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INTRODUCTION: Entrustable professional activities (EPAs) are units of concrete daily clinical tasks that trainee physicians should be able to handle with increasing autonomy during their postgraduate training. EPAs are gaining international recognition as an essential component of competency-based medical training programmes. The process of developing EPAs for a nationwide training programme is complex and requires an in-depth understanding of EPAs as a concept and good knowledge of appropriate development processes...

Light-assisted Li-O2 batteries exhibit a high round-trip efficiency attributable to the assistance of light-generated electrons and holes in oxygen reduction and evolution reactions. Nonetheless, the excitonic effect arising from Coulomb interaction between electrons and holes impedes carrier separation, thus hindering efficient utilization of photo-energy. Herein, porphyrinic metal-organic frameworks with (Fe2 Ni)O(COO)6 clusters were used as photocathodes to accelerate exciton dissociation into charge carriers for light-assisted Li-O2 batteries...

Cervical cancer screening programs, including triage tests, need redesigning as human papillomavirus (HPV)-vaccinated women are entering the programs. Methylation markers offer a potential solution to reduce false-positive rates by identifying clinically relevant cervical lesions with progressive potential. In a nested case-control study, 9242 women who received the three-dose HPV16/18-vaccine at ages 12-15 or 18 in a community-randomized trial were included. Subsequently, they were re-randomized for either frequent or infrequent cervical cancer screening trials...

Facial dysostosis syndromes (FDS) are rare congenital conditions impacting facial development, often leading to diverse craniofacial abnormalities. This study addresses the scarcity of evidence on these syndromes about optimal diagnostic and treatment practices. To overcome this scarcity, European experts from ERN CRANIO collaborated to develop a clinical consensus statement through the Delphi consensus method. A systematic search of Embase, MEDLINE/PubMed, Cochrane, and Web of Science databases was conducted until February 2023...

INTRODUCTION: Primary immune thrombocytopenia (ITP) is an acquired disorder of platelets with complex and unclear mechanism of increased immune distruction or impaired production of platelets. While management of ITP is evolving, there is a need for guidance particularly in certain circumstances such as pregnancy, emergency and for patients requiring co-medications. We aimed to determine the tendencies of hematologists in Turkiye on such special conditions. METHODS: As a modified Delphi method, Turkish National ITP Working Group founded under Turkish Society of Hematology developed a questionnaire consisting of statements regarding pregnancy, emergency and circumstances regarding co-treatment with antiaggregant or anticoagulants...

Oncocytic mucoepidermoid carcinoma (OMEC) is an uncommon variant of mucoepidermoid carcinoma. Histopathologically, it is characterised by the predominance of cells with large polygonal morphology and with an abundance of eosinophilic granules. We present a rare case of OMEC manifested as painless palatal swelling in a 25-year-old young male. The overlying mucosa was normal in appearance, with no evidence of ulceration or discharge. Histopathology examination showed the presence of sheets of mucous and intermediate cells along with cystic areas of variable sizes and shapes...

BACKGROUND: Various artificial chemical agents have been evaluated over many years with respect to their antimicrobial effect in oral cavity. The gold standard for removal of plaque is usage of chlorhexidine, but it can cause alteration in taste sensation and staining of teeth. Electrolytes and oxidizing water may be useful against microbes, but its clinical application has still not been evaluated. Hence this present study was conducted to evaluate the effectiveness of the alkaline ionized water on oral microbial flora...

OBJECTIVE: Resident autonomy in an operation theatre has been directly linked with patient safety in healthcare. The objective of this study was to identify the factors necessary for making resident-entrustment decisions from the perspective of a supervisor/consultant viewpoint. The second objective was to develop a checklist for assessing resident readiness for independent work. MATERIALS AND METHODS: This study employed a mixed-method Delphi approach. In the first stage, a comprehensive literature review and a qualitative exploratory study produced a list of factors related to residents...

A metastatic condition involving signet ring cells rich in mucin is the Krukenberg tumor, which affects the ovaries. Usually, the metastatic disease does not include both ovaries and usually originates from the stomach side, while it can also occur less frequently from other locations. Krukenberg tumors are uncommon in younger age groups and usually occur after the age of 40. We report a case of a 34-year-old female patient with a primary form of past medical history. The patient was treated with multiple rounds of chemotherapy...

Magnetic foreign body ingestion poses a threat especially if more than one is ingested. If consumed alone, small magnetic foreign bodies are likely to pass without significant event; however, when multiple magnets are ingested, they can be attracted to each other through the intestinal wall, which may lead to serious consequences and complications, including bowel perforation, obstruction, peritonitis, and death. We report a case of a 2-years male child patient presented with multiple small round magnetic beads ingestion from a magnetic pendant that appeared like a necklace pearl after conglomeration on abdominal radiograph...

BACKGROUND: Malnutrition affects up to a third of children in India, with severe and acute malnutrition prevalent among under five children. Nutritional assessment skills for detecting malnutrition in children in primary care settings are vital. Hybrid problem-based learning (HPBL) is an innovative, collaborative, and adaptable instructional learning strategy that can be used to teach medical students clinical skills in a community setting. METHODS: A two-month quasi-experimental study was undertaken in a rural setting with third-year medical students...

As therapies, oncolytic viruses regress tumors and have the potential to induce antitumor immune responses that clear hard-to-treat and late-stage cancers. Despite this promise, clearance from the blood prevents treatment of internal solid tumors. To address this issue, we developed virus-delivering Salmonella (VDS) to carry oncolytic viruses into cancer cells. The VDS strain contains the PsseJ-lysE delivery circuit and has deletions in four homologous recombination genes (Δ recB , Δs bcB , Δ sbcCD , and Δ recF ) to preserve essential hairpins in the viral genome required for replication and infectivity...

Species of the family Polycephalomycetaceae grow on insects or entomopathogenic fungi and are distributed from tropical to subtropical regions. This study proposed four new species of hyperparasitic fungi from China based on six molecular markers (ITS, SSU, LSU, TEF-1α , RPB1 and RPB2 ) phylogenetic analyses and morphological characteristics. The four new species, i.e. Pleurocordycepslitangensis , Polycephalomycesjinghongensis , Po.multiperitheciatae and Po.myrmecophilus , were described and illustrated...

Angiogenesis, as a tumor hallmark, plays an important role in the growth and development of the tumor vasculature system. There is a huge amount of evidence suggesting that the vascular endothelial growth factor receptor (VEGFR-2)/VEGF-A axis is one of the main contributors to tumor angiogenesis and metastasis. Thus, inhibition of the VEGFR-2 signaling pathway by anti-VEGFR-2 mAb can retard tumor growth. In this study, we employ phage display technology and solution-phase biopanning (SPB) to isolate specific single-chain variable fragments (scFvs) against VEGFR-2 and report on the receptor binding characteristics of the candidate scFvs A semisynthetic phage antibody library to isolate anti-VEGFR-2 scFvs through an SPB performed with decreasing concentrations of the VEGFR-2-His tag and VEGFR-2-biotin...

BACKGROUND/OBJECTIVE: Severe dysphagia is a rare presenting symptom of primary hyperparathyroidism, whereas the most common hypercalcemia-related causes include gastrointestinal symptoms, such as anorexia, constipation, and pancreatitis. This case presentation aimed to describe swallowing difficulty as a leading symptom of hypercalcemia. CASE REPORT: A 62-year-old man experienced vomiting, dysphagia bordering with aphagia, and 20-kg weight loss in a 2-month period...

We developed an expert panel approach for identifying expert views on the effectiveness and implementability of population-level policy interventions. ROMPER-the RAND/USC OPTIC Method for Policy Expert Ratings-involves an online, three-round, modified-Delphi process:•Experts rate and comment on policies according to domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework.•To identify consensus on policy effectiveness and implementability, expert ratings are analyzed using the Inter-Percentile Range Adjusted for Symmetry (IPRAS) technique from the RAND/UCLA Appropriateness Method and visualized using a forest plot...

Medical librarians participating as infectious disease rounding team members add value by facilitating knowledge acquisition and dissemination and by improving clinical decision making. This pilot study implementing medical librarians on infectious disease rounding teams was a well-received and beneficial intervention to study participants.

OBJECTIVES: Calcifying nanoparticles (CNPs), referred to as nanobacteria (NB), are recognized to be associated with ectopic calcification. This study aims to isolate and culture CNPs from the dental plaque of patients with periodontal disease and investigate their possible role in unravelling the aetiology of periodontal disease. MATERIAL AND METHODS: Supragingival and subgingival plaques were sampled from 30 periodontitis patients for CNPs isolation and culture...

Four species of the genus Longidorus were recovered from southern (Bushehr province) and southeastern (Southern Khorasan province) Iran. The first species, L. paratabrizicus n. sp. represents a new member to the genus and is characterised by 4.8-5.6 mm long females with anteriorly flattened lip region separated from the rest of the body by depression, amphidial fovea pocket-shaped without lobes, tail conical, dorsally convex, ventrally almost straight with bluntly rounded tip and males in population. By having similar lip region and tail shape, the new species most closely resembles five species viz...

Extreme weather and climate events have become more frequent and directly affect the ecological structure and function of integrated grazing lands. While the Great Plains have experienced a long history of regular disturbances from drought and floods, grazing, and fires, the increased frequency and magnitude of these disturbances can reduce ecological resilience, largely depending on management practices. Alternative strategies designed to adaptively manage grazing land resources based on the ecology of the system should increase the resistance and resilience to disturbances when compared to prevailing practices...