Preliminary report on Permian radiolarians from the Numakuma peninsula in Japan: Paleontological evidence for the presence of the Ultra-Tamba Belt

frame. 1. v.t. & i. Shape, direct, dispose, adapt, fit, devise, express, articulate, conceive, plot. In this paper a preliminary report on the study of landscape meaning and how it is shaped, expressed and so on by windows is described. Landscape is conveyed as being understood in at least four different ways: perceptually, politically, experientially and existentially. The framing quality of windows is shown to be complicit in these understandings. Using a contextual and inter-textual approach, a case for the consideration of the philosophical possibility of framing is presented. Through the model of linguistics used in a hermeneutic way, it is shown in this study that ‘aesthetic experience is not a solitary monologue... but an integral part of a shared discourse concerning the realisation of meaning’ (Heywood & Sandywell, 1999, p. 10).

Prophylactic embolization is usually performed using gelatin sponge particles, which are absorbed within several weeks, for managing angiographically negative gastrointestinal bleeding. This study aimed to evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) with quick-soluble gelatin sponge particles (QS-GSP) that dissolve in less than 4 h for treating angiographically negative gastrointestinal bleeding. We included ten patients (M:F = 7:3; mean age, 64.3 years) who underwent prophylactic TAE with QS-GSP for angiographically negative acute gastrointestinal bleeding between 2021 and 2023. The technical success rate of TAE, clinical outcomes focusing on rebleeding, and procedure-related complications were evaluated. The embolized arteries were the gastroduodenal (n = 3), jejunal (n = 4), and ileal (n = 3) arteries. QS-GSP (150–350 µm or 350–560 µm) were used alone (n = 8) or in combination with a coil (n = 1). A 100% technical success rate was accomplished. In 1 patient (10%), rebleeding occurred 2 days after prophylactic TAE of the gastroduodenal artery, and this was managed by repeat TAE. There were no procedure-related complications. The use of QS-GSP for prophylactic TAE appears to be safe and effective for controlling bleeding among patients with angiographically negative gastrointestinal bleeding. There were no cases of related ischemic complications of the embolized bowels likely attributable to recanalization of the affected arteries following biodegradation of QS-GSP.

The primary aim is to assess the efficacy of the surgical callus distraction technique of the metatarsus in paediatric patients. Secondary objectives are to assess complications and treatment duration. We have also described the details of our surgical technique. A case series review of paediatric patients who had metatarsal lengthening at our unit between 2014 and 2022. Patient demographics, duration of time in frame, complications and metatarsal length achieved were recorded. The AOFAS Midfoot and the MOXFQ were taken pre-operatively and at final follow-up. Sixteen metatarsals in 8 patients (14 feet) underwent lengthening between 2014 and 2022 using the MiniRail OrthoFix 100 (Orthofix Medical Inc, Lewisville, TX, USA). The mean age was 13.3 (12-17) years. The average duration between surgery and implant removal was 5.2months. According to Paley's classification, there was one obstacle encountered in a patient who required a revision of their osteotomy and one problem in another patient who had an infected metatarsophalangeal joint stabilising k-wire treated with oral antibiotics. The Mean AOFAS Midfoot score improved from 53.10 to 86.40 (p < 0.0001) and the Mean MOXFQ improved from 32.5000 to 12.1250 (p < 0.05); these were statistically significant. Gradual metatarsal lengthening using the MiniRail external fixator is a safe and effective method to treat brachymetatarsia in paediatric patients. This preliminary report describes and supports metatarsal lengthening in appropriate patients. Holistic care in terms of a pre-operative assessment, psychological support and preparation for the extended rehabilitation period are vital.

Excavations at the site of Kınık Höyük have brought to light over the past twelve years several occupational phases dated to the first Millennium BCE both on the acropolis and in the lower town, especially for the Middle Iron Age and the Hellenistic period. Since 2021 the University of Firenze joined the University of Pavia (Italy), NYU-ISAW (USA) and Dokuz Eylül University in Izmir (Turkey) in the excavations at the site of Kınık Höyük, and since 2022 the same university took over in the management of the project. This article is a preliminary report on recent excavations area D2-3, located in the lower town, where archaeologists could identify six phases of occupation and two large primary contexts dated to the beginning of the Middle Iron Age, that provide new insights on every-day assemblages and inventories produced locally and the architectural and archaeological context they are related to. The most interesting element in terms of urban layout and structure is related to the construction of the massive defensive fortification of the lower town, that seems to be related so far to the earliest occupation of the Iron Age lower town, i.e. possibly at the end of the Early Iron Age. A selection of the materials and a detailed report on deposits and architecture provides the reader with the archaeological data collected mainly in the campaign 2022 and 2021 in the lower town excavations, while a general overview on the urban fortification of the acropolis allows a general picture of the whole settlement defensive system and space organisation.

Preliminary report on therapeutic potential of coal-derived carbon quantum dots against SARS-CoV-2 virus

ObjectiveDrug induced sleep endoscopy (DISE) is often performed for pediatric obstructive sleep apnea (OSA) when initial diagnostic studies do not provide adequate information for therapy. However, DISE scoring is subjective and with limitations. This proof-of-concept study demonstrates the use of a novel long-range optical coherence tomography (LR-OCT) system during DISE of two pediatric patients. MethodsLR-OCT was used to visualize the airway of pediatric patients during DISE. At the conclusion of DISE, the OCT probe was guided in the airway under endoscopic visual guidance, and cross-sectional images were acquired at the four VOTE locations. Data processing involved image resizing and alignment, followed by rendering of three-dimensional (3D) volumetric models of the airways. ResultsTwo patients were included in this study. Patient one had 18.4%, 20.9%, 72.3%, and 97.3% maximal obstruction at velum, oropharynx, tongue base, and epiglottis, while patient two had 40.2%, 41.4%, 8.0%, and 17.5% maximal obstruction at these regions, respectively. Three-dimensional reconstructions of patients’ airways were also constructed from the OCT images. ConclusionThis proof-of-concept study demonstrates the successful evaluation of pediatric airway during DISE using LR-OCT, which accurately identified sites and degrees of obstruction with respective 3D airway reconstruction.

Abstract On February 6, a successive rupture of major faults in the Eastern Anatolian Fault Zone and Cardak-Surgu fault triggered a strong mainshock (Mw 7.7) and a major aftershock (Mw 7.6) in Kahramanmaras. The successive earthquake sequence hit southern provinces in Türkiye and northern regions in Syria, causing severe fatality and economic loss. After the earthquakes, the International Consortium on Geo-disaster Reduction (ICGdR) organized an investigation team, involving specialists from China, Japan and Türkiye, to conduct a primary field reconnaissance on seismic damage of infrastructure and ground failures. The 10-day reconnaissance, including a mini-symposium at the Istanbul Technical University (ITU), was conducted from 25 March to 3 April and specifically focused on fault ruptures, liquefaction, landslide, rockfall and lateral spreading along the major ruptured faults from Antakya in Hatay to Goksun in Kahramanmaras, passing through provinces of Gaziantep, Adıyaman and Malatya. By this reconnaissance, a large amount of original seismic data was collected and a primary understanding was established for further steps on mitigation and reduction of seismic damages and its secondary geohazards.

Perioperative partial-breast irradiation (PBI) with multicatheter interstitial brachytherapy (MIB) is less invasive and more convenient than postoperative one. This study aimed to compare ultrashort perioperative MIB-PBI (uPBI) and conventional perioperative MIB-PBI (cPBI) performed during the same period of time. Inclusion criteria of the study were patients aged ≥ 40years and those with T0-2 (≤ 3cm), N0-mi, and negative margins on mammography. The locoregional recurrence (LRR) and toxicity rates were compared between uPBI at a dose of 25.2Gy in four fractions and cPBI at a dose of 32Gy in eight fractions. In total, 198 patients (151 with uPBI and 47 with cPBI) were evaluated. At a median follow-up of 20.1months, one (0.66%) patient in the uPBI group had LRR. The 2-year ipsilateral breast tumor recurrence-free survival rates of the uPBI and cPBI groups were 98.7% and 100%, respectively. The highest toxicity grades were grade 1 in 23 (15.2%) and grade 2 in 2 (1.3%) patients in the uPBI group, and grade 1 in 8 (17.0%) and grade 2 in 1 (2.1%) patient in the cPBI group. None of the patients in the two groups presented with grade 3 and higher toxicities. The toxicity rates between the two groups did not significantly differ. Further, 22 (14.6%) patients in the uPBI group and 8 (17.0%) in the cPBI group, and 3 (2.0%) patients in the uPBI group and 1 (2.1%) in the cPBI had acute and late toxicities, respectively. The timing of toxicity development between the two groups did not significantly differ. Although this preliminary report included a small sample size and had a short follow-up period, the local control and toxicity rates were similar between the uPBI and cPBI groups. Further research is warranted to investigate the ideal dose schedule of MIB-PBI.

Rabies remains a significant public health concern, especially in endemic regions like Africa and Asia, with likely underreported cases. Primarily transmitted through dog bites, rabies poses a substantial risk in Nigeria, where dogs are the main carriers. This study investigated rabies awareness and control practices among dog owners in livestock farming communities in Plateau State, Nigeria. This was done using structured questionnaire interviews with 50 respondents from five Local Government Areas. Data analysis revealed that 78% were aware of rabies, but few recognized its severity. Only 46% knew about rabies vaccination, and merely 16% sought clinical assistance post-dog bite. Despite relatively high awareness, gaps exist in understanding susceptible hosts, proper management, prevention, and health-seeking behaviours. Findings underscore the necessity of bolstering awareness and management, including vaccinations, to encourage effective rabies control measures among vulnerable populations within remote communities and nationwide.

Between 2013 and 2015, the Republic of Indonesia’s Directorate of Preservation of Cultural Heritage and Museums held a series of capacity-building workshops at Selayar Island in South Sulawesi, Indonesia. Maritime archaeologists and practitioners from various government and research institutions attended the training program, including foreign delegates from ASEAN (Association of Southeast Asian Nations) countries. The program’s field school centred on the Bontosikuyu shipwreck site. This shipwreck is dated to the late 13th to early 14th century CE based on 14C dating of organic remains and ceramics analysis. It is considered one of the earliest shipwreck sites around the South Sulawesi region and is significant for understanding further the maritime trade of the eastern Indonesia area.

Abstract Introduction Peyronie’s disease is a medical issue with significant psychological overtones. However, trainee exposure to initial counseling and management can be limited and therefore understanding both the disease state and its psychological effects can be difficult to master. Institutions have incorporated simulation-based education to augment resident skills and knowledge in topics such as transgender health and SICU patient management. The gold standard of assessing trainees in simulated clinical interaction has been objective structured clinical examinations (OSCE). However, novel AI-based technologies like ChatGPT offer a promising alternative for resident education and assessment. ChatGPT, developed by OpenAI, utilizes natural language processing technology to provide human-like responses to open-ended questions posed by users. Preliminary reports have already described its use in training emergency medicine residents in delivering bad news. Objective To simulate a realistic clinical scenario utilizing ChatGPT to improve resident and student confidence in Peyronie’s disease evaluation and treatment, and to assess ChatGPT’s ability to deliver actionable feedback to trainees on both knowledge base and patient interaction compared to evaluation by a sexual medicine specialist. Methods ChatGPT Plus was utilized to roleplay the patient in an initial consultation for Peyronie’s disease. A detailed input was composed to establish the rules of the simulation (Figure 1). ChatGPT was prompted to conduct a final assessment of trainee performance with standardized scales in accuracy, comprehensiveness, and empathy (A, C, E). ChatGPT was prompted to use the 2015 AUA Peyronie’s Disease Diagnosis and Treatment Guidelines when formulating its assessment and feedback. Three trainees with different experience levels performed the simulation. At completion, a fellowship-trained sexual medicine specialist separately graded each trainee’s performance using the same scale. Cohen’s kappa was calculated to assess inter-rater reliability. Results Three urology trainees performed the simulation: a 3rd year medical student, a PGY2 resident, and a PGY4 resident. Trainee performance scores are shown in Table 1. Mean ChatGPT ratings were 8.7, 8.0, and 9.0 (A, C, E), while andrologists ratings were 7.0, 4.7, and 6.3 (A, C, E). Progressive improvement was demonstrated as trainee experience increased. ChatGPT generally rated trainees at higher competency levels than andrologists. Cohen’s kappa was calculated to be -0.125, -0.125, and 0.0 (A, C, E), indicating an overall low level of agreement between ChatGPT and andrologists assessment of trainees. Conclusions Our findings demonstrate that ChatGPT has potential to be a successful tool for urology resident and medical student education on Peyronie’s disease counseling. However, there was disagreement in trainee ratings between ChatGPT and the sexual medicine specialist. ChatGPT provided trainees constructive, actionable feedback referencing current guidelines (Figure 2). When given defined parameters for a clinical scenario, ChatGPT can be effective in designing a realistic standardized patient simulation. However, ChatGPT has not appeared to master the competency and accuracy of that expected from a sexual medicine specialist. Tweaking the initial input can allow for testing competency in various alternative clinical vignettes. Further collection of real-world data is needed to better assess ChatGPT’s rating of the learner’s performance, ideally in conjunction with national/international guidelines. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Fellow, Posterity Health, Coloplast, Hims, Genentech.

A preliminary report on critical antimicrobial resistance in Escherichia coli, Enterococcus faecalis, and Enterococcus faecium strains isolated from healthy dogs in Chile during 2021-2022

Epidemiology and clinical picture of obstetric and gynecological conditions in women with acromegaly – a preliminary report

Efficacy of sacral neuromodulation in the treatment of refractory overactive bladder and non-obstructive urinary retention –A preliminary report

ABSTRACT Introduction: The measurement of bite force is increasingly gaining importance in dentistry. This preliminary report evaluates the maximum voluntary bite force (MVBF) of young healthy individuals with normal occlusion and correlates the effect of age and gender with the maximum bite force (MBF) Materials and Methods: 405 participants in the age group of 18 to 40 years were selected from the outpatient department meeting inclusion and exclusion criteria. MVBF was measured with the help of a digital device called “Byte” at incisors, right first molar, and left first molar region. Results: There was a strong correlation between age with bite force. Bite force increased with age. Males had more bite force than females. The posterior region had higher bite force than the anterior region Conclusion: Measurement of bite force is very important for every patient undergoing restorative treatment. The “Byte” device was found to be very efficient.

Background: The integration of stakeholders is crucial in developing smart living technologies to support the autonomy of elderly populations. Despite the clear benefits of these technologies, there remains a significant gap in comprehensive research. Methods: This study presents the viewpoints of 19 stakeholders from Europe and Japan, focusing on the sustainability of smart living solutions for Active and Healthy Ageing (AHA). Data were gathered through qualitative semi-structured interviews and analysed using a Framework Analysis approach. Results: Analysis of the interviews revealed six key sustainability categories: addressing the unmet needs of older adults, functionalities of the smart living coach, integration within organizations, identified barriers, financial considerations, and the social role of the smart living coach. Conclusions: This research underscores the importance of evaluating user needs through the involvement of various stakeholders, including the elderly, their caregivers, professionals, technicians, service providers, and government bodies. Collaborative efforts are essential to generate new evidence demonstrating the value of smart living solutions in facilitating Active and Healthy Ageing.

A preliminary report on clinical and polysomnographic features of comorbid insomnia and sleep apnea in type 1 and type 2 narcoleptic patients

Background: Tolvaptan sodium phosphate (Samtas®; Otsuka Pharmaceutical, Tokyo, Japan) is a novel intravenous aquaretic diuretic aimed at individuals experiencing advanced congestion refractory to conventional diuretics and having difficulty with oral intake. Despite its potential, the true efficacy and practicality of this compound within real-world clinical settings remain obscure. Methods: A retrospective analysis of clinical data was conducted, examining trends among consecutive in-hospital patients diagnosed with congestive heart failure who underwent treatment with tolvaptan sodium phosphate at a prominent academic medical center between June 2022 and June 2023. Results: Twenty-one patients were enrolled (median age: 75 years, serum N-terminal pro B-type natriuretic peptide: 8941 pg/mL). Among them, 14 patients (67%) received non-invasive/invasive positive-pressure ventilation, and 17 patients (81%) concurrently received intravenous inotropes. Subsequent to the initiation of tolvaptan sodium phosphate treatment, a significant increase in urine volume was observed on the following day (p = 0.036). Urine osmolality decreased from 356 (318, 443) at baseline to 247 (176, 333) mOsm/kg after 4 h (p = 0.002). No occurrences of hypernatremia were recorded during the therapeutic period. Notably, two patients transitioned from tolvaptan sodium phosphate treatment to continuous hemodiafiltration due to insufficient efficacy. Conclusions: In routine clinical practice, intravenous tolvaptan sodium phosphate exhibits potential efficacy and practicability in the majority of congestive heart failure patients exhibiting refractory congestion, unstable hemodynamics, and challenges with oral intake.

Abstract Background Subcutaneous (SC) infliximab (IFX) effectively maintains biochemical, clinical and endoscopic remission in inflammatory bowel disease (IBD) with a comparable safety profile to intravenous (IV) formulation. Transmural healing is considered a desirable long-term treatment endpoint in IBD, especially in Crohn’s disease (CD). Whether switching from intravenous to SC-IFX effectively maintains transmural remission in IBD is still unknown. Methods This is a preliminary report from a prospective multicentre cohort study on IBD patients in clinical and endoscopic remission on IV-IFX treatment switched to SC-IFX. Enrolled patients were followed-up for 12 months, with fecal calprotectin (FC), C-reactive protein (CRP), infliximab trough levels and anti-drug antibodies (ADAs) measured at baseline, at 3, 6 and 12 months. Intestinal ultrasound (IUS) was performed at baseline and every six months. At month 12 a full colonoscopy was performed for mucosal healing assessment. Remission rates and safety profile were subsequently recorded. T-Test and ANOVA for mean comparisons and Kaplan-Meier estimates were used for survival curves. Results 43 IBD patients (69% males) were enrolled, 58% with CD, of whom 52% reported a history of perianal disease. Median disease duration and IFX therapy were 6 (IQR 3-12) and 5 (IQR 2-9) years, respectively. During a median follow-up of 311 (range 122-489) days, clinical remission rate was 98% (Harvey-Bradshaw Index &amp;lt;5 and Mayo score &amp;lt;2). No reactivation of perianal disease was reported. FC and CRP remained stable at each time point (p&amp;gt; 0.05). The median baseline infliximab level was 10.02 ( range 0.1- 41.84) ug/ml. Undetectable infliximab levels (&amp;lt;1 ug/ml) and positive ADAs were found in 6 and 14 patients, respectively; at 3 months, a significant increase in infliximab levels (mean increase 27.5 ng/ml; ± 12.5 SD; p&amp;lt; 0.001) and a progressive decrease of ADAs titer were observed, despite unchanged SC-IFX dose. At baseline, all patients had normal bowel wall thickness (i.e. ileum ≤ 3mm, colon≤4 mm) and a Limberg score ≤1at IUS; reactive lymphadenopathies were reported in 5 patients and a mild abdominal effusion in 1. No significant changes were shown during follow-up. Mild endoscopic activity was found in 2 out 30 patients who performed follow-up endoscopy. Regarding safety profile 12 mild infectious events, 2 mild cutaneous injection site reaction and 1 non-IBD related hospital admission were observed. Conclusion Switching from IV to SC infliximab in a selected cohort of IBD patients confirmed to be safe and effective in maintaining clinical, biochemical, and transmural remission. IUS is a useful, non-invasive and low-cost tool for periodic disease assessment in this subset of patients.