Simulated Patient as a Learner: Medical Volunteers Gain Knowledge by Participating in a Wilderness Medicine Training Session.

Introduction: -A multifaceted approach to wilderness medicine education and training is necessary to provide a high-quality learning experience, often requiring innovative instructional techniques. Using volunteers to act as patients in medical education is a well-established practice that helps teach crucial skills. However, more is needed to know if there is potential knowledge acquisition through participation.

Fiber- and acetate-mediated modulation of MHC-II expression on intestinal epithelium protects from Clostridioides difficile infection.

Here, we explore the relationship between dietary fibers, colonic epithelium major histocompatibility complex class II (MHC-II) expression, and immune cell interactions in regulating susceptibility to Clostridioides difficile infection (CDI). We find that a low-fiber diet increases MHC-II expression in the colonic epithelium, which, in turn, worsens CDI by promoting the development of pathogenic CD4 intraepithelial lymphocytes (IELs). The influence of dietary fibers on MHC-II expression is mediated by its metabolic product, acetate, and its receptor, free fatty acid receptor 2 (FFAR2).

Diversity, Species Richness, and Community Composition of Wetland Birds in the Lowlands of Western Nepal.

Wetlands serve as crucial habitats for diverse bird species, playing a vital role in maintaining the ecosystem. Geographical location, climate, hydrology, and vegetation composition of wetlands determine the diversity of birds. This study investigated species richness, seasonal diversity, and composition of wetland birds in three prominent water bodies of western Nepal, namely Ghodaghodi, Rani, and Jokhar lakes, from 2021 to 2022 in summer and winter using the point count method.

SARS-CoV-2 Prevalence in a Delivering Refugee Population: Refugee Status, Payor Type, Race, and Vaccination Status.

Underserved communities were disproportionately affected during the coronavirus (COVID-19) pandemic. Limited data exist on the impact of COVID-19 among refugee populations because refugee status is not often classified in electronic medical record (EMR) systems, unlike race or primary language. The study aim was to evaluate the PCR-based prevalence of SARS-CoV-2 in a delivering population over the first 2 years of the pandemic by refugee status, ethnicity, insurance, and vaccination status.

Bacteriophages carry auxiliary metabolic genes related to energy, sulfur and phosphorus metabolism during a harmful algal bloom in a freshwater lake.

Cyanophages play an important role in nutrient cycling in lakes since they can modulate the metabolism of cyanobacteria. A proper understanding of the impact of cyanophage infection on the metabolism and ecology of cyanobacteria is critical during a complete cycle of harmful algal bloom (HAB). The ecology of cyanophages in marine environments has been well-delineated, but cyanophages in freshwater lakes remain less studied.

Live Multi-Strain Probiotics Enhance Growth Performance by Regulating Intestinal Morphology and Microbiome Population in Weaning Piglets.

The effects of different forms of multi-strain probiotics on weaning piglets are limitedly addressed. Thus, this study investigated the effects of live or inanimate multi-strain probiotics comprising , , and on growth performance, intestinal morphology, fecal microbiota, short-chain fatty acids, and intestinal gene expression of weaning piglets. A total of 160 weaning piglets (4 weeks old) were randomly allocated into four treatments (CON: basal diet; AB: basal diet with 110 ppm and 66 ppm colistin in the weaning and nursery phases, respectively; LP: basal diet with 2.

Impact of a virtual antenatal intervention for improved diet and iron intake in Kapilvastu district, Nepal - the VALID randomized controlled trial.

Introduction: Counseling, together with iron and folic acid supplements, can improve hemoglobin levels in pregnant women, but few interventions have tested a virtual method of delivering counseling. We hypothesized that a virtual counseling intervention delivered via a mobile device (mHealth) would prevent and treat anemia, compared with routine antenatal care (ANC).

Methods: Virtual antenatal intervention for improved diet and iron intake (VALID) was a non-blinded parallel group two-arm, individually randomized superiority trial (1:1 allocation).

Antibacterial, Antifungal, and Cytotoxic Effects of Endophytic Species Isolated from the Himalayan Regions of Nepal and Their Metabolite Study.

Recently, antimicrobial-resistant pathogens and cancers have emerged as serious global health problems, highlighting the immediate need for novel therapeutics. Consequently, we aimed to isolate and characterize endophytic strains from the rhizospheres of the Himalayan region of Nepal and identify specialized metabolites with antibacterial, antifungal, and cytotoxic potential. To isolate sp.

Analgesic efficiency of dexketoprofen trometamol in third molar surgery: a systematic review and meta-analysis.

This study aims to compare the analgesic efficacy of dexketoprofen trometamol (DT) with other analgesic drugs for pain relief after third molar surgery. The PubMed, Scopus, and Web of Science databases were searched to identify randomized controlled trials comparing DT with other analgesics for third molar surgery. The outcome measures were the sum of pain intensity differences (SPID), total pain relief (TOTPAR) at the 6 and 8 postoperative hours, time to rescue medication, and tolerability.

A service evaluation of weight management for glycaemic control and remission of type 2 diabetes using traditional food in Nepal (Ho-DIRECT NEPAL): a single-arm trial.

Background: Remission of early type 2 diabetes (T2D) is possible; however, diet programmes proven effective are unaffordable in many southeast Asian populations where T2D is more frequent and more aggressive at lower body weight and younger age. We evaluate an entirely food-based service.

Methods: This study employed a single-arm intervention and follow-up design for intervention evaluation in existing hospital people with T2D of under 5 years known duration.

Brain-Engrafted Monocyte-derived Macrophages from Blood and Skull-Bone Marrow Exhibit Distinct Identities from Microglia.

Microglia are thought to originate exclusively from primitive macrophage progenitors in the yolk sac (YS) and to persist throughout life without much contribution from definitive hematopoiesis. Here, using lineage tracing, pharmacological manipulation, and RNA-sequencing, we elucidated the presence and characteristics of monocyte-derived macrophages (MDMs) in the brain parenchyma at baseline and during microglia repopulation, and defined the core transcriptional signatures of brain-engrafted MDMs. Lineage tracing mouse models revealed that MDMs transiently express CD206 during brain engraftment as CD206 microglia precursors in the YS.

Landscape-level habitat connectivity of large mammals in Chitwan Annapurna Landscape, Nepal.

The populations of many species of large mammals occur in small isolated and fragmented habitat patches in the human-dominated landscape. Maintenance of habitat connectivity in the fragmented landscapes is important for maintaining a healthy population of large mammal. This study evaluated the landscape patches and their linkages on two carnivores (leopard and Himalayan black bear) and seven prey species (northern red muntjac, chital, sambar, wild pig, Himalayan goral, rhesus macaque, and langur) between Chitwan National Park (CNP) and Annapurna Conservation Area (ACA) by using the least-cost path (LCP) approach and the Linkage Mapper tool in ArcGIS.

M-VAAL: Multimodal Variational Adversarial Active Learning for Downstream Medical Image Analysis Tasks.

Acquiring properly annotated data is expensive in the medical field as it requires experts, time-consuming protocols, and rigorous validation. Active learning attempts to minimize the need for large annotated samples by actively sampling the most informative examples for annotation. These examples contribute significantly to improving the performance of supervised machine learning models, and thus, active learning can play an essential role in selecting the most appropriate information in deep learning-based diagnosis, clinical assessments, and treatment planning.

De Garengeot hernia: A unique presentation of femoral hernia with perforated appendicitis.

Introduction: De Garengeot hernia is a rare subset of femoral hernias containing the vermiform appendix. It is more common in females. The presenting symptoms are non-specific hence diagnosis is challenging and there is no consensus on treatment of it.

Improving Medical Image Classification in Noisy Labels Using only Self-supervised Pretraining.

Noisy labels hurt deep learning-based supervised image classification performance as the models may overfit the noise and learn corrupted feature extractors. For natural image classification training with noisy labeled data, model initialization with contrastive self-supervised pretrained weights has shown to reduce feature corruption and improve classification performance. However, no works have explored: i) how other self-supervised approaches, such as pretext task-based pretraining, impact the learning with noisy label, and ii) any self-supervised pretraining methods alone for medical images in noisy label settings.

Concomitant intussusception and appendicitis "appendi-sception" in children: A case report and review of literature.

Introduction: Pediatric intussusception is the leading cause of bowel obstruction in children under 2 years of age. Concurrent intussusception and appendicitis, known as "appendi-sception" is exceptionally rare in the pediatric population.

Case Presentation: A 37-month-old boy presented with periumbilical abdominal pain, vomiting, and red currant jelly stool for two weeks.

The Role of Ultrasound in Pediatric Peritonsillar Infection: A Descriptive Analysis.

In this study, we describe the role of ultrasound in diagnosing pediatric peritonsillar abscesses (PTAs). A retrospective chart review was conducted on 54 children aged 4 to 17 years who had an ultrasound performed for suspected PTA. Based on ultrasound imaging, the patients were classified into 2 groups: PTA-positive (8, 14.

Extracellular matrix modulates depot-specific adipogenic capacity in adipose tissue of dairy cattle.

Adipose tissue (AT) expands through both hyperplasia and hypertrophy. During adipogenesis, adipose stromal and progenitor cells (ASPC) proliferate and then accumulate lipids, influenced by the local AT microenvironment. Increased adipogenic capacity is desirable as it relates to metabolic health, especially in transition dairy cows where excess free fatty acids in circulation can compromise metabolic and immune health.

Microplastics in feed affect the toxicokinetics of persistent halogenated pollutants in Atlantic salmon.

Microplastics (MPs) are carriers of persistent organic pollutants (POPs). The influence of MPs on the toxicokinetics of POPs was investigated in a feeding experiment on Atlantic salmon (Salmo salar), in which fish were fed similar contaminant concentrations in feed with contaminants sorbed to MPs (Cont. MPs); feed with virgin MPs and contaminated feed (1:1), and feed with contaminants without MPs (Cont.