Once daily Bromelain-based enzymatic debridement of venous leg ulcers versus gel vehicle (placebo) and non-surgical standard of care: a three-arm multicenter, double blinded, randomized controlled study.

Background: Debridement is considered the first step in treatment of chronic wounds, however, current enzymatic and autolytic debridement agents are slow or ineffective. Previous studies have shown positive initial results with EscharEx® (EX-02 formulation), a Bromelain-based enzymatic debridement agent in development for chronic wounds. The main objective of this study was to assess its efficacy in debriding venous leg ulcers (VLU), compared to gel vehicle (GV) as a placebo control and to non-surgical standard of care (NSSOC).

Effect of a competence based medical education program on training quality in Intensive Care Medicine. COBALIDATION TRIAL.

Objectives: The main objective of this study was to evaluate whether the implementation of CoBaTrICE (Competency-Based Training in Intensive Care Medicine in Europe) provides higher levels of competency in comparison with the current official time-based program in Intensive Care Medicine in Spain. Secondary objectives were: 1) To determine the percentage of critical essential performance elements (CEPE) accomplished, 2) To determine compliance with workplace-based assessments (wba).

Design: Multicenter cluster randomized trial.

Barriers to early detection: Insurance denials for breast MRI screening in women with germline BRCA1/2 mutations.

Objectives: Women with germline BRCA1/2 pathogenic variants (gBRCA1/2) are recommended to undergo annual breast MRI and mammography. Our objective was to describe the frequency of insurance denials for annual breast MRIs in women with gBRCA1/2 and determine denial trends.

Methods: Women with gBRCA1/2 following in a high-risk breast cancer clinic with breast MRIs ordered from 2020 to 2021 were identified and cross-referenced with a database of insurance denials.

Comparative analysis of the stress and immune responses in Atlantic salmon (Salmo salar) inoculated with live and inactivated Piscirickettsia salmonis.

Piscirickettsiosis causes the highest mortality in Atlantic salmon (Salmo salar) farming, and prophylactic treatment has not provided complete protection to date. In this study, we analyzed the immune and metabolic responses of Atlantic salmon inoculated with live and inactivated Piscirickettsia salmonis, monitoring plasma markers related to immune and stress responses. The fish were inoculated with inactivated P.

Disentangling Sources of Momentum Fluctuations in Xe+Xe and Pb+Pb Collisions with the ATLAS Detector.

High-energy nuclear collisions create a quark-gluon plasma, whose initial condition and subsequent expansion vary from event to event, impacting the distribution of the eventwise average transverse momentum [P([p_{T}])]. Disentangling the contributions from fluctuations in the nuclear overlap size (geometrical component) and other sources at a fixed size (intrinsic component) remains a challenge. This problem is addressed by measuring the mean, variance, and skewness of P([p_{T}]) in ^{208}Pb+^{208}Pb and ^{129}Xe+^{129}Xe collisions at sqrt[s_{NN}]=5.

Physical and Mental Changes Reported by Transgender and Non-Binary Users of Commercial and Non-Commercial Chest Binders: A Community-Informed Cross-Sectional Observational Study.

Purpose: There are no standardized chest binding guidelines available to health care providers serving transgender and nonbinary individuals, exacerbating the significant health disparities affecting this community. Our study aimed to demonstrate the need for further evidence-based investigations into the association between chest binder type and health outcomes.

Methods: For this cross-sectional observational study, a community-engaged online survey evaluating individuals' experiences with their current or most recent chest binder was distributed to LGBTQ+ community centers, online forums, and clinics from July to November 2021.

Aicardi-Goutières syndrome type 6: report of ADAR variant and clinical outcome after ruxolitinib treatment in the neonatal period.

Background: Aicardi-Goutières Syndrome is a monogenic type 1 interferonopathy with infantile onset, characterized by a variable degree of neurological damage. Approximately 7% of Aicardi-Goutières Syndrome cases are caused by pathogenic variants in the ADAR gene and are classified as Aicardi-Goutières Syndrome type 6. Here, we present a new homozygous pathogenic variant in the ADAR gene.

Effects of Powder on the Growth Performance, Immune Organ Weights, Cecal Microbiology, Serum Immunoglobulins, and Tibia Minerals of Broiler Chickens.

A total of 640 one-day-old Cobb 500 MV × Cobb 500 FF mixed broilers were randomly assigned to one of four experimental treatments with four replicates per treatment and 40 birds per replicate for 32 days. The treatments consisted of a basal diet (control group), basal diet + 0.02% zinc bacitracin (AGP group), basal diet + 0.

Image Analysis and Untargeted Metabolomics Reveal Potential Phytotoxins from Against Major Parasitic Weed (L.) Pomel.

Branched broomrape ( (L.) Pomel), an obligate parasitic weed with a wide host range, is known for its devasting effects on many crops worldwide. Soil fungi, notably sp.

Satisfaction and Workload as Predictors of Psychological Distress in Professionals of Psychosocial Care Centers During the COVID-19 Pandemic.

Background And Aims: The COVID-19 pandemic significantly impacted the mental health of healthcare professionals, especially those working in Psychosocial Care Centers (CAPS), which are crucial services in the Brazilian mental health system. This study aimed to investigate the association between job satisfaction, workload, and psychological distress among CAPS professionals during the pandemic.

Methods: A cross-sectional study was conducted with 53 professionals from seven CAPS.

Impacts of acid mine drainage remediation in the largest gold mine of Latin America on natural water bodies in the Dominican Republic.

Impacts of the acid mine drainage (AMD) remediation are investigated on the largest gold mine in Latin America, located in the Dominican Republic. Geochemical analysis of suspended matter in water performed in 2022 on water bodies located downstream to the mine, namely, the Margajita River and Lake Hatillo, are compared with analyses made in 2007, before the AMD remediation. The results for the Margajita River show a strong decrease in heavy metal and metalloid concentrations in the dissolved phase for Al, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Cd, Sb, and Pb (between 89.

Impact of the CAPTURE COPD Screening Tool in US Primary Care: A Cluster Randomized Trial.

The impact of COPD screening on US primary care clinician behavior and patient outcomes is unclear. Assess the impact of receiving CAPTURE (COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk) screening scores on clinical and patient outcomes. Cluster randomized trial included 49 usual care (COPD education only) and 51 intervention (COPD and CAPTURE education plus screening scores) primary care practices.

Fast autofluorescence imaging to evaluate dynamic changes in cell metabolism.

Significance: Cellular metabolic dynamics can occur within milliseconds, yet there are no optimal tools to spatially and temporally capture these events. Autofluorescence imaging can provide metabolic information on the cellular level due to the intrinsic fluorescence of reduced nicotinamide adenine dinucleotide (phosphate) [NAD(P)H] and flavin adenine dinucleotide (FAD).

Aim: Our goal is to build and evaluate a widefield microscope optimized for rapid autofluorescence imaging of metabolic changes in cells.

Incidence, Risk Factors, and Outcomes of BK Hemorrhagic Cystitis in Hematopoietic Stem Cell Transplantation From HLA-Matched and Haploidentical Donors With Post-Transplant Cyclophosphamide.

BK hemorrhagic cystitis (BK-HC) is a common complication following hematopoietic stem cell transplantation (HSCT), particularly when posttransplant cyclophosphamide (PTCy) is used as graft-versus-host disease (GVHD) prophylaxis. However, comparative studies of BK-HC incidence in matched sibling donors (MSD) and unrelated donors (MUD) often include small haploidentical (HAPLO) donor cohorts and usually lack detailed information on disease evolution, coinfections, management and impact on outcomes. This study aimed to evaluate the incidence, risk factors, and outcomes in patients with hematologic malignancies undergoing HSCT from MSD, MUD, HAPLO donors using PTCy as GVHD prophylaxis.

Feasibility of Alerting Systems and Family Care Partner Support for Postoperative Delirium Prevention.

Background: The objective of this study was to determine whether postoperative pager alerts to the Hospital Elder Life Program (HELP), a delirium prevention service, would accelerate program enrollment for older surgical patients. This study also tested feasibility of family care partner interventions for delirium prevention.

Methods: This single-center, pilot clinical trial factorially randomized 57 non-cardiac surgical patients ≥70 years of age to 4 arms: (1) standard care, (2) pager alerts to accelerate HELP enrollment, (3) family care partner-based delirium prevention interventions, or (4) a combined arm with both HELP and family interventions.

Bundled de-implementation of recurring hospital orders with a novel electronic medical record order set.

Introduction: High-frequency recurring orders placed through the electronic medical record (EMR) may contribute to unnecessary care in hospitalised patients. This quality initiative sought to develop and pilot test a hospital order set for bundled review and de-implementation of common recurring orders.

Methods: A voluntary-use EMR order set was developed to display low-frequency order alternatives for common hospital care components.

A Meta-Analysis of Levofloxacin for Contacts of Multidrug-Resistant Tuberculosis.

Background: Data from randomized trials evaluating the effectiveness of tuberculosis (TB) preventive treatment for contacts of multidrug-resistant (MDR)-TB are lacking. Two recently published randomized trials that did not achieve statistical significance provide the opportunity for a meta-analysis.

Methods: We conducted combined analyses of two phase 3 trials of levofloxacin MDR-TB preventive treatment - Levofloxacin for the Prevention of Multidrug-Resistant Tuberculosis (VQUIN) trial and the Levofloxacin preventive treatment in children exposed to MDR-TB (TB-CHAMP) trial.

Effectiveness of an Online Medical Spanish Course in Improving Medical Students' Spanish Proficiency.

Introduction: A growing need exists for language-concordant healthcare for Spanish speakers in the United States. More than three-quarters of American medical schools provide Spanish language instruction, but little data exists on best practices. The purpose of this retrospective study was to examine whether an online medical Spanish course is effective at improving medical students' Spanish proficiency.

Classification performance of Spanish and English word recognition testing to identify cochlear implant candidates.

Objective: To explore the effects of language on word recognition ability and associated access to cochlear implants in Spanish- and English-speakers with hearing loss.

Design: Retrospective chart review.

Study Sample: The study included 1411 English and Spanish-speaking adults with sensorineural hearing loss.

Inflammation biomarkers and neurobehavioral performance in rural adolescents.

Background: Systemic inflammation has been associated with lower neurobehavioral performance in diverse populations, yet the evidence in adolescents remains lacking. Cytokines can alter neural network activity to induce neurocognitive changes. This work seeks to investigate the association between inflammation and neurobehavior in adolescents living in a rural region of Ecuador.

Effect of Leaf Powder on Growth Performance, Diarrhea Incidence, Blood Biochemistry, and Intestinal Traits in Weaned Piglets.

To evaluate the phytobiotic effect of leaf powder (AOLP) on growth performance, diarrhea incidence, blood biochemistry, and intestinal traits, seventy-two weaned piglets were randomly distributed into four groups (six replicates/group and three pigs/replicate) for 28 days, receiving a control diet (T0) or being supplemented with 5 (T1), 10 (T2), or 15 (T3) g/kg of AOLP. The diets did not affect the growth performance ( > 0.05); however, the AOLP groups had a decreased diarrhea incidence and malondialdehyde concentration ( < 0.

Contrastive Clustering-Based Patient Normalization to Improve Automated In Vivo Oral Cancer Diagnosis from Multispectral Autofluorescence Lifetime Images.

Multispectral autofluorescence lifetime imaging systems have recently been developed to quickly and non-invasively assess tissue properties for applications in oral cancer diagnosis. As a non-traditional imaging modality, the autofluorescence signal collected from the system cannot be directly visually assessed by a clinician and a model is needed to generate a diagnosis for each image. However, training a deep learning model from scratch on small multispectral autofluorescence datasets can fail due to inter-patient variability, poor initialization, and overfitting.

Performance of a score to characterise adequate contact among the social network of persons with TB.

Background: Transmission of requires adequate contact between an infectious case and a susceptible host. The aim of this analysis was to validate a recently developed contact score that assessed settings of exposure and relationships between the case and contact.

Methods: In a cross-sectional study from Kampala, Uganda, we estimated the prevalence of tuberculous infection (TBI) in social contacts of adult TB cases according to the setting and relationship domains of the contact score.