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International Journal of Surgery Case... May 2024Lipoma is the most common benign tumor of adipose tissue. Giant lipoma of the breast is defined as lesions larger than 10 cm and weighing more than 1000 g. A breast...
INTRODUCTION
Lipoma is the most common benign tumor of adipose tissue. Giant lipoma of the breast is defined as lesions larger than 10 cm and weighing more than 1000 g. A breast lipoma rapidly enlarging and fast growing; can be managed as a malignant tumor. It is crucial to make a correct diagnosis to prevent an overtreatment.
CASE PRESENTATION
A 48-year-old patient presented with a painless, huge rapidly growing tumor in her right breast. Physical examination and imaging studies was suggestive of benign lipomatous breast tumor: A breast lipoma, a fibroadenolipoma or adenolipoma, an angiolipoma, or a breast fatty hamartoma. The patient underwent surgical excision of the mass, and histological examination confirmed the diagnosis of a giant breast lipoma.
DISCUSSION
Giant breast lipoma is a rare benign tumor that develops in the breast tissue. They can mimic various breast conditions, even neoplastic conditions. Giant breast lipomas are often treated with surgical excision to avoid recurrence.
CONCLUSION
Giant breast lipoma rapidly growing can pose a diagnostic challenge due to its resemblance to various benign or malignant pathologies. Unnecessary invasive investigations can be avoided with better understanding and improved imaging-based diagnosis of giant breast lipoma.
PubMed: 38815443
DOI: 10.1016/j.ijscr.2024.109787 -
PLoS Neglected Tropical Diseases May 2024Plague continues to be a major public health concern in African countries. Several social practices and environmental conditions have been associated with the...
INTRODUCTION
Plague continues to be a major public health concern in African countries. Several social practices and environmental conditions have been associated with the reoccurrence of bubonic plague, especially in places where the disease is prevalent. Therefore, it remains important to understand people knowledge, behavior and practices related to disease risks in order to identify factors that may hinder prevention and control strategies in the foci.
METHODS AND RESULTS
A study survey of 100 households was conducted in Mbulu district to assess plague knowledge, factors that influence flea bite and measures used for rodent and flea control. Majority of participants (86%) were familiar with the plague disease and about (50%) mentioned swelling lymph nodes as a common symptom. Most of the participants (62%) claimed to observe human plague cases during the long rain season. The majority of participants (97%) reported to experience flea bite in their domestic settings, with most stating that they experienced more flea bites during the dry season. Houses with livestock had a greater likelihood of flea bite (OR = 2.7; 95% CI: 0.36-18.80, p = 0.267) compared to houses with no livestock. Furthermore, residents reported using both local and chemical methods to control rodents and flea inside houses. Most respondents preferred using local methods in flea control. Respondents stated that the efficacy of flea control methods being applied ranged from few days to several months. There was limited knowledge of the residual effects of the agricultural chemicals being used to control fleas among the surveyed community.
CONCLUSION
Our study highlights the importance of raising awareness and adopting effective control methods for controlling fleas and lower the risk of plague transmission and other flea borne diseases in the local communities. Sensitization of the local community on the use of appropriate chemicals for flea control is urgent to avoid any potential long-term impacts of the residual effects on the health of the local communities.
PubMed: 38814990
DOI: 10.1371/journal.pntd.0012202 -
PloS One 2024There are two species of free-roaming feral equids in North America: horses (Equus caballus) and donkeys or "burros" (E. asinus). Both species were introduced as...
There are two species of free-roaming feral equids in North America: horses (Equus caballus) and donkeys or "burros" (E. asinus). Both species were introduced as domestic animals to North America in the early 1500s and currently inhabit rangelands across the western United States, Canada, and all continents except Antarctica. Despite their global distribution, little is known about their fine scale spatial ecology. Contemporary research tools to assess space use include global positioning system (GPS) tracking collars, but older models were problematic due to stiff collar belting causing poor fit. We tested modern designs of GPS collars on n = 105 horses and n = 60 burros for 4 years in five populations (3 horse, 2 burro) across the western United States, to assess whether collars posed welfare risks to horses or burros. We found no difference in survival of collared versus uncollared mares and jennies, and no difference in survival of their foals. In 4036 of 4307 observations for horses (93.7%) and 2115 of 2258 observations for burros (93.6%), collars were observed symmetrical, maintaining proper fit on the neck. Fur effects from collars (sweaty neck, indented fur, broken fur) were seen in 3% of horse observations and 25% of burro observations. Superficial effects (chafes and marks on skin surface) were seen in 2% of horse observations and 11% of burro observations; no severe effects from collars were seen. Body condition was not affected by collars; mean body condition of collared horses was 4.70 ± 0.54 (mean ± s.d) and 4.71 ± 0.65 for collared burros. Behavior results indicated minimal effects; collared horses stood slightly more than uncollared, and collared burros stood and foraged more in one population, but not in the other. For 6.3% of observations of horses and 6.4% of observations of burros, we found an effect of time wearing a collar on the cumulative sum of fur effects which increased over time (burros: rs = 0.87, P = <0.0001; horses: rs = 0.31, P = 0.002). Burros also showed an increase over time in the number of superficial effects, but horses did not. Collars occasionally moved into the wrong position, shifting forward over the ears; we observed this on 19 horses and 1 burro. Of those, most collars went over the ears in summer (n = 12). All collars were equipped with a remote release mechanism as well as a timed-release mechanism for redundancy, thus removed when observed in wrong position to avoid rubbing or discomfort. Our finding of no consequential physical effects in 98% of horse observations, and 89% of burro observations suggests the consequences of collars on free-roaming equid welfare and survival is biologically insignificant, although collars should be monitored regularly and continue to be equipped with a remote release mechanism to remove a collar if needed. With frequent welfare-driven, visual monitoring, collaring of free-roaming equids can be a safe and useful tool to increase our understanding of their spatial ecology, demography, habitat use, behavior, and interactions with other wildlife.
Topics: Animals; Telemetry; Equidae; Geographic Information Systems; Horses; Female; Male
PubMed: 38814957
DOI: 10.1371/journal.pone.0303312 -
JMIR Formative Research May 2024Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One...
BACKGROUND
Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home.
OBJECTIVE
This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens.
METHODS
We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context.
RESULTS
We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens.
CONCLUSIONS
These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
PubMed: 38814705
DOI: 10.2196/56916 -
JAMA Network Open May 2024The decision for surgical vs nonsurgical treatment for hip fracture can be complicated among community-dwelling people living with dementia.
IMPORTANCE
The decision for surgical vs nonsurgical treatment for hip fracture can be complicated among community-dwelling people living with dementia.
OBJECTIVE
To compare outcomes of community-dwelling people living with dementia treated surgically and nonsurgically for hip fracture.
DESIGN, SETTING, AND PARTICIPANTS
This retrospective cross-sectional study undertook a population-based analysis of national Medicare fee-for-service data. Participants included community-dwelling Medicare beneficiaries with dementia and an inpatient claim for hip fracture from January 1, 2017, to June 30, 2018. Analyses were conducted from November 10, 2022, to October 17, 2023.
EXPOSURE
Surgical vs nonsurgical treatment for hip fracture.
MAIN OUTCOMES AND MEASURES
The primary outcome was mortality within 30, 90, and 180 days. Secondary outcomes consisted of selected post-acute care services.
RESULTS
Of 56 209 patients identified with hip fracture (73.0% women; mean [SD] age, 86.4 [7.0] years), 33 142 (59.0%) were treated surgically and 23 067 (41.0%) were treated nonsurgically. Among patients treated surgically, 73.3% had a fracture of the femoral head and neck and 40.2% had moderate to severe dementia (MSD). Among patients with MSD and femoral head and neck fracture, 180-day mortality was 31.8% (surgical treatment) vs 45.7% (nonsurgical treatment). For patients with MSD treated surgically vs nonsurgically, the unadjusted odds ratio (OR) of 180-day mortality was 0.56 (95% CI, 0.49-0.62; P < .001) and the adjusted OR was 0.59 (95% CI, 0.53-0.66; P < .001). Among patients with mild dementia and femoral head and neck fracture, 180-day mortality was 26.5% (surgical treatment) vs 34.9% (nonsurgical treatment). For patients with mild dementia who were treated surgically vs nonsurgically for femoral head and neck fracture, the unadjusted OR of 180-day mortality was 0.67 (95% CI, 0.60-0.76; P < .001) and the adjusted OR was 0.71 (95% CI, 0.63-0.79; P < .001). For patients with femoral head and neck fracture, there was no difference in admission to a nursing home within 180 days when treated surgically vs nonsurgically.
CONCLUSIONS AND RELEVANCE
In this cohort study of community-dwelling patients with dementia and fracture of the femoral head and neck, patients with MSD and mild dementia treated surgically experienced lower odds of death compared with patients treated nonsurgically. Although avoiding nursing home admission is important to persons living with dementia, being treated surgically for hip fracture did not necessarily confer a benefit in that regard. These data can help inform discussions around values and goals with patients and caregivers when determining the optimal treatment approach.
Topics: Humans; Dementia; Hip Fractures; Female; Male; Aged, 80 and over; Cross-Sectional Studies; Retrospective Studies; Independent Living; Aged; United States; Medicare; Treatment Outcome
PubMed: 38814642
DOI: 10.1001/jamanetworkopen.2024.13878 -
Microbiology Spectrum May 2024is the leading cause of bacterial sexually transmitted infections in the USA and of preventable blindness worldwide. This obligate intracellular pathogen replicates...
is the leading cause of bacterial sexually transmitted infections in the USA and of preventable blindness worldwide. This obligate intracellular pathogen replicates within a membrane-bound inclusion, but how it acquires nutrients from the host while avoiding detection by the innate immune system is incompletely understood. accomplishes this in part through the translocation of a unique set of effectors into the inclusion membrane, the lusion membrane proteins (Incs). Incs are ideally positioned at the host-pathogen interface to reprogram host signaling by redirecting proteins or organelles to the inclusion. Using a combination of co-affinity purification, immunofluorescence confocal imaging, and proteomics, we characterize the interaction between an early-expressed Inc of unknown function, Tri1, and tumor necrosis factor receptor-associated factor 7 (TRAF7). TRAF7 is a multi-domain protein with a RING finger ubiquitin ligase domain and a C-terminal WD40 domain. TRAF7 regulates several innate immune signaling pathways associated with infection and is mutated in a subset of tumors. We demonstrate that Tri1 and TRAF7 specifically interact during infection and that TRAF7 is recruited to the inclusion. We further show that the predicted coiled-coil domain of Tri1 is necessary to interact with the TRAF7 WD40 domain. Finally, we demonstrate that Tri1 displaces the native TRAF7 binding partners, mitogen-activated protein kinase kinase kinase 2 (MEKK2), and MEKK3. Together, our results suggest that by displacing TRAF7 native binding partners, Tri1 has the capacity to alter TRAF7 signaling during infection.IMPORTANCE is the leading cause of bacterial sexually transmitted infections in the USA and preventable blindness worldwide. Although easily treated with antibiotics, the vast majority of infections are asymptomatic and therefore go untreated, leading to infertility and blindness. This obligate intracellular pathogen evades the immune response, which contributes to these outcomes. Here, we characterize the interaction between a -secreted effector, Tri1, and a host protein involved in innate immune signaling, TRAF7. We identified host proteins that bind to TRAF7 and demonstrated that Tri1 can displace these proteins upon binding to TRAF7. Remarkably, the region of TRAF7 to which these host proteins bind is often mutated in a subset of human tumors. Our work suggests a mechanism by which Tri1 may alter TRAF7 signaling and has implications not only in the pathogenesis of infections but also in understanding the role of TRAF7 in cancer.
PubMed: 38814079
DOI: 10.1128/spectrum.00453-24 -
A systematic review on the physical, mental, and occupational effects of exercise on pregnant women.Dialogues in Health Jun 2024Complications in pregnancy have been proven to be less frequent with exercise. The American College of Obstetrics and Gynecology suggests pregnant women should exercise... (Review)
Review
Complications in pregnancy have been proven to be less frequent with exercise. The American College of Obstetrics and Gynecology suggests pregnant women should exercise an average of 20 to 30 min a day; however, only 13% of pregnant women exercise throughout their pregnancy. This amount could be improved if women are aware that exercise: 1. Can help avoid pregnancy complications or death and 2. Comes in various forms with different health outcomes associated with it. For this reason, this systematic literature review was conducted to review different types of exercise for pregnant women. Peer-reviewed articles were selected to discuss the benefits of the most researched exercises for pregnant women, which included yoga, resistance training, aquatic exercises, dance, and aerobic exercise such as running, walking, and cycling. Data from the review revealed that different types of exercises led to various benefits at different stages of pregnancy. Aquatic activities and yoga helped pregnant women toward the end of their pregnancies, whereas resistance training, dance, and aerobic exercises provided the most benefits during the first trimester. Other studies found that any form of exercise for 30 min a day or every other day for 60 min provided extensive beneficial results. Ultimately, this information could be used to create individualized exercise plans for pregnant women to adhere to throughout their pregnancy.
PubMed: 38813580
DOI: 10.1016/j.dialog.2024.100181 -
Frontiers in Psychology 2024The increased diversity of students (e.g., students with special educational needs) has presented teachers with unprecedented challenges. Teachers' attitudes toward...
INTRODUCTION
The increased diversity of students (e.g., students with special educational needs) has presented teachers with unprecedented challenges. Teachers' attitudes toward inclusive education play a crucial role in teachers' organizational well-being. However, existing studies mostly explored attitudes toward inclusive education based on a variable-centered approach. This study used a person-centered approach to identify teachers' attitude profile membership and explored the relationships of attitude profiles with demographic factors (i.e., gender, years of teaching experience, subject taught, and in-service training) and organizational commitment.
METHODS
Nine hundred and seventy-two in-service teachers from forty-nine inclusive education schools in Beijing responded to the Revised Multidimensional Attitudes toward Inclusive Education Scale and the Organizational Commitment Inventory. Latent profile analyses, multinomial logistic regression, and univariate analysis of variance were used to analyze data.
RESULTS AND DISCUSSION
The results revealed four attitude profiles: , , , and . Years of teaching experience and in-service training were significant predictors of teachers' latent profile membership. Teachers belonging to the profile showed the highest levels of maladaptive commitments to inclusive education schools. Teachers belonging to the and the behavior avoidance profiles showed higher levels of adaptive commitments. However, teachers belonging to the profile had the lowest levels of adaptive commitments. The theoretical contributions, practical implications, and limitations are discussed.
PubMed: 38813566
DOI: 10.3389/fpsyg.2024.1391862 -
Frontiers in Molecular Neuroscience 2024The complex nature of the retina demands well-organized signaling to uphold signal accuracy and avoid interference, a critical aspect in handling a variety of visual... (Review)
Review
The complex nature of the retina demands well-organized signaling to uphold signal accuracy and avoid interference, a critical aspect in handling a variety of visual stimuli. A-kinase anchoring proteins (AKAPs), known for binding protein kinase A (PKA), contribute to the specificity and efficiency of retinal signaling. They play multifaceted roles in various retinal cell types, influencing photoreceptor sensitivity, neurotransmitter release in bipolar cells, and the integration of visual information in ganglion cells. AKAPs like AKAP79/150 and AKAP95 exhibit distinct subcellular localizations, impacting synaptic transmission and receptor sensitivity in photoreceptors and bipolar cells. Furthermore, AKAPs are involved in neuroprotective mechanisms and axonal degeneration, particularly in retinal ganglion cells. In particular, AKAP6 coordinates stress-specific signaling and promotes neuroprotection following optic nerve injury. As our review underscores the therapeutic potential of targeting AKAP signaling complexes for retinal neuroprotection and enhancement, it acknowledges challenges in developing selective drugs that target complex protein-protein interactions. Overall, this exploration of AKAPs provides valuable insights into the intricacies of retinal signaling, offering a foundation for understanding and potentially addressing retinal disorders.
PubMed: 38813437
DOI: 10.3389/fnmol.2024.1412407 -
Frontiers in Neurology 2024Ultrasound waves were initially used as a diagnostic tool that provided critical insights into several pathological conditions (e.g., gallstones, ascites, pneumothorax,... (Review)
Review
Ultrasound waves were initially used as a diagnostic tool that provided critical insights into several pathological conditions (e.g., gallstones, ascites, pneumothorax, etc.) at the bedside. Over the past decade, advancements in technology have led to the use of ultrasound waves in treating many neurological conditions, such as essential tremor and Parkinson's disease, with high specificity. The convergence of ultrasound waves at a specific region of interest/target while avoiding surrounding tissue has led to the coined term "focused ultrasound (FUS)." In tumor research, ultrasound technology was initially used as an intraoperative guidance tool for tumor resection. However, in recent years, there has been growing interest in utilizing FUS as a therapeutic tool in the management of brain tumors such as gliomas. This mini-review highlights the current knowledge surrounding using FUS as a treatment modality for gliomas. Furthermore, we discuss the utility of FUS in enhanced drug delivery to the central nervous system (CNS) and highlight promising clinical trials that utilize FUS as a treatment modality for gliomas.
PubMed: 38813245
DOI: 10.3389/fneur.2024.1387986