow's Milk to Cheese, Yogurt, and Labneh: Evaluating aflatoxin M fate in Traditional Lebanese Dairy Processing and the Efficacy of Regulations through a Risk Assessment Approach.

Aflatoxin M (AFM1) is a potent mycotoxin that can contaminate milk and dairy products. It is a metabolite of aflatoxin B (AFB1), which is produced by certain fungi that infect crops. In Lebanon, traditional dairy production-including various cheeses, yogurt, and Labneh-is widely practiced.

Determinants of complexity in clinical practice guidelines: a Delphi study including perspectives from guideline developers and implementers.

Abstract: The Medical Research Council proposed a framework to develop and implement complex interventions in practice. How to adopt these interventions is described in recommendations of evidence-based clinical practice guidelines. Many factors may influence the complexity of a guideline.

Identification of variants from parent-proband duos via long-read sequencing.

While variants cause many Mendelian disorders, their detection currently requires sequencing of the proband and both biological parents. This is not feasible when only one parent is available, a limitation for millions of families. We developed , which identifies variants from single parent-proband duos using long-read sequencing followed by haplotype reconstruction and detection of identical-by-descent haplotype blocks.

Cigarette Smoke and Decreased DNA Repair by Xeroderma Pigmentosum Group C Use a Double Hit Mechanism for Epithelial Cell Lung Carcinogenesis.

Emerging evidence suggests a complex interplay of environmental and genetic factors in non-small cell lung cancer (NSCLC) development. Among these factors, compromised DNA repair plays a critical but incompletely understood role in lung tumorigenesis and concurrent lung diseases, such as chronic obstructive lung disease (COPD). In this study, we investigated the interplay between cigarette smoke, DNA damage and repair, focusing on the Nucleotide Excision Repair (NER) protein Xeroderma Pigmentosum Group C (XPC).

Voxel-Wise Map of Intracerebral Hemorrhage Locations Associated With Worse Outcomes.

Background: Prior studies on the clinical impact of intracerebral hemorrhage (ICH) location have used visual localization of hematomas to neuroanatomical structures. However, hematomas often cross neuroanatomical structure boundaries with inter-reviewer variability in visual localization. To address these limitations, we applied voxel-wise analysis to identify brain regions where ICH presence is independently predictive of worse outcomes.

Proceedings of the National Cancer Institute Workshop on combining immunotherapy with radiotherapy: challenges and opportunities for clinical translation.

Radiotherapy both promotes and antagonises tumour immune recognition. Some clinical studies show improved patient outcomes when immunotherapies are integrated with radiotherapy. Safe, greater than additive, clinical response to the combination is limited to a subset of patients, however, and how radiotherapy can best be combined with immunotherapies remains unclear.

Optimizing Automated Hematoma Expansion Classification from Baseline and Follow-Up Head Computed Tomography.

Hematoma expansion (HE) is an independent predictor of poor outcomes and a modifiable treatment target in intracerebral hemorrhage (ICH). Evaluating HE in large datasets requires segmentation of hematomas on admission and follow-up CT scans, a process that is time-consuming and labor-intensive in large-scale studies. Automated segmentation of hematomas can expedite this process; however, cumulative errors from segmentation on admission and follow-up scans can hamper accurate HE classification.

Eosinophilic esophagitis manifesting as intractable hiccups in an elderly patient: a case report.

Background: Eosinophilic esophagitis is a condition characterized clinically by symptoms related to esophageal dysfunction and histologically by a marked eosinophilic infiltrate in the esophageal mucosa. The most typical symptoms of eosinophilic esophagitis include intermittent dysphagia with episodic food impaction and heartburn with propensity for young individuals. The relationship between hiccups and eosinophilic esophagitis is unclear but has been described.

Identification and Functional Analysis of Novel SNPs in Enterocin Genes of Enterococcus faecium GHB21.

This study investigates the functional and structural impact of single nucleotide polymorphisms (SNPs) in the enterocin and associated immunity genes of Enterococcus faecium GHB21, a strain known for producing potent antimicrobial peptides. Enterocins, most of them classified as class IIa bacteriocins, exhibit strong activity against pathogens such as Listeria monocytogenes, making them promising candidates for food preservation and therapeutic interventions. Using cloning, sequencing, and bioinformatics tools, we analyzed key enterocin genes (entA, entB and entP) and their associated immunity genes (entAi and entPi).

Conversion during Minimally Invasive Left Pancreatectomy: A Nationwide Study of Causes and Consequences.

Objectives: To identify risk factors for conversion, develop a predictive Conversion Risk Score (CRS), and assess the association between conversion and severe postoperative complications.

Background: Conversion occurs in 15-30% of minimally invasive left pancreatectomies (MILP). Risk factors and potential negative impacts on postoperative outcomes are poorly described.

MHC-I-Driven Antitumor Immunity Counterbalances Low Absorbed Doses of Radiopharmaceutical Therapy.

Preclinical and clinical studies increasingly show that the immune response plays a major role in radiotherapy. Here, we investigated the role of major histocompatibility complex class I (MHC-I) molecules recognized by cytotoxic CD8 T cells in the response to radiopharmaceutical therapy (RPT). Two murine melanoma cell lines that express low and high MHC-I levels (B16F10 and B16K1, respectively) were grafted in syngeneic or athymic and nude mice, and the response to a single injection of [Ac]Ac-DOTA-TA99 monoclonal antibodies (9.

Risk Factors of Difficult Intubation in Patients with Severe Obesity Undergoing Bariatric Surgery: A Retrospective Cohort Study.

Background: Obesity poses significant challenges by altering upper airway anatomy and making mask ventilation and tracheal intubation difficult. In 2023, 46.1% women and 35.

Acute Kidney Injury Associated with Novel Anti-Cancer Therapies: Immunotherapy.

The landscape of cancer survival has been positively affected by the introduction and dissemination of immunotherapy with the wide usage of immune checkpoint inhibitors (ICIs) and chimeric antigen receptors cell therapies (CAR-T). The success of these novel therapies can however be limited to a certain extent by systemic inflammatory toxicities affecting directly or indirectly the kidney. In the case of ICIs severe acute interstitial nephritis is the main adverse event and can lead to permanent discontinuation of the therapy.

Infratuberosity Anterior Closing-Wedge High Tibial Osteotomy for Slope Correction in Anterior Cruciate Ligament-Deficient Knees.

Graft failure after anterior cruciate ligament reconstruction is multifactorial, with increased tibia slope identified as one of the risk factors. Several slope-correcting osteotomies have been proposed to address this in revision surgery, with most of the procedures using a supratuberosity or transtuberosity approach. Although satisfactory results have been presented, severe complications involving the extensor mechanism can occur.

Immune checkpoint inhibitors plus debulking surgery for patients with metastatic renal cell carcinoma: clinical outcomes and immunological correlates of a prospective pilot trial.

Surgical removal of primary tumors reverses tumor-mediated immune suppression in pre-clinical models with metastatic disease. However, how cytoreductive surgery in the metastatic setting modulates the immune responses in patients, especially in the context of immune checkpoint therapy (ICT), is not understood. We report the first prospective, pilot, non-comparative clinical trial (NCT02210117) to evaluate the feasibility, clinical benefits, and immunologic changes of combining three different ICT-containing strategies with cytoreductive surgery or biopsy for patients with metastatic clear cell renal cell carcinoma.

Malnutrition and outcomes in patients with tricuspid regurgitation undergoing transcatheter tricuspid valve repair.

Aims: The impact of malnutrition in patients with tricuspid regurgitation (TR) undergoing tricuspid transcatheter edge-to-edge repair (T-TEER) is not well established. We evaluated the impact of malnutrition among patients with symptomatic TR undergoing T-TEER.

Methods And Results: Baseline nutritional status was evaluated using the geriatric nutritional risk index (GNRI), based on serum albumin concentrations and body weight to ideal body weight ratio, among patients with symptomatic TR undergoing T-TEER, enrolled in the multicentre EuroTR registry between March 2016 and February 2024.

Not Every Headache Warrants a Head CT: A Recurrent Headache Unveiling H. Pylori-Positive MALToma.

is a urease-producing bacterium that has a tendency to colonize the gastric mucosa. can cause atrophic gastritis and gastric intestinal metaplasia (GIM). has also been associated with MALT lymphoma, which is an extranodal marginal zone lymphoma.

A Rare Finding of Herpes Simplex Virus Esophagitis Concomitant With Duodenitis in an Immunocompetent Host.

Herpes simplex virus (HSV) esophagitis and duodenitis are well-known features of herpes virus reactivation in immunosuppressed patients. We discuss the case of HSV esophagitis concomitant with duodenitis in an immunocompetent individual. A 77-year-old male patient, previously healthy, was found to have on upper endoscopy several ulcers in the esophagus and second portion of the duodenum.

Iliopsoas Abscess Heralding the Diagnosis of Crohn's Disease in a Young Male.

Iliopsoas abscess (IPA) is a rare but potentially life-threatening complication that may occur in patients with Crohn's disease. We present the case of a 28-year-old male with Crohn's disease who developed a complicated IPA. Diagnosis was confirmed via CT imaging and colonoscopy, revealing a fistulous connection to the terminal ileum.

Breast Mass Revealing Hidden Lung Cancer.

Lung cancer is the second most common cancer and the leading cause of cancer-related deaths in the United States, frequently metastasizing to the brain, bones, liver, and adrenal glands. However, it is uncommon for lung malignancies to metastasize to the breast, and is generally assumed to carry a poor prognosis.  We present the case of a 62-year-old female who presented for an annual physical exam and complained of persistent neck pain without neurological deficit.

Validation of the Skindex-16 questionnaire for assessing patient-reported outcomes in radiation dermatitis among breast cancer patients.

Background And Purpose: Radiation dermatitis (RD) is often experienced by cancer patients undergoing radiation therapy (RT) and can negatively impact the quality of life of patients. The Skindex-16 questionnaire is an instrument that measures the impact of skin conditions on patient quality of life. The Skindex-16 has been validated for use in assessing many benign conditions, however it has not yet been validated for the assessment of patient-reported outcomes (PROs) for patients experiencing RD.

Factors associated with financial toxicity in patients with transthyretin amyloidosis: results from Amyloidosis Research Consortium's treatment affordability patient and caregiver survey.

Introduction: Transthyretin (ATTR) amyloidosis is an ultimately fatal disease. While approved therapies slow disease progression, the cost of care can be significant for patients. The objective of this survey was to describe the factors associated with financial toxicity of ATTR amyloidosis and the economic burden of care and treatment.

The Gut Microbiome and Colorectal Cancer: An Integrative Review of the Underlying Mechanisms.

Colorectal cancer (CRC) is the second leading cause of cancer-related mortality worldwide. While the incidence and mortality of CRC have decreased overall due to better screening, rates in adults under 50 have risen. CRC can manifest as inherited syndromes (10%), familial clustering (20%), or sporadic forms (70%).

Management of Adverse Skeletal Effects Following Bariatric Surgery Procedures in People Living with Obesity.

Purpose: This review focuses on recent findi+ngs regarding the management of adverse skeletal effects following weight loss in people living with obesity (PwO). We summarize the guidelines provided by various societies for the prevention and treatment of osteoporosis resulting from bariatric surgery. Next, we discuss the use of traditional antiosteoporosis medications in this population.

Tricuspid Regurgitation Disease Stages and Treatment Outcomes After Transcatheter Tricuspid Valve Repair.

Background: Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as a treatment option for patients with severe tricuspid regurgitation (TR). However, randomized trials have not shown a survival benefit, possibly because of the inclusion of patients in an early or too advanced disease stage.

Objectives: The authors sought to investigate the association between disease stage and outcomes following T-TEER.