Prospective Review Research Articles

Nutritional Supplementation to Preserve Healthy Lean Mass and Function During Periods of Pharmacological and Nonpharmacological-Induced Weight Loss: Protocol for a Systematic Review and Meta-Analysis.

Weight loss without adequate anabolic stimuli can lead to reductions in lean, as well as adipose, tissue. Health benefits typically associated with weight loss are therefore attenuated,as body composition potentially shifts from an obese to sarcopenic/frail phenotype. In contrast to the traditional connotation of frailty, this might occur in younger adults and is characterized by reduced performance in functional tasks of daily living. Nutritional supplements as an adjunct to weight loss intervention could support the maintenance of lean mass, particularly if structured exercise is contraindicated. This systematic review aims to quantify the effect of nutritional supplements, without concurrent exercise, on lean mass in individuals undergoing pharmacological and nonpharmacological-induced weight loss. This protocol describes a prospective systematic review and meta-analysis of randomized controlled trials investigating the effect of nutritional supplements on lean mass during weight loss. Comparison arms will not use nutritional supplements. Literature searches will be conducted using the following online databases: Embase, MEDLINE, Web of Science, Google Scholar, and OpenGrey. Outcome measures related to body composition, lean mass, skeletal muscle mass/size, or physical function will be extracted. Risk of bias will be assessed using the United States National Heart Lung and Blood Institute quality assessment tool for controlled intervention studies. A meta-analysis will be conducted to synthesize comparable outcomes. The results of this review will be reported in adherence to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) standards, and published in a peer-reviewed journal. This study will be the first to systematically review nutritional interventions for the preservation or accretion of lean mass during weight loss. This review will identify gaps in the literature and inform the development of optimized weight loss strategies, for use in research and practice. International Prospective Register of Systematic Reviews: PROSPERO CRD42024521540.

Post-COVID Mucormycosis: An Emerging Threat in Developing Countries - A Prospective Review

COVID-19, with its rapidly mutating strains, poses a significant global health challenge. Recent reports of a surge in mucormycosis cases among COVID-19 patients highlight the urgent need for understanding and addressing this critical complication. This review explores the factors contributing to mucormycosis development in COVID-19 patients and outlines strategies for prevention and management. Several factors, including high glucose levels (diabetes, onset, steroid-induced hyperglycemia), low oxygen levels, elevated iron levels (especially ferritin), metabolic acidosis, and diabetic ketoacidosis, can facilitate the germination of mucor spores. COVID-19 patients with underlying conditions such as diabetes, cancer, or organ transplants are particularly susceptible to mucormycosis due to their immunocompromised state. The growth of the mucor pathogen requires free iron, which is elevated in conditions like diabetic ketoacidosis. This elevated iron level promotes the formation of Cot-H, a crucial component of fungal growth, leading to mucormycosis. Additionally, comorbidities and corticosteroids can suppress the immune system, hindering the body's ability to fight off infections like mucormycosis. Therefore, it is imperative to avoid the indiscriminate use of corticosteroids. Strict control of acute hyperglycemia and comprehensive monitoring of diabetic and immunocompromised COVID-19 patients are essential preventive measures. By addressing these factors, healthcare providers can mitigate the risk of mucormycosis in COVID-19 patients and improve overall outcomes.

Application of AI in Talent Management A Systematic Review of Benefits, Challenges, and Prospects

This systematic literature review explores the current state, advantages, disadvantages, and potential future of using artificial intelligence in talent management. A total of 29 articles published in 2015- 2024 suggest that 33% of the organizations have implemented AI/ML tools, and only 16% are optimally using HR technologies for organizational results. The review identifies four key domains of AI implementation: recruitment and selection, performance analysis, development and training of employees, and strategic implementation. Benefits include increased operational effectiveness, improved decision-making, organizational talent management, and workforce planning processes. That said, technical difficulties, ethical issues on the use of artificial intelligence, privacy, and some organizational individuals' reluctance towards using artificial intelligence remain major hurdles. The results show an increase in the number of publications in recent years, focusing on 2023 and occupying the majority share of journals (83%). More future directions focus on developing a strong theoretical foundation, implementation proposals, and improved ethical standards. These observations indicate that AI holds the potential to revolutionize TM practices but also that organizations need to be cautious of the challenges pertaining to technology integration keeping in view the ethical and human aspects of organizational functioning to effectuate successful implementation.

Nanotechnology-Based Drug Delivery Systems for Chemotherapy: A Review of Current Approaches and Future Prospects

Nanotechnology-based drug delivery systems have developed as a novel approach to cancer treatment, notably chemotherapy, with higher precision, efficacy, and less side effects than traditional approaches. Chemotherapy, while successful in targeting rapidly dividing cancer cells, frequently encounters considerable hurdles such as systemic toxicity, non-targeted drug distribution, and resistance. Nanotechnology offers a promising alternative for targeted delivery, controlled release, and overcoming multidrug resistance (MDR). Various nanocarriers, such as liposomes, polymeric nanoparticles, dendrimers, and metallic nanoparticles, have been developed to improve drug delivery by leveraging the increased permeability and retention (EPR) effect for tumour targeting. The design of these nanocarriers, which includes size, surface qualities, and functionality, provides longer circulation time, increased tumour formation, and fewer side effects on healthy tissues. Despite multiple clinical achievements, such as the FDA's clearance of nanomedicines like Doxil and Abraxane, there are still obstacles in translating these technologies from laboratory research to clinical practice. Nanoparticle stability, scalability, regulatory barriers, and cytotoxicity are all important considerations. This study examines the current state of nanotechnology-based drug delivery systems, emphasizing clinical accomplishments, problems, and upcoming technologies such as stimuli-responsive and AI-assisted drug delivery systems. The future of cancer treatment is in the creation of smart nanocarriers that can combine chemotherapy with other therapeutic modalities such as immunotherapy, gene therapy, and photodynamic therapy. Hence, personalized nanomedicine, which tailors drug delivery systems to individual patients' genetic profiles and tumour features, is a promising future direction. Overall, this review seeks to investigate the most recent developments and future prospects in nanotechnology-driven chemotherapy.

Current knowledge of vertebral osteomyelitis: a review.

As life expectancy increases worldwide, the elderly population in every country is growing in both the size and proportion. This review aims to provide a comprehensive overview of the microbiology, clinical presentation, diagnostic strategies, and therapeutic approaches to vertebral osteomyelitis, summarizing the latest evidence to guide effective treatment. A comprehensive literature search was conducted using the Medline and Embase databases to identify relevant studies on vertebral osteomyelitis. The search included the following keywords: "vertebral osteomyelitis," "spinal infection," "discitis," "spondylitis," " spondylodiscitis," and "spinal epidural abscess." Both retrospective and prospective studies, case series, and reviews were considered. This condition is commonly caused by bacteria such as Staphylococcus aureus or gram-negative bacilli, but can also be caused by other pathogens like fungi and parasites. The onset of vertebral osteomyelitis is insidious, with low specificity in clinical manifestations, often making early diagnosis difficult. Delayed or inadequate treatment may lead to sepsis, permanent neurological damage, or even death. Treatment strategies emphasize the importance of identifying the causative pathogen to guide effective antimicrobial therapy. Current consensus does not advocate for empirical antibiotic treatment unless patients exhibit signs of neurological impairment or severe sepsis. Severe cases involving neurological paralysis, spinal instability, or sepsis may require surgical intervention. Vertebral osteomyelitis requires prompt diagnosis and treatment for a good prognosis. Delayed diagnosis and treatment can lead to permanent neurological deficits or death. Identifying the causative organism is crucial for guiding appropriate antimicrobial therapy. In addition to conservative and surgical treatments, local drug delivery systems offer new approaches to managing spinal osteomyelitis.

Biodiesel Production from Waste Cooking Oil: A Review of Prospects and Challenges

The consumption of fossil fuels is increasing as people become more reliant on them. It is consequently vital to discover more environmentally friendly and sustainable alternative energy sources. Because of its considerable potential to reduce greenhouse gas emissions and its renewable nature, biodiesel derived from WCO has gained attention as a feasible alternative. Enhancing product quality and guaranteeing consistent economic growth are substantial challenges. This investigation aims to assess the feasibility of utilizing WCO as a renewable resource to produce biodiesel. In particular, the investigation investigates the feasibility of obtaining cost-effective and high-quality biodiesel results. To optimize outcomes, this investigation implements a transesterification approach that employs calcium oxide catalysts. Biodiesel's economic value and environmental benefits are assessed through the Life Cycle Cost Assessment (LCCA) assessment method. WCO biodiesel exhibits a high conversion rate and favorable physicochemical properties, as indicated by the results. Therefore, WCO biodiesel can meet the worldwide demand for fuel. The results show that WCO biodiesel has favorable physicochemical properties and a high conversion rate. As a result, WCO biodiesel can meet global fuel demand. It has the potential to generate many benefits for the environment, but there are problems with the collection and processing of WCO. However, WCO collection and processing issues still exist. Biodiesel derived from WCO reduces harmful pollutants, improves public health and air purity, according to engine performance tests.

Occupational Noise Exposure in Foot and Ankle Surgery and the Risk of Noise-Induced Hearing Loss.

Occupational exposure to high levels of noise increases the risk of noise-induced hearing loss (NIHL), resulting in significant long-term quality of life implications. Hearing protection is recommended if occupational noise exposure routinely exceeds 85 decibels (dB). The purpose of this study was to determine if foot and ankle surgeons are exposed to excessive levels of noise, thus putting them at an increased risk for NIHL. A prospective review was conducted of intraoperative recordings during a variety of foot and ankle procedures. Recordings were categorized into 3 subgroups: trauma, deformity correction and degenerative conditions, and soft tissue procedures. Noise levels were reported as maximum dB level (MDL) and time-weighted average (TWA), defined as the average dB level projected over an 8-hour period. Dose was reported as the percentage of allowable daily noise, with projected dose reported as the measured dose projected over an 8-hour period. A total of 147 operative recordings consisting of 64 (44%) deformity correction and degenerative conditions, 40 (27%) soft tissue procedures, and 43 (29%) trauma cases were collected. Maximal and average noise exposures were similar for all procedures (P = .077; P = .090), with an average MDL of 98.9 dB (range, 87.9-109.2) and TWA of 60.5 dB. Procedures also did not significantly differ in dose (P = .273), even when projected over an 8-hour period (P = .362). The average MDL of total ankle arthroplasty (TAA) and hindfoot arthrodesis procedures was 101.5 dB (range, 93.9-109.2), with 52% of all deformity correction and degenerative procedures having an MDL over 100.0 dB. Foot and ankle surgeons are typically not exposed to dangerous levels of occupational noise as per National Institute for Occupational Safety and Health recommendation; however, specific procedures, such as arthrodesis and TAA, routinely achieve noise levels that are above the recommended limits.

Parasite Fauna of Sand and Stone Sculpins (Scorpaeniformes, Cottidae) from Lake Baikal (Review of Results and Prospects of Investigations)

Parasite Fauna of Sand and Stone Sculpins (Scorpaeniformes, Cottidae) from Lake Baikal (Review of Results and Prospects of Investigations)

Correction: Solar-driven carbon dioxide reduction: a review of recent developments and future prospects

Correction: Solar-driven carbon dioxide reduction: a review of recent developments and future prospects

HPB SO09 - Review of the management and the outcome of acute pancreatitis in a tertiary centre in the United Kingdom

Abstract Background Acute idiopathic pancreatitis (IP) is a challenging condition in surgical practice. We undertook a prospective review of all patients presenting with idiopathic pancreatitis to identify the natural course of the disease. Method Fifty-nine patients were identified within a 12-month period from a prospectively maintained database. Patients were diagnosed with idiopathic pancreatitis (IP) following a standardised protocol excluding other causes of pancreatitis. Results Over one year, a total of 373 new patients with acute pancreatitis were admitted. IP constituted 15.8% of admissions; 15.2 % of which presented with severe pancreatitis. Average LOS for the index IP admission was 7.05 days, compared with 6.4 days for the rest of cohort. 8.47% with IP were re-admitted within 3 months of index admission, increasing to 13.6% over 12 months. Overall, 16.9% developed long term complications including pancreatic insufficiency or chronic pancreatitis over 12 months compared to 15.3% in the rest of AP cohort. The mortality rate was 3.4% and 12.1% in the IP and AP cohort respectively. Conclusion Idiopathic pancreatitis constitutes a larger burden than expected in a large prospective cohort of patients with AP. Patients with IP have a longer LOS and a high risk of long-term sequelae.

Abstract 4136822: Implementation of a Community-Engaged Amputation Prevention Intervention in Rural Appalachia

Amputation is a devastating complication of diabetes and peripheral artery disease and a marker for health inequity. Implementation Science (IS) and Community Engaged-Research (CenR) allow for real-world adaptation of evidence-based interventions and provide critical frameworks for reproducibility and sustainability. However, few amputation interventions use these approaches. We describe the feasibility and acceptability of an IS and CEnR driven amputation intervention in a high-risk rural community. A Pre-Post mixed methods design was used (Fig 1). Intervention components were mapped to the Social-Ecological Model (Fig 2) and guided by the CFIR. Community and Project Advisory Boards collaborated on needs assessment, mobilizing resources, intervention adaptation, data review and dissemination. A 3-component intervention was implemented in 2 clinics to improve local foot care. Components included diabetic foot exams (DFEs), a multidisciplinary limb preservation team, and a “hot-foot” hotline. Pre-implementation, a retrospective chart review was performed along with focus groups. DFE training was then conducted at each site. After training, a prospective chart review was performed with clinic check-ins for 12 months. Focus groups were held 6- and 12-months post-implementation. Concurrently, monthly multidisciplinary teleconferences were held, and a “hot-foot” phoneline connected providers to specialty nurses. At baseline, 155/224 (69.2%) patients received an annual DFE, 17% had all four exam components, 15.6% had foot abnormalities identified and 3.6% were referred to specialists. At 12-months 212/268 (79.1%) patients received a DFE, 84.7% had all components, 54.9% had abnormalities and 20.1% were referred. All findings were statistically significant. Clinically there was a significant decrease in patients with foot wounds, infection, and foot-related hospitalization/ED visits. There were no changes in amputations. (Table 1) The virtual teleconference completed 12 sessions. The hotline was used once with clinicians reporting they did not need it. We demonstrate successful, sustained implementation of an amputation prevention intervention in a high-risk rural community using IS and CEnR. This approach was crucial for overcoming barriers to intervention implementation in a resource poor environment. Additional research to assess patient experience, understand key components of the intervention and study scalability and clinical effectiveness is planned.

BIOM-75. MRI FLAIR SIGNAL ASSESSMENT IN NEURO-ONCOLOGY (SANO) AS A MEASURABLE TIMEPOINT FOR INTERVENTIONAL THERAPY PRIOR TO PROGRESSION IN HIGH GRADE GLIOMAS: A WINDOW OF OPPORTUNITY

Abstract BACKGROUND There are no validated clinical or radiographic assessments for response to therapy in glioblastoma (GBM). Offering interventions at the time of progression using our current assessment tools is likely too late as second-line therapies have failed to significantly delay progression and extend survival. In 2020, our team was first in the US to publish the largest and most comprehensive retrospective review identifying the T2/FLAIR MRI signal assessment protocol as an early indicator of progressive GBM. We proposed that the time of FLAIR signal abnormality within the resection cavity (RC) anticipated GBM progression by nearly 4 months and if used as a timepoint for therapeutic intervention could reshape glioma clinical trial design. METHODS To support validation of SANO, a prospective assessment of 146 GBM patients between 2019-2021 yielded 71 cases meeting resection and imaging inclusion criteria. We analyzed sequential brain MRIs from initial diagnosis to first progression for development of T2 FLAIR signal intensity (SI) within the RC as previously reported (Gatson et al 2020) and included cases with ventricle associated surgery as a comparator. PFS and OS were evaluated using Kaplan-Meier curves stratified by SI. RESULTS Development of SI occurred in 80.3% (n=57) GBM patients on average 2.8 months before RANO-assessed progression. A faster time to progression from SI development occurred in cases with ventricle associated RC. SI-positivity again portended poorer outcomes for PFS and OS as compared to SI-negative cases. Use of the eye (globe) for FLAIR assessment, instead of the ventricles, to qualitatively discern the presence of SI in ventricle associated RC. CONCLUSIONS This small prospective review supports our initial findings to validate a highly sensitive brain tumor imaging biomarker, SI, and should at least supplement existing response assessment criteria to improve declaration of GBM progression. Furthermore, use of SANO might also offer an earlier window of opportunity for salvage therapy intervention and offer new avenues for glioma clinical trial design.

The prevalence of synovitis during hip arthroscopy for labral tears – An observational study

Objectives: Hip pain, secondary to labral tears (LT), can significantly impact the quality of life in the young adult population. LTs can be an incidental finding or can arise from underlying pathology, most commonly from femoroacetabular impingement (FAI). The cause of hip pain in young adults can represent a diagnostic challenge to clinicians. Magnetic resonance imaging (MRI)/magnetic resonance arthrography may be inconclusive in some cases. Therefore, diagnostic hip arthroscopy may be performed to provide a definitive diagnosis and to address intra-articular pathology. During hip arthroscopy, synovitis is often an initial finding. Synovitis can have multiple causes or can also be idiopathic. The aim of this study was to determine the incidence of synovitis detected during hip arthroscopy in patients with an MRI-confirmed LT. Materials and Methods: We conducted a prospective review of 50 consecutive patients undergoing hip arthroscopy who had a confirmed LT on MRI. We recorded the presence or absence of synovitis during the initial insertion of the arthroscope. In addition, we recorded demographic data and the grade of LT identified. Results: During hip arthroscopy, 31 patients had synovitis present, while 19 did not have synovitis. No significant difference was identified when comparing Visual Analog Score and EQ5D scores between both cohorts. Conclusion: Our study found that synovitis is a common finding during hip arthroscopy for FAI syndrome, with 62% of patients with an MRI diagnosis of LT associated with FAI having global hip synovitis present at the time of surgery.

Efficacy of domestic single-hole robotic surgery system in the treatment of pediatric urological diseases

To explore the efficacy of domestic single-hole robotic surgery system in the treatment of pediatric urological diseases. A prospective review of clinical data of children who underwent laparoscopic surgery in the Department of Urology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, was conducted from July to November 2023. All surgeries were performed using the sharp single-port serpentine arm robotic surgery system, with an umbilical access route. All surgeries are performed by the same chief physician. Operative time, intraoperative blood loss, incision size, and postoperative complications were recorded. A total of 12 patients were included, consisting of 8 males and 4 females, aged 8.0-17.0 (13.5±2.7) years. The procedures included 5 pyeloplasties (1 case of bilateral pyeloplasty), with a unilateral operative time [M (Q1, Q3) ]of 180 (145, 200) minutes and a blood loss of 5 (5, 10) ml. Oral mucosa ureteroplasty was performed in 1 patient, taking 3 hours and 52 minutes with a blood loss of 10 ml. Renal cyst decortication was conducted in 1 case in 85 minutes with a blood loss of 20 ml. High ligation of the spermatic vein was conducted in 3 patients, with an average operative time of 97 minutes and no intraoperative blood loss. Bilateral gonadectomy was completed in 80 minutes with a blood loss of 5 ml. Ovarian cystectomy (1 case) was performed in 69 minutes with a blood loss of 5 ml. All surgeries were successfully completed without conversion to open surgery. Except for the oral mucosa ureteroplasty, which required an additional 5 mm auxiliary port, all procedures were performed through a 3 cm umbilical incision. Among the patients who underwent pyeloplasty, 1 case of urinary leak was identified and successfully treated conservatively with adequate drainage over 25 days. Re-stenosis was experienced by 1 patient with a long segment ureteral stricture postoperatively, while no Clavien-Dindo grade≥2 complications were observed in other patients. All umbilical wounds were concealed, and satisfactory postoperative appearances were noted. The domestic single-hole robotic surgery system is effective in treating pediatric urological diseases.

Determinants of China's Oil Production: Review of Current Developments and Future Prospects

Crude oil is a key tool for national financial expansion, and the persistence of fluctuations in crude oil prices has affected all aspects of the economy. In order to maximize its global oil production, China's rapid economic development has necessitated an increase in claim for crude oil and increased its requirement on imported oil. This paper uses a combination of regression analysis and a time series model to achieve greater accuracy. The consequences of the Johansen Cointegration Test demonstrate the existence of a long-term association among crude oil production, the CP index, crude oil prices and GDP Per Capita. After the co-integration of the variables, VEC Model was then applied and Parsimonious model was established. In addition, the multiple regression analysis also shows that there are significant linear relationships between crude oil output, the CPI index, international crude oil prices and GDP per capita which specify that the model is well fit to the information and therefore reliable for future predictions. Diagnostic test such as normality, multicollinearity, heteroscedasticity and autocorrelation were performed and it was revealed that both OLS regression and VEC model did not suffer from a problem of first order autocorrelation, and heteroscedasticity. The OLS model shows that there is no problem of multicollinearity between the CPI index and Global crude oil values and this make the model not misleading and reliable. The satisfactory outcome of the diagnostic test which is also conformity to satisfaction of the basic underlying assumption show that the product is excellent, sturdy, and trustworthy.

WITHDRAWN: Advancements in Surface Plasmon Resonance Biosensors: A Comprehensive Review of Technologies, Applications, and Future Prospects

WITHDRAWN: Advancements in Surface Plasmon Resonance Biosensors: A Comprehensive Review of Technologies, Applications, and Future Prospects

A narrative review of veterinary pharmacovigilance situations and prospects in East African countries.

Veterinary pharmaceuticals must be safe and effective for treating and preventing diseases in animal sectors. Strict adherence to regulations at every stage of production, storage, and administration is necessary as the global sector grows in order to lower the possibility of adverse veterinary drug events. Strong pharmacovigilance regulatory systems are critical in monitoring and managing safety concerns related with veterinary pharmaceuticals. This review aimed to investigate the implementation of veterinary pharmacovigilance, collaborative initiatives, and reporting practices within the veterinary sector across East African countries. A thorough search was performed using online platforms such as Google Scholar, PubMed, the Web of Sciences, and regulatory Web sites. The search strategies relied heavily on selecting relevant published findings related to veterinary pharmacovigilance status, veterinary adverse drug event reporting practice, and collaborative efforts in veterinary pharmaceutical sectors within the East African landscape. This article search approach confirmed the inclusion state of veterinary pharmacovigilance and associated collaborative initiatives in the region. In comparison to more developed regions, the review indicated that the veterinary pharmacovigilance system in East African countries was still in its early state. A strong legislative foundation and a large commitment from the veterinary profession are needed to establish a nationwide veterinary pharmacovigilance system. The review reveals a significant lack of consistency in the infrastructure of veterinary pharmacovigilance among the countries of East Africa. Tanzania, Kenya, and Ethiopia have some institutional processes for veterinary pharmaceutical safety, but they lack thorough documentation, which suggests that this systems still require improvement. The analysis emphasizes how inadequate the reporting systems are for adverse veterinary medication events in the majority of East African nations. Given the challenges East Africa faces, customized strategies are required to guarantee the safety and oversight of veterinary medications and improve veterinary pharmacovigilance. For systems to be more effective, veterinary pharmaceutical legal frameworks must be strengthened and stakeholder collaboration must be improved. Stakeholders include legislators, law enforcement, customs officials, regulatory organizations, scientists, pharmaceutical businesses, veterinarians, farmers, and the general public. A multidisciplinary strategy is needed to solve current gaps in veterinary pharmacovigilance and improve overall veterinary drug safety in East Africa. It is feasible to create more reliable methods for tracking and guaranteeing the safety of veterinary medications by combining the efforts of numerous stakeholders, including as legislators, regulatory agencies, veterinary practitioners, and the general public.

Female urethral stricture

The aim of the present report was to provide an up-to-date overview of the existing literature on female urethral stricture (FUS) including its definition, epidemiology, risk factors, diagnostic and therapeutic approaches. A literature search was conducted in January 2024 using the MedLine and Embase databases, screening for randomized controlled trials (RCTs), prospective and retrospective series and reviews on female urethral stricture. Urethral stricture is a rare occurrence in female patients. However, as it can be responsible of any LUTS, a high level of suspicion is needed to avoid underdiagnosis which results in burdensome persisting LUTS in these patients, severely affecting their quality of life. PVR and uroflowmetry are the cornerstones of the screening process that should be used in every female patient with LUTS. Conversely, overdiagnosis and overuse of "random" urethral dilation could be equally harmful by generating FUS and a stringent and rigorous diagnostic process including urethrocystoscopy, urodynamics and fluoroscopy is needed to make the proper diagnosis. When FUS has been formally diagnosed, a single session of endoscopic treatment, ideally urethral dilation can be attempted. As in male patients, urethroplasty is the next step for any recurrence with various techniques being available (buccal mucosa vs vaginal flap; dorsal vs ventral onlay) with no robust evidence to support one over the other but which all yield satisfoactory outcomes with>85% of success. FUS is a rare occurrence but should be ruled out in every female LUTS. While endoscopic treatment is the first line management, several successful female urethroplasty techniques can be used to treat patients with recurrent FUS. The level of evidence on the diagnosis and treatment of FUS is overall very low.

Dynamics of Dairy Product Consumption, Confounding Factors, and Their Influence on the Risk of Type 2 Diabetes.

It has long been debated whether or not dairy consumption increases the risk of type 2 diabetes (T2D). This link has been assessed by a large number of case-control studies, prospective cohort studies, systematic reviews, and meta-analyses. The majority of their studies demonstrated an inverse relationship between the risk of T2D and dairy consumption. It is yet unclear how dairy products specifically contribute to metabolic diseases like type 2 diabetes. However, a surprising number of studies have indicated either no association or a positive correlation between the development of type 2 diabetes and certain dairy products. The objective of this narrative review is to collate research findings from diverse geographical contexts, exploring the impact of dairy product consumption on the incidence and risk of Type 2 diabetes (T2D). This review includes studies that addressed this research issue and were released between the years 2000 and 2023. This will help the public draw logical inferences and validate the body of recent research. To shed light on this matter, the writers conduct a comprehensive search of electronic scientific databases such as PubMed, Scopus, and Web of Science. Thus, this review emphasizes the connection between the usage of different dairy products and the risk of T2D. After controlling for confounding variables, this review indicates that the relationship between the incidence of type 2 diabetes and consumption of dairy products is context-dependent. In conclusion, not all dairy products help to prevent type 2 diabetes. There is no association between most other dairy products and T2D, while in some cases benefits of yogurt and other low-fat dairy products have been reported.

DUETS for Light's in separating exudate from transudate.

Fifty years since its inception, Light's criteria have aided in classifying pleural effusions (PEs) as exudates if 1 or more criteria are met. Thoracic ultrasound (US) emerges as a non-invasive technique for point of care use especially if pleural procedures are contemplated. We aimed to develop a score based on radiological and US features that could separate exudates from transudates without serum and pleural fluid biochemical tests necessary for Light's criteria. A prospective review of consecutive patients with PE who underwent thoracocentesis was performed. CXRs were evaluated for laterality followed by US for echogenicity, pleural nodularity, thickening and septations. PE was classified as exudate or transudate according to Light's criteria and corroborated with albumin gradient. A score combining radiological and US features was developed. We recruited 201 patients with PE requiring thoracocentesis. Mean age was 64 years, 51% were females, 164 (81.6%) were exudates, and 37 (18.4%) were transudates. Assigning 1-point for Diaphragmatic nodularity, Unilateral, Echogenicity, Pleural Thickening and Septations, DUETS ranged from 1 to 5. DUETS ≥2 indicated high likelihood for exudate (PPV 98.8%, NPV 100%) with 1% misclassification versus 6.9% using Light's criteria (p < 0.001). DUETS separated exudates from transudates with good accuracy, and could obviate paired serum and pleural fluid tests necessary for Light's criteria computation. Our study reflected real world practice where DUETS performed better than Light's criteria for PE that arose from more than one disease processes, and in the evaluation of patients with PE who have received diuretics.