Report of successful treatment of follicular occlusion triad with adalimumab and research progress on biologic therapy for follicular occlusion triad.

Purpose: This article aims to present a case report of a patient with Follicular occlusion triad (FOT) who achieved successful disease control with adalimumab combined with isotretinoin and provide a comprehensive review of the current research progress on biologic therapies for FOT.Methods: We report a case of a 22-year-old female patient diagnosed with FOT, who was treated with adalimumab combined with isotretinoin after failing to respond to conventional therapies. A systematic literature review was conducted to summarize the current research progress on biologic therapies for FOT, including TNF-α inhibitors, IL-17 inhibitors, IL-12/IL-23 inhibitors, IL-23 inhibitors, IL-1 inhibitors, and other novel biologic agents.Results: The patient achieved significant improvement in skin lesions, pain, and quality of life after three months of treatment with adalimumab combined with isotretinoin, without experiencing severe adverse reactions. The literature review revealed that adalimumab and secukinumab are the two FDA-approved biologics for FOT, while others, such as bimekizumab, infliximab, anakinra, and bermekimab, have shown promise in clinical studies.Conclusions: Biologic therapies have revolutionized FOT management, providing effective options for patients unresponsive to conventional treatments. As our understanding of FOT pathogenesis and the mechanisms of action of biologics grows, further advancements in biologic therapies for FOT are expected.

A Case of Follicular Atresia Triad Combined with Necrotising Fasciitis and Squamous Carcinoma of the Lower Limbs.

Follicular atresia triad, also known as paradoxical acne (FOT), is a rare and serious clinical syndrome in dermatology, mainly manifested by coalescing acne, purulent perifolliculitis of the head, and suppurative sweating inflammation, and FOT combined with necrotising fasciitis of the lower limbs and squamous cell carcinoma is rare both at home and abroad. In this article, we share the clinical data and treatment of a patient with follicular atresia triad and necrotising fasciitis and squamous cell carcinoma of the left lower limb for your reference.

The Prevalence of Stress Fractures and the Associated LEAF-Q Responses, Self-Reported Exercise Volume and Dietary Behaviors in Female Recreational Runners.

Previous research suggests a high prevalence of low energy availability (LEA) and stress fractures (SF) among competitive female endurance athletes. However, much less is known about these issues among recreational female runners. This study aimed to assess the prevalence and number of self-reported SF and risk of LEA among noncompetitive, recreationally active female runners, aged 18 - 25 years. Additionally, it compared characteristics between females with a history of multiple SF vs. one or no SF, and between those 'at risk' vs. 'not at risk' of LEA. Female recreational runners (n=485) completed an online survey that included the Low Energy Availability in Females Questionnaire (LEAF-Q) and the Disordered Eating Screening Assessment (DESA-6). Thirty-three percent of participants reported ≥ 2 SF. Eighty-two percent of the ≥ 2 SF group were classified as 'at risk' of LEA (LEAF-Q score ≥ 8). In addition, ≥ 2 SF was associated with higher total LEAF-Q score, self-reported intentional food restriction for weight loss, and self-reported current eating disorder while weekly exercise duration was inversely associated with ≥ 2 SF. In conclusion, one-third of participants had multiple SF with a majority (82%) of this group classified as 'at risk' of LEA. Screening tools such as the LEAF-Q and DESA-6 are useful tools to identify characteristics associated with multiple SF in this demographic, especially questions regarding food restriction and the presence of a current or previous eating disorder.

Atomistic Simulations Reveal Crucial Role of Metal Ions for Ligand Binding in Guanidine-I Riboswitch.

Riboswitches are structured ribonucleic acid (RNA) segments that act as specific sensors for small molecules in bacterial metabolism. Due to the flexible nature of these highly charged macromolecules, molecular dynamics simulations are instrumental to investigating the mechanistic details of their regulatory function. In the present study, the guanidine-I riboswitch serves as an example of how atomistic simulations can shed light on the effect of ions on the structure and dynamics of RNA and on ligand binding. Relying on two orthologous crystal structures from different bacterial species, it is demonstrated how the ion setup crucially determines whether the simulation yields meaningful insights into the conformational stability of the RNA, functionally relevant residues and RNA-ligand interactions. The ion setup in this context includes diffuse ions in solution and bound ions associated directly with the RNA, in particular a triad of 2 Mg2+ ions and a K+ ion in close proximity to the guanidinium binding site. A detailed investigation of the binding pocket reveals that the K+ from the ion triad plays a decisive role in stabilizing the ligand binding by stabilizing important localized interactions, which in turn contribute to the overall shape of the folded state of the RNA.

Endoscopic Management of Gastric Volvulus in an Elderly Patient With Multiple Comorbidities: A Case Report.

Gastric volvulus is a rare condition whose incidence remains largely unknown. Unless actively considered by healthcare providers, the diagnosis of gastric volvulus, which can lead to significant morbidity and mortality, may be overlooked. This condition can manifest in either acute or chronic forms, presenting with diverse symptoms. Notably, the presence of a hiatal hernia alongside persistent vomiting despite initial antiemetic therapy should raise suspicion for gastric volvulus, even if the patient appears clinically stable. Acute gastric volvulus is usually managed surgically. Here, we describe the case of an elderly male who was diagnosed with acute gastric volvulus and was treated conservatively with endoscopy.

Individual differences in the impostor phenomenon and its relevance in higher education in terms of burnout, generalized anxiety, and fear of failure.

Few theoretical and empirical works have described impostor phenomenon (IP) and no study explored impostorism from a dark perspective. We adopted a person-centered approach to identify clusters of impostors based on scores on the IP, perfectionistic self-presentation and the Dark Triad using a sample of 306 university students (Mage = 22.82). The latent profile analysis suggested a 6-cluster solution, which was further compared in terms of psychopathology symptoms (i.e., burnout, generalized anxiety, and fear of failure) by means of (M)ANOVAs. Our results indicated that impostorism relies on a self-presentation strategy. Moreover, individuals scoring high on IP experienced enhanced levels of psychopathology symptoms. Looking at IP from a continuum perspective might improve our understanding about what makes someone suffer from impostorism.

The anconeus-triceps lateral flap approach in terrible triad of the elbow: good outcome in a series of ten cases.

Introduction: Standard surgical management for the terrible triad of the elbow (TTE) has been established since 2004, yet postoperative complications are common and consensus on optimal management is absent. Different surgical algorithms for treating TTE and their efficacy have been reported worldwide, yet evidence from Vietnam remains limited. Methods: Ten cases diagnosed with TTE admitted to the Hospital of Traumatology and Orthopedics, a tertiary orthopedic center in Ho Chi Minh City, were presented to demonstrate the effectiveness and rate of postoperative complications following our stepwise surgical procedures using the anconeus-triceps lateral flap approach. The intraoperative "drop sign", quantitative assessment of pain and level of upper arm disability (via VAS and QuickDASH score) was mentioned to assess the algorithm's benefit. All patients' information was retrieved from medical records from August 2022 to January 2024. Results: All 10 cases required repair of the lateral ligament complex and underwent surgery within 2 days of hospitalization. Immediate postoperative imaging revealed no drop sign, and none of the patients experienced elbow dislocation nor the need for repeated surgery, and a full range of elbow motion was demonstrated at 3-6 months follow-up. Conclusion: TTE is a challenging injury that almost always obligates surgical correction. The anconeus-triceps lateral flap approach, with its advantages of better visualization and preservation of certain essential stabilizing muscles of the elbow, was demonstrated to yield a high success rate and low postoperative complication rate.

The dark side of mental toughness: a meta-analysis of the relationship between the dark triad traits and mental toughness.

Introduction: This meta-analysis investigates the relationships between the Dark Triad personality traits (narcissism, Machiavellianism, and psychopathy) and mental toughness. Previous research has shown mixed results regarding the influence of these traits on mental toughness. The objective of this meta-analysis is to synthesize existing literature and provide a comprehensive understanding of how Dark Triad traits correlate with mental toughness. Methods: A comprehensive literature search was conducted in 7 databases, Data were extracted by correlation and analyzed using a random-effects model. Results: The results yielding 27 effect sizes with a total of 12,378 participants, revealed a significant moderate positive association between narcissism and mental toughness (r = 0.327, p < 0.001), suggesting that individuals with higher levels of narcissism tend to exhibit greater mental toughness. However, no significant associations were found between Machiavellianism (r = 0.023, p = 0.719) or psychopathy (r = -0.022, p = 0.625) and mental toughness. Discussion: The findings contribute to a more nuanced understanding of the Dark Triad traits and their differential associations with adaptive psychological constructs, highlighting the unique role of narcissism in mental toughness. This meta-analysis provides valuable insights for future research and practical applications in fostering adaptive aspects of narcissism while mitigating its potential maladaptive consequences.

The Connection Between Dark Traits and Emotional Intelligence: A Multistudy Person-Centered Approach.

OBJECTIVE: Several studies have analyzed the relationship between Emotional Intelligence (EI) and dark personality, but the results are inconclusive. One study tested correlations between traits that may underlie a person-centered profile of "dark EI." Our study aimed to replicate and extend that research, identifying profiles in Spaniards and examining the differences between the profiles based on different variables of interest. METHOD: Two studies were designed, the first one (N = 1241) focused on trait EI and the Dark Triad, and the second one expanding the previous (N = 392) focusing on ability EI and the Dark Tetrad. RESULTS: Three profiles were obtained in both studies: nondark and non-EI profile, dark profile, and average narcissistic and high EI profile. The latter showed the highest self-esteem, strengths, well-being, and civic engagement, and the lowest psychological difficulties and personal distress. CONCLUSIONS: Our results reinforced the findings of the study we replicated, not supporting the presence of dark EI, but also not supporting the presence of high EI with very low levels of dark traits. These results have implications when designing preventive actions to improve emotional education.

Makeup Usage in Women Is Positively Associated to Narcissism and Extraversion but Negatively to Psychopathy.

Appearance modification practices are ubiquitous, serving to enhance physical attractiveness and accrue social advantages, including increased desirability as a potential mate. Facial cosmetics are frequently used for appearance modification, yet individual differences in makeup usage remain understudied. While makeup usage in women has been linked to traits like narcissism and extraversion, the broader association with Dark Triad traits and how personality influences makeup application across diverse social contexts were less explored. Here we examined these relationships in 1,410 Brazilian women (Mage = 29.9, SD = 10.35), who completed online Big Five and Dark Triad personality measures, reported their usual makeup usage habits, and detailed their makeup usage across different social scenarios. Results revealed makeup usage was positively associated with narcissism and extraversion, and negatively with psychopathy. Additionally, women used less makeup when alone (at home, exercises) and more in social settings, particularly for the first date. However, women with higher narcissism and neuroticism showed larger differences among low and high makeup usage situations, while individuals with higher psychopathy used makeup in similar frequencies among different situations. Further, (1) overall greater users of makeup scored higher on narcissism, conscientiousness, and agreeableness; (2) average users displayed lower psychopathy; and (3) lesser users reported lower narcissism and higher psychopathy. These findings underscore the nuanced relationship between makeup usage and personality, particularly highlighting the influence of narcissism. These findings contribute to the interplay between personality traits and makeup usage, considering interindividual differences and intraindividual variation in understanding cosmetic behaviors among women.

Neonatal Encephalopathy is a Complex Phenotype Representing Reproductive and Pregnancy Exposome Effects on the Maternal-Placental-Fetal Triad.

Reproductive, pregnancy, and placental exposomes influence the fetal neural exposome through toxic stressor interplay, impairing the maternal-placental-fetal (MPF) triad. Neonatal encephalopathy represents different clinical presentations based on complex time-dependent etiopathogenetic mechanisms including hypoxia-ischemia that challenge diagnosis and prognosis. Reproductive, pregnancy, and placental exposomes impair the fetal neural exposome through toxic stressor interplay within the MPF triad. Long intervals often separate disease onset from phenotype. Interdisciplinary fetal-neonatal neurology training, practice, and research closes this knowledge gap. Maintaining reproductive health preserves MPF triad health with life-course benefits.

'The Treatable Triad' Long term functional results of surgically treated acute, isolated terrible triad injuries: An 18-year follow up.

BACKGROUND: Surgical techniques for Terrible Triad injuries developed 20 years ago. Good and excellent short- and medium-term functional results have been reported. No long-term (over 10 years) functional outcomes have previously been reported. This case-series is the longest follow-up of patients treated for acute, isolated terrible triad injuries using a standard treatment protocol. METHODS: 20 Patients with acute, isolated, surgically managed terrible triad injuries were treated between October 2001 and May 2008. 10 of these patients were seen face-to face for a clinical follow-up and if required a radiological assessment. Mayo Elbow Performance Scores (MEPS) and Disability of the Arm, Shoulder and Hand (DASH) scores, requirement for further surgery and elbow instability were recorded. RESULTS: The average length of follow-up was 18.8 years. The mean MEPS was 88 and the mean DASH score was 12.3. The average loss of pronation was 8 degrees. The average loss of supination was 13 degrees. The re-operation rate was 40%, only one of these was a functionally limiting operation. A trend towards osteoarthritis was observed but there were no conversions to total elbow replacement. DISCUSSION: This is the longest-term follow-up study of these injuries and demonstrates the functional performance that the majority of patients achieve. The low follow-up rate can be expected with such a long interval between treatment and assessment. A relatively high re-operation rate is largely made up of minor procedures (removal of metalwork and cubital tunnel release) which did not impact the patients' functional status. CONCLUSION: This study adds to the evidence that the terrible triad of the elbow is surgically treatable to allow a high functional standard not only in the short-term but also in the long-term. As such this is a useful adjunct to have both when informing patients of what can be expected in their long-term recovery from this injury.

Early Presentation of Boerhaave Syndrome in the Emergency Department: A Case Report and Review of the Literature.

We present the case of a 46-year-old patient who arrived at the emergency department with chest pain following an episode of vomiting. The diagnosis was Boerhaave syndrome and acute mediastinitis. Due to the prompt presentation and the location of the rupture in the lower esophagus, emergency surgical intervention was performed, including esophageal suturing, mediastinal drainage, and jejunostomy for feeding. Postoperatively, the patient was transferred to the intensive care unit for advanced monitoring and support. The patient's condition improved favorably in the intensive care unit, allowing for extubation. Progress continued positively, and the patient was discharged 12 days postoperatively with a functional jejunostomy. At regular follow-ups, the patient's recovery remained favorable, and the jejunostomy was removed 30 days after the surgery. This case highlights the importance of rapid diagnosis and early surgical intervention in Boerhaave syndrome, demonstrating the successful management of a severe condition through a multidisciplinary effort.

Circulating immune complexes and G6PD deficiency predict readmissions for blackwater fever and severe anemia in children with severe malaria in Eastern Uganda.

BACKGROUND: Recently, there has been an unexplained increase in the incidence of blackwater fever (BWF) in Eastern Uganda. In this study, we evaluate the association between immune complexes, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and the occurrence and recurrence of BWF in children with severe malaria (SM). METHODS: Between 2014 and 2017, children aged six months to <4 years hospitalized with SM and community children (CC) were recruited at two hospitals in Central and Eastern Uganda. We measured serum circulating immune complexes (cIC) and their relationship to SM complications and post-discharge outcomes and evaluated effect mediation through G6PD deficiency. RESULTS: 557 children with SM and 101 CC were enrolled. The mean age of children was 2.1 years. Children with SM had higher cIC levels than CC, p<0.001. After controlling for age, sex, and site, cIC were associated with severe anemia, jaundice, and BWF (adjusted odds ratio, 95% confidence interval: 7.33 (3.45, 15.58), p<0.0001; 4.31 (1.68, 11.08), p=0.002; and 5.21 (2.06, 13.18), p<0.0001), respectively. cIC predicted readmissions for SM, severe anemia, and BWF (adjusted incidence rate ratios (95% confidence interval): 2.11 (1.33, 3.34), p=0.001; 8.62 (2.80, 26.59), p<0.0001; and 7.66 (2.62, 22.45), p<0.0001), respectively. The relationship was most evident in males where the frequency of the G6PD African allele (A-) was 16.8%. G6PD deficiency was associated with increases in cIC in males (p=0.01) and mediation analysis suggested G6PD deficiency contributes to recurrent severe anemia and BWF via increased cIC. CONCLUSIONS: Immune complexes are associated with hemolytic complications and predict recurrences in SM survivors.

Exploring the Influence of Dark Triad and Light Triad Traits on Sport Sciences Students.

Background and Objectives: The primary purpose of the article was to examine the relationship between dark and light personality traits in university students enrolled in the Faculty of Sport Sciences. Materials and Methods: Data were collected from 518 students (208 female, 310 male) with an average age of 20.89 (±2.25). The Short Dark Triad and the Light Triad Scales were used. Harman's single-factor analysis minimized measurement error, and various statistical methods assessed the effect of gender and age on personality traits. Results: Results indicated a positive correlation among dark personality traits, while light personality traits exhibited more complex relationships. Gender and age were found to significantly influence certain personality traits. Conclusions: This study contributes to the sports literature by exploring the role of demographic variables in personality formation.

Machiavellianism and Intimate Partner Violence Perpetration: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis estimated the size of the relationship between Machiavellianism and intimate partner violence (IPV) perpetration. Further, we explored whether the strength of this relationship varied depending on IPV type (i.e., physical, psychological, sexual, and cyber), and perpetrator gender. Systematic searches of Medline Complete, PsycInfo, Scopus, and Web of Science databases were conducted on July 4, 2023. Studies were included if they were a peer-reviewed published paper or unpublished dissertation, in English, included a measure of Machiavellianism and IPV perpetration, and reported the relationship between these variables. Study quality was assessed using the AXIS tool. Nineteen studies (N = 9,464) were included in a random-effects meta-analysis revealing a significant, weak, positive correlation between Machiavellianism and IPV perpetration (r = .16, 95% CI [0.11, 0.21], p < .001). Machiavellianism had a significant, weak, positive relationship with cyber (r = .25, 95% CI [0.17, 0.32], p < .001), psychological (r = .20, 95% CI [0.15, 0.24], p < .001), and sexual IPV (r = .10, 95% CI [0.02, 0.19], p = .020). No significant relationship was found for physical IPV. There was no significant difference in the strength of the relationship between women and men. These findings are limited by the measures being self-report, heterogeneity across studies, and the cross-sectional nature of the included studies which limits the understanding of causal pathways. Nonetheless, this meta-analysis shows a link between Machiavellianism and IPV perpetration, and future research should examine how this knowledge may be used to reduce IPV perpetration.

Usability of Minimal Invasive Surgery for Elbow Dislocation with Coronoid Process Fracture: A Protocol Development Study.

OBJECTIVE: The study aims to explain whether or not minimal invasive surgery (MIS) would be feasible in elbow fracture-dislocation with coronoid process fracture. METHODS: At Taipei Veterans General Hospital, patients who had elbow dislocations with coronoid process fractures underwent a single surgeon's MIS techniques which included the fluoroscopy-guided ulnar anteromedial (FGUAM) approach in the stage of reducing the coronoid process. When there is a proximal ulnar fracture, the posterior incision should be necessary, followed by the incision over the lateral or medial elbow for treating radial fractures or ligament injuries. RESULTS: The Flow Diagram for approach recommendation was established on the basis of defining MIS as that which does not include cross-plane dissection. The importance of anterior rigid fixation for the coronoid process was also emphasized. CONCLUSIONS: MIS can be achieved by multiple limited surgical incisions. Although the posterior extensile approach is necessary in situations of ulnar metaphysis or ligament avulsion fracture, the FGUAM approach decreases the cross-plane dissection.

Investigation of Social Innovations for Handling Opisthorchis viverrini and Cholangiocarcinoma in Thailand's Highest-Risk Areas for Further Development of Successful Solution.

BACKGROUND: Despite the national campaigns in 1997 to control Opisthorchis viverrini (OV), a significant risk factor for cholangiocarcinoma (CCA) was accounted for in the northeast of Thailand, which is also considered the highest-risk area for CCA as per the latest national-wide survey in 2019. Social innovations were employed to address OV and CCA issues in this area, but they have yet to be thoroughly investigated. Investigating social innovations in areas where issues can already be solved is a particular approach for expanding on a broad basis. OBJECTIVE: This study aimed to search for social innovations used to handle OV and CCA in northeast of Thailand. METHODS: Researchers coordinated with the Office of Disease Prevention and Control Region-10 (1 of 12 regional offices under the Department of Disease Control, Ministry of Public Health) to specify the model areas for taking OV and CCA. In addition, researchers cooperated with local coordination units for data collection. The data were coded and classified for content analysis, and triangulation was performed for comparative analysis. Finally, a meeting was conducted to summarize the social innovations discovered in each study site area. RESULTS: Our findings have been presented according to the epidemiologic triad: agent (risk factors), host (individuals/communities), and environment. The researchers and experts addressed and proposed social innovations for dealing with OV and CCA, such as the "3 Health" (Health Behaviours, Health Hygiene, and Environmental Health), in order to achieve a CCA-free society. CONCLUSIONS: This is the first study to highlight the significance of social innovations in managing OV and CCA. The findings will be utilized to further create strategies for addressing these public health issues in this and other regions in a sustainable and successful manner.

Identifying and Analyzing Low Energy Availability in Athletes: The Role of Biomarkers and Red Blood Cell Turnover.

Low energy availability (LEA) is a growing concern that can lead to several problems for athletes. However, adaptation to LEA occurs to maintain balance over time, making diagnosis difficult. In this review, we categorize LEA into two phases: the initial phase leading to adaptation and the phase in which adaptation is achieved and maintained. We review the influence of LEA on sports performance and health and discuss biomarkers for diagnosing LEA in each phase. This review also proposes future research topics for diagnosing LEA, with an emphasis on the recently discovered association between red blood cell turnover and LEA.