Traveller

A 21-year-old female patient presented with fever, pharyngitis, lymphadenopathy and generalized exanthema that had started 2 weeks prior. Allergies were not known, the family and travel history were negative. Due to depression, Duloxetine had been taken for 1.5 years, and due to bipolar disorder, a treatment with Lamotrigine was started four weeks prior but was stopped because of increased transaminase levels. Laboratory findings on admission showed eosinophilia (1.327 /nl), lymphocytosis and acute hepatitis (GOT 428 U/l, GPT 438 U/l) with deranged coagulation...

Objectives. To examine the accessibility of hospital facilities with maternity care services in 1 rural county in Alabama in preparation for the initiation of prenatal care services at a federally qualified health center. Methods. We analyzed driving distance (in miles) from maternal city of residence in Conecuh County, Alabama to hospital of delivery, using 2019-2021 vital statistics data and geographic information system (GIS) software. Results. A total of 370 births to mothers who have home addresses in Conecuh County were reported, and 368 of those were in hospital facilities...

INTRODUCTION: The analysis of patients submitted to heart surgery at three assessment times has been insufficiently described in the literature. OBJECTIVE: To analyze chest expansion, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), distance traveled on the six-minute walk test (6MWT), and quality of life in the preoperative period, fourth postoperative day (4th PO), and 30th day after hospital discharge (30th-day HD) in individuals submitted to elective heart surgery...

BACKGROUND: Community-based mask wearing has been shown to reduce the transmission of SARS-CoV-2. However, few studies have conducted an economic evaluation of mask mandates, specifically in public transportation settings. This study evaluated the cost-effectiveness of implementing mask mandates for subway passengers in the United States by evaluating its potential to reduce COVID-19 transmission during subway travel. MATERIALS AND METHODS: We assessed the health impacts and costs of subway mask mandates compared to mask recommendations based on the number of infections that would occur during subway travel in the U...

Measuring breathing rates is a means by which oxygen intake and metabolic rates can be estimated to determine food requirements and energy expenditure of killer whales (Orcinus orca) and other cetaceans. This relatively simple measure also allows the energetic consequences of environmental stressors to cetaceans to be understood but requires knowing respiration rates while they are engaged in different behaviours such as resting, travelling and foraging. We calculated respiration rates for different behavioural states of southern and northern resident killer whales using video from UAV drones and concurrent biologging data from animal-borne tags...

BACKGROUND: One of the few studies to estimate infection risk with SARS-CoV-2 in the general population was the UK Office of National Statistics Infection Survey. This survey provided data that allowed us to describe and interpret apparent risk factors for testing positive for SARS-CoV-2 in a period when variants and COVID-19 controls experienced large changes. METHOD: The ONS published estimates of likelihood of individuals testing positive in two week monitoring periods between 21st November 2021 and 7th May 2022, relating this positivity to social and behavioural factors...

The outer membrane (OM) of didermic gram-negative bacteria is essential for growth, maintenance of cellular integrity, and innate resistance to many antimicrobials. Its asymmetric lipid distribution, with phospholipids in the inner leaflet and lipopolysaccharides (LPS) in the outer leaflet, is required for these functions. Lpt proteins form a transenvelope bridge that transports newly synthesized LPS from the inner membrane (IM) to OM, but how the bulk of phospholipids are transported between these membranes is poorly understood...

BACKGROUND: Despite its significant roles in the functions of the platysma and lower lip, the cervical branch of the facial nerve is often overlooked compared to other branches, a consideration critical for ensuring the safety of neck surgeries. OBJECTIVES: We aimed to clarify the anatomical discrepancies associated with the cervical branch of the facial nerve to enhance surgical safety. METHODS: The study utilized twenty fresh-frozen hemiheads...

BACKGROUND: Cosmetic surgery tourism has become a significant global industry. Oftentimes, patients who develop postoperative complications present for care in their home U.S. state. OBJECTIVES: This study evaluated patients who either traveled abroad or to other states within the United States for cosmetic surgeries and returned with complications treated in the authors' center. We sought to compare rates of complications between patients that underwent cosmetic surgery internationally and domestically...

IMPORTANCE: Trichophyton indotineae is an emerging dermatophyte causing outbreaks of extensive tinea infections often unresponsive to terbinafine. This species has been detected worldwide and in multiple US states, yet detailed US data on infections with T indotineae are sparse and could improve treatment practices and medical understanding of transmission. OBJECTIVE: To correlate clinical features of T indotineae infections with in vitro antifungal susceptibility testing results, squalene epoxidase gene sequence variations, and isolate relatedness using whole-genome sequencing...

INTRODUCTION: Myasthenia gravis (MG) has a negative impact on patients' health-related quality of life; however, many clinicians do not fully understand their patients' lived experience of the disease. To understand the actual conditions of patients with MG and clarify the problems they perceive, we conducted a survey to evaluate the effects of the disease on patients' daily life and work. METHODS: A questionnaire-based, qualitative, cross-sectional, non-interventional survey was conducted in Japan between April and May 2022 in patients with MG who were receiving regular outpatient treatment...

This study reports a challenging diagnosis of Plasmodium ovale malaria in a Colombian citizen returning from Cameroon. Initial microscopy screenings conducted at two private hospitals yielded conflicting results, with the first showing negative smears and the second diagnosing P. vivax. Subsequent microscopy examinations at two government laboratories identified P. ovale, although the routine species-specific PCR strategy was negative. PCR confirmation was finally obtained when P. ovale wallikeri primers were used...

The enterotoxigenic Escherichia coli (ETEC) strain is one of the most frequent causative agents of childhood diarrhea and travelers' diarrhea in low-and middle-income countries. Among the virulence factors secreted by ETEC, the exoprotein EtpA has been described as an important. In the present study, a new detection tool for enterotoxigenic E. coli bacteria using the EtpA protein was developed. Initially, antigenic sequences of the EtpA protein were selected via in silico prediction. A chimeric recombinant protein, corresponding to the selected regions, was expressed in an E...

Soap bubbles exhibit abundant fascinating phenomena throughout the entire life of evolution with different fundamental physics governing them. Nevertheless, the complicated dynamics of small objects in soap films are still unrevealed. Here, we report the first observation of spontaneous particle ordering in a complicated galaxy of soap films without any external energy. The balance of interfacial tension at two liquid-gas interfaces is theoretically predicted to govern belted wetted particles (BWPs) traveling along a specified path spontaneously...

OBJECTIVES: This study aims to assess cancer patients' accessibility to healthcare services and perceived barriers during the COVID-19 pandemic in Khartoum state, aiming to explore the consequent impact on cancer patients. It also aims to determine the coping strategies used by patients to overcome these barriers. STUDY DESIGN: This is a retrospective analytical cross-sectional study. METHODS: Data were collected from August 2020 to March 2021, with a sample size of 316 cancer patients...

BACKGROUND: Student nurses in high-income countries are increasingly taking opportunities to undertake international clinical placements in low- and middle-income countries as part of their pre-registration studies. OBJECTIVES: This review aimed to identify and evaluate existing research explores what local people in low- and middle-income countries think of international clinical placements taking place in their localities. This includes a range of local stakeholders, such as clinicians (including midwives, nurses, physicians, pharmacists, and academics), healthcare students (from any discipline), patients, carers, and community members...

BACKGROUND: The emergence of the zoonotic monkey parasite Plasmodium knowlesi as the dominant cause of malaria in Malaysia has disrupted current national WHO elimination goals. Malaysia has free universal access to malaria care; however, out-of-pocket costs are unknown. This study estimated household costs of illness attributable to malaria due to P. knowlesi against other non-zoonotic Plasmodium species infections in Sabah, Malaysia. METHODOLOGY/PRINCIPAL FINDINGS: Household costs were estimated from patient-level surveys collected from four hospitals between 2013 and 2016...

Humans have the remarkable ability to manage foot-ground interaction seamlessly across terrain changes despite the high dynamic complexity of the task. Understanding how adaptation in the neuromotor system enables this level of robustness in the face of changing interaction dynamics is critical for developing more effective gait retraining interventions. We developed an adjustable surface stiffness treadmill (AdjuSST) to trigger these adaptation mechanisms and enable studies to better understand human adaptation to changing foot-ground dynamics...

BACKGROUND: In Malawi, community wide flooding, especially in high HIV burdened districts, continues to affect continuity of care and access to facilities. We explored the lived experiences of clients and healthcare workers (HCWs) to gain understanding of challenges and to propose interventions for improved ART care delivery. METHODS: Participants came six health facilities and surrounding communities impacted by flooding between Dec 2021-Apr 2022 in Chikwawa, Nsanje and Mulanje districts in Malawi...

UNLABELLED: Epilepsy, a neurological disorder affecting millions worldwide, poses great challenges in precisely delineating the epileptogenic zone - the brain region generating seizures - for effective treatment. High-frequency oscillations (HFOs) are emerging as promising biomarkers; however, the clinical utility is hindered by the difficulties in distinguishing pathological HFOs from non- epileptiform activities at single electrode and single patient resolution and understanding their dynamic role in epileptic networks...