Folic and folinic acid load tests for dynamic assessments of compliance and metabolism in folate deficiency and hyperhomocysteinaemia patients unresponsive to high-dose folate replacement.

We describe the utility of 'folic and folinic acid load tests' in the investigation of a 26-year-old woman with persistently low serum folate and moderate hyperhomocysteinaemia unresponsive to folic acid supplements. Serum folate, plasma 5-methyltetrahydrofolate (5-MTHF), red cell 5-MTHF and plasma total homocysteine at baseline, 2-h, 4-h and 2- or 4-days (if applicable) post administration of a large dose of oral folic acid, or oral or parenteral folinic acid were measured. The tests confirmed non-compliance but also suggested an unsuspected possible defect in the folate pathway based on differential response to folic versus folinic acid supplements.

Mechanisms of resistance to cell wall and plasma membrane targeting antifungal drugs in candida species isolated in africa.

Introduction: There is a rise in antifungal resistance as well as the emergence of multidrug resistant fungal pathogens worldwide, including in Africa.

Method: This systematic review summarized the published data on the mechanisms and epidemiology of antifungal resistance in species in Africa between 2000 and early 2024.

Result: Seventeen reports from seven African countries were analyzed but due to the paucity of data, the prevalence of antifungal resistant isolates in Africa could not be estimated.

Low and high frequency isometric handgrip exercise training similarly reduce resting blood pressure in young normotensive adults: A randomised controlled trial.

We investigated the effects of low and high frequency isometric handgrip exercise training (IHGT) on resting blood pressure, and the affective/perceptual responses during training. Sixty young normotensive adults were randomised to either a no-intervention control group (CON:  = 20; 12 female) or a group performing either two (LOW:  = 20; 18 female) or four (HIGH:  = 20; 13 female) sessions/week of IHGT for 4 weeks. IHGT involved 4 × 2-min holds at 30% maximal voluntary contraction using the dominant hand.

Narrative and obesity: Managing weight stigma associated with bariatric surgery.

The present study examined how individuals who have been clinically diagnosed as obese explain their decision to undergo bariatric surgery and how they deal with the stigmatization that such a decision may entail. A total of 23 participants (15 women and 8 men) who were awaiting bariatric surgery within the Spanish healthcare system, were interviewed about their weight trajectory and their decision to undergo this surgery. In order to examine the participants' stories, a narrative analysis of the interviews was conducted, with attention to both content ( they told) and structure ( they told) and examining the stories in line with the socially and culturally available narratives that they had access to, and the context in which the stories were produced.

Associations between structural brain changes and blood neurofilament light chain protein in treatment-resistant schizophrenia.

Objective: Around 30% of people with schizophrenia are refractory to antipsychotic treatment (treatment-resistant schizophrenia). Abnormal structural neuroimaging findings, in particular volume and thickness reductions, are often described in schizophrenia. Novel biomarkers of active brain pathology such as neurofilament light chain protein are now expected to improve current understanding of psychiatric disorders, including schizophrenia.

Behind the scenes of EQA-characteristics, capabilities, benefits and assets of external quality assessment (EQA).

The main stakeholders in external quality assessment (EQA) programs are the participants, in whose interests these challenges are ultimately organised. EQA schemes in the medical field contribute to improving the quality of patient care by evaluating the analytical and diagnostic quality of laboratory and point-of-care tests (POCT) by independent third parties and, if necessary, pointing out erroneous measurement results and analytical or diagnostic improvement potential. Other benefits include the option of using EQA samples for other important laboratory procedures, such as the verification or validation of diagnostic medical devices (IVD-MDs), a contribution to the estimation of measurement uncertainty, a means of training and educating laboratory staff through educational EQA programmes or samples, or even for independent and documented monitoring of staff competence, such as on samples with unusual or even exceptional characteristics.

Ethical Use of Cadaveric Images in Anatomical Textbooks, Atlases, and Journals: A Consensus Response From Authors and Editors.

Nowadays, consent to use donor bodies for medical education and research is obtained from the body donors and their families before the donation. Recently, the International Federation of Associations of Anatomists (IFAA) published guidelines that could restrict the appearance of cadaveric images in commercial anatomical resources such as textbooks and other educational products. These guidelines state that the donor must expressly consent to using such images for this purpose.

Urinary Kidney Injury Biomarker Profiles in Healthy Individuals and After Nephrotoxic and Ischemic Injury.

Two observational studies were conducted to support an initiative to qualify translational kidney safety biomarkers as clinical drug development tools that identify tubular injury prior to changes in estimated glomerular filtration rate (eGFR). Normal healthy volunteers provided three morning spot urine collections over 4 weeks. Patients undergoing surgical resection and intrathoracic cisplatin for malignant pleural mesothelioma provided urine samples pre- and postoperatively at 4, 8, and 12 hours and daily for 6 days.

Complex cesarean section: Surgical approach to reduce the risks of intraoperative complications and postpartum hemorrhage.

The incidence of cesarean section is dramatically increasing worldwide, whereas the training opportunities for obstetrician/gynecologists to manage complex cesarean section appear to be decreasing. This may be attributed to changing working hours directives and the increasing use of laparoscopy for gynecological surgical procedures, including in gynecological oncology. Various situations can create surgical difficulties during a cesarean section; however, two of the most frequent are complications from previous cesarean (myometrial defects, with or without placental intrusion and peritoneal adhesions) and the high risk of postpartum hemorrhage (uterine overdistension, abnormal placentation, uterine fibroids).

Lower ACLR Failure Rates in Bone-Soft Tissue Versus Soft Tissue-Only Allografts in Adults: A Systematic Review and Meta-analysis.

Background: While allografts are commonly used for anterior cruciate ligament reconstruction (ACLR), evidence to guide specific allograft selection is lacking.

Purpose: To compare clinical and graft failure rates after ACLR using soft tissue-only allografts and bone-soft tissue allografts in adults.

Study Design: Systematic review and meta-analysis; Level of evidence, 4.

Mental Health Services for Serious Mental Illness: Scoping Review of Randomised Controlled Trials.

Aims: This review aims to classify the evidence from randomised controlled trials (RCTs) on mental health services (MHS) for people with serious mental illness (SMI) available in the Cochrane Schizophrenia Group's (CSzG) specialised register.

Design: Scoping review.

Methods: We retrieved and screened RCTs of service-level interventions considering non-pharmacological approaches for mental healthcare of the CSzG register.

Land Use Change Consistently Reduces α- But Not β- and γ-Diversity of Bees.

Land use change threatens global biodiversity and compromises ecosystem functions, including pollination and food production. Reduced taxonomic α-diversity is often reported under land use change, yet the impacts could be different at larger spatial scales (i.e.

Annual Research Review: Psychosis in children and adolescents: key updates from the past 2 decades on psychotic disorders, psychotic experiences, and psychosis risk.

Psychosis in children and adolescents has been studied on a spectrum from (common) psychotic experiences to (rare) early-onset schizophrenia spectrum disorders. This research review looks at the state-of-the-art for research across the psychosis spectrum, from evidence on psychotic experiences in community and clinical samples of children and adolescents to findings from psychosis risk syndrome research, to evidence on early-onset psychotic disorders. The review also looks at new opportunities to capture psychosis risk in childhood and adolescence, including opportunities for early intervention, identifies important unanswered questions, and points to future directions for prevention research.

Patient's Perception of Primary Health Care Provision With Respect to Access, Continuity and Coordination-InCept: An International Qualitative Perspective.

Health care systems are confronted with an increasing burden of (multi-)morbidity and a shortfall of healthcare providers. Coordination and continuity of care in chronic and multi-morbid patient is especially important. As qualitative patient experience data within care processes is scarce, we aim to increase the understanding of chronically ill patient's perspectives by assessing patient experiences in different health systems while treated in primary care.

Middle Ear Mechanics in the Barn Owl.

The barn owl is a common research subject in auditory science due to its exceptional capacity for high frequency hearing and superb sound source localization capabilities. Despite longstanding interest in the auditory performance of barn owls, the function of its middle ear has attracted remarkably little attention. Here, we report the middle ear transfer function measured by laser Doppler vibrometry and direct measurements of inner ear pressures.

Impact of number of passes and futile reperfusion in basilar artery occlusion acute ischaemic stroke.

Introduction: Mechanical thrombectomy (MT) is the standard of care in anterior circulation large vessel occlusion. A vital modifiable factor is successful reperfusion. While multiple passes improve the rates of successful reperfusion, previous studies have reported progressively diminishing returns.

Electronic Polarizability Tunes the Function of the Human Bestrophin 1 Cl Channel.

Mechanisms of anion permeation within ion channels and nanopores remain poorly understood. Recent cryo-electron microscopy structures of the human bestrophin 1 Cl channel (hBest1) provide an opportunity to evaluate ion interactions predicted by molecular dynamics (MD) simulations against experimental observations. Here, we implement the fully polarizable force field AMOEBA in MD simulations on different conformations of hBest1.

Evidence for microbially-mediated tradeoffs between growth and defense throughout coral evolution.

Background: Evolutionary tradeoffs between life-history strategies are important in animal evolution. Because microbes can influence multiple aspects of host physiology, including growth rate and susceptibility to disease or stress, changes in animal-microbial symbioses have the potential to mediate life-history tradeoffs. Scleractinian corals provide a biodiverse, data-rich, and ecologically-relevant host system to explore this idea.

Exploring the relationship between proactive inhibition and restrictive eating behaviours in severe and enduring anorexia nervosa (SE-AN).

Background: There is a need for improved understanding of why 20-30% of individuals with anorexia nervosa (AN) develop a severe and enduring form of illness (SE-AN). Previously, we reported differences in proactive inhibition (a pre-emptive slowing of responses) in individuals with AN compared to healthy controls (after controlling for intolerance of uncertainty). The present study is a preliminary exploration of proactive inhibition in which we compared women with SE-AN with healthy comparison (HC) women and explored its association with restrictive/avoidant eating behaviours.

Professional judgement: a social practice perspective on a multiple mini-interview for specialty training selection.

Background: Interviewers' judgements play a critical role in competency-based assessments for selection such as the multiple-mini-interview (MMI). Much of the published research focuses on the psychometrics of selection and the impact of rater subjectivity. Within the context of selecting for entry into specialty postgraduate training, we used an interpretivist and socio-constructivist approach to explore how and why interviewers make judgments in high stakes selection settings whilst taking part in an MMI.

Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesis.

Background: Chronic respiratory diseases are important causes of disability and mortality globally. Their incidence may be higher in remote locations where healthcare is limited and risk factors, such as smoking and indoor air pollution, are more prevalent. E-health could overcome some healthcare access obstacles in remote locations, but its utilisation has been limited.

Translation, adaptation, and validation of the Care Coordination Instrument for cancer patients.

Background: Cancer requires interdisciplinary intersectoral care. The Care Coordination Instrument (CCI) captures patients' perspectives on cancer care coordination. We aimed to translate, adapt, and validate the CCI for Germany (CCI German version).