Mucosal melanoma is rare and the occurrence of an invasive malignant melanoma metastasis 11 years post-initial diagnosis is equally uncommon. This is a case of a 66-year-old woman with a history of ...bilateral vulvar invasive melanoma, who presented with an enlarging inguinal mass with associated tenderness upon palpation. After a right inguinal excisional lymph node biopsy, the pathological findings determined the final diagnosis as metastatic melanoma. To the best of our knowledge, this is the first report of vulvar mucosal melanoma metastasis greater than 10 years after initial diagnosis and treatment in the English language. This case discusses how treatment options for metastatic mucosal melanoma pose a challenge in such cases where follow-up for medical care is lacking. It also highlights the need for further preventative techniques and research directed towards screening techniques, staging guidelines, and treatment options for mucosal melanoma.
Wheelchair users face an elevated risk of metabolic syndromes due to their sedentary lifestyles. One of the methods to prevent and treat various metabolic syndromes is regular physical activity, ...which varies among individuals based on their abilities. Monitoring physical activity among them can be performed by using wearable physical activity monitors (WPAMs), which utilize accelerometers and algorithms to track wheelchair push counts. However, the accuracy of push count detection varies among the devices due to technological limitations. The objective of this literature review was to evaluate the accuracy of WPAMs, specifically smartwatches, in measuring physical activity in the wheelchair population. This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched in November 2022 for relevant articles. The initial search yielded 447 articles, seven of which were selected based on the inclusion criteria, which were as follows: participant ability to maneuver a wheelchair, arm- or wrist-worn WPAMs, and articles published after 2017. Among the devices studied, the Apple Watch was determined to be the most accurate calibration system for wheelchair users, with the lowest mean absolute percentage error (MAPE). Each succeeding generation of the Apple Watch (first to fourth) studied was more accurate than the previous. The review demonstrates that research on wheelchair fitness tracking remains scarce and further studies are required to address this issue.
Surgery is a common and often necessary treatment option for a wide range of medical conditions, with an estimated 40 to 50 million surgeries performed in the US alone each year. While the various ...types of surgeries performed may be effective in treating or managing different conditions, the post-operative period can be challenging for patients. Osteopathic manipulative treatment (OMT) is a hands-on approach to medical care that seeks to restore balance and harmony to the body from the lens of an interconnected mind, body, and spirit. Given the potential for adverse events in patients following surgical treatments, OMT may be a viable adjunct post-operatively to enhance patient care and recovery. The purpose of this scoping review is to evaluate the state of current research examining the effectiveness of OMT in improving outcomes in post-operative patients. Three hundred articles were collected; 53 duplicates were removed. Eleven independent reviewers evaluated all 247 articles. Thirty articles were identified, including nine in general surgery, six in cardiothoracic surgery, five in orthopedic surgery, four in spinal surgery, three in neurosurgery, and three others (otolaryngology, oral/maxillofacial, and gynecologic surgery). Post-operative patients were treated with various OMT techniques with myofascial release and muscle energy being some of the most common treatments utilized in all surgical fields. Many studies demonstrated the benefits of OMT usage including significant pain relief, improved and earlier bowel function, and decreased lengths of hospital stay. This study demonstrates how OMT can be effective in reducing post-operative pain, reducing the incidence of post-operative ileus, and shortening the length of stay. Further research into the utilization of OMT in post-operative patients should be considered a potential adjunct to surgical intervention, especially in vulnerable patient populations.
Background
Excess epicardial fat volume (EFV) has been recently implicated in cardiovascular structural and functional abnormalities. It has been associated with abnormal microvascular stiffness (as ...reflected by radial artery waveform; C2), which may result in microvascular dysfunction and contribute to the atypical chest pain syndrome without obstructive coronary artery disease (CAD). Women have been statistically shown to present with atypical chest pain more often than men and specifically without obstructive CAD. The aim of this study is to assess whether excess EFV in female subjects is associated with significant microvascular dysfunction (i.e., C2), in subjects without obstructive CAD.
Results
We screened 596 asymptomatic subjects, ages 20–79, using the Early Cardiovascular Health Risk Scoring System (ECVHRS), which has been reported. Out of the 596 total subjects, 230 subjects had a CACS. Out of these 230 subjects, 77 subjects (45 females; 32 males) had a 0 CACS. The 45 females from this cohort were the subjects of this study, and they were further categorized into 3 groups: group 1 (normal EFV, non-obese female subjects;
n
=16), females with ECVHRS < 3 and ACC/AHA risk score < 5%; group 2 (
n
= 9), females with elevated EFV and no abdominal visceral obesity; and group 3 (
n
=20), females with elevated EFV and abdominal visceral obesity. The average EFV was determined to be 72±20 cm
3
among group 1, which indicates the values for normal EFV. The results in group 2 indicate that excess EFV is contributing to the development of microvascular dysfunction, resulting in abnormal micro-arterial (C2) elasticity (
p
< 0.00001), increase in resting blood pressure (
p
=0.0001), an abnormal rise in blood pressure (BP) at rest and post-mild protocol exercise (PME) (
p
= < 0.00001), and abnormal increase in carotid intima-media thickness (CIMT) (
p
= 0.000164).
Conclusion
Excess EFV appears to be not only a novel cardiovascular risk marker, but also the culprit for other cardiovascular risk markers. Based on these findings, elevated EFV may contribute to the development of the atypical chest pain syndrome in females without obstructive CAD. Additionally, EFV is emerging as a potential clinically relevant significant cardiovascular risk biomarker and may become a target to reduce cardiovascular morbidity and mortality.
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•Iron based MOFs and GQD incorporated iron MOFs (GQD-Fe-MOFs) were synthesized.•Role of GQD based composite on degradation of Congo red dye was examined.•GQD-Fe-MOFs showed higher ...degradation and decolorization efficiency than parent MOF.•Ultrahigh photocatalytic degradation efficiency of 1876 mg/g was obtained.
The present work outlines the synthesis of a visible light responsive photocatalyst by incorporating graphene quantum dots (GQD) in an iron-based metal organic framework (MOF) (i.e., MIL-100(Fe). The composite was synthesized via one-pot solvothermal approach and applied for degradation of Congo red (CR) dye from contaminated water. The composite was characterized in terms of structure, functionality, morphology, and optical properties. Noteworthy, the composite showed significant improvement in the photocatalytic activity in comparison with nascent MIL-100(Fe). Incorporation of GQD in the MOF framework resulted in increased surface area and pore volume and reduced PL intensity. MIL-100/GQD showed maximum dye degradation of 93.8% within 5 min of contact time using photocatalyst dose of 0.025 g/L. The incorporation of GQD resulted in increased charge separation between holes and electrons compared to pre MIL-100 (Fe) as evident from the PL spectra. The Mott-Schottky plot and the trapping experiment demonstrated that the active species like h+ and ̇O2− were responsible for degradation of CR dye. The photocatalyst exhibited appreciable reusability even after four cycles of reuse.
A BSTRACT Aim and Objective: To assess the dentist perception of efficiency, treatment outcome, and stability of the tooth movement treated with mysmartalign clear aligner therapy (MSA CAT). ...Materials and Method: A cross-sectional web-based questionnaire survey was carried out to evaluate the dentist perception of MYSMARTALIGN (MSA). To determine the sample size, a pilot study has been carried out and the final sample arrived was 4990 subjects. The current study’s inclusion criteria took into account those who had finished their BDS and MDS as well as dentists and orthodontists who had been using the MSA CAT system on their patients for the previous 7 years. Results: The result of the study showed that most research participants (3650) used MSA to treat mild to moderate malocclusion, and 3996 participants said that initial digital treatment plans have been authorised with no revisions. In view of efficiency, 3894 doctors were satisfied with the final outcome. Conclusions: Finally concluded that recent survey showed that dentists were very satisfied with the effectiveness and treatment results of the MSA clear aligner procedure.
Contemporary advances in material development associated with membrane gas separation refer to the cost-effective fabrication of high-performance, defect-free mixed matrix membranes (MMMs). For clean ...energy production, natural gas purification, and CO2 capture from flue gas systems, constituting a functional integration of polymer matrix and inorganic filler materials find huge applications. The broad domain of research and development of MMMs focused on the selection of appropriate materials, inexpensive membrane fabrication, and comparative study with other gas separation membranes for real-world applications. This study addressed a comprehensive review of the advanced MMMs wrapping various facets of membrane material selection; polymer and filler particle morphology and compatibility between the phases and the relevance of several fillers in the assembly of MMMs are analyzed. Further, the research on binary MMMs, their problems, and solutions to overcome these challenges have also been discussed. Finally, the future directions and scope of work on quaternary MMM are scrutinized in the article.
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•Comprehensive review of the advanced MMMs wrapping various facets of membranes.•Filler modification to improve the gas separation performance.•Ternary/quaternary MMMs to overcome the lacunae of binary MMM.•Defect-free biopolymeric MMMs are an option for large-scale applications.•MMM with MOFs, and MXenes enhanced the CO2 separation performance.
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