Scalp ulceration: a rare manifestation of giant cell arteritis.

An 81-year-old woman presented with an enlarging, tender ulcer on her scalp over an 8-week period, attributing it to a prior graze with garden shears. C-reactive protein and erythrocyte sedimentation rate were elevated at 87.7 mg/L and 112 mm/hour, respectively.

Borohydride stabilized gold-silver bimetallic nanocatalysts for highly efficient 4-nitrophenol reduction.

Bimetallic Au Ag nanoparticles, prepared using sodium borohydride as the sole reducing and capping agent for various NaBH : metal molar ratios, were investigated as catalysts for 4-nitrophenol reduction. This approach yielded the highest catalytic activities observed for this model reaction to date.

Global distribution of earthworm diversity.

Soil organisms, including earthworms, are a key component of terrestrial ecosystems. However, little is known about their diversity, their distribution, and the threats affecting them. We compiled a global dataset of sampled earthworm communities from 6928 sites in 57 countries as a basis for predicting patterns in earthworm diversity, abundance, and biomass.

Co-morbidities in Patients with a Hip Fracture.

Hip fractures usually occur in elderly patients who commonly have pre-existing medical problems or comorbidities. We retrospectively reviewed 100 patients admitted to our unit with a hip fracture to quantify their medical complexity. Age and comorbidity profile were used to determine an age-adjusted Charlson Co-morbidity Index (ACCI).

Investigating imaging network markers of cognitive dysfunction and pharmacoresistance in newly diagnosed epilepsy: a protocol for an observational cohort study in the UK.

Introduction: Epilepsy is one of the most common serious brain disorders, characterised by seizures that severely affect a person's quality of life and, frequently, their cognitive and mental health. Although most existing work has examined chronic epilepsy, newly diagnosed patients present a unique opportunity to understand the underlying biology of epilepsy and predict effective treatment pathways. The objective of this prospective cohort study is to examine whether cognitive dysfunction is associated with measurable brain architectural and connectivity impairments at diagnosis and whether the outcome of antiepileptic drug treatment can be predicted using these measures.

Ten things every neurologist needs to know about neuropsychological assessments and interventions in people with epilepsy.

This paper describes 10 core features of a neuropsychological assessment with the aim of helping neurologists understand the unique contribution the evaluation can make within the wider context of diagnostic methods in epilepsy. The possibilities, limitations and cautions associated with the investigation are discussed under the following headings. (1) A neuropsychological assessment is a collaborative investigation.

Vascular endothelial function is improved after active mattress use.

Objective: Active mattresses are used to prevent, treat and relieve pressure ulcers (PU) by intermittent contact pressure/relief. However, no studies have directly assessed the vascular endothelial response to long-term active mattress use. This study investigated the hypothesis that eight weeks use of an active mattress would lead to improvements in vascular endothelial function in healthy participants.

Characterization of a New Electron Donor-Acceptor Dyad in Conventional Solvents and Ionic Liquids.

Ionic liquids are being tested as potential replacements for current electrolytes in energy-related applications. Electron transfer (ET) plays a central role in these applications, making it essential to understand how ET in ionic liquids differs from ET in conventional organic solvents and how these differences affect reaction kinetics. A new intramolecular electron donor-acceptor probe was synthesized by covalently linking the popular photoacceptor coumarin 152 with the donor dimethylaniline to create the dyad "C152-DMA" for potential use in probing dynamical solvent effects in ionic liquids.

Donation approval among obese living kidney donor candidates: The impact of metabolic syndrome.

Background: The scarcity of organs available for transplantation has increased attempts to augment transplantation by utilizing obese living kidney donors. The literature has suggested that these donors have increased risks postdonation. Not surprising, the threshold for living kidney donor approval among obese persons is typically higher and the process more costly.

Inhalation exposure to multi-walled carbon nanotubes alters the pulmonary allergic response of mice to house dust mite allergen.

Increasing evidence from rodent studies indicates that inhaled multi-walled carbon nanotubes (MWCNTs) have harmful effects on the lungs. In this study, we examined the effects of inhalation exposure to MWCNTs on allergen-induced airway inflammation and fibrosis. We hypothesized that inhalation pre-exposure to MWCNTs would render mice susceptible to developing allergic lung disease induced by house dust mite (HDM) allergen.

Esketamine for treatment resistant depression.

: Treatment Resistant Depression (TRD) is a common and burdensome condition with poor outcomes and few treatment options. Esketamine is the S-enantiomer of ketamine and has recently been FDA approved in the United States for treating depression that has failed to respond to trials of two or more antidepressants. : This review will briefly discuss current treatment options for TRD, then review esketamine.

Effects of Switching to a Heat-Not-Burn Tobacco Product on Biologically Relevant Biomarkers to Assess a Candidate Modified Risk Tobacco Product: A Randomized Trial.

Background: Cigarette smoking increases the risk of chronic diseases; heating instead of burning tobacco can lower these risks, contributing to tobacco harm reduction. This study (with 984 adult American smokers) examined whether favorable changes occur in 8 co-primary endpoints (HDL-C, WBC, FEV%pred, COHb, Total NNAL, sICAM-1, 11-DTX-B2, 8-epi-PGF2α) indicative of biological and functional effects when cigarette smokers switch to the heat-not-burn Tobacco Heating System 2.2 (THS).

Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults.

In our first paper in this series (Epilepsia 2015; 56(5): 674-681), we published recommendations for the indications and expectations for neuropsychological assessment in routine epilepsy care. This partner paper provides a comprehensive overview of the more specialist role of neuropsychological assessment in the pre and postoperative evaluation of epilepsy surgery patients. The paper is in two parts.

Polyhedral borane-capped coinage metal nanoparticles as high-performing catalysts for 4-nitrophenol reduction.

Small (<5 nm) gold and silver nanoparticles and their bimetallic counterparts were prepared using the fundamental boron cluster [closo-B10H10]2- as the reducing and stabilizing agent. The resulting carbon-free nanoparticles possess striking activity toward the reduction of 4-nitrophenol, laying the groundwork for a new class of boron polyhedron-stabilized metal nanocatalysts.

Biological and Functional Changes in Healthy Adult Smokers Who Are Continuously Abstinent From Smoking for One Year: Protocol for a Prospective, Observational, Multicenter Cohort Study.

Background: The harm of smoking results mainly from long-term exposure to harmful and potentially harmful constituents (HPHCs) generated by tobacco combustion. Smoking cessation (SC) engenders favorable changes of clinical signs, pathomechanisms, and metabolic processes that together could reduce the harm of smoking-related diseases to a relative risk level approximating that of never-smokers over time. In most SC studies, the main focus is on the quitting rate of the SC program being tested.

Evaluation of interventions to make top tether hardware more visible during child restraint system (CRS) installations.

The objective of the study is to determine whether specific child restraint system (CRS) or vehicle conditions improve top tether attachment rates during volunteer installations. A factorial randomized controlled trial was designed to evaluate 4 different experimental categories: (1) Color of tether adjuster casing (black or red), (2) labeling on tether adjuster casing (labeled with "Tether: Use for forward-facing" or unlabeled), (3) storage location of tether (bundled in a rubber band on the back of CRS or Velcroed over the forward-facing belt path), and (4) labeling in vehicle (labeled under head restraint and below anchor or unlabeled). Ninety-six volunteers were randomly assigned to one combination of conditions.

Neutrophils acquire antigen-presenting cell features after phagocytosis of IgG-opsonized erythrocytes.

Neutrophils are particularly well known for their antimicrobial function. Although historically they are regarded as strictly a phagocyte of the innate immune system, over time it has become clear that neutrophils are versatile cells with numerous functions including innate and adaptive immune regulation. We have previously described a role for human neutrophils in antibody-mediated red blood cell (RBC) clearance.

Implementing a New Score Scale for the Clinical Science Subject Examinations: Validity and Practical Considerations.

Prior to August 2015, the National Board of Medical Examiners' (NBME) clinical science subject examination scores were reported as a scaled score. However, the scaled scores had some undesirable properties that threatened the validity of the inferences that score users were making based on the scores. The NBME changed the score scale to equated percent correct scores to address score validity concerns and to better meet the needs of medical school faculty and students.

Adult Granulosa Cell Tumor With High-grade Transformation: Report of a Series With FOXL2 Mutation Analysis.

Adult granulosa cell tumor (AGCT) is a low-grade malignant neoplasm with a significant propensity for late recurrence and metastasis. Almost all AGCTs are composed of cells with bland nuclear features and even when these tumors recur or metastasize, the nuclear features are almost always low-grade. We report 5 cases of AGCT in patients aged 37 to 88 years composed of areas of typical AGCT with low-grade morphology admixed with areas of high-grade morphology, with marked nuclear atypia, often with bizarre multinucleate cells and high mitotic activity; this is the first reported series of high-grade transformation in AGCTs.

Evaluation of Breast and Axillary Lymph Node Specimens in Breast Cancer Patients Treated With Neoadjuvant Systemic Therapy.

Breast and axillary lymph node specimens from breast cancer patients treated with neoadjuvant systemic therapy are being encountered by pathologists with increasing frequency. Evaluation of these specimens presents challenges that differ from those encountered during the examination of other types of breast specimens. This article reviews the key issues regarding the gross and microscopic evaluation of post-neoadjuvant systemic therapy breast and lymph node specimens, and emphasizes the importance of accurate specimen evaluation in assessing treatment response.

Evaluation Design of EFFICHRONIC: The Chronic Disease Self-Management Programme (CDSMP) Intervention for Citizens with a Low Socioeconomic Position.

: The Chronic Disease Self-Management Programme (CDSMP) intervention is an evidence-based program that aims to encourage citizens with a chronic condition, as well as their caregivers, to better manage and maintain their own health. CDSMP intervention is expected to achieve greater health gains in citizens with a low socioeconomic position (SEP), because citizens with a low SEP have fewer opportunities to adhere to a healthy lifestyle, more adverse chronic conditions and a poorer overall health compared to citizens with a higher SEP. In the EFFICHRONIC project, CDSMP intervention is offered specifically to adults with a chronic condition and a low SEP, as well as to their caregivers (target population).

Favorable Changes in Biomarkers of Potential Harm to Reduce the Adverse Health Effects of Smoking in Smokers Switching to the Menthol Tobacco Heating System 2.2 for 3 Months (Part 2).

Introduction: Tobacco Heating System (THS) 2.2, a candidate modified-risk tobacco product, aims at offering an alternative to cigarettes for smokers while substantially reducing the exposure to harmful and potentially harmful constituents found in cigarette smoke.

Methods: One hundred and sixty healthy adult US smokers participated in this randomized, three-arm parallel group, controlled clinical study.

Facile, one-pot, in aqua synthesis of catalytically competent gold nanoparticles using pyrogallol[4]arene as the sole reagent.

We report a simple, single-pot, room temperature synthetic route to prepare colloidally-stable pyrogallol[4]arene-capped gold nanoparticles. The number of carbon atoms in the pyrogallol[4]arene pendent alkyl chain and the addition of base (e.g.

Time to endoscopy for acute upper gastrointestinal bleeding: Results from a prospective multicentre trainee-led audit.

Background: Endoscopy within 24 h of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24 h of admission).

Methods: This prospective multicentre audit enrolled patients admitted with AUGIB who underwent inpatient endoscopy between November and December 2017.